WAR ON DISEASE

( By Radhika Ramasubban, Bhanwar Singh & Nigel Crook )

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Nirmala Forms Her Team

How Filth Keeps Diseases Active

Then Nirmala returned home it was getting dark and beginning to rain. The path leading up from the main road through Vikhroli to Indira Nagar the place where she stayed was full of water and very filthy. Just as she entered it, her Hawaii chappal got caught on a stone in the mud and as she stumbled the strap broke.

There was no alternative but to continue barefoot. Garbage and shit lay everywhere and she tried to walk carefully to keep herself clean. But it was impossible to do so. When she eventually reached her hut, she was very dirty and she called to her daughter, Pushpa, to bring her some water to wash her feet. By that time she was in a foul mood.

"Other people making this place so dirty," she said in disgust, "throwing out their rubbish and their dirty water everywhere." "Yes mother " Pushpa replied quietly.

"Some parents donít know how to bring up their children," continued her mother. " They let them use the footpath as a toilet. Now you look what a mess I am in." "Yes I can see," said Pushpa. Then after a thought she added, " But what else can they do when there are not enough toilets ; and those we have are smelly, dirty and dark ? And where else, " she continued, " can they throw the garbage when there are no beans ?"

Her mother was not in the right mood for a discussion. "I am telling you , other donít even bother to use the toilets we have, and the whole place becomes filthy, and we suffer like this."

Then Pushpa, who was in the 9th standard at school by now, added; "Krishna is also getting himself dirty every day. " "Krishna was her younger brother, who loved to play football on the small open space at the entrance to the colony with his friends every evening. They all played barefoot.

"That is why Krishna falls sick so often, " continued Pushpa , "so often that we keep having to go to the clinic to buy some medicines for his stomach, or to stop his loose motions. It is costing us so much. "

Nirmala looked up from her washing with a puzzled expression on her face. " What are you saying ? " she asked. " I am telling you about the filth and shit everywhere, and now you are telling me Krishna getting sick. Why do you jumble everything up? You donít seem to bother about what I am saying .... people keep this place so filthy .... just look at my feet .... "

"Yes mother, " her daughter replied. "But I was just thinking what they taught us at school. If a child is sick with diarrhoea and has loose motions, tiny germs come out. Then other children go around barefoot and step in the shit, and carry the germs on their feet. "

"How can that make them sick ?" asked her mother.

"Well maybe they touch their feet with their hands, and then eat their food with dirty hands so that the germs go all the way into their stomach," Pushpa replied.

"Then they get sick also, I suppose, " said Nirmala.

"Thatís rightí and then the germs come out of them when they use the open space as a toilet , and someone else puts their foot on them, like Krishna always does. And so it goes on and on and on. "

Next day Pushpa was walking to the bus stand when she met Mumtaz taking her child unwilling to school. The child looked ill and seemed to be yellowish.

"He has been vomiting off and on for the last two days and this morning he fainted, " explained Mumtaz. "But heís missed school yesterday, so he should go today, shouldnít he ?"






HOW DIARRHOEA DISEASES SPREAD

Commonly Diarrhoea Is Caused By Germs


When someone having diarrhoea defecates, some of the germs come out. Flies carry the germs from the faeces to fruits and vegetables or food stalls. They land on the food leaving the germs there. Someone eating the food swallows the germs and also gets diarrhoea. In the same way flies also help to spread the germs of other disease like dysentery, typhoid and cholera.

When the rains come, waste matter is spread into pools along the road. Germs multiply very well in water, especially in a hot and humid climate like Bombayís. From here germs are carried on the feet into the home.

The water in nullahs is full of waste carrying germs. It should flow directly to the sewers, but often the nullahs are blocked and spill into ponds and streams. If the streams are used for washing clothes or vessels the germs will pass on to peopleís hands and into their food.

The germs continue to be kept alive by the dirt and waste that lies around.


But Pushpa looked worried ; "I think he may be seriously ill. Look, he looks yellowish. He may have jaundice - it is quite common in Bombay. It is better you consult a doctor. "

"So much sickness; what is happening ?" exclaimed Mumtaz looking worried. "What have we done? My sister, you know - the one who stays in Shantinagar at Dahisar - her daughter has got polio. I cannot believe it, something is happening to our family."

"No, no," said Pushpa quietly. "It is not you who have done anything to cause this. All these diseases, diarrhoea, jaundice, polio and typhoid also, are caused by germs. "

"But why do the germs come to us ?" Mumtaz complained.

"The germs are lying around everywhere," Pushpa explained.

"They are carried in waste water and in the filth that is everywhere. People who have any of these diseases pass out the germs when they go to the toilet, and other people accidentally take in the germs when they get tiny bits of dirt on their hands or in their food and water. Look at all the flies around us ! They also carry the dirt. If there was not so much waste lying in the open it would not be so easy for the germs to travel and the diseases would die away... "

At that moment Sunita ran up, clutching her sleeping baby girl, and looking very agitated. Sunita was usually quiet and not very talkative. But something had happened.

"She has a serious problem , " she said looking at her little girl, "She has this cold and a blocked nose. When I blew her nose do you know what happens ? Such a long worm came out !" She showed the length with her index finger. " She might be having some more inside her. How did they come ? Others are saying their children have worms in their stools. But I at least thought my baby would be free from them. "

" No child can easily escape getting worms in these slums, " said Pushpa "but there is a medicine to cure them if you take her to a doctor. " Then she added . " Do you wash her fingers carefully before you give her food - do you cut and clean her finger-nails regularly ?"

"How can she do all that ?" laughed Mumtaz. "children dirty their finger-nails all the time. "

"But itís very important, " replied Pushpa. "You see, those worms have hatched out of tiny eggs your baby must have swallowed."

Both Sunita and Mumtaz looked disbelieving.

"Eggs!" they exclaimed.

" Little children crawl a lot in the dirt, " she went on, " and get the eggs on their fingers. Then itís easy to get the eggs into their mouth and stomach. The eggs hatch inside the stomach and worms come out. "

"So how do the eggs get into the dirt in the first place ?" asked Mumtaz, still rather doubtful.

Pushpa thought for a moment. "I suppose they come out like everything else when the baby passes stools, " she said.






HOW WORMS ARE SPREAD FROM ONE PERSON TO ANOTHER


Worms are also spread through wastes lying around. Their eggs are carried by peopleís hands and feet, or by flies, and eventually enter the stomach with food or drink. Inside the stomach they hatch out into worms which feed on the food in the stomach. The worms sometimes come out of the body through the anus, the mouth, or even the nose, with other waste matter. The eggs are also excreted, and if defecation is done in the open they lie around ready to enter someone elseís body.


That evening, Nirmala called some of her friends for a meeting. She had been thinking over her conversation with Pushpa the night before, after her chappal broke.

"Itís the same thing every year ", she said. "Every monsoon the place gets filthy."

"And we fall sick from the germs in the filth," added Pushpa quickly. Nirmala went on : "We need more toilets. We need some garbage bins. The Municipality should provide them. Weíll go to our Municipal Corporator and demand these services. "

Mumtaz laughed loudly. "NO, no. They would not do anything. They think about repairing the roads only, and building all those flyovers and grand things. They will not bother to spend money for our slums." By now several more neighbours had come up to hear the discussion.

"Money ? They donít seem terribly short of money," exclaimed Nirmala. "They had better spend some on our colony as well. They need our votes donít they ? A few toilets and garbage bins donít cost much money. Iíve seen some of these in other places. " Several people agreed.






A PLAN FOR COMMUNITY ACTION




  1. Find out how cheap but safe toilets can be constructed. Read the box on community toilets at the end of this chapter.


  2. Talk to your Municipal Corporator or MLA, and request them to construct more toilets built to these designs. They usually know of funds sanctioned for such works.


  3. Demand that the Municipality sends its workers regularly to empty the toilets.


  4. Get everyone in the community to agree to use the toilets, and not the open ground, and to keep them clean. Children should be taught to use them too.


  5. Request the Municipality to arrange for garbage van. Demand that they are emptied every day. Get every household to keep its own garbage in a bin and to empty these into the garbage bins. Schemes like this have already started in some of Bombayís slums.


  6. Get every household to agree to keep the drain clear near its own house so that water flows freely. Each household should take the responsibility to empty the filth from the drains into the garbage bins.


"But this is no use if the toilets get full and mucky and the garbage bins are never emptied, " said Pushpa. "The Municipality must be told to clear them regularly, " replied Nirmala. "And I tell you one thing," she added angrily, " everyone has to use these toilets if we get them, and help to keep them clean. NO more going to the toilet in the open."

"But children are scared to use toilets," said Pushpa, "theyíre too dark."

"Then the Municipality should put lights inside the toilets," replied Nirmala, " and provide lots of water, so that no one has any excuse for making them dirty. And another thing, no one is to throw garbage in the drains or on the road when we get those bins."






WHAT EVERY HOME CAN DO




  1. Teach your children to wash their hands well every time they have been to the toilet and before they eat any food.


  2. Teach them never to dip their fingers into the water pot when taking drinking water. Make sure to keep a Ďdoyaí near the pot with which water can be lifted, or use pots with small openings from which water can be poured out.


  3. Always drink only that water which has been boiled and filtered. This is very important to stress with young children.


  4. Discourage children from eating outside foods especially exposed foods on which flies could have come and sat. An important way to do this is to avoid giving children money to buy outside foods.


"Perhaps every household could keep its own garbage in a small tin which has a lid, and then empty it into the bins, " said Pushpa thoughtfully ; " and every household could be responsible for keeping the drain clear near its house. "

"Asking for the moon," remarked Mumtaz.

"But I suppose we can try ; I have seen other colonies like ours which have done this. Itís better than all this disease." Several neighbours standing around agreed it was worth trying. Sunita, who had said nothing until now, asked hesitantly ; " But the doctor gave us some medicines today. Wonít they drive away the disease ? Surely the doctor knows the best about worms and things ?"






COMMUNITY TOILETS




  1. The aqua privy. This is the type usually constructed by the Municipal Corporation. The waste matter drains away into a large tank. This has to be emptied after some time. It is important for water from a tap to be provided for each toilet so that it can be kept clean.

    An electric light in each cubicle is absolutely essential. Then children too will be encouraged to use the toilets.


  2. The toilets-cum-bath. This type has been provided at public places in Bombay ( for example at Haji Ali or outside Chitra Cinema at Dadar T.T. ) by SULABH, a voluntary organisation based in Patna. Each cubicle contains a latrine and a shower for bathing. The water from the bathing is used to flush the latrine.

    For information contact : Your ward officer in he Municipal Ward Office nearest your locality.


  3. The Gobar Gas Plant. This might be most suitable in the extended suburbs of Bombay. The waste matter from the toilets is all channelled underground into one pit. As the matter rots away a methane gas is generated. This gas is led through pipes to houses in the slum , where it can be used for cooking or lighting ( like bottled gas). You might not have to pay anything for this fuel.

    For information contact : Maharashtra Energy Development Agency, New Kamani Chambers, Adi Murzban Path, Ballard Estate, Bombay 1.


"But Sunita, " argued Pushpaí " so long as the filth stays around, the germs and the eggs also stay around. So we get them in our bodies again and again. "

" And who likes having this filth around anyway!" replied Nirmala. "Letís start getting rid of it once and for all. First of all we can find our Corporator. He wants us to vote for him. He will have to listen to us and give us what we want. Then weíll also have to agree to make some rules about keeping the place clean." Everyone seemed to agree to this.

Just as the meeting was about to end Pushpa had something she wanted to say.

"We wonít get these things immediately, " she said. "First of all we need to organise ourselves, and be united about what we want.

MLAs and Corporators also need to be visited several times and forced into listening to us and doing something about it. IN the meantime we should remember how germs get into our stomachs.

So we should wash our food carefully before preparing it. And we should not use mud to clean our cooking utensils. We should keep food and water pots covered so that flies cannot get in. "

"And," Sunita added, "we should wash our childrenís fingers well before they eat. Even their finger nails should be clean and cut regularly. "

Finally Mumtaz spoke, " We should tell mothers of young children how diarrhoe and worms are spread by wastes. "

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