Infection

There are grave consequences when people do not wash their hands or wash them improperly. It is known that hands are the main media for contaminants getting to people, whether the infections are airborne, oral or tactile. Infectious diseases that are commonly spread through hand to hand contact include the common cold, and several gastrointestinal disorders such as diarrhoea (WaterAid, 2006). Human hands usually harbour microorganisms both as part of a person’snormal microbial flora as well as transient microbes acquired from the environment (Lindberg et al, 2004).

According to Kartha (200! ), many people consider handwashing a waste of time. However, they are unaware that hands are hosts to many bacteria and viruses that can cause infectious diseases. Every human being comes in contact with germs and bacteria in their daily life. These harmful microorganisms are present all around – on door knobs, faucets, light switches, tables, and railings. People touch these things during the day while doing their routine work without much thought, and then touch their face, eyes, nose, and sometimes eat food too.

Through these acts, the microorganisms get into the body, causing several diseases. People, who are careless at washing hands, risk catching flu, or cold, or any gastrointestinal illness (Kartha, 2001). Mayo Clinic (2009) also asserted that as people touch one another, surfaces and objects throughout the day, they accumulate germs on their hands. In turn, they can infect themselves with these germs by touching their eyes, nose or mouth. Hands serve as vectors transmitting pathogens to foodstuffs and drinks and to the mouths of susceptible hosts (Huttly, 1997).

Many food borne diseases and pathogenic microorganisms are spread by contaminated hands. If pathogens from human faeces enter a person’s mouth, they will cause diarrhoea. School going children are exposed to greater risks of diarrhoeal disease by consuming contaminated water and food (Dasgupta, 2005). Students in schools or colleges are more likely to take meal and water without washing hands and may be exposed to risk of infection (Tambekar et al, 2007). If proper treatment is not given, this can prove fatal, particularly to children (WHO, 2006).

In Ghana, funeral celebrations are very important social functions at which hundreds of people gather. From experience, one important activity during such gatherings is handshaking. Indeed, it is considered offensive and disrespectful for cultural values when one does not proffer his hand for shaking. It is however unfortunate that when people are served snacks and food during such occasions, handwashing facilities are not made available. People therefore eat with unwashed hands.

The advent of some serious gastrointestinal illnesses (for example, cholera) had been traced to such gatherings. Handwashing defined Handwashing is defined as the act of cleansing the hands with water or other liquid, with or without the inclusion of soap or other detergent, for the purpose of removing soil or microorganisms (Biology-online, 2011; Medconditions, 2011). 2. 6. 1 Attitudes of handwashing Handwashing has been an age old practice globally. It is carried out for varied reasons, including religious, cultural, health and moral reasons.

Attitudes towards handwashing are very important. They go a long way to determine the practice of handwashing and its effect on health. In a study by Hoque et al (1995), 90 women from randomly selected households in rural Bangladesh were observed washing their hands after defaecation. Thirty-eight percent of the women used mud, 2% used ash, 19% used soap, and 41% used water only without a rubbing agent. A total of 44% of women washed both hands, while 56% washed only their left hands.

About 78% of the women dried or wiped their hand on their clothes and the rest let them air dry. According to SHEWA-B (2007), in Bangladesh (and in some regions of the sub-continent), observations on handwashing practices identified that handwashing with water alone before food preparation and eating was quite common (47 – 76%), but washing hands with soap or ash was observed =2% of the time. Washing of both hands with soap or ash was more common after defaecation (17 – 18 %), after cleaning a child’s anus (22 – 24%) or after handling cow dung (12 – 20%).

Findings also showed that availability of handwashing materials such as soap, ash or mud at the site of handwashing was low, with approximately 30%, and =1% of households having the specified material. Water availability was high. Hand drying was observed to take place before preparing food, after defaecation, after eating and before serving food. A high proportion of females did not dry their hands after handwashing. A staggering one out of three Americans skips handwashing after going to the bathroom.

Only 30% of people who have coughed or sneezed into their hands wash their hands afterwards. Kids are even worse. In a survey of junior high and high school boys and girls, only 58% of girls and 48% of boys washed up after using the rest room (Wisegeek. com, 2011). Worldwide rates of handwashing with soap are very low. While many wash their hands with water, only a small percent use soap at critical times. In Ghana, for example, the rates for handwashing with soap after defaecation is 3% and after cleaning up a child is also 3% each (PPPHW, 2010). 2. 6. Economic considerations Efforts to modify human behaviour are complex. People can only expect to be successful if there is an understanding of what motivates, facilitates, and hinders adequate handwashing behaviour (Curtis et al, 1997; O’Boyle et al, 2001). Curtis et al (2001) noted that modern methods of promoting handwashing can be effective and cost-effective on a large scale. Studies suggest that soap is widely available, even in poor households in developing countries, although it is mostly used for bathing and washing clothes (Borghi et al, 2002).

In rural India and Bangladesh, soap is often considered a beautifying agent or for the physical feeling of cleanliness which it gives, rather than being associated with the removal of microorganisms or health benefits (Hoque and Briend, 1991; Hoque et al, 1995). In low income communities, soil, mud or ash may be used as a zero cost alternative to soap for handwashing (Zeitlyn and Islam, 1991). Hoque et al (1995) again reported that altogether, 81% of non-soap users stated that they might use soap, but were unable to afford it. Critical times for handwashing

A defensive strategy is important when trying to avoid infecting oneself with an illness lying in wait (Wisegeek. com, 2011). According to Mayo Clinic (2009), frequent handwashing is one of the best ways to avoid getting sick and spreading illness. Although it is impossible to keep hands germ-free, washing hands frequently can help limit the transfer of bacteria, viruses and other microbes. It is possible that people do not wash their hands as often as they should. Handwashing prevents both diarrhoea and respiratory infections effectively whendone properly and at critical times.

The critical times must be observed and conscious efforts made to clean hands at such times. A number of sources (Mayo Clinic, 2009; ASH, 2011, All Family Resources, 1999 and CDC, 2010) agree on a number of critical times when hands must be washed. The critical times include: ? Before preparing food; ? Before eating; ? Before treating wounds or giving medicine; ? Before touching a sick or injured person; ? Before inserting or removing contact lenses; ? After preparing food, especially raw meat or poultry; ? After using the toilet/bathroom; ? After changing a diaper; After touching an animal, or animal toys, leashes or waste; ? After blowing your nose, coughing or sneezing into your hands; ? After touching a sick or injured person; ?

After handling garbage or something that could be contaminated, such as a cleaning cloth or soiled shoes; ? Whenever hands look dirty. Some include also washing hands after handling money (ASH, 2011), before going home, immediately one gets home, on arrival at the workplace (All Family Resources, 1999), after combing hair (USDA, 2011) and after smoking (Earth’s kids, 2011). . 6. 4 Process of handwashing Though people know the importance of handwashing, not many know how to do it properly. Handwashing does not mean just running water over your palms. It has to be done very carefully and in detail (Kartha, 2001). Mayo Clinic (2009) suggests the following steps: ? Wet hands with (running) water; ?

Apply cleansing agent; ? Lather well; ? Rub hands vigorously for at least 10 to 20 seconds, remembering to scrub all surfaces, including the backs of hands, wrists, between fingers and under fingernails; ? Rinse well; Dry hands with a clean or disposable towel or dryer. The above steps have been advocated by several sources as well. These include ASH (2011); All Family Resources (1999); CDC (2010); Kartha (2001); Wisegeek. com (2011) and Gavin (2011). 2. 6. 5 Correct length of time Equally important is the length of time that hands are to be washed. The key is to lather up hands and rub vigorously for at least 15 to 20 seconds. Some suggest singing ‘Happy Birthday’ or the ABCs to keep a child washing hands for the correct amount of time (Wisegeek. com, 2011).

Earth’s Kids (2011) suggested that children sing a fun song while washing hands to mark the time of 15 – 20 seconds, so that they know how long they wash. Gavin ((2011) said to use soap and lather up for 20 seconds. Mayo Clinic (2009) noted that wet, soapy hands should be rubbed together outside the stream of running water for at least 20 seconds. CDC (2010) suggested scrubbing hands for 20 seconds, and while singing ‘Happy Birthday’ twice to get to 20 seconds. PPPHW (2008) also suggested singing any local fun song that would make up to 20 seconds while hands are being rubbed together after applying cleansing agent.

According to ASH (2011), hands must be rubbed together for at least 10 seconds while singing ‘Happy Birthday’ once for a perfect length of time. Rub hands vigorously until a soapy lather appears and continue for at least 15 seconds (All Family Resources, 1999). Mohave County Information Technology (2001) also recommends rubbing hands briskly for at least 20 seconds. From the foregone discussions it can be seen that rubbing hands together vigorously for anytime between 10 to 20 seconds or more should be adequate for pathogen reduction on the hands. Quantity of water needed for rinsing hands

Accessible and plentiful water has been shown to encourage better hygiene, particularly handwashing (Curtis and Cairncross, 2000). Also, interventions to improve water quality at the source along with treatment of household water and safe storage systems have been shown to reduce diarrhoea incidence by as much as 47% (WHO, 2008). Hoque et al (1995), in a study, observed that as many as 74% of the 90 women rinsed their hands with 0. 7 litre of water or less. They however recommend that rinsing with 2 litres of clean water was protective, although such volumes may be difficult tosustain in the absence of on-plot access to water.

Since pathogens removed during handrubbing have to be rinsed away, there must be a reasonable flow of water (Standard Operating Procedures, 1997). Mayo Clinic (2009) suggested the use of running water for rinsing hands. Water scarcity has an impact on hygiene practices such as handwashing. It could lead to person-to-person transmission due to inadequate personal and domestic hygiene. Water scarcity can therefore result in faecal-oral, skin and eye infections (Cairncross, 2011). Temperature of water

Contrary to popular belief, scientific studies by Michaels et al (2002), and Laestadius and Dimberg (2005), have shown that using warm water has no effect on reducing the microbial load on hands. Hot water that is comfortable for washing hands is not hot enough to kill bacteria. Microorganisms proliferate much faster at body temperature (37 degrees C). However, warm, soapy water is more effective than cold, soapy water at removing the natural oils which hold soils and bacteria (US Food and Drugs Administration, 2006). All Family Resources (1999) indicated that warm water should always be used for handwashing.

ASH (2011), Kartha (2001), Wisegeek. com (2011) and Gavin (2011) also suggested the use of warm water for handwashing. CDC (2010) said that clean running water that was warm or cold could be used. The temperature of water has not been shown to be important in handwashing (Standard Operating Procedures, 1997). Efficacy of cleansing agents in microbial reduction Esrey et al (1991) have suggested that reducing the rate of pathogen ingestion causes the incidence of severe infections to begin to fall before that of mild ones. The reduction in the severity of infection is the ultimate purpose of handwashing.

Therefore microbial reduction on hands would reduce the ingestion of pathogens since the hands have been proved to be the main transport route for gastrointestinal diseases, respiratory tract infections, skin infections (eg. impetigo) as well as eye infections (eg. conjunctivitis). This makes the agent employed in handwashing a necessary factor. Water only Pure water has a pH of seven, which makes it neutral. It is also known as a universal solvent. A number of studies (Cairncross, 1993; Ghosh et al, 1995; Khan, 1982; Oo et al, 2000) suggested that handwashing with water only provides little or no benefit.

The application of water alone is inefficient for cleaning skin because water is often unable to remove fats, oils and proteins, which are components of organic soil (Standard Operating Procedure, 1997). Kalanke (Mali) (2011) noted that handwashing with water alone does not remove many germs. Hoque and Briend (1991), on the contrary, showed that whilst less effective than when using a rubbing agent such as soap, mud or ash, some reductions in contamination were found when washing with water alone.

Data on the effectiveness of handwashing with soap-based formulations, compared with water alone, in the removal of bacteria and viruses (Ansari et al, 1989; Mbithi et al, 1993) suggest that, in most (but not all) cases, liquid soap-based formulations were more effective than water only. However, the authors concluded that the differences were not statistically significant. Ash Hoque and Briend (1991) indicated that the use of alternative rubbing agents (mud or ash) provided the same benefits as soap.

Again, Hoque et al (1995) also found that the use of ash and soap all achieved the same level of cleanliness. Ash, however, is considered less pleasant on the hands compared with soap or soil (Hoque and Briend, 1991). Despite the positive lifesaving potential of handwashing with soap (ash), proper handwashing is not being practiced regularly by children in schools and homes (WASH United, 2010). Citrus lime fruit Scientifically known as Citrus aurantifolia, there are two natural groups of the citrus lime fruit – acid (sour) limes, and acidless (sweet) limes.

The ‘West Indian’ lime, also called Mexican and Key lime is round, small-fruited, moderately seedy and highly polyembryonic; it has a thin, smooth rind, greenish flesh and a citric acid content ranging from 7% to 8%. It is usually grown as a seedling, as no satisfactory rootstock is known, but in Ghana it is grown on Rough lemon stock (Samson, 1986). Soap A number of studies indicate that washing hands with soap is the critical component of the handwashing behaviour (Cairncross, 1993; Ghosh et al, 1997; Khan, 1982; Oo et al, 2000). Kartha (2001) noted that the most essential thing required to wash hands is soap.

Again, studies have shown that hands can carry faeces to surfaces, to foods, and to future hosts, and handwashing with soap is effective in removing pathogens (Han et a. , 1986; Kaltenthaler et al, 1991; Ansari et al, 1991). Improvements in access to safe water and adequate sanitation, along with the promotion of good hygiene practices (particularly handwashing with soap), can help prevent diarrhoea (Black et al, 2003). PPPHW (2011) affirmed that promoted on a wide enough scale, handwashing with soap can be thought of as a ‘do- it-yourself’ vaccine. Choice of soap

Debate has been ongoing about the best type of soap to be used in handwashing. A study by Aiello (2007) indicated that plain soaps are as effective as consumer-grade antibacterial soaps in preventing illness and removing bacteria from the hands. Mayo Clinic (2009) admonished people to keep in mind that antibacterial soap is no more effective at killing germs than is regular soap. Using antibacterial soap may even lead to the development of bacteria that are resistant to the products’ antimicrobial agents – making it harder to kill these germs in the future.

Commenting on favoured features for soap, women in Ghana cited a range of attributes – smell, cost, texture and durability, and its capacity to be used for multiple purposes. For the women, the most important attribute was the smell of the soap, andthe most popular scents were mild lime and lemon. Concerning cost, cheaper soaps were preferred, although women were sometimes willing to pay more if the soap was larger or they thought it would last longer. Commenting on texture / durability, associated with cost, women preferred harder bar soaps or liquid varieties as they thought they lasted longer.

So strong was the preference for hard soaps that many stored soap in cool or sunny or airy places to harden them before use. Some women thought liquid soap more economical since only a peanut size was adequate for each hand wash. Many women preferred laundry bar soap because it could be used as a multipurpose soap such as for laundering, bathing and washing dishes at the same time (PPPHW, 2010). The act of handrubbing It has been suggested by Hoque et al, (1995) that the key component of the handwashing process is the mechanical rubbing of the hands.

They noted that the trend towards better results from handwashing with both hands, increased frequency of rubbing and an increased volume of rinsing water all support the prime importance of scrubbing / frictional motion and consequent washing out of loose bacteria with water. Although results of studies carried out suggest that the use of a rubbing agent is important, the authors suggested that the nature of the rubbing agent is a less important factor. Soap, they indicated, was more effective than soil and ash because soap users tend to rub their hands more and use more water to rinse away the soapy feeling on them.

CDC (2011) advised people to rub hands together vigorously to make a lather and to continue scrubbing for 20 seconds because it takes that long for the soap and scrubbing action to dislodge and remove stubborn germs. Beneficial effects of handwashing Handwashing has been regarded as a key infection-control practice since Semmelweis suggested its introduction in health care settings (Semmelweis, 1847 in Koo, 2008). The handwashing behaviour has been shown to cut the number of child deaths from diarrhoea (the second leading cause of child deaths) by almost half and from pneumonia (the leading cause of child deaths) by one-quarter (WHO, 2008).

The strong causal relationship between hand hygiene and gastro-intestinal disease risk has also been demonstrated by meta-analysis of community based interventions. Curtis and Cairncross (2003) estimated a reduction of 42 – 47% in diarrhoeal diseases associated with handwashing. Fewtrell et al (2005) showed a 44% reduction in diarrhoeal illness associated with handwashing. In a study, Aiello et al (2008) estimated that handwashing with soap combined with education could produce a 39% reduction in gastrointestinal illness. All the three meta-analyses were carried out using data from studies conducted in both developed and developing countries.

In a review of hand hygiene studies involving respiratory tract infections, Rabie and Curtis (2006) reported that hand hygiene (handwashing, education and waterless hand sanitizers) can reduce the risk of respiratory infections by 16%. Aiello et al. (2008) also estimated that the reduction in respiratory illness associated with the pooled effects of hand hygiene (handwashing with soap, use of alcohol handrubs) was 21%. A study conducted by Luby et al (2005) reported the impact of handwashing with soap on pneumonia in children under five, in squatter settlements in Karachi, Pakistan.

The results indicated a 50% reduction in pneumonia in the intervention compared with the control group. Luby et al noted that a link between handwashingand the prevention of pneumonia in developing countries is plausible on the basis that, in developing countries it is known that viruses cause pneumonia. Another study found that children under 15 years living in households that received handwashing promotion and soap had half the diarrhoeal rates of children living in control neighbourhoods (Luby et al, 2004).

Because handwashing can prevent the transmission of a variety of pathogens, it may be more effective than any single vaccine. Handwashing can also prevent skin infections (eg. impetigo), eye infections (eg. conjunctivitis), intestinal worms, Severe Acute Respiratory Syndrome (SARS), and Avian Flu. It benefits the health of people living with HIV/AIDS. Handwashing is effective in preventing the spread of disease even in overcrowded, highly contaminated slum environments (PPPHW, 2008).

Wonder Drug Most people know that Penicillin is an extremely important drug, but few know just how important and influential it really is. Think about what life would be like today without it. What would be of contemporary medicine today? Would society as a whole succumb to these relentless infinitesimal organisms? What would have been of one’s ancestors if they too like so many before and after incurred a serious infection? This essay shall explore these questions and many like it. It will explain why penicillin is undoubtedly the best medication of the century, perhaps the best medication ever in existence.

Penicillin is produced by a bread mold, known as Penicillium. The discovery of Penicillin sometimes referred to as the “wonder drug” has been the most important drug to date. It has the ability to kill just about any bacterial infection and at the time of it’s creation there was no other drug or anything like it. To this date it has saved millions of children, women, men and animals. The wonder drug was originally discovered purely by accident by one Alexander Fleming, a Scottish Scientist in the year 1928.

Penicillin was later developed further by many different Scientists who were able to use it to create numerous versions of antibiotics to cure a vast range of illnesses. Antibiotics have been used for several years in treatment for a variety of skin disorders, sexually transmitted diseases, strep throat, and respiratory illnesses. Before Penicillin was discovered, if one were to have a serious infection, death was irrefutable. People often would die of the smallest wounds due to bacterial infections. Bacteria mutates quite often, creating antibiotic-resistant organisms. Which makes it become resistant to the drug.

Even with this said, there are still only a small amount of bacteria that Penicillin and it’s predecessors can not tackle and over come. One of Penicillin’s most advertised uses was for combating sexually transmitted diseases. There are websites that show old advertisements for penicillin on the side of mailboxes that shamelessly state, “Penicillin cures gonorrhea in four hours see your doctor today. ”  Believe it or not during the late 1940’s researchers from the United States performed experimental studies in Guatemala. They had to because these types of studies were not allowed in the states.

So with the cooperation of the Guatemalan government, local prostitutes were used to pass on STD’s to prisoners, insane asylum patients, and Guatemalan soldiers to test the wonder drug’s effectiveness. Out of approximately thirteen hundred infected people, eighty three died. Although at that time it was not possible to establish if the experiments were the actual cause of death. Penicillin made a major difference in the amount of amputees and deaths during World War II. Because of the difficulties of manufacturing large amounts of Penicillin, availability was extremely limited.

Imagine what the death toll would have been if Penicillin had not been made readily available? In fact Penicillin was so scarce, that in it’s infancy, medical personnel would collect the urine from patients and filter the drug from the urine and reuse it. This is because Penicillin passes through the body at rapid rate, usually in about three to four hours. So some may wonder what makes Penicillin so significant, and what makes it the most important medical drug that has ever come into existence? A lot would argue perhaps Morphine or even the Smallpox vaccines are better examples for the most valuable drug.

And although one who would argue this may have some validity to one’s argument in an overall comparison there is really no comparison. Smallpox was a devastating disease that crippled the world, the survival rate was approximately seventy percent, which left the other thirty percent of it’s victims suffering immensely. One who contracted this disease would develop blisters and a high fever and often feel malaise with head and body aches and sometimes experience violent vomiting. The blisters were excruciatingly painful and there was little to ease the pain and suffering for its victims.

The fever was like none other, often so high that it would cause seizures and hallucinations. It was not until the year 1796 that the Smallpox vaccine was created by a scientist named Edward Jenner. Yet as significant of a vaccine this was it does not outweigh the benefits of Penicillin. At the time Smallpox was a great vaccine for the world. After the world wide eradication though, there was no longer a demand for it. The only people who receive the vaccine currently are military personnel and government contractors traveling overseas. Which in a way is better considering the risks of the vaccine.

Some of the risks include seizures, an actual mild case of smallpox, risk spreading it to others by being careless with one’s open wounds, plus it only provides ninety five percent immunity for up to five years. Penicillin has a decent amount of competing antibiotic drugs such as Clindamycin, Azithromycin, Doxycyclin. First and foremost these would not be in existence if it wasn’t for the creation of Penicillin to perpetuate the making of these. All of the competitor drugs are just various versions of Penicillin so as one can see there is very little argument that it’s predecessors are only what they are because of Penicillin’s creation.

The only difference between all of these is the functionality due to the amino group and the gram spectrum of the bacteria one heals. This basically means that each one of these targets a different part or kind of bacteria, but still uses the same principle of the original drug. This is why as stated above there is no argument when it comes to the importance of the creation of Penicillin. This essay has explored what Penicillin is, why it is so influential, and who has benefited from it.

It has been used in an array of situations from anything such as a sexually transmitted diseases to strep throat. There is no discrediting the fact that without Penicillin the world as one knows it would never have come into existence, this is why Penicillin is conclusively the most important medical drug ever in existence. Works Cited “Drugs. ” Questions and Answers for Consumers on Penicillin G Procaine. Food and Drug Administration, 23 May 2003. Web. 11 Mar. 2013. . “Smallpox Disease Overview. ” CDC Smallpox. Centers for Disease Control and Prevention, 30 Dec. 2004. Web. 11 Mar. 2013. .

Public Handwash, Why Should They And Why They Don’t

Funny how little attention is paid to the importance of washing hands? After all, who does not know about it? Isnt it something we all learnt at a very tender age? It may appear to be a common sense thing. It is known that the hands are so much active in ones everyday life. It is the hands that touch everything and do all the work whether clean or dirty. Hands are therefore the routes through which germs and bacteria get their way into the body and eventually causing infections. According to Larson, et al, (2003), there is the need to always keep the hands clean and at all times. Keeping the hands clean prevents transmission of germs and prevents sickness and illnesses to oneself as well as to others. Others tend to trivialize the whole idea and overlook it. It is hard to believe the number of people who get their hands contaminated but will not wash them. Is washing of hands for some people?

After all, some get dirtier than others, don’t they? What with the gardener, the mechanic and all those known to indulge in jobs known to be dirty? Is it only the young children who need to be reminded to wash their hands because they have been out playing? Is it only the women or those preparing food that should continuously wash their hands? Washing of hands is not for a particular kind of people but for everybody. This is so by the fact that everyone’s hands are contaminated from time to time. It is surprising though to realize that even such people as doctors and nurses go without washing hands, considering that they sing the monotonous song to everybody of washing hands. Are they not the role models? Don’t they understand the reason behind it more than any one else?

Some people who are adversely affected by this are school children. They are known to be very playful and they tend to use their hands. This exposes them to the hazard of getting infected because they are likely to forget to wash their hands and come lunchtime, they will use the same hands to eat without even hint of what they might be taking in.

The fact that there is public handwash indicates the essence of the washing of hands. It is not necessary that your hands be soiled so that you can be convinced to wash them. You will be surprised to know how much dirty your hands are, much as they may appear clean. Whether in the hospitals, schools or restaurants, washing of hands is mandatory. It is shocking to come to the realization that only few people wash their hands after visiting the toilet.

Is it because of the notions that the people have about these public places? Most people are known to view these public toilets and washrooms as dirty places. Does this excuse them from washing their hands? There are numerous reasons that call for one to see to it that their hands are washed regardless of whether they appear dirty or not. Just like I have said above, one has no option but to ensure that his hands are washed immediately after visiting the toilet. This is because there are so many germs that are got here and failure to wash hands dictates spread of germs and bacteria known to cause sickness and illnesses.

The human body is one source of harmful germs and so one should ensure that he has washed hands after touching bare human body. One should also make it a duty to wash hands after handling animals. This much affects people who have pets like cats and dogs. These animals are known to be the carry a lot of germs and bacteria harmful to ones health as they cause illnesses.

Before handling any food, one must wash hands to avoid contaminating it. This prevents harmful germs from being transferred from the Hands to the food and consequently into the body through the mouth, (Roberts, 2001). Again, it is essential that one wash the hands after coughing, sneezing or even scratching. It is unbelievable the germs that are transmitted through sneezing or coughing. There is the need to wash hands frequently because every one is likely to touch the eyes or nose or any other sensitive body part that is likely to cause transmission of the germs from the hands and causing diseases. Last but not least, one should ensure that hands have been washed after handling soiled equipment. The fact that the equipment is already soiled is a clear indication of the need to wash the hands.

This brings us to the key reason of discussing public handwash: its importance! To begin with, handwashing is essential to stop the spread of germs and bacteria that cause infections. Preventing sicknesses and illnesses subsequently prevents you from missing classes, job or social activities. This is so in that you do not go down with any infection that may have been caused by the germs. Washing of hands is particularly mandatory for the hospital workers. As the truth is, they are constantly in contact with sick people who may be secreting body fluids. This increases the chances of the doctor or nurse to have hospital-acquired infections. It is therefore only wise for these health workers to wash their hands after every short while.

Washing of hands not only keeps an individual safe from infections but it also keeps everyone else healthy. In The Journal, December 16,2006, it is promised that one cannot transmit germs from themselves to the next person as they have their hands washed and free from any germs. This applies largely in the context that one is preparing food for others. The chance of having germs transmitted from the hands to the food is drastically reduced owing to the fact that hands have been washed. People should always see to it that they have washed their hands before getting into the house. More applicable is the duty to wash hands before handling anything in the house. This ensures that no germs from outside have been brought into the house.

I have always wondered why someone would think it ok to use the bathroom and comfortably check out without washing his or her hands. Don’t they know the kind of germs they can spread? I can bet women do it so acceptably; walking right out of the stall and out the exit door without so much as a care. Men on the other hand are not any better. In fact they are on the worse side. Now, someone has their hands on the same surfaces that you will be using soon after and still you don’t bother to wash your own hands after you are through? Something is just so wrong, or what shall I say about it?

There are still people known not to wash their hands at all. Do these people have a valid reason why they should not? Aren’t they at the same risk with everyone else of contracting infections? One of the biggest reasons why some people don’t wash hands is if one is a man. Fewer men are known to wash their hands after visiting the public restroom than women. The crucial fact is that both men and women are at the same risk of getting infected with diseases if the hands are not washed. It is not so much that the men are incapable of contracting diseases but rather it is the issue about gender. The men see it as though it is only the women and childern who should have their hands washed while they overlook it altogether. It is disheartening when such simple task is not carried out as expected. Doesn’t it only require soap and water to have the whole thing done? Its not even like it takes long, yet it is a task not done by many.

So much about people not feeling like washing their hands. It is very well known that some public restrooms and washrooms are not anything to write home about. In fact if the truth is to be told, they are so disgusting such that no one would wish to use them. This therefore becomes a reason why one would not use the public handwash facilities.

Having talked about washing hands as a way of preventing spread of germs, it does not necessarily follow. By saying this, I want to bring into the limelight the fact that public handwashing may be a source of infections and affects the health of the community. Considering that there is universal use of soap and water, chances of spreading germs from one person to another are high. Thus handwashing becomes a problem in itself other than a problem solver. This therefore explains why many people would rather remain with dirty hands than expose them to greater danger. Everyone’s health is at this time put in danger as the rate at which the germs are to spread is quite high and the facilitators as well a in large numbers.

It becomes apparent therefore that the best thing that one can do is to avoid it at all costs. There is the cost of medication to be looked into. This is the aftermath of handwashing and being infected with the germs that eventually cause diseases. The thought of visiting the hospital about a case of diarrhea is not at all pleasant. For it being a preventable illness indicates uncleanliness and poor hygiene. It would therefore be acceptable to deduce that while it is very much recommendable for one to wash their hands, there is also the need for great caution. In thinking that one is preventing germs and their spread, he may actually be getting more than he already has in his hands and thus exposing himself to danger of getting sick.

Washing hands is therefore a very careful task that should not be overlooked or assumed (Curtis, 2002). Much as one might wash hands, it does not necessarily mean that they are really clean. One should then use the appropriate materials, which are clean water and soap. In doing so, one will be doing himself a lot of good and not just to himself but the other people as well. Just like we have seen, the other people’s health is very much affected by the individual’s hygiene. Public handwash is therefore both good and bad, as we have seen in the discussion above. This however does not mean that the public handwash should be done away with.

References:

Roberts, C. (2001). The food safety information handbook. Oryx Press.

Larson, E., et al (2003). Short-and long-term effects of handwashing with antimicrobial or plain soap in the community. Journal of community health, Vol.28

The journal (Newcastle, England,) (2006,December 16). How to avoid flu and colds this Christmas.

Curtis, V. (2002,Oct): Health in your hands Lessons from building public-private partnerships for washing hands with soap, Retrieved September 29, 2007 from: http://www.globalhandwashing.org/Publications/Lessons_learntPart1.htm

Nature of Life in the Trenches The nature of life in the trenches was a dangerous place. It was a place for the dead or for the survivors. Trenches were a front line which was dug metres underground, inside the trenches, were supplies, training areas, stores and mainly headquarters. The trenches were the main area to store arms of artillery and mortars. Life was hell for soldiers. Bearing the pain they went through, the diseases, the infections, the bad conditions living in, having to deal with sickness, all these illnesses became worse in the long run as soldiers ceased from them.

The whole idea of the trenches was to gain and to give protection from enemy lines who would want to attack their enemies once seen, so trenches were a good hiding spot hence other various reasons as well. September 1914 was when trench warfare began and ended in August 1918. In the area of the River Somme on the Western Front, the ground is deathly and is easily tunnelled. The trench sides would dissolve easily after rain so the ideas would have to be changed and wood, sandbags or any other suitable material would have to be a substitute of dirt.

Trenches were never built to be straight for a reason, in case an enemy ever jumped into the trench they could have point blank shot of everyone hiding inside it, whereas, trenches were built in a zigzag form to avoid quick target shots from enemies. The living conditions in the trenches were unbearable. In order to minimise the risk of trench foot (a disease on the feet) they would have to build duckboards on the bottom of trenches to clear the mud and faeces at the bottom. The health risk was very severe and was a maximised hazard of death as the unhygienic smell can affect the body.

The weather was a big factor in the trenches, temperatures down to less than 10 degrees Celsius was made impossible for soldiers to cope while sleeping or doing any activity. Diseases such as frost bites could occur as well as exposure and trench foot. Uses of secondary weapons were used in the war as well as fire weaponry. Secondary weapons such as grenades, bombs, gas bombs, and much more were used and it was effective at long and short range targets. Gas masks were used continually due to the gas mixing with the air and making it hard to breathe so gas masks were introduced to protect the face from burnt skin as well as inhaling it.

The main diseases caught while in trenches were trench foot, shell shock, blindness from mustard gas, snakes, infected rats, grenades, bombs, colds from low temperatures, frost bite, gangrene, body lice was a main disease maker as it irritated soldiers to itch numerous times of the day and that would cause infectious diseases on skin and could be caught off one another, the insufferable conditions, stench from rotting bodies, self-inflicting punishments and as well as suicide due to the trauma and depression. Body lice were a main factor in the trenches.

It brought upon soldiers infections, high fevers, diseases and probably death. Lice would stay on the body throughout the whole day and eat at the flesh and irritate soldiers, they would have to itch and itch and itch continuously in order to get the irritation feeling away. The aftermath would leave redness, bad smells, trench fever, first symptoms and shooting pains around the body and high illnesses. Many of the other diseases were much similar to lice and the treatment was similar was well but some things did differ, such as the kind of sickness, disease and the way the “infection” was going to affect the soldier.

Mud affected the body as well as their existence, what they ate, what they were wearing and how they breathed. Mud was an enemy and misery to soldiers. Trench foot was a painful swelling of the feet caused by constant absorption in water. Some cases, toes could rot off and that can lead to gangrene and that can be led to amputation. Rats were known as “trench rats” because they were sizes of small dogs. Rats would consume food that was left on the ground as well as fresh food and take all food supplies which would then be limited for soldiers the next day or so.

Rats were also good humour for the soldiers as they would attract it to food and shoot them once they seem them and hang them as a “trophy”. Gas gangrene was an easy target for many soldiers, the least of their problems were rats. They had to survive and live to continue the war, they couldn’t afford to inhale dangerous gases and die instantly. If the gas was ever inhaled, it would destroy the tissue inside the human body and the body will decay gradually and disintegrate. Gas masks were then produced.

The cold fell to temperature of minus Forty degrees Celsius; nevertheless, trenches had temperature of minus Fifteen degrees Celsius. Soldiers had to manage with the cold, hard to believe, it was worse than lice. The cold made it impossible to sleep. Frostbite affected many men and frequently directed to infection, decomposition and later on, amputation, along with hypothermia. In addition the infections led to boils, impetigo (a contagious skin disease caused by streptococcal bacteria, forming pustules and yellow sores), ulcers, hypothermia, frostbite, gangrene and amputation.

There were many psychological effects that were put onto soldiers such as trauma, shell shock, tics, a feeling of disillusionment and a growing sense of distrust of political leaders. The effects led to long term effects which made them think about the past most of their lives and that caused controversy to war officials. In conclusion, life in the trenches was difficult and distressing. Soldiers sacrificed their life to create peace in the world but it continued unfortunately. As oppose to all the past dramatic effects on soldiers, they had to live with it their whole lives, having to go through long or short term effects.

Unit 10: Blood/Immunology Case Study Lab What were your three diagnoses? 1. Case 1: normal blood smear 2. Case 2: acute lymphocytic anemia 3. Case 3: mononucleosis Journal Questions for lab 1. In what ways do normal red and white blood cells differ? Red blood cells are easier to see under high levels of a microscope and white blood cells are better seen under low levels. Also white blood cells are used to fight off infections as for red blood cells carry oxygen throughout the body. 2. Which type of white blood cell would you expect to be most common in a normal blood smear?

Neutrophils 3. A differential count of white blood cells from a patient gave the absolute number of lymphocytes as 8000 per mm3 and the total number of white blood cells as 12,000 per mm3. Calculate the percentage of lymphocytes in this sample of white blood cells. Is this a normal or abnormal percentage? Explain your answer. 8000/12000*100= 66. 67% and normal lymphocytes ranges from 20% to 40% I would conclude it to be a little about average. 4. Describe the difference between a communicable disease and an inherited disease.

Use examples you have studied in this exploration to support your description. A communicable disease is an infectious disease that can be transmitted from person to person. An inherited disease is passes down to a human by genetics. An example of a communicable disease is mononucleosis that is transmitted through people’s saliva and a inherited disease would be sickle cell anemia. 5. Why are white blood cells in a stained blood smear usually counted at low power under a microscope? Explain your answer.

Because they have nuclei and when looked through a low powered microscope they appear as blue dots. 6. Why is the presence of a larger than normal number of neutrophils indicative of an infection? Explain your answer. Because neutrophils are responsible for destroying infectious agents in the body. So when an infection is present it makes sense to see more neutrophils to fight off the infection agents. 7. Why would you not expect to see tissue macrophages in a blood smear? Explain your answer. Macrophages move within the tissue so when taking a blood smear tissue will be present.

THE PRINCIPLES OF INFECTION PREVENTION AND CONTROL

We as health care assistants, such senior health carer , we all have different kinds of roles and responsibilities that we have to follow.

We have to always be aware of and report changes in the health conditions of the individuals that we support. We also have a responsibility to assist with keeping work areas, andequipment clean, tidy and free from infection hazards.

Related article: Outline Procedures For Infection Control In Own Work Setting in a Nursery

We are also encouraged to maintain good personal hygiene for ourselves as well as our service users. For example, helping service users bath, use the toilet and change remove anddispose of any soiled clothing. Another responsibility we hold is preparing and maintaining environment before and after episodes of patient care.Following “Health and Safety Legislation” our employer like other employers must: – write and communicate a health and safety policy, including an infection control policy – carry out risk assessments to assess infection hazards and risks and ensure that, where possible, infection risks are eliminated – provide equipment which is safe and properly maintained – make sure there are safe systems of work and adequate supervision |264 |1 |2- make sure safety procedures are followed – provide a safe working environment- provide employees with adequate information, training and supervision necessary to ensure their health and safety at work – provide and maintain any necessary Personal Protective Clothing (PPE), equipment and safety devices free of charge -provide adequate welfare facilities to allow employees to maintain good levels of personal hygiene (i. e. proper toilet and washing facilities).

Current legislation and regulatory body standards which are relevant to the prevention and infection control are: – The Health and Safety at Work Act 1974 -The Public Health (Control of Diseases) Act 1984.

Provides information on the legal requirements for the reporting of contagious or infectious diseases – Food Safety Act 1990. The requirements of this act apply to any area where food is prepared, stored or eaten. Control is required to ensure that the risks of any infection, as a result of bad handling of food, are minimised. – Food Hygiene Regulations 1995. These regulations also require that employees who handle food as part of their normal duties should also undertake specific food hygiene training.- Reporting Injuries Diseases and Dangerous Occurrence Regulations (RIDDOR) 1995. The employer or manager in control |264 |2 of work premises has a responsibility under RIDDOR to report any work related accidents or disease which result in serious injury or an employee being “off sick” due to injury for more than three working days. – The Public Health (Infectious Diseases) Regulations 1998. Describe the reporting systems and the types of disease which must be reported.- Management of Health and Safety at Work Regulations 1999. Requires all staff to be provided with adequate and appropriate training and a set of working instructions demonstrating ‘safe working practices’ for work related activities. – Controls Assurance Standards – HSC 2000/02. This standard provides a framework to control and manage infection. In our care home are required to ensure effective protection and to minimise the risk of healthcare associated infections.

Effective prevention and control must be applied consistently by everyone and all staff must demonstrate good infection control and hygiene practice. Roles and responsibilities of members of staff in the organisations are:personal hygiene requirements, when and how to use personal protective equipment’s, decontaminating equipment, safe handling and disposal of clinical waste, managing blood and bodily fluids products and spills, maintaining a clean environment, cleaning routines and requirements, how to record and report accidents and incidents.

Procedures and systems relevant to the prevention and infection control are: -cleaning is a process that removes foreign material from an object. Cleaning is normally accomplished by the use of water, mechanical action and detergents. It may be manual or mechanical, using ultrasonic cleaners or washer/disinfectors that may facilitate cleaning and decontamination of some items and reduce the need for handling. -disinfection is a process that reduces the number of pathogenic icroorganisms from objects or skin, to a level which is not harmful to health. Disinfection can be carried out by either thermal or chemical processes. Thermal disinfection is preferred whenever possible. It is generally more reliable than chemical processes, leaves no residues, is more easily controlled and is non-toxic. -decontamination of equipment and the environment is a process which removes or destroys microorganisms to render an object safe for use.

It includes cleaning, disinfection and sterilisation. |264 |2 -sterilisation is a process that destroys all microorganisms including bacterial spores. Sterilisation is accomplished principally by steam under pressure (autoclaving), dry heat, by ethylene oxide gas or low temperature steam and formaldehyde. The outbreak of an infection within a care home can have serious consequences for people who come into contact with contaminated person and also for the entire organization.

An individual who acquire an infection will require medicaltreatment or antibiotic therapy, if the individual does not take medical treatment it may be risk of spread of the infection in that entire care home. Some infections may require the patient to be isolated from others to help prevent and control the spread of infections, for example infection chest.

In my opinion risk is the probability that an event will occur.

We can say that: a person may be at risk when there is the chance to be injured, to cause harm, to become infected of a desease or something that can put your life in 64 danger. A hazard can cause harm or adverse effects to individuals as health effects or to organizations as property or equipment losses. Me like care worker, I can be exposed to various potential infection within the workplace. These include the most common infections like: colds, flu, diarrhoea, vomiting.

We, carers assistants often come into contact with clients blood and body fluids, which can cause greater infections risks and may include also the risk of acquiring hepatitis or HIV, scabies ,this last one can be spread by touch. We are also exposed to infections spread through the air, such as tuberculosis and swine flu, ,this are quite rare. Other airborne infections such as streptococcal infections are more common and can lead to sore throats and raised temperature. A a care worker, I can be a source o infection to the people I provide care for, because these people are at an increased risk of acquiring an infection.

In this cause I must to take precautions to minimize the risk of cross infection. Even if I only have a common cold, I must to check my care home ‘s sickness policy and to inform my manager if I am sick . The process of carrying out a risk assessment content 5 steps: Step 1 Identify the hazards Step 2 Decide who might be harmed and howStep 3 Evaluate the risks and decide on precautions Step 4 Record findings and implement them Step 5 Review assessment and update if necessary 64 A risk assessment is one of the most important assessments. The measures put in place to reduce the potential harm from these risks, for example ensuring adequate PPE is available for staff to use.Under the “ Health and Safety at Work Act 1974”, all employers have a legal responsibility to protect the health and safety of their employees and anyone else using the work place, in care homes this would include clients, friends andfamily. The risk assessment is one of the most important assessment an employer can undertake to protect these peopleas well as their organisation’s reputation. The assessment identifies the risks in the workplace and the measures put in place to reduce the potential harm from these risks, ex. ensuring adequate PPE is available for staff to use.Failure to undertake a risk assessment is illegal because put at risk the health and safety of all people who is 64 inside of care home, especially the most vulnerable, the residents who are living there and about we are providing care for.

Personal protective equipment (PPE) is used by us, health care assistants to protect us and also the people who receive care from harm, to protect our skin and mucous membranes of the eyes, nose, and mouth from exposure to blood or other potentially infectious body fluids or materials and to avoid contact. All PPE should be removed when 64 leaving the resident care area.The different types of PPE used in care health are: – Uniform – is important to wear the uniform only at work place to reduce the risk of infections. The uniform should be clean every day and should be changed if become soiled. -Gloves – prevent gross contamination of the hands when touching body fluids; reduce the likelihood that microorganisms present on the hands of personnel will be transmitted to an individual during invasive or other individual care procedures.

Gloves may have small, unapparent defects or may be torn during use, and hands can becomecontaminated during removal of gloves hand hygiene is essential before donning another pair of gloves. – Aprons – protect the uniform from becoming soiled during wound care or toileting the resident. Should be placed over the uniform before activities involving body fluids. Blue aprons when feeding a resident, white aprons for toileting, bath and wound care. – Masks – should be used when microorganisms might be present in the air.

Visors can be attached to provide full faceprotection; -Goggles – protect eyes; -Hats 64 -Visors -Face shields – protect face, mouth, nose and eyes;- Shoes – every employer require a type and colour of shoes. The shoes must be comfortable and do not have high heelsor opened toe. Any PPE equipment used must be handled correctly to be efficient. Before to use any PPE equipment we need to wash properly our hands. Important key points about PPE:-done before contact with the client,-use carefully , don’t spread the infection,-remove and discard carefully, and immediately wash your hands properly.Gloves -we must used them from “clean to dirty” 64 -limit opportunities for” touch contamination”, protect us, others and the environment -don’t touch our faces or adjust PPE with contaminated gloves -don’t touch environment surfaces except as necessary during client care -change gloves during use if torn and heavily soiled, even during use on the same client; -discard in appropriate receptacle, never wash or reuse disposable gloves. Under Health and Safety at Work Act 1974, it is made clear that if items of PPE are required, then they must be provided free by the employer.

Under same Act, are specific regulations which specifically address PPE, this are:-Personal Protective Equipment at Work Regulation 2002 -Management of Health and Safety at Work Regulations 1999 64 -Control of Substances Hazardous to Health Regulations 2002(COSHH) The responsibility regarding the use of PPE is in section 7 of the Health and Safety at Work Act 1974 and impose allcare workers to take responsible care for their own health and safety and that of others who may be affected by theiracts or omissions at work, in our case ,our residential clients.The important responsibilities include: -attending training provided by the employer relating to how to use PPE -using PPE in accordance with training 64 -taking responsible care of all PPE provided by the employer -returning PPE to the correct storage accommodation provided for it after use – reporting to the employer any loss or obvious defect as soon as possible. Under the Health and Safety at Work Act 1974, employers have the responsibility to ensure, as far as possible the health, safety and welfare at work.

Employers have a duty of care under the Personal Protective Equipment at Work Regulations 2002: -properly assessing the need for PPE and assessing PPE before it is used to ensure it is suitable -providing free PPE to employees -ensuring PPE are maintained and stored properly -providing employees with adequate information, instruction and/or training on its use. -ensuring employees follow the training provide and that they use the PPE provided.When removing its recommended to avoid touching as much is possible to reduce the risk of transferring pathogenic organisms. Washing should be at a temperature at least 60 degree and separately from other cloths. Gloves should be applied on clean, dry hands and ensure there are no holes and tears and is the correct size. When remove gloves grab the cuff one glove with the opposite hand, while still holding the removed glove pull of the second by holding the cuff and pulling down over hand, dispose gloves and wash hands.

Aprons should be applied over uniform and after use removed carefully do not touching the front of the apron. The apron will end up securely enclosed in the gloves and disposed. Masks should be removed by untying the bottom tie then the top tie and moving it away from face by holding the ties, after dispose it. Visors should be removed sliding the visor up and away from face. Should be cleaned and 64 decontaminated as appropriate and then dried. Shoes should be cleaned and decontaminated as required.Masks, hats, gloves and aprons are classed as clinical wastes are regarded as high risk items. They must be disposed carefully to reduce the risk of cross infection. When removing PPE avoid touching the contaminated surface, remove the items before moving to the next resident, place the items in the correct waste containers ready for collection, decontaminate equipment such as visors and return them to their correct storage accommodation, inform manager if any PPE is damaged or stock levels are low.

As a care assistant I’m a model and need to set a good example because I have a vital role to play in the prevention and control of infection and this start with my own personal hygiene, daily body hygiene, baths or showers, washing hands when appropriate, keep clean hair and tied up if is long, wear clean cloths, uniform, clean nails and well-trimmed free from polish, remove jewellery except small earrings and wedding ring.Hand-washing is the single most important aspect of prevention and control of infection and nevertheless the most neglected practice. A good hand washing reduce the risk of cross infection and also can significantly reduce the presence of pathogenic organisms on the hands. As well, an effective hand washing technique aims to remove dirt, organic material and pathogenic organisms such as those found in blood, faeces and respiratory secretions like expectoration. 64 After we washed our hands, it’s very important as well to dry them with absorbent disposable paper towels.The correct sequence for hand washing is: I Rub palm to palm II Rub palm over back of hand, fingers interlaced III Palm to palm fingers interlaced IV Fingers interlocked into palm 64 V Rotational rubbing of thumb clasped into palm VI Rotational rubbing of clasped fingers into palm.Hand washing should be carried out: -before putting on a clean uniform or PPE, -before any aseptic procedure, -after resident contact, -after removing PPE, -after using the toilet, -before eating, handling food, -after finishing work.The types of products should be used for hand washing: General hand washing soap used for routine hand wash has minimal ability to destroy microorganisms and is useful toremove dirt, grease and loosely adhered microorganisms. – Disinfectant hand wash is commonly used in clinical areas for clinical purposes. -Surgical scrub solutions- used for antiseptic procedures, these solutions can lead to dry skin and irritations. – Alcohol gel used where sinks and soap is unavailable immediately after contact with patient.Correct procedures that relate to skin care are: maintaining healthy skin, maintaining body hygiene, apply moisturising cream, do not use a substance unless it is identified, always read the label on a product before use it,wear the correct gloves for the task and as instructed, never wear gloves which are torn or share gloves with anotherperson, wash hands after removing gloves, report immediately to the manager any: skin irritation or puncture wounds, cuts or abrasions which occur at work and obtain first aid if necessary, cover cuts and wounds with a waterproof self-adhesive plaster when at work and change it at least daily.

Sources:

http://www. wales. nhs. uk/sites3/Documents/739/RCN%20infection%20control. doc. pdf http://www. markedbyteachers. com/as-and-a-level/healthcare/describe-the-roles-and-responsibilities-of-staff-in-relation-to-infection-prevention-and-control-in-a-health-or-social-care-workplace. tml -“Health and Social Care Level 2 Diploma” – book

Global Health Nursing Primary Health Care/Primary Care This discussion will cover the demographic trends that impact global health today, look at patterns of health and disease that impact global health, explain the difference between primary health care and primary care, and review the World Health Organizations (WHO) priority for global health. There are many factors that affect global health including population, environment, and disease. One of the greatest pressures on the global community is the growing population. This demographic trend has a great impact on global health.

The global population was 2. 8 billion in 1955 and is 5. 8 billion now. It will increase to about 8 billion by the year 2025. Average life expectancy at birth in 1955 was just 48 years; in 1995 it was 65 years; in 2025 it will reach 73 years (World Health Organization [WHO], 2012). The increasing population means more people living in urban areas; therefore the closer we live together the increased chance of disease and illness. The added people also puts an increased stress on the environment leading to air pollution, water contamination, and less land to depend on for food.

The growing numbers presents a threat to health and the economy of many nations. In developing counties, malnutrition and disease are problematic; whereas in developed countries overcrowding leads to pollution, disease, and violence. With increasingly dense living arrangements and global travel, the health of the general populations is threatened by environmental factors and disease, for example, the H1N1 influenza pandemic (Nies & McEwen, 2011, p. 270). Mortality rate, based on disease patterns, vary throughout the world.

The biggest difference depends on if it is in a developed country or a developing country. Of 57 million deaths worldwide in one year, 33 million are from noncommunicable disease, 18 million are from communicable diseases, and 5 million are from injuries and violence (Nies & McEwen, 2011, p. 271). Developed countries have the highest mortality rate of chronic disease patterns such as cardiovascular disease, cancer, respiratory disease, stroke, violence, and traumatic injury. While developing countries have the highest mortality rates of infection, malnutrition, and violence.

Developed countries are able to reduce mortality rate due to diseases by improving sanitation and immunization through community health. As a country becomes developed, an epidemiological change occurs from risk of infection and malnutrition to having chronic disease. In developing countries, infectious diseases that contribute to high rates of mortality include acquired immune deficiency syndrome (AIDS), tuberculosis, endemic malaria, hepatitis B, rheumatic heart disease, parasitic infection, and dengue fever. Yet, these diseases could be reduced by 50% through effective public health interventions (Nies & McEwen, 2011, p. 71). When we discuss the global community, some tend to get the terms primary health care and primary care confused. Primary health care refers to essential services that support a healthy life including access, availability, service delivery, community participation, and the citizen’s right to health care. In contrast, primary care refers to first-line or point-of-access medical and nursing care controlled by providers and focused on the individual (Nies & McEwen, 2011, p. 276). In developing countries focusing on the individual in not realistic, the main focus is on the group, therefore primary health care is first priority.

One must meet the basic needs such as safe drinking water and food before we can provide individual care. Promoting health worldwide is a great challenge. Several agencies play a part in accomplishing this goal, including the WHO. The WHO stated a goal of “health for all by the year 2000” back in the 70’s. This goal was then extended to 2010 once it was unattained. Working for the WHO as a nurse would require one to open their mind and think more broadly. The main focus would be solving the problems of the health care delivery system (Nies & McEwen, 2011, p. 275) in order to accomplish the stated goal.

As nurses’ we need to look at the comparison between developed and developing counties because there is much we can learn. There is a need for health care reform, and the goal of “health for all” should guide this. Cuba and Canada were both recognized for reaching the goal of “health for all”. Collective responsibility or population-based focus must be established with less emphasis on the individual (Nies & McEwen, 2011, p. 275). Prevention is the first line of defense for the reduction of disease and illness. As a nurse working for the WHO, my main focus would be health care reform.

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Nursing, as the pivotal health care profession, is well positioned to advocate on behalf of, and in concert with, individuals, families, and communities who are in desperate need of a well-financed, functional, and coordinated health care system that provides safe, high-quality care. Accessible, affordable, and high-quality health care will positively contribute to our individual health, the strength of society, our national well-being, and overall productivity (American Nurses Association [ANA], 2008, p. 4). References American Nurses Association. (2008). ANA’s health system reform agenda.

Retrieved from http://www. nursingworld. org/Content/HealthcareandPolicyIssues/Agenda/ANAsHealthSystemReformAgenda. pdf Nies, M. A. , & McEwen, M. (2011). Globalization and international health. In Community/public health nursing: promoting the health of populations (5th ed. , p. 269-283). St. Louis, MO: Elsevier Sanders. World Health Organization. (2012). Global health observatory. Retrieved from http://www. who. int/gho/ncd/mortality_morbidity/ncd_total/en/index. html World Health Organization. (2012). The world health report. Retrieved from http://www. who. int/whr/1998/media_centre/50facts/en/