CHAPTER-VII

SOCIAL SERVICE

224
 INDEX

CHAPTER-VII SOCIAL SERVICE JD/JW SD/SW

SECTION-1 Weaker Sections of our Society and their

Needs √ √
SECTION-2 Social Service and its Need
√ √
SECTION-3 Family Planning
√ √
SECTION-4 HIV/AIDS : Causes & Prevention
and Contribution of Youth Towards √ √
Prevention of AIDS
SECTION-5 Cancer, its Causes and Preventive
Measures √ √
SECTION-6 Contribution of Youth towards Social
Welfare √ √
SECTION-7 NGOs and their Contribution to Society
√ -
SECTION-8 Drug Trafficking and Crime
- √

225
 SECTION-1

WEAKER SECTIONS OF OUR SOCIETY AND THEIR NEEDS

Introduction

1. India is still divided into many endogamous groups, or castes and sub-castes, as a
result of centuries of practicing a form of social hierarchy called the caste system. The
traditional caste system, leads to severe oppression and segregation of the lower castes
and other weaker sections and limits their access to various freedoms e.g, education and
employment. According to ancient scriptures such as ‘Manu Smriti’, caste is
‘Varnasrama Dharma’, which means ‘offices given according to colour’. The practice of
caste in India followed this rule.

2. After independence the constitution of India included safeguards for suppressed

and other backward classes. The constitution came into effect from 26 January 1950. The
Indian constitution prohibits any discrimination based on religion, race, caste, sex and
place of birth. But, while providing equality of opportunity for all citizens, the
constitution also contains special clauses to ensure reservation, ‘for the advancement of
any socially and educationally backward classes of citizens or for the Scheduled Castes
and the Scheduled Tribes’.
Classes of Society

3. The weaker section of society comprise of the following categories:-

(a) Scheduled Caste (SC) and Scheduled Tribes (ST).

(b) Other Backward Classes (OBC).

Scheduled Caste and Scheduled Tribes

4. Scheduled Castes and Scheduled Tribes are communities that are accorded special
status by the Constitution of India. These communities were considered “outcastes”.
These castes and tribes have traditionally been relegated to the most menial labour with
little possibility of upward mobility and are subject to extensive social disadvantage and
discrimination. The Scheduled Caste people are also known as Dalits and the Scheduled
Tribes people as Adivasis. Mahatma Gandhi used the terms Harijans and Girijan , for SC
and ST respectively. According to 2001 census, population of SC and ST is
approximately 16% and 8% of India’s total population respectively.

Other Backward Classes (OBCs)

5. These classes are a group of sub castes which are socially and educationally
backward while still having a higher status than scheduled castes or scheduled tribes. As
of 2006 approximately 2300 communities are listed backwards. Central and all state
governments are enjoined to ensure their social and educational development.

226
Problems of Weaker Sections and their Solution

6. Problems. The general problems are widespread poverty, unemployment,

backwardness, untouchability and lower status in society. They suffer discrimination
in all walks of life vis-à-vis the privileged sections of the society. Scheduled tribes
are basically nomads and don’t have any land to settle down or cultivate. OBC
comprises persons belonging to backward classes of country and due to
backwardness, remoteness or lack of infrastructure and development, job opportunities
are grossly insufficient.

7. Likely Solution

(a) Education. Right approach would be to provide all weaker sections

proper primary education , to prevent them from dropping out of school and
making them ‘natural competitors’ and to give scholarships at higher level.
Number of educational institutes should be increased.

(i) At the village level opening of schools which impart basic

education coupled with the vocational skill that can be taught with
the naturally available resources e.g. basket weaving, painting
printing, tailoring, embroidery, pottery, music, dance, etc will help in
achieving self sufficiency. Specially trained teachers should be
adequately compensated so that talented people do not hesitate to go
to villages.

(ii) School should also educate the villagers on moral values,

hygiene, first aid, family planning, budgeting, savings etc.

(iii) Villagers must be educated on the need for educating the girl
child as she is the one responsible in bringing up the future
generations. She should therefore develop courage, self confidence,
competitive spirit and a sense of equality with boys.

(iv) Social evils such as the dowry system, child marriages and
superstitions, should be taken up for discussion and their drawbacks
be pointed out, so that they become events of history.

(b) Employment. Provision of land to landless and helping them in

working out a life by providing softer loans for cultivations etc can take care
of employment problems to some extent. Taking up of infrastructure projects
will help in creating large number of jobs.

(c) Reservation in Educational Institutions and Govt Jobs. Reservations

are intended to increase the social diversity in campuses and workplaces by
lowering the entry criteria for certain identifiable groups who are grossly
under represented in proportion to their number in general population.

227
Reservation Policy of the Government

8. Reservation is a term used to describe policies whereby a portion of jobs,

positions or academic seats are set aside or reserved for a given group. Government has
taken initiatives on a large scale by providing reservations in different fields
such as government jobs, educational institution and other such government
aided and semi-govt institutions, to help the SCs, STs and OBCs. A certain
percentage of seats are reserved for sections so that the discrimination against
them can be reduced and they will be provided with equal opportunities to work
and grow. The Constitution lays down that 15% and 7.5% of vacancies in
government-aided educational institutes and for jobs in the government /public sector are
reserved as quota for the SC and ST respectively. Although originally supposed to last for
10 years, the reservation system has continued till date and now applies to higher
education and legislative offices also. Currently 22.5% of the seats in higher education
institutes under the Central Government are reserved for SC and ST, and 27% for OBCs.

9. It was felt that intended benefits were not percolating down to the
deserving candidates of OBC. Well-to-do families only within OBC were reaping the
benefits again and again. Hence ‘creamy layers’ in the OBC is excluded from the
policy of reservation. This layer includes children of President, Vice-President and
Judges of the Supreme Court and High Court. Children of members of the UPSC and
State Public Commission, Chief Election Commissioner, Comptroller and Auditor
General of India and other persons holding Constitutional positions of this nature, also
fall under the creamy layer category. Further, persons with gross annual income of
Rs2.5lakh or above are also excluded. The creamy layer also covers children of Group
A/Class 1 officers of the All India Central and State Services.

Points in Favours of Reservation

10. (a) Social diversity is desirable in campuses and work places. It can
bring out hidden talent of society.

(b) One way to do it is to provide relaxed entry criteria for under

privileged groups.

(c) Hardship faced by those in general category is due to shortage of

seats in professional colleges and shortage of employment opportunities and
not due to reservation.

Points in Favour of Anti Reservation

11. (a) Economic conditions should be the basis for reservation. Reservation
based on economic backwardness can be the only way to give justice to
all deprived sections of society.

(b) Reservation decisions are taken keeping political interests in mind.

228
 (c) Allocation of quotas on the basis of caste is a form of racial
discrimination and thus contrary to right to equality.

(d) Merit is severely compromised by reserving seats for certain caste-

based communities.

(e) Caste system is being kept alive by reservation policy.

Contribution of NCC Cadets

12. Our NCC Cadets are from every nook and corner of India. We must
therefore utilise this huge potential of eager, helpful, energetic, educated and
talented cadets, to achieve our aim of imbibing values and skills amongst the
weaker sections of our society which will make themselves self-sufficient and
confident. They will cease to be a drain on the resources of India and will
become valuable contributors to our economy.

Conclusion

13. There is no doubt that the interests of the weaker sections need to be
protected and their legitimate needs fulfilled so that we can have a just and fair
society where the under privileged are not discriminated against and no section
lags behind the other.

SECTION-2

SOCIAL SERVICE AND ITS NEED

Introduction

1. The origin of social service is ancient, stemming from the tenets of the Judaco-
Christian teachings. The modern institutional service took shape with the impact of the
industrial revolution upon family and community life , substituting as it did an industrial
for an agrarian economy, urban living for rural living and creating dependence upon the
wage system as a means of livelihood.

Definition

2. The term ‘Social Service’ is defined broadly as the provisions made by

governmental or voluntary efforts to meet income maintenance , medical care , housing
and recreational needs and provisions for the care and protection of recognised special
groups.

Objective

3. Social service characterises a formalised way of helping people to help

themselves. It is based on the reorganization of variations in individual capability and
229
variations in the social structure . The objective is to help the individual to utilise his
capability for his own welfare and for that community.

Methods

4. There are generally three accepted methods identified in social service which are
as under :-

(a) Social Case Work. This aims to help the individual make maximum
use of the established community, through understanding the individual in his
total situation.

(b) Social Group Work. It seeks to help the individuals utilize their fullest
capacity for their own welfare and for the welfare of the group as a whole,
through understanding of the behaviour of individuals in a group setting.

(c ) Community Organization. It attempts to help groups of individuals or

groups of agencies to work together so that their combined efforts will be useful
for the social welfare of the whole community .

Types of Social Services

5. The various types of social services which have been initiated are as under :-

(a) Education.

(b) Family welfare, Medical care, Family planning and Nutrition.

(c) Provision of Water and Cooking fuel, Roads, Electricity and

Sanitation.

(d) Old age support systems.

(e) Employment.

(f) Social assistance, Social security and Care & protection.

(g) Housing and Rehabilitation.

(h) Recreation, Sports and Social activities.

230
 SECTION-3

FAMILY PLANNING

Introduction

1. The rapid growth of population is one of the major problems facing the country
today. Considering that the population of the country is over1000 million and the annual
surplus of births over deaths at 15 million, the population explosion continues. Some
social facts like reluctance of uneducated masses and minority groups towards adopting
family planning programmes emerge as major constraints. Family planning is not only
concerned with limiting the measure of children through preventive measures, but very
much related with aspects of health care and better standard of living.

2. Family planning is defined as the voluntary, responsible decision made by

individual and couples as to the desired family size and timing of birth. Therefore on the
micro level it means children are born because they are wanted and provided for and on
the macro level it contributes to the betterment of human life.

3. Family Planning. Family planning versus population growth was the motto of
the national population policy of independent India since the first five-year plan. Family
planning programme is perhaps the most effective policy-intervention to stabilise
population size. Since the effect of the program the varies from state to state, the impact
also varies from state to state. Contraception is the need of the day to counter the
explosive increase of population. After independence, family planning was stepped up.
The sole aim was the lowering of the birth rate. However, there was no significant
economic or social measures to accompany it.

Factor Affecting Family Planning

4. This concept deals with the health consequences of uncontrolled fertility:-

(a) Fatal, infant and childhood morbidity.
(b) Poor physical and intellectual development of the unwanted child.
(c) Pregnancy wastage.
(d) Maternal risk of illness and death.
(e) Father’s risk of hypertension and gastric ulcers.
(f) Marital risk.
(g) Poor nutrition.
(h) Environmental hazards such as overcrowding, poor water supply and
atmospheric contamination.
(j) Increased incidents of genetic diseases.
231
 (k) Mental health problems of parents as well as children due to strains caused
by large family.

Methods of Family Planning

5. Family planning methods are:-

(a) Vasectomy.
(b) Tubectomy.
(c) Conventional contraceptives like condoms and diaphragms.
(d) Oral pills.

Measures to Attain Objectives

6. Effective measures to be under-taken are:-

(a) Voluntary encouragement of family planning can have positive health

benefits. In small families mother takes more care of child which is necessary for
healthy development.

(b) Stringent laws be enacted to curb the menace and the violators severely
punished. Couples violating family norms should be debarred from contesting
elections and their voting rights withdrawn. A massive campaign could be
launched through the electronic and print media to create conducive environment.

(c) Take steps encouraging a two-child norm so that growing population is

controlled.

(d) Educating women particularly in backward and rural areas be taken up

with complete sincerity which would help in eradicating this menace.

(e) Early marriage be strictly checked and efforts be made to raise the living
standard and improve literacy rate.

(f) Couples adopting family planning should be given all possible assistance.
In this regard, couples should be made to attend counseling sessions after
marriage in which they should be made aware of the needs and benefits of family
planning.

(g) The problem can also be solved by providing basic health care facilities
specially to the backward classes and such families to be given assurances that
proper health care would make sure their children survive.

(h) Involvement of religious leaders in the programme.

(j) Development of rural areas.

232
Conclusion

7. Family planning assumes greater importance today as population has passed the
one billion mark. Rapid growth of population is straining the available resources. In
India resources are already scarce. There will be scarcity of land, houses and food
coupled with unemployment. This will give rise to crime in the society. There is an
immediate requirement to educate the masses involving religious, political and
intellectual aspects to motivate them to adopt family planning if we want to see India as
the economically and technologically leading nation in the world.

SECTION-4

HIV/AIDS :CAUSES & PREVENTION

AND
CONTRIBUTION OF YOUTH TOWARDS PREVENTION OF AIDS

Introduction

1. Few diseases have been feared as much as HIV/AIDS has been ever since human
beings began efforts to prevent and control major diseases. Although a large number of
health problems continue to defy human efforts to control them, none of them presents a
challenge greater than the prevention and control of HIV/AIDS. This is mainly because at
the moment there is neither a scientifically proven cure for HIV/AIDS nor a vaccine to
prevent it. Globally, an estimated 38.6 million people are living with HIV, of which an
estimated 4.1 million were new infections. In Asia, an estimated 8.2 million people are
living with HIV including 1.2 million new infections last year. In India, an estimated 5.2
million people are living with the virus, most of whom are poor and marginalised.
Although HIV is more common in six states of India – Tamil Nadu, Karnataka, Andhra
Pradesh, Maharashtra, Manipur and Nagaland – it is present all over the country.

2. HIV is not just a disease. It is a developmental problem. Just as in other countries,

the patterns of HIV infection in India reflect underlying patterns of social and economic
inequality, such as in terms of distribution of wealth, power, gender relations, women’s
status, poverty, lack of sustainable livelihoods, civil unrest and disorder, etc. Several
misconceptions about the causes and mode of transmission of HIV/AIDS exist in India.
These misconceptions and the social stigma associated with AIDS have been major
barriers to prevent and control this disease. They have also been major hurdles in
providing the desirable social and medical support to people with HIV infection. A
concerted and broad based approach is necessary to mitigate the adverse impact of HIV
and AIDS.

233
What is HIV/AIDS

3. Although HIV and AIDS are often used synonymously, they are different. HIV
(Human Immuno-deficiency Virus) is a virus that gradually destroys the body’s immune
system. AIDS (Acquired Immuno Deficiency Syndrome) is a condition wherein various
diseases affect the body because of the body’s weak natural defense mechanism – the
immunity. AIDS stand for Acquired (not inborn, but passed from mother to baby),
Immune (relating to the body’s immune system, which provides protection from disease
causing bacteria/viruses/ fungi); Deficiency (lack of response by the immune system to
bacteria / viruses / fungi / cancer cells); Syndrome (a number of signs and symptoms
indicating a particular disease or condition).

4. Therefore, AIDS is an acquired condition in which a person may have various

diseases that cause similar symptoms, all of which are due to the body’s diminished
ability to fight diseases. Anyone who has HIV infection will develop AIDS over a period
of time.

How Does HIV Affect the Body

5. A special variety of white blood cells called T lymphocytes secrete chemicals that
are necessary for destroying the disease causing germs or agents. HIV destroys T
lymphocytes (also called T-cells), and thereby reduces the body’s ability to fight diseases.
T-cells contain a protein called CD4 on their surface. HIV first attaches itself to CD4 and
then fuses with the T-cells to multiply. Fusion with T-cells destroys the T cell and several
copies of HIV are produced.

How Does HIV/AIDS Spread

6. HIV is present in all body fluids of an infected person and is more in number in
blood, semen and vaginal fluids. HIV infection normally spreads when there is contact
with these body fluids through four main routes:-

(a) Sexual transmission

(b) Blood transfusion.
(c) Sharing needles and syringes for intravenous drug use.
(d) Mother-to-child transmission during pregnancy, delivery or breastfeeding.

7. Sexual Transmission. The most common route of spread of HIV infection is

through unprotected sex between two people, where at least one has HIV infection.
Unprotected sex means having sex without condom. Although the risk of HIV being
transmitted during one sexual act depends upon several factors, it is important to
remember that even one episode of unprotected sex with an infected partner can transmit
HIV. Increased number of unprotected sex increases the risk of infection. Detailed below
are some issues related to sexual transmission of HIV.

234
8. Increased Risk for Women. Women are at greater risk of developing HIV
infection through unprotected sex. This means that the risk of transmission of HIV from
man to woman is higher than that from woman to man. There are five main reasons why
women are at greater risk:-

(a) The semen from the infected male sexual partner remains in the woman’s
vagina for a longer time, thereby increasing the duration of contact between
infected semen and delicate lining of the vagina.

(b) The surface area of the vagina is larger than the surface of tip of the penis
in men, which provides greater opportunity for the virus to enter the body.

(c) Many women with sexually transmitted infections (STIs) do not have any
symptoms and therefore do not seek treatment. Presence of STIs increases the risk
of HIV transmission.

(d) The gender imbalance makes it difficult for women to exercise their
sexual rights. This means that they have less control over, when and with whom,
they have sex.

(e) Women are less likely to take treatment, especially for STIs, which
increase the risk of HIV transmission.

9. Sexually Transmitted Infections. Presence of STIs increases the risk of HIV

transmission. People who have ulcers in the genital organs or abnormal discharge either
from the penis or the vagina are at higher risk of HIV transmission. Early treatment of
STIs reduces the risk of HIV infection.

10. Anal Sex. Although anal sex is more common among men who have sex
with men (MSM), some heterosexual partners also practice it. Anal sex has higher risk of
HIV transmission as compared to vagina sex. This is mainly because the delicate inner
lining of the anus gets easily damaged during anal sex. This damage helps the HIV to
enter the body easily.

11. Menstruation. The menstrual blood of a woman with HIV infection will
contain the virus. Thus, sexual intercourse during menstruation with an infected woman
increases the risk of the male partner getting HIV infection.

12. Blood Transfusions. As per the guidelines of the National AIDS Control
Organization (NACO), it is mandatory to test blood for HIV before transfusion. The risk
of transmission of HIV through tested blood is therefore very remote. The only
possibilities of infection through blood are if the blood was not tested for HIV or the HIV
infection was in the window period. Window period is the term used for the duration
between the entry of HIV in the body and the detection of its antibodies through blood
tests. Window period is normally up to three months. This means that during this time,
even if a person is HIV infected he/she will test negative. He/she can however transmit
infection to others. Blood donation has no risk of getting HIV infection because the
needle and other equipment used for collecting your blood are safe.
235
13. Intravenous Injections.

(a) When people inject drugs intravenously, they may draw small amounts of
blood into the needle. If another person uses this needle immediately, the blood
containing HIV will be injected into the second person. Thus, he/she can also be
infected with HIV. Normally, people who are addicted to intravenous drugs form
a group and share needles with each other. Thus, the infection can spread very
rapidly from one to another in the same group. In India, intravenous drug abuse is
the most important cause of HIV infection in the North East.

(b) Despite several concerns about the poor sterilisation practices by some
doctors, especially in rural areas, HIV infection through injections given at a
health centre is not a common mode of transmission in India. This is mainly
because most of these doctors, even if they are not qualified, boil them for a short
time. HIV is destroyed by even short duration heat and drying. Shorter boiling
time for sterilizing needles may not destroy other disease causing germs such as
Hepatitis B virus. It is also important to remember that injections that are given in
the muscles, under the skin or in the skin layers carry little risk of transmitting the
HIV. They however can carry higher risk of transmitting infections such as
Hepatitis B.

(c) For several years now, rumours are periodically spread about people with
HIV infection intentionally pricking other people with infected needles in public
places such as movie theatres, markets, bus-stops etc. with an intention of
transmitting the infection to them. These rumours are baseless because of three
main reasons:-

(i) There should be adequate amounts of blood containing the virus on

the needle before it can cause infection. A needle that has been merely
pricked in the body of a person with HIV is not likely to have the number
of HIV necessary to cause infection.

(ii) Even if the infected person were to use needle that has been used
intravenously, the virus may not be alive if the blood on the needle has
dried up.

(iii) When an infected needle is pricked into the muscles, the risk of
transmitting the infection is very low.

14. Mother to Child Transmission. Mother to child transmission of HIV can

occur in three ways:-

(a) During pregnancy, when the HIV crosses the placenta.

(b) During delivery.

(c) During breastfeeding.

236
15. Although HIV is present in breast milk, it does not mean that the baby will
always be infected with it. Also, in a country such as India, the alternative to breast-
feeding is bottle-feeding, which is not only expensive but also carries a higher risk of
diarrhoea, poor nutrition and as a result death. Since the benefits of breast-feeding are
much more than the risk of getting HIV infection, it is recommend that women with HIV
infection breast-feed their babies.

16. Skin Piercing. There are several cultural practices in India that involve skin
piercing such as piercing ears or nose for ornamental reasons, tattooing, etc. Although
skin piercing is not currently one of the major routes of transmission of HIV infection in
India, it is desirable to use sterilized equipment for prevention of infections such as
Hepatitis B.

17. Oral Route. Many people believe that kissing, sharing utensils etc. with people
who have HIV can transmit the infection. This is not true. HIV has not been shown to be
transmitted through saliva. If the virus is ingested in the stomach, the acids in it are likely
to inactivate or destroy the virus. The risk through oral route may be there only if there
are cuts or wounds in the mouth or bleeding gums.

18. There are several misconceptions about the spread of HIV infection through oral
sex. Some studies have indicated that oral sex has higher risk of transmitting HIV
infection as compared to kissing. This is because oral sex allows vaginal secretions
and/or semen to enter the mouth. In case there are wounds or injuries in the mouth, the
virus present in vaginal secretions or semen can easily enter the body. Although the risk
of getting HIV infection is lower with oral sex if there are no wounds in the mouth, it is
not recommended as an alternative to safer sex, i.e. sex using condom.

How is HIV Diagnosed

19. HIV is normally diagnosed through blood tests that detect antibodies to HIV.
Although many private laboratories conduct HIV test, it is recommended that they are
done only at the Voluntary Counselling and Testing Centres (VCTCs) set up by National
AIDS Control Organisation (NACO). At these centres, person’s risk assessment is done
before recommending testing for HIV. Counselling is done before and after the test in
order to ensure that the person being tested is aware of all the issues related to HIV
transmission, prevention, treatment, care and support. In case of a negative test result, the
test is repeated after three months to rule out the possibility of the first test being carried
out in the window period.

20. Confidentiality is strictly maintained while testing for HIV. This means that no
one other than the person being tested is informed about the test results. He/she is
encouraged to share the results with those who can offer emotional and other forms of
care and support.

21. It is desirable that people with high-risk behaviours test for HIV at the earliest in
order to:-

(a) Prevent further transmission of HIV.

237
 (b) Improve their quality of life and longevity by adopting recommended
lifestyles and treatment as and when necessary.

Prevention of HIV/AIDS

22. HIV/AIDS can be prevented in four main ways:-

(a) Being in a mutually faithful sexual relationship. If this is not possible, then
correct and consistent use of condoms for every sexual act, irrespective of the
type of sex is essential.

(b) Checking all the blood and blood products for HIV infection before
transfusion.

(c) Avoiding drug abuse, especially sharing needles and syringes for injecting
drugs.

(d) Reducing the risk of mother-to-child transmission by following

recommended guidelines for preventing parent to child transmission of HIV
infection.

23. Condom Use. Condoms have two main advantages-they prevent infections
such as sexually transmitted infections (STIs) and HIV, and also prevent pregnancy.
Many people use condoms only for commercial sex. It is important to remember that
anyone who is not in a mutually faithful sexual relationship should use condoms for
every sex.

24. Some people argue that condoms do not offer complete protection. This is not
true. Several studies have persuasively indicated that failure of prevention of pregnancy
with condoms is often because of inconsistent and incorrect use of condoms. This is also
true for sexually transmitted diseases including HIV/AIDS.

25. Some people complain that condoms, especially those that are distributed free by
the government, are probably not of good quality and therefore break during sexual act.
These complaints are not valid as several strict quality control methods are adopted
during condom manufacturing. They normally break only if they have not been used
correctly or have been damaged because of improper storage.

26. A belief that condoms reduce sexual pleasure is one of the major barriers to
condom use. This is also not true. There may be a difference in the sensation in the initial
stages of using condoms but most people adapt to them very soon. Also, newer condoms
such as ribbed condoms, dotted condoms, etc. are reported to enhance pleasure for some
people.

27. Preventing Parent to Child Transmission. NACO has set up ‘Prevention of

Parent to Child Transmission (PPTCT) centres in all districts of the six states where HIV
infection is high and in several other hospitals in other states. In these centres, pregnant
women are counselled and tested for HIV. If they are positive, they are given medicines
238
for HIV at the time of delivery and caesarean section is done to surgically deliver the
baby. This reduces the risk of infection for the newborn from about 45% to less than 2%.

Symptoms of HIV

28. Most people infected with HIV are not likely to have any symptoms for about
three to ten years. Few develop symptoms earlier while few others may not develop any
symptoms for more than ten years. Even if a person does not have symptoms, he/she can
transmit the infection to others. This is why it is recommended that anyone who has sex
with a partner who is not in mutually faithful relationship should use condoms for every
sex.

29. A normal person has about 500 to 1500 CD4 cells per millilitre of blood. When
the CD4 count decreases below 200, people with HIV can present with opportunistic
infections, which are infections that affect the body because of poor immunity.
Opportunistic infections are caused by bacteria, virus, fungus and parasites. They may
also get some types of cancer.

30. When HIV progresses to AIDS, the infected person would have had unexplained
weight loss of more than ten percent, unexplained diarrhoea or fever for more than one
month, fungal infections, tuberculosis or severe bacterial infections.

31. Tuberculosis. Since tuberculosis is already one of the major health problems in
India, people with HIV infection are at higher risk of getting it. Very often, tuberculosis
is the first indication that a person has HIV infection. Although tuberculosis largely
affects the lungs, it can affect other organs of the body also. People with AIDS are more
likely to get infection in other organs of the body. One of the major concerns related with
tuberculosis and AIDS is resistance of the tuberculosis bacteria to several medicines that
were earlier effective for its treatment. Common symptoms of tuberculosis include
cough, fever, increased sweating at nights, loss of weight and excessive fatigue.

Ethical Issues Related to HIV Infection

32. Ethical issues related to HIV infection are mainly for ensuring that a person with
HIV infection leads a life of dignity. HIV testing should not be done without informed
consent of the person to be tested. This means that the person to be tested should have
understood what test results would mean and its likely impact on his/her life. People with
HIV infection have as much right to get education, employment and medical treatment
from any source as everyone else.

Role of the Youth in Preventing HIV

33. HIV is more common in the most productive age group of 15-45 years, and
therefore causes major impacts on the economic status of the affected individual, family,
community, and the nation at large. The young adults can play a very important role in
preventing the HIV at community level, and also minimise its impact at all levels.

239
34. Youth can assume responsibility in preventing HIV infections. Both men and
women share the responsibility of avoiding behaviour that might lead to HIV infections.
Equally, they also share the right to refuse sex and assume responsibility for ensuring
safe sex. In many societies, however, men have much more control than women with
whom and how they have sex. In such cases, men need to assume greater responsibility
for their actions.
35. Since everyone is entitled to fundamental human rights without discrimination,
people living with HIV/AIDS have the same right to education, employment, health,
travel, marriage, recreation, privacy, social security, scientific benefits etc. All should
share responsibilities for avoiding HIV infection / re-infection.
36. NGOs and youth have an important and very special role to play. The close inter-
personal interaction that NGOs/youth have with people in the communities they work in
is extremely useful for implementing the behavioural interventions necessary for
HIV/AIDS prevention and care. NGOs have a lot of flexibility and the capacity to
accommodate changing programmes and public needs and can innovate and implement
new initiatives more easily.
37. The youth needs to be actively engaged not just in spreading awareness about
HIV but also in promoting responsible behaviours, especially those related to sexual
behaviours and drug abuse. Peer pressure often leads to unsafe behaviours such as
experimenting with alcohol, drugs and sex. By creating a positive peer pressure, it is
possible to delay the age at first sex, avoid sex before marriage, practicing safer sex, and
preventing alcohol and drug abuse. The stereotypical image of a “macho” male needs to
be changed to depict responsible behaviours.
38. The young can also play an important role in addressing gender imbalance, which
is one of the important factors for underdevelopment and HIV transmission. Increasing
values to the roles and responsibilities assigned to women, increasing access to services
for women and encouraging them to be involved in decision making at individual, family
and community levels can address the gender imbalance.
39. Youth should educate general public by spreading the information that HIV can
not be transmitted by the following modes:-
(a) Shaking Hands.
(b) Sharing of Clothes.
(c) Sharing of Food and Utensils.
(d) Sharing of Toilets.
(e) Insect Bites.
(f) Hugging or Kissing.
(g) Working in the same office or travelling in the same vehicle.
(h) Playing or swimming with the infected person.
(j) Coughing, sneezing or in routine patient-care activities (bed- making,
feeding etc).
240
Conclusion

40. HIV can be transmitted from person to person only if the body fluids like blood,
semen and vaginal fluids come in contact with body fluids of an HIV infected or AIDS
patient. Young people, with or without HIV/AIDS, have an important role to play in
actively countering discrimination against young people living with HIV/ AIDS. We
require to provide a platform for people living with HIV/AIDS, so that we work together
according to their interests. We also need to mobilize support of local authorities and
community leaders to listen to people living with HIV/AIDS and to combat actively
against their discrimination and exclusion. Setting up training programmes, to improve
the integration of the young people suffering from HIV/AIDS into society, is the need of
the hour.

SECTION-5

CANCER, ITS CAUSES AND PREVENTIVE MEASURES

Introduction

1. Six million worldwide die of cancer every year. The present rapid growth rate of
cancer is required to be controlled or retarded to prevent an epidemic-like situation in
India. If growth of cancer is not controlled, it may lead to a ‘National Crisis’. Sixty
percent cancer cases are preventable and it is curable if detected and treated in time.
Experts strongly feel that improved level of cancer awareness to the masses will help
prevention of cancer considerably. NCC as a disciplined organization with assistance and
co-operation of Non Governmental Organizations can play a vital role by educating
masses on cancer awareness. There are billions of cells in the human body. Normally
they grow in a well-regulated pattern. But when cancer sets in, a group of cells, suddenly
starts multiplying and forms a tumor or lump. As the tissue progresses in the degree of
malignancy, it invades the original site where it has occurred and through blood vessels
or lymphatic channels can reach distant parts of the body.
Types of Cancer

2. Different types of cancer that men and women suffer are :-

(a) Oral cancer.

(b) Larynx cancer.
(c) Lung cancer.
(d) Cervical cancer.
(e) Breast cancer.
(f) Prostate cancer.
(g) Colon cancer.

241
Causes of Cancer

3. Main causes of cancer are:-

(a) Prolonged chewing of tobacco, zarda, pan and pan masala.

(b) Heavy smoking.
(c) Excessive drinking.
(d) Poor oral hygiene and inadequate dental care.
(e) Air and water pollution.
(f) Deficiency of balanced diet.

Effects of Cancer

4. (a) Pain.
(b) Mental anguish.
(c) Results in loss of work.
(d) Expenses to family.
(e) Loss of loved one.

Cancer Signs

5. An early detection of cancer can lead to an early cure. The cancer signs are:-

(a) A change or lump anywhere in body however small.

(b) A persistent sore throat that does not heal.
(c) A change in a mole or a prominent new spot on the skin,
(d) A constant cough or hoarseness.
(e) Frequent difficulty in swallowing.
(f) Persistent indigestion.
(g) Vomiting and coughing of blood.
(h) Persistent diarrhoea or constipation.
(j) Blood in urine bowel movement.
(k) Weight loss without causes.
(l) Abnormal vaginal bleeding.
(m) Unexplained loss of appetite.

242
6. Early warning sings due to gutka and tobacco chewing are:-

(a) Any sore and ulcer on tongue, cheek or gums that does not heal within a
fortnight.
(b) Red and white patches on the lips or mouth.
(c) A lump of swelling anywhere in the mouth or neck.
(d) Difficulty in walking.
(e) Difficulty in speech.
(f) Repeated bleeding in the mouth.
(g) Numbness in the mouth.
7. Warning signs of lung cancer, which kills more people than any other type of
cancer, are:-

(a) Increasing cough and breathlessness.

(b) Change in voice.
(c) Pain in chest.
(d) Lump in neck.
(e) Coughing out blood.
Preventive Measures
8. Endeavour should be made to prevent cancer from ever occurring by :-
(a) Avoiding smoking.
(b) Avoiding tobacco in any form.
(c) Good oral hygiene.
(d) Avoiding diet high in processed and preserved meat, smoked and salted
food.
(e) Avoiding obesity.
(f) Handling asbestos and certain dyes with precaution.
(g) Early treatment on detection.

Myths About Cancer

9. (a) Cancer is contagious and infectious.

Fact : Cancer is not transmitted by touching, eating from the same plate, kissing
or sexual intercourse.

243
(b) Severe depression can cause cancer.

Fact: Cancer is a physical phenomenon and not related to emotions as its cause.
However, depression affects the disease adversely.

(c) Cancer is a disease of the blood.

Fact : Though cancer cells travel through blood, it is not caused by any
imbalance or impurity in the blood.

(d) Cancer spreads very fast after a knife (i.e surgical knife) touches it.

Fact : This impression has been created by the fact that many patients die soon
after a surgery. This actually means that there was delay in diagnosis or treatment
and by the time surgery was performed, the disease had spread substantially and
became unmanageable. The patient did not die because of surgery.

(e) Cancer is a product of the ills of modern civilisation.

Fact: Indications of bone cancer have been found even in Egyptian mummies,
more than 3000 years old. ‘Ayurveda’ also deals with cancer.

(f) Cancer is God’s punishment for sins committed.

Fact: Religious man like Ramakrishna Paramahamsa Dev and Maharshi Raman
had cancer.

(g) Irregular food habits may cause cancer.

Fact : No co-relation exists However, irregular food habits may cause other
gastric problems.

(h) All moles and warts will become cancer.

Fact : Not necessarily. Attention is to be paid only when colour or size changes
and if there is any discharge from them.

(j) All lumps in the breast are malignant.

Fact : Only a small percentage is malignant . However, all lumps need attention
and self-examination helps in early detection of tumour in breast.

(k) Children do not get cancer.

Fact : Unfortunately there is no lower age limit for cancer.

(l) Nausea and other side effects mean the treatment is working.

244
 Fact : Each patient responds differently to the treatment. Some get a lot of side
effects, some hardly any.

(m) Pain killing medicines are habit forming and hence should be avoided as
far as possible.

Fact : People do not get high on pain killer and hence these do not cause
addiction. Patient should not wait till the pain becomes unbearable and then ask
for a pain killer. It is easier to control the pain when it is mild.

(n) Over a period of time pain control drug will stop working.

Fact : At times the body may become used to a particular drug. In that case
another drug or a combination of drugs or an increase in the dosage of the present
drug may be prescribed.

(o) Homosexuals and lesbians are more vulnerable to cancer.

Fact : No scientific correlation exists.

(p) Neglected piles may turn into cancer.

Fact : Piles is enlargement of vein in the rectal wall and cancer is found above
this area. However, bleeding through rectum should be carefully investigated.

(q) Cancer cannot be prevented.

Fact : Through at present no anti cancer vaccine is available, careful life style
like healthy food habit, avoiding tobacco and betel products, limiting alcohol
intake etc may help in preventing cancer.

(r) Physically weak people are more prone to cancer.

Facts : No scientific correlation exists.

( s) Cancer is incurable.

Facts : With timely detection more than 80% cancer is fully curable.

(t) A patient of TB cannot get cancer.

Facts : Cancer may develop in a TB patient or a patient having any other

disease.

Conclusion

10. Cancer is not a contagious disease. There is a life after cancer. Sixty percent of
the cancers can be prevented through life style changes, diet, exercise, weight control,
245
alcohol in moderation and non consumption of tobacco in any form. More than eighty
percent cancer is completely curable if detected and treated early. We must not get scared
of cancer but must fight cancer with full sincerity. There is an urgent need to organise
cancer awareness programmes in print and electronic media to reach out to the people in
a meaningful manner.

SECTION-6

CONTRIBUTION OF YOUTH TOWARDS SOCIAL WELFARE

Introduction

1. Youth constitute the most creative segment of any society. Their role and
contribution are vital to all societies and more so in a country like India with wide social,
cultural and other demographic diversities. Youth constitute about 34 % of the total
population of India and their role and contribution towards social welfare and nation
building can not be ignored. For a better understanding of the subject it is important to
first understand the basic of social welfare.
Definition of Social Welfare
2. Social welfare has been defined by a United Nations expert group as “ Organised
activity that aims towards a mutual adjustment of individuals and their social
environment”. Social welfare is considered as including the attempts made by
governments and voluntary organizations to help families and individuals by maintaining
incomes at an acceptable level. This can be achieved by providing medical care and
public health services, adequate housing and community development, facilitate social
adjustment, facilities for recreation , in addition , pass legislation and creating facilities
to protect against exploitation and to care for the underprivileged social groups. It will
also include subject relating to education.
Contribution of Youth Towards Social Welfare
3. The contribution of youth towards social welfare have been discussed in the
succeeding paras :-
(a) Leadership. Youth are the leaders of tomorrow and young and vibrant
youth are essential for future leadership. Support is provided to voluntary
organizations to participate in youth development programmes. Youth need to
involve themselves in activities which will develop creditable leadership.
(b) Community Service. Youth need to work in social welfare activities and
community services. Therefore, Community Service has been developed as an
integral part of the curriculum for education, instruction and training of all
students enrolled in educational institution so that youth can fruitfully understand
and contribute in community service.

246
(c ) National and Cultural Integration. The youth, when organized as youth
force will contribute for the promotion of national and cultural integration of the
country. Fostering and developing interaction between youth from different parts
of the country specially the isolated border and tribal areas will help in achieving
national integration. It should be the endeavour of youth to motivate the general
public to work against the separatist forces and ensure unity of the country is
maintained.
(d) Education and Literacy. The Youth need to educate themselves and
subsequently get into the process of providing quality education to all sections of
society. They need to promote education and self development capabilities of the
rural youth specially of girls and youth in backward areas.
(e) Environment. The youth must understand the importance and
implications of environment on the society and the ecological wealth of the
nation. They must help in improving and protecting the environment. They need
to engage in aforestation programmes and cleaning of rivers and lakes and
disposal of degradable and non degradable waste.
(f) Health Care and Family Welfare. They must promote awareness and
involvement in social programmes pertaining to health and family welfare.
Programmes such as ‘Youth against AIDS’ campaign, ‘Pulse Polio’, ‘Small
Family’ norm and various immunization programmes should be promoted. They
must also volunteer in manpower intensive programmes at the implementation
stage.
(g) Physical Education and Adventure Training. The youth must
understand the importance of physical education for health and physical fitness
with a view to increasing individual productivity and the value of sports as a
means of recreation and with a potential for promoting social harmony and
discipline .
(h) Old Age Care. Our basic social fabric and the joint family system
inherently provide for old age care. However with the break down of the joint
family system the need for old age care has increased. The youth must contribute
to the well being of the senior citizen of the society by taking care of their aged
and provide them financial security and moral self respect and make all efforts to
ensure that they have a secure old age with adequate housing and health care.
(j) Watershed and Waste Land Development. These two are one of our
major resources which need to be continuously protected and systematically
proclaimed and developed and can be used for various social welfare activities .
Youth has genuine potential for this nature of work. They must contribute in these
programmes and ensure that these areas are protected from unscrupulous elements
who may enter these areas of interests for personal gains.

247
Conclusion

4. Our youth are the strength of the family , village , locality and the community .
They are also the future of our nation. We must take all necessary steps to mobilize this
most idealistic, inspired and energetic section of our society in the mission of nation
building and social welfare.

SECTION-7

NON- GOVERNMENT ORGANISATION AND

THEIR CONTRIBUTION TO THE SOCIETY

1. For the progress and development of the country, there are mainly two types of
organizations, Government and Non Government.

2. Government Organisation. The steps undertaken by the government for the

overall development of the nation and the society are included in the charter of duties of
our government organisation. The government fully controls such actions which are
directly or indirectly undertaken for such developments. Some of the works undertaken
by government organisation are implementation of Five year plans, Welfare and
empowerment of women, Rozgar yogana, Child welfare programme, Literacy
programme and AIDS awareness programme.

3. Non Government Organisations. These organisations are controlled by

members of society, who form a group or groups and work towards social welfare and
nation building. People with common objective and aspirations, together make
organisations called Non Government Organisation (NGOs) and get them registered.
An NGO is a non-profit group or association that acts outside of institutionalised political
structures and pursue matters of interest to its members by lobbying, persuasion, or direct
action. Their goals are primarily non-commercial. They collect funds both from people
and the government.

4. NGOs firstly make survey of various problems, collect information about them,
organize various demonstrations, give speeches and wherever action needs to be taken,
they take with full vigour. They understand social problems, the causes, affects and create
necessary infrastructure to overcome them. NGOs usually gain at least a portion of their
funding from private sources. Major sources of NGO funding include membership dues,
grant from international institutions or national governments and private donations.

5. Some of the examples of important NGOs are:- Shri Niketan Yojna-Started by

Ravinder Nath Tagore, Seva Gram Yojna-by Gandhiji, Gram Yojna by Vinoba Bhave,
Child Relief and You, Helpage India, People for Animals(PFA), Society for
Prevention of Cruelty to Animals (SPCA). International Red Cross and Red
Cresent Movement are the world’s largest group of humanitarian NGOs.

248
Types of NGOs

6. Some of the types of NGOs are as follows:-

(a) INGO. It stands for International NGOs.

(b) BINGO. Business oriented International NGO.
(c) RINGO. Religious International NGOs.
(d) ENGO. Enviornment NGO.

Activities of NGOs

7. Following activities are undertaken by NGOs:-

(a) Blood Donation.

(b) Adult Literacy.
(c) Anti Dowry Drive.
(d) Anti Leprosy Drive.
(e) Anti Drug Drive.
(f) Tree Plantation.
(g) Environmental Programmes.
(h) Help in natural calamities such as Flood, Earth-quake.
(j) Educating people about the ill-effects of AIDS and education for
prevention of the same.
(k) Family Planning Programmes.
(l) Community Development Work.
(m) Promotion of Social-equality.
(n) Wildlife and Animal Care.
(o) Human-rights.
(p) Awareness Campaign.
(q) Child Care.
(r) Polio Eradication drive.
(s) Providing schooling facilities especially in remote villages and rural
areas.
(t) Creating and providing health and hygiene infrastructure and facilities to
reduce diseases and help in creating a healthy and fit population.
(u) Cottage Industry.
249
 (v) Orphanage and Old Age Homes.

Conclusion
8. NGO are the true example of selfless service and teamwork. Employees are
highly committed to the aims and the principles of the organisation. They share equal
contribution with government organisation and social welfare programme. Though
government on its part has introduced a number of programmes, however government
cannot be entirely successful without the active participation by each member of society.
NGOs provide the necessary platform towards this end.

SECTION-8

DRUG TRAFFICKING AND CRIME

Introduction
1 A `DRUG` is a substance–solid, liquid or gas that brings about physical and / or
psychological changes. Drugs affect the central nervous system. They act on the brain
and can change the way a person thinks, feels or behaves. These drugs are known as
psychoactive drugs. Drug menace is one of the most serious problems facing the world.
Drug trafficking is considered as a greater problem than drug consumption.
Types of Drugs
2. There are three main types of drugs affecting the central nervous system:-
(a) Depressants. Depressants are drugs that slow down the function of the
central nervous system. Depressant drugs do not necessarily make a person feel
depressed. They include:-

(i) Alcohol.
(ii) Cannabis.
iii) Barbiturates, including Seconal, Tuinal and Amytal.
(iv) Benzodiazepines (Tranquilisers), Benzos, Tranx, such as
Rohypnol, Valium, Serepax, Mogadon, Normison and Eupynos.

(v) GHB (Gamma- hydroxybutrate), or Fantasy

(vi) Opiates and Opioids, including Heroin.

(b) Stimulants. Stimulants act on the central nervous system to speed up the
messages to and from the brain. They make the user feel more awake, alert or
confident. Stimulants increase heart rate, body temperature and blood pressure.
Other effects include appetite, dilated pupils, talkativeness, agitation and sleep
disturbance. Mild stimulants include:-

250
 (i) Ephedrine used in medicines for bronchitis, high fever and asthma.
(ii) Caffeine in coffee, tea and cola drinks.
(iii) Nicotine in tobacco.
(c) Hallucinogens. Hallucinogens affect perception, People who have taken
them may believe they see, hear and perceive things that are not really there or
what they see may be distorted in some way. The effects of hallucinogens vary a
great deal, so it is impossible to predict how they will affect a particular person at
a particular time. Hallucinogens include:-

(i) Dhatura
(ii) Ketamine
Legal Drugs

3. Laws and regulations control the availability, quality and price of the legal drugs.
For example tobacco may not be sold to persons below age of 18 years .

4. Illegal Drugs. Because they are illegal there are no prices or quality controls on
the illicit drugs such as heroin. This means that a user can never be sure that the drug
they are taking is in fact what they think it is. The user also cannot be sure of a drug`s
strength or purity. Various batches of an illegally manufactured drug may have different
mixtures of the drug and additives such as poisons, caffeine or even talcum powder.

Golden Crescent

5. India due to its geographical location has become a transit route base for illicit
heroin, hashish and morphine from Afghanistan, Pakistan and Iran. This area is known as
Golden Crescent. Cannabis smuggled from Nepal is mainly consumed in India. Most
heroin transiting through India is bound for Europe.

6. A peculiar system of supply and demand that characterizes the Indian drug
market is that the user and traders are often the same. To fund drug consumption many
users resort to crimes and thefts.

Users

7. It was found that all the addicts were taking either cannabis or heroin. Seventy two
percent of addicts are in the age group of 20-24 years. Females comprise only 2% of the
addicts. Seventy eight percent of addicts come from the families which are facing
problems such as loss of one or both parents or separation of the parents, However, no
correlation is found between liability for addiction and economical status of the family, as
judged by per capita income.

8. Drug addiction is found to be most common in peer group. The other reasons are
curiosity (19.85%), pleasure seeking (12%) and mental tension (5%). Majority of addicts
(84%) mention that the drug is easily available to them. Education and occupation has no
significant effect on the habit. The problem of drug addiction appears to be common
251
amongst youths (20-24 yrs). High incidents in youth may be due to their emotional
immaturity. Children from problem families and broken homes, who lack proper parental
control and guidance are most likely to become victims of this dreadful habit. In peer
groups, Curiosity and pleasure seeking are the common reasons for developing the
addiction. The availability and easy access of the drugs contribute towards continuing
drug use.

The Law

9. Control over cultivation of opium and all matters relating to narcotic drugs and
psychotropic substances are regulated by the “Narcotic Drugs and Psychotropic
Substances (NDPS) Act and Rules”, which provide for:-

(a) Punishment of upto 20 yrs rigorous imprisonment and fine up to Rupees

Two Lakhs for indulging in trafficking of narcotic drugs and psychotropic
substances.

(b) Death sentence in case of repeat of this offence.

(c) Forfeiture of property of smugglers.
(d) Regulating of legitimate trade and commerce of NDPS for medicinal and
scientific purposes. The “Prevention of Illicit Trafficking in Narcotic Drugs and
Psychotropic Substances”( PITNDPS) provides for detention of persons indulging
in trafficking of narcotic drugs for 1 to 2 years by an executive order.

Conclusion

10. Drug trafficking and consumption has become a global menace. To eradicate this,
it requires mobilisation of international communities through a comprehensive approach
in combating illicit production, trafficking and consumption of drugs. Government and
NGOs should emphasise on education, healthcare, treatment and rehabilitation for
effective control of drug abuse.

252
 CHAPTER-VIII

HEALTH AND HYGIENE

253
 INDEX

CHAPTER-VIII HEALTH AND HYGIENE JD/JW SD/SW

SECTION-1 Structure and Function of the Human

Body √ √
SECTION-2 Hygiene and Sanitation
√ √
SECTION-3 Preventable Diseases
√ √
SECTION-4 First Aid in Common Medical
Emergencies √ √
SECTION-5 Dressing of Wounds
√ √
SECTION-6 Yoga: Introduction and Exercises
√ √
SECTION-7 Physical and Mental Health
- √
SECTION-8 Fractures, Types and Treatment
- √
SECTION-9 Evacuation of Casualties
- √

254
 SECTION-1

STRUCTURE AND FUNCTION OF THE HUMAN BODY

1. The human body is the greatest of all complex machineries. In order to carry out
first aid, a, first aider should have basic idea of structure and function of every part of
human body.

Structure of the Body

2. Human body consists of :-

(a) Skelton (Bones of the body) - see Fig 1

(b) Muscles.

(c) Blood Circulatory Organs.

(d) Respiratory Organs.

(e) Digestive Organs.

(f) Excretory Organs.

(g) Nervous System Organs.

Functions

3. (a) Skeleton. Bones of the body (See Figure-1) gives shape and firmness to
the body. It protects the important organs of the body like brain, heart, lungs,
spinal chord and so on. There are 206 bones in the body. Bones are either long,
short, flat or irregular in shape. Long bones are found in the upper limb. Femur,
Tibia, Fibula are in Lower limb and Sternum and Ribs on the chest. Short bones
are found in wrist and ankles, flat bones, are found in cranium, shoulder and hips.
Irregular bones are found in the vertebral column. Joints are places where two or
more bones meet which permit the movement of the body.

(b) Muscles. They are attached to the bones and are responsible for body
movement. They are of two types, voluntary and involuntary.

255
256
(c) Blood Circulatory System

(i) Heart is most important organ of blood circulation. It lies on the

left side of the chest and is of the size of a closed fist. It is an in-voluntary
hollow muscular organ which functions without the control of our will.
Pericardium, Myo Cardium and Endo Cardium are its three layers. It is
divided into two compartments, right and left. Right side contains impure
blood while left side contains pure blood. Each side is again divided into
AURICLE and VENTRICLE. Auricles are the receiving chambers. Heart
circulates blood to all parts of the body through arteries and receives it
back through veins. This is done by pumping action of the heart
contraction and dilation.

(ii) Blood. Blood is an essential fluid which circulates in our body. It

carries oxygen and nourishment to the body tissues without which we
cannot survive. It also removes all waste products like carbon- di-oxide.
Blood circulation is brought about by function of the heart and blood
vessels.

(iii) Blood Vessels

(aa) Arteries. These are the Blood vessels which carry pure
blood from the heart. Aorta is the biggest artery from where the
branches of other arteries take the pure blood to each part/organ.

(ab) Veins. These blood vessels collect and carry impure

blood to the heart. Main veins are superior and inferior Vena Cava.

(ac) Capillaries. Tiny blood vessels which connect the small

arteries and veins. The exchange of oxygen and nutrition with
carbon-oxide by the tissue takes place in capillaries.

(d) Respiratory System. Two lungs ‘Right’ and ‘Left’ are the important
organs of respiration. During breathing in, fresh air goes in to the lungs, the blood
absorbs the oxygen from inhaled air and distributes it to all parts of the body.
Oxygen is most essential for living. Carbon-di-oxide , a poisonous waste product
is removed from the lungs during breathing out. Thus we see that the process of
`breathing in’ and `breathing out’ are most important for the continuation of life
process.

(e) Digestive Organs. Stomach and intestines help in the digestion of flood
we eat, through a number of gastric juices and secretions from the liver, pancreas
and intestines and the nourishment is carried to all parts of the body by blood. The
unabsorbed food passes via intestines and is evacuated as faeces.

257
 (f) Excretory Organs

(i) Kidneys. Waste material in the form of urine is removed by

kidneys.

(ii) Skin. Waste matter in the form of sweat is removed through

perspiration by skin.

(g) Nervous System Organs

(i) Brain. It is a compact nerve tissue structure which controls

and coordinates all body functions through nerves.

(ii) Nerves. They control all the organs and their function. They are
silvery wire like fibres which are connected with brain.

SECTION -2

HYGIENE AND SANITATION

Introduction

1. Hygiene is the science which seeks to preserve and improve the health of the
individual and of the community as a whole. Its study is aimed at making the cadets
aware of the many health hazards and to enable them to look after themselves more
efficiently. It seeks to develop in them the concepts of healthy living. Hygiene has
nothing to do with religion or social customs but it is simply based on scientific
requirements. Personal hygiene involves all aspects of the health of an individual.
Responsibility for the maintenance of personal health, therefore lies with the individual.
Every person must remain in perfect physical, mental and social health, only then can he
serve the community and the country well. The basic factors which make a person
healthy are enumerated in the subsequent paragraphs.

Personal Hygiene

2. Sleep. Sleep means the periodical rest of both body and mind. The amount of
sleep one requires varies with individuals and age. Older people sleep less than the
young. The average requirement of sleep is from 7 to 8 hours a day.

3. Bathing. Keeping the Skin clean and in healthy condition is essential for good
health. A warm bath in winter and cool one is summer and use of soap are essential for
body cleaning.

4. Eating and Drinking. Properly cooked food with its full nutritive value is
beneficial for health. Eat slowly and chew well. Do not swallow hastily. Avoid
strenuous exercise after a heavy meal. Drink plenty of water between meals.

258
5. Care and Cleanliness of Skin, Hand, Hair and Teeth. Our skin keeps on
secreting sweat and hence it is necessary to keep it clean through bathing and by
removing dust and dirt. Constant use of soap is required otherwise the clothing would get
a foul smell and attract vermin. Regular changing and cleaning of clothing is essential to
keep the body fit. Hands and finger are to be kept clean and washed before taking meals
and after a visit to the lavatory. Nails should be kept trimmed to keep them free from dirt.
The hair should be kept clean by regular washing and combing. Care of teeth plays an
important part in keeping fit. Digestive and other disorders take place when decayed
teeth and unhealthy gums bleed giving foul smell in the mouth. Teeth should be
regularly brushed after the last meal at night and early in the morning. In-sufficient
vitamins C &D are the cause of dental decay.

6. Food and Rest. Properly balanced diet is essential for physical well being.
Food should be hygienically and properly cooked. It should be chewed well and taken in
proper proportion. Sufficient rest, recreation and sleep are essential for mental and
physical fitness.

7. Exercise. Organized games and physical exercise are necessary for proper
development of the body and mind.

Water Supply and Its Purification

8. Source of Water Supply. These are:-

(a) Rain Water.

(b) Surface Water.

(c) Underground Water.

9. Rain Water. Life on land depends on rain. It fills the rivers and lakes, it lets
seeds germinate and grow, and provide us with drinking water though it is unfit for
drinking as it comes through suspended impurities in the atmosphere.

10. Surface Water. Rivers and streams get polluted by discharge of human,
animal and industrial waste into them. Lakes and ponds provide good water source
if kept away from pollution. This can be achieved by:-

(a) Providing fence all round the water point to keep away the animals.

(b) Prohibiting animal grazing and human habitation in the vicinity of the
fenced area.

(c) Prohibiting washing of clothes.

(d) Ensuring no draining of dirty/industrial waste water is allowed from

the surroundings.

259
11. Underground Streams. Wells are a good sources of water supply which
can be protected as under:-

(a) Avoid soakage pits, latrines, urinals, sewerage or any leaking drains
within 100 ft of a well.

(b) The well should be protected with stones or bricks set on concrete
or cement lining. Construction of a parapet is necessary to stop waste water
going into the well.

(c) Cover the well with a dust proof top.

(d) It is desirable to have a pump, if facilities are available or

alternatively a bucket and a chain.

(e) Use of fence all around is necessary.

12. Purification of Water. Safe drinking water comes only from an authorised
source. Purification provides good and safe water by eliminating the following:-

(a) Suspended matter.

(b) Harmful salts in solution, bad taste, smell and undesirable colours.

(d) Disease germs.

13. Method of Purification. The following methods are used:-

(a) Boiling and Distilling Water.

(b) Clarification. Removal of suspended matter through filtration by

passing it though filter beds of gravel and sand or through properly sterilized
filters.

(c) Sterilization. By using chlorine gas or bleaching powder.

(d) Pinking. During cholera epidemic potassium permagnate should be

used for pinking of wells.

(e) Precipitation. By adding alum or some similar chemical to water

which carries all impurities to the bottom with it and leaves pure water.
Water is then passed through a filter.

260
Latrines

14. These are of various types:-

(a) Water Carriage System. It implies ample supply of pipe water

available to carry the faeces away. It is simple, hygienic but require a lot
of money and time.

(b) Aqua Privy Latrines. Nominal cost, used where construction of

water carriage system is not possible.

(c) Removal System. It implies collection of faeces and subsequent

removal for final disposal. The method is not very hygienic.

(d) Deep Trench Latrines. A pit three feet wide, atleast eight feet deep
and of a length suitable to the requirement is constructed and wooden seats
placed over it with proper partitions and curtains. Soil may necessitate
reverting of sides with sand bags, bamboos or wire netting.

(e) Shallow Trench Latrines For Temporary Camps. For camps of

less than a week’s duration dig a row of trenches in parallel, each trench
being 3 feet long, 1 foot wide and 2 feet deep. Each trench should be 2
feet apart. The ratio is 5 trenches for the first hundred users and three for
each subsequent hundred. After defecation cover the excreta with loose earth
by providing a shovel or a scoop. Fill the trenches after 24 hours and get
new trenches dug in.

Urinals

15. (a) Trough Urinals. Made of corrugated plain galvanized iron bent
in the form of a gutter and mounted on four wooden legs. It slopes
slightly towards one end where a vertical drain pile runs down in a soakage
pit.

(b) Funnel Urinals. For temporary camps funnel urinals can easily be
constructed over a simple soakage pit.

Soakage Pits.

16. Essential for the disposal of liquid refuse like greasy water from kitchen
and waste water from bathrooms. Dig a pit 4 feet by 4 feet and 5 feet to 6 feet
deep. Fill with small stones and broken bricks. Cover the top with oiled sacking
and put earth or sand 6 inches above. In the centre keep a perforated empty tin
of kerosene oil. Fill this tin with layers of gravel or sand and gravel. In this, fit
in a bucket, filled with straw, grass or some other grease retaining material.
Remove the strainer daily and replace with fresh one.

261
Disposal of Garbage.

17. Disposal of solid refuse like kitchen garbage, bones etc, be done by
burial or burning. The household refuse should be deposited in a covered bin placed
outside. Improvised kerosene/ oil tins are not advisable. Further disposal should be
done under municipal arrangements.

SECTION-3

PREVENTABLE DISEASES

Introduction

1. Many of the deadly diseases can be prevented from spreading to healthy persons
if proper precautions are taken by checking infection and contagion of several diseases
and by killing carriers of several other diseases.

Classification

2. Communicable diseases can be classified as follows :-

(a) Excremental Diseases. The germs pass out of the body of a sick man
suffering from the diseases along with excreta (urine and faeces). The excreta can
contaminate food, water or hands of cooks and thus pass the infection. Thyphus
fever, dysentery, diarrhoea, jaundice and intestinal worms are some of the
important diseases belonging to this group.

(b) Droplet Infection. The germs are sprayed out from the nose, throat or
lungs in the air in small droplets of saliva during coughing, sneezing or even
while talking. These germs are inhaled by a healthy man if he happens to be near
the sick. Common cold, tonsilitis, influenza, diphtheria, meningitis, (inflammation
of the brain) and tuberculosis are the common diseases in this group.

(c ) Contact Diseases. The germs move pass from the sick to the healthy by
actual body contact. Veneral diseases i.e. syphilis, gonorrohoea and skin infection
are common examples. Complete segregation of patient can prevent the spreading
of the diseases.

(d) Inset Borne Diseases. The germs move from a sick person to a healthy
person through blood sucking insects known as `Carriers’. These insects first bite
a sick person and then a healthy person leaving the germs of the diseases in the
blood of the healthy person. These germs multiply in the blood of the healthy
person during the period of incubation, at the end of which he starts showing
symptoms of the disease carried by the inset. These are:-

(i) Carried by Mosquito – Malaria, Dengue and Filariasis.

(ii) Carried by sand fly - Sand fly fever, Kala Zar, Oriental sore.
262
 (iii) Carried by lice - Typhus, Relapsing fever.
(iv) Carried by flies - Diarrhoea, Dysentry, Cholera, Typhoid.
(v) Carried by fleas - Plague, Typhus.
(vi) Carried by ticks - Relapsing fever, Typhus.

(e) The preventive steps that can be taken to stop spreading of these diseases
are to destroy all these insects by draining out all stagnant water, puddles and by
spraying drains and muddy places with anti-mosquito emulsion. Mass drives
should be organized to kill all files, fleas, ticks and lice through sanitation. All
heaps of dirt and refuse should be removed. Anti- rat campaigns ought to be
organized. All casualties ought to be segregated.

(f) Water Borne Diseases. Certain diseases spread due to infection carried
through water. These are cholera, dysentery, diarrhoea, jaundice etc. These
spread as water gets contaminated through vomits or faeces passing into it.
Epidemics are likely to spread if immediate steps are not taken to disinfect water
and to properly dispose off the excreta through efficient conservancy
arrangements. All sources of the diseases ought to be segregated.

(g) Animal Borne Diseases. The germs are transmitted through the agency
of animals by drinking milk or through the agency of insects. Rabies, plague,
anthrax and tuberculosis are some of the common diseases.

Preventive Measures

3. The following preventive measures are necessary to ward off these diseases:-

(a) Segregate the patient

(b) Destroy agents (germs) causing infection.
(c) Dis-infection.
(d) Control of the food and drink.
(e) Inoculation and Vaccination.

SECTION-4

FIRST AID IN COMMON MEDICAL EMERGINCIES

Introduction

1. There will be a number of occasions on which we may be faced with situations

where we may be required to provide First Aid to the injured because of an accident or
due to any calamity. Therefore it is very important for all cadets to have knowledge of

263
providing First Aid in common medical emergencies. In the succeeding paras we will
deal with certain medical emergencies and discuss about the method of First Aid to be
provided.

Injuries to Internal Organs

2. These injuries cannot be seen but can only be suspected where bleeding instead
of coming to surface, occurs into the cavity of chest or abdomen wherein important
organs like Heart, lungs liver or Spleen might get ruptured . The following symptoms are
observed in case of internal injuries:-

(a) Cold clammy skin.

(b) Weak thready rapid pulse.
(c ) Shallow sighing and breathing.
(d) Face pinched and pale.
(e) Eyes deeply sunken with dark rings around them.
(f) Patient usually restless and anxious and may lose consciousness

3. First Aid Treatment.

(a) Keep the patient warm and lying down with feet raised up and head kept
low.

(b) Apply cold application on the suspected injured region.

(c) Cheer up the patient.

(d) Arrange medical attention as soon as possible.

Burns and Scalds.

4. Burns may be caused by heat, either dry as by contact with fire or flame. Burns
caused by moist heat such as hot water, hot fluids and steam, is called a scald. Chemical
burns may be caused by strong acids or alkalies. If the burn is chemical let water from a
pipe or hose flow freely on the burn so that the chemical flows off.

5. First aid Treatment

(a) Protect burnt area by applying bandage or cover exposed part with clean
towel or cloth.

(b) Give complete rest and plenty of fluids to the patient.

(c ) Re-assure the patient.

264
 (d) Give him morphia if available.

(e) Evacuate patient to the nearest hospital or dispensary.

Snake Bite

6. In Snake bite the poison is injected by the snake through a pair of hollow and
deeply grooved biting fangs. The majority of bites occur on parts of limbs which are
exposed like hands, feet and lower legs.

7. First Aid Treatment. All cases of Snake bite should be treated as being bitten
by poisonous snakes. The first aid treatment will be as follows:-

(a) Make the victim lie down comfortably.

(b) Give convincing reassurance against fear of death.

(c ) Apply a light constricting tourniquet with handkerchief, bandage or shoe

lace above the knee for a bite on the leg and above the elbow for a bite on the
arm. So that the poison does not flows to all part of the body.

(d) Wash with soap and water. Use water freely.

(e) Incise into the skin 2” x ½” across the fang mark with a blade.

(f) Suck the blood either with mouth or with a suction pump. Be careful that
there is no cut or ulcer in the mouth.

(g) Evacuate the patient quickly to the nearest dispensary or hospital.

(h) If breathing fails, start artificial respiration.

Scorpion Bite

8 Bite by a scorpion should be treated as snake bite.

9. First Aid Treatment

(a) If blood has been drawn , the wound should be cleaned well with
antiseptic lotion.

(b) Evacuate casualty to the nearest dispensary or hospital.

Rapid Dog Bite

10. Rabies is a very dangerous disease transmitted by a rabid dog. The disease is
preventable by giving anti- rabies vaccine.

265
11. First Aid Treatment

(a) Immediately wash with water and soap.

(b) Wound should be cleaned with available antiseptic.

(c) Patient should be sent to hospital for an anti- rabies injection course.

(d) Dog and the patient should be kept under observation for at least 10 days.

Foreign Bodies in Eye, Ear and Nose

12. Foreign Body in Eye. Particles of coal or dust may lodge on the eye-ball or
inside the eye lid causing discomfort and damage to the tender structure.

13. First Aid Treatment

(a) Ask the patient not to rub the eyes.

(b) Wash the eye with water repeatedly for a minute or two.

(c ) Search for the foreign body by lifting the upper eyelid and parting the
lower eyelid down. The patient should face the light. If the foreign body is seen, it
can be wiped off with the moistened corner of a handkerchief, cloth or cotton
swab.

(d) If foreign body is fixed to the eye-ball, patient should be sent to the
hospital with a light eye bandage.

14. Foreign Body in Ear. This is common with children. They often put beads, peas,
nuts and other objects into the ear or an insect may get into the ear.

15. First Aid Treatment. Do not try to remove the foreign body with the help of a
pin or forceps as this may push the foreign body further in, causing damage to the ear
drum. The patient should be sent to the hospital.

16. Foreign Body in Nose. This is a common occurrence among children. They
might put peas, beads, etc in the nostril.

17. First Aid Treatment

(a) Blowing the nose and sneezing may expel the foreign body.

(b) Make the casualty breath through the mouth.

(c ) Do not try to remove the foreign body.

(d) Send the patient to the nearest hospital.

266
Respiration: Natural and Artificial, Asphyxia and Insensibility

18. The tissue and organs of the body are supplied with oxygen through respiration,
essential for the functioning of body. Respiration consists of inspiration, expiration, and a
pause. During inspiration air is drawn inside causing the lungs to expand. During
expiration the lungs contract and air is pushed out. The respiratory system consists of the
air passage known as respiratory tract and lungs. The actions of muscles concerned with
respiration are controlled and regulated by the respiratory centre of the brain.

Asphyxia

19. Any thing which interferes with respiration producing irregularities in breathing
produces a condition known as Asphyxia.

20. Causes

(a) Drowning – Due to water entering the air passage.

(b) Hanging and Strangulation due to obstruction to entry of air

(c ) Suffocation

(i) Due to obstruction to entry of air through the air passage.

(ii) Foreign body obstructions in air passage.
(iii) Inhalation of poisonous gases e.g. carbon monoxide.

(d) Over dosage of drugs such as sleeping pills, morphine, pathedine.

(e) Electric Shock.

(f) Diseases e.g. tetanus, epilepsy, rabies.

21. Sign and Symptoms

(a) Dizziness and weakness.

(b) Shortness of breath - rate of breathing increases.

(c) Rapid pulse.

(d) Partial loss of consciousness.

(e) Swelling of the veins of the neck.

(f) Face, lips, nails, fingers and toes turn blue.

267
22. General Rules for Treatment of Asphyxia

(a) Remove the cause if possible or the casualty from the cause.

(b) Ensure that there is a free passage for air.

(c ) Lay the individual on his back. Press the head back- wards supporting the
neck on your palm, lift the tongue clear of the airway. Give mouth to mouth
breathing.

23. First Aid for Special Cases: Drowning

(a) Wet clothes should be loosened.

(b) Mouth, throat and nostrils should be cleaned of mucus and of any foreign
body.

(c ) Patient should be made to lie down over his belly , face down , head
turned to one side , arms stretched beyond the head, tongue pulled out.

(d) Artificial respiration should be given till he starts breathing.

(e) Cover the patient with a blanket.

24. First Aid in case of Strangulation or Hanging

(a) Cut the constriction.

(b) Clear the air passage.

(c ) Start artificial respiration.

(d) Give inhalations if possible.

(e) Make the patient warm and comfortable.

25. First Aid in case of Choking. Bend the casualty’s head and shoulders forward,
to dislodge the obstruction. In case of a small child hold him upside down, and thump his
back hard between the shoulder blades or encourage vomiting by passing two fingers to
the back of the throat.

26. First Aid in Case of Suffocation by Poisonous Gas. Protect yourself and
remove the casualty from the gas as early as possible.

27. First Aid in Case of Electric Shock

(a) Switch off or break the current if possible.

268
 (b) Remove the casualty from contact with the current, if possible. Stand on
some insulating material such as rubber soled shoes or boots or piles of
newspapers.

(c ) Give artificial respiration.

(d) Treat for shock and burns.

Insensibility or Unconsciousness

28. It is due to interruption of the action of the brain through some interference with
the functions of the central nervous system.

29. Stage of Unconsciousness.

(a) Ist Stage- Delirium – When the restlessness of body and mind are
present.
(b) IInd Stage- Patient responds to loud commands, gives maximum
response to minimum stimulus.
(c) IIIrd Stage- Semi - Coma- Patient responds to painful stimuli only
(minimum response to maximum stimulus).
(d) IVth Stage- It is a stage when the patient makes no response to any
stimulus.

30. Causes of Unconsciousness of Coma

(a) Head Injury.

(b) Hemorrhage from brain.
(c) Heart failure.
(d) Diabetic coma , Hepatic coma , Uraemic coma.
(e) Excessive narcotic e.g. sleeping pills, morphine.
(f) Intracranial or brain infections like meningitis, encephalitis.
(g) Physical agents such as heat strokes, electric socks.
(h) Epilepsy.
(j) Hysteria.

31. General Rules of First Aid in Casualties of Unconsciousness

(a) Make the patient lie down with head turned to one side, pull out his
tongue.

269
 (b) Loosen the clothing, ensure fresh air.

(c ) If breathing has stopped or is irregular, start artificial respiration.

(d) Keep the air passage clear.

(e) Nothing should be given by mouth. Remove false teeth, if any.

Artificial Respiration

32. If there is any irregularity in breathing or a cardiac arrest, artificial respiration is

given. If it is given correctly and in time, the patient’s life can be saved.

33. Type of Artificial Respiration

(a) Holger–Nielson Method.

(b ) Schaefer’s Method.
(c) Mouth to Mouth Breathing.

34. Holger-Nielson Method. Keep the casualty in prone position.

(a) Movement -1. Go down on the left opposite the casualty’s head, placing
the right foot on the ground. Place the casualty’s arm carefully above his head and
keep them there during the turn. Grasp his right upper arm and turn his face to one
side. The mouth and nose must be unobstructed. The operator should be 6” to 12”
from the top of his head. Place the hands on casualties back with the heel of the
hand on the lower part of the shoulder blade, the thumb on spine and fingers
pointing to casualty’s feet. Keeping the arms straight rock gently forward until
the arms are almost vertical, depending on the build of the casualty using no
special force. The movement takes 2 second counting one, two. This pressure
causes expiration. This is called movement 1.

(b) Movement -2. The operator now rocks back counting 3 for one second
and slides his hand and grips the upper arms near the elbow. He raises and
pulls on the arms for 2 second counting 4,5. He should take care not to raise the
chest from the ground. This movement causes inspiration. Counting 6 the operator
lowers the casualty‘s arm. The movements should be rhythmic in character and
continued until breathing recommences. When the casualty begins to show signs
of breathing the operator should continue with movement 2 only. For children the
pressure on the shoulder blade should be considerably reduced or applied with
fingers. The ratio should be 12 times in a minute.

35. Schaefer’s Method. Position of the casualty: Lay the casualty in prone
position with hand one over other under his head, the head turned to one side, mouth and
nose unobstructed.

270
 (a) Position of the Operator. Face the casualty’s head, kneel on both
knees at the side of casualty just below his hip joint. Sit back on your heels, place
your hands on the loins of the casualty, one on each side of back bone with wrists
almost touching, and thumbs as far forward as possible with out strain, and
fingers together.

(b) Movement -1. With out bending your elbows swing slowly forward by
unbending the knees until the thighs are in almost upright position, allowing the
weight from your body to be communicated to the casualty’s loins. This causes
abdominal organ compression against the ground and up against the diaphragm.
Air is forced out of the lungs, thus expiration takes places.

(c) Movement -2. Swing back slowly on to your heels, thus relaxing the
pressure. This causes the abdominal organs to fall back and the diaphragm to
come down thus inducing inspiration. These 2 movements must be carried out
smoothly and rhythmically and should take 5 second (i.e. 12 times per minutes).
Artificial respiration must be continued until natural breathing is restored, or
unless a doctor decides that further efforts will be of no use.

36. Mouth to Mouth

(a) Casualty should be in supine position.

(b) Clean the mouth and throat to maintain clear air passage.

(c) Extend the neck to straighten the air passage.

(d) Cover the patient’s mouth with clean gauze and blow directly and slowly
into it (10-12 times per minute).

SECTION -5

DRESSING OF WOUNDS

Definition and Classification of Wound

1 Definition. It is the brake in continuity of the skin or muscles membrane. It is

caused by violence.

2. Classification. Wound can be classified as follow:-

(a) Inside Wound. It is wound caused by sharp instrument like knife, razor
and so on. Its edges are clean.
(b) Lacerated Wound. It is caused by blunt instrument. The edges are torn
or uneven.

271
 (c) Punctured Wound. It is a deep narrow wound caused by a pointed
instrument like knife, bayonet. The wound is small on the surface but may be very
deep injuring internal organs.
(d) Gun Shot Wound. It is caused by a bullet. The bullet may lodge in the
body and the wound become infected. It may have both an entry and exit, The
entry is usually very small and exit may be very large and lacerated. It may
become complicated with fracture if bullet strikes a bone.
(e) Shell Wound. It is caused by splinters of a shell or grenade wound is
lacerated and fragment may lodge in the body .
(f) Contusion. A contusion is an injury or a bruise in which some of the
tissues or a part is irregularly torn or ruptured but the skin, may not be broken. It
is caused by a blow or blunt instrument.
First Aid
3. (a) Place the patient in comfortable position.
(b) Stop the bleeding, if any.
(c) Remove any foreign body if it is easily visible and can be easily removed.
(d) Prevent the entry of germs by applying sterilized dressing like first field or
shell dressing.
(e) Give rest to the part by sling.
(f) Immobilize the part, if wound is large or complicated by fracture.
(g) Treat the patient for shock.
(h) Send the patient to nearest hospital.

Dressing of Wounds

4. A wound is to be cleaned with anti septic lotion and covered with cotton or Gauze
piece with medication before applying bandage.
5. Aim. Aim of dressing of wound is manifold:-
(a) To protect the wound from infection.
(b) Reduce swelling and early healing.
(c ) To support the effected part.
(d) Enable the individual to carry out his day to day routine.
(e) Stop the bleeding.

6. Articles Required.
(a) Anti septic (A/ S) lotion.

272
 (b) Cotton.
(c ) Gauze piece.
(d) Bandage of different size and band aid.
(e) A/S ointment or powder.
(f) Scissor.
Procedure

7. (a) Reassure the patient and place him in comfortable position.

(b) Stop the bleeding, remove foreign body and clean the wound with A/S
lotion and cotton.
(c ) Apply A/S ointment or powder and cover it with gauze. Select suitable
bandage, Start bandaging clock wise from outer aspect to inner aspect by covering
1/3 of previous lining.
(d) Put the knot away from the wound.
(e) Bandaging should not be either too tight or loose.

SECTTION-6

YOGA: INTRODUCTION AND EXERCISES

Introduction

1. Health is not merely considered by absence of disease or infirmity in a person but

who has complete state of physical, mental and social well being. Fitness of a person
strictly relates to his ability to meet the demands of the environment. Yoga fulfills all
needs to be in a state of complete fitness. Sage Patanjali was founder and father of yoga.
Yoga of Patanjali is Ashtanga or has eight fold path.
(a) Yama.
(b) Niyama.
(c) Asana.
(d) Pranayama.
(e) Pratyahara.
(f) Dharma.
(g) Dhyana.
(h) Samadhi.

2. Yoga is a science for right living. Yoga not only relieves pain, rigidity and tension
but it gives much more to acquire peace and mental tranquility. Yoga calms and clears
the mind and rejuvenates it. Yoga helps in purifying the disrupted natural rhythm and
harmony of the body, bestows grace, heals and makes one free from all ill effects.

273
Holistic Approach of Yoga

3. One undergoes through various degrees of stress, strain, tension, anger, sadness
and other emotional upsets in day to day life. This adversely affects the physical, mental
and spiritual power of a person. Yoga harmonises all disturbances in the body and
eradicates ill effects completely. For better management of stress, strain and other
disorders, Yoga approach is more holistic, which brings efficiency and mental clarity. A
person who develops his power of thoughts through Yoga has charming and dynamic
personality.
Stress Management by Yoga
4. Today no one can escape stress due to high expectations and pressures from the
environment, be it industrial sectors or students or Armed Forces. Revolutionary changes
in attitude, living pattern, work design, transport and communication methods have all
transformed the environment and work culture. However, body response has remained
same which gets exposed to psychological, organizational and societal stress. Yoga
provide physical, mental and spiritual strength, thus help in overcoming the stressors.

Asanas

5 There are innumerable asanas. Some of the asanas useful for curing ailments and
maintain good health are as follows:-

(a) Padmasana. Sit on the asan. Spread the legs

forward, place your left foot on the joint of your right
thigh, and right foot on the joint of left thigh in such a
way that both heels touch each other below your navel
in the middle of abdomen. Place your hands on your
knees. Keep the head and spinal column erect. Keep
your eyes close or open. Stay in the final position for 1
-2 minutes in the initial stage. Later increase the time
gradually. This asan is useful for Jaap, Dhyana and
Samadhi. This asan also helps in curing diseases like
asthama, hysteria and insomnia.

(b) Baddha Padmasana. Sit in padmasana.

Try to project the feet as far as possible. Take the
hand behind your back. Catch the right toes with
your right hand and left toe with your left hand.
Keep the back bone straight and fix your eyes on
the tip of the nose. This asana improves nervous
system and the abdomen. It also cures drowsiness,
sleepiness, laziness and night discharge.

274
 (c) Siddhasana. The main function of
this asana is to awaken the power of
kundalini. Sit on the carpet. Place the heel of
left foot under the testis on the prostrate
gland in such a way, that the sole of your
foot should be placed at root of genitals.
Place the hand on the knees so that palm
face upward. This asana helps the mind to
be firm, attentive and alert.

(d) Gyan Mudra. Sit in

Padmasana or Siddhasana. Put your
hands on your knees with palm
facing upwards. Bend your index
finger and place them at the root of
your thumbs. Spread the remaining
three fingers forward, all joined
together. This asana is most suitable
for pranayam and dhyana.

(e) Trikonasana. Stand erect

keeping the distance between the feet
60 - 75 cm. Raise your right hand
towards the sky and look towards its
palm. Then bend the truck to the left
side and try to touch left toe with
the left hand without bending your
legs. Repeat this process with your
left hand up and right hand down.
This asana is useful to the eyes,
spinal cord, neck and mental power.
Timings 3 - 6 sec. 4 - 6 times.

(f) Ardha Chandrasana. Stand erect.

Raise your both hands and join them above
your head. Bend towards left from the waist.
After some time bring the body back in
straight position. Repeat this by bending the
body towards right. This asana improves the
functioning of heart, liver, intestine,
stomach, lungs and make the body flexible.
Timings 4-6 sec, 4-5 times.

275
 (g) Suryanamaskara.
Suryanamaskara is a com-
bined sequence of 12
positions. By this sequence
of 12 positions, the whole
4 body is well exercised.
While practicing Surya-
namaskara recite the
different names of Sun God
5 at each position.

Stage 1 :- Stand in attention. Fold your hands in the centre of your chest. Now
recite the first of the twelve mantras.
Stage 2 : - Stretch your hands up and take the body backwards from the waist as
far as possible. The hands must remain straight and touch your ears.
Stage 3 :- Now bend down without bending the knees. Try to put the palms on
the ground and touch the nose with knees without bending knees.
Stage 4 :- Take left leg back. Bend your right knee, the knee will remain between
the two arms, with the hands sticking to the ground, Now bend the neck backward
as for as possible. Look forward and hold the breath.

Stage 5 :- Take right leg back. Put both the toes and the knees together and pull
your body up in such a way that it looks like inverted ‘V’. Look backward
through your legs keeping the head, the waist and the arms in a straight line.
Stage 6 :- Bend down your body in such a way that your forehead, chest and
knees should touch the ground except your hips which should be slightly raised
from the ground.
Stage 7 :- Stretch the arms, Inhale, put the chest forward and move back your
neck as much as you can. Look up and hold the breath.

276
Stage 8:- Maintain same position as in Stage 5.
Stage 9:- Maintain same position as in Stage 4.
Stage 10:- Maintain same position as in Stage 3.
Stage 11:- Maintain same position as in Stage 2.
Stage 12:- Maintain same position as in Stage 1 and then take your hand down.
Make the rest posture.

(h) Shavasana. The main aim of this

asana is releasing the mind from the body.
By this asana we can achieve relaxation in
the shortest possible time. This asana
provides relief in disease like blood
pressure, weakness of nerves and other
ailments. Lie on your back and let your body
be relaxed completely. Your feet should be
30-45 cm apart, arms in sides with palm
upwards, eyes gently closed with attention
on breathing. Keep body in a straight
position. For proper blood circulation in the
body, the legs, hand and neck should have
no curves or bend. Take a long and deep
breath then concentrate on each and every
part of your body, putting it in a relaxed
state. Timing 5-10 minutes.

(j) Gomukhasana. Sit on the seat

comfortably. Place your left foot heel
under your left hip. Now take the right leg
over the left buttock in such a manner that
the heel of your right foot is placed near
your left hip. Take right arm behind back
from above and left arm from below, so
that fingers of the both hands are
interlocked behind the back. Stay in this
position for sometime. Then repeat this
with opposite side. Timings 20-30
seconds, 4-6 times.

(k) Vajrasana. Bend the legs

and sit on knees. Place the heels at
the sides of the anus in such a way
that thighs rest on the legs and the
buttock rest on the heels. Stretch the
arms and place the hands on the

277
knees. Keep the knees close by. Sit
erect. This asana can be done
immediately after eating food. This
helps digestion and eliminates gas
troubles. Timing 1-3 minutes.

(l) Dhanurasana. Lie down on the

chest, legs should be folded at the knees
and the feet should be grasped with both
the hands near the ankles. The thighs and
the chest should be raised, making the
body appear like a bow. This asana
provides good exercise to the abdominal
muscles, lower back and thighs, Timing
10-30 seconds, 4-5 times.

(m) Bhujangasana. Lie down

on the chest. The hands should be
below the shoulders with the fingers
pointing forward. The legs are kept
straight with the feet touching each
other and the soles facing up. Raise the
head, giving a backward bend to the
spine. Try to keep the spine bent
backward as much as possible without
raising the navel. This asana is good
for the spine, the chest, the neck and
the head. Timings 20-30 sec. 4-6
times.

(n) Chakrasana. Lie down on

the back. Bend the legs at the knees.
Heels are close to the hips and sole
touching the ground. Bend the arms at
the elbows and place them on the
ground on either side of the head.
Place them in such a way that palms
should rest on the ground and the
direction of the fingers should be
towards your feet. First raise your hips
and waist, keeping the legs straight.
Raise the back as far as possible. This
asana helps in making the spine
supple. Timing ½ -1 min, 1-2 times.
278
 (o) Sarvangasana. Lie down flat
on the back. Raise legs from the hips, push
the trunk up until legs are in vertical
position. The chin should press against
the chest. The hands are giving support to
lower ribs. Hold this position upto 2-10
minutes. Come back as slowly as possible.
Do not give any jerks to the body. This
asana improves circulatory, respiratory
and alimentary systems of the body.
Timings: ½ - 1 minute.

(p) Halasana. Lie down flat

on the back. Place the arms by sides
along the hips, palm facing the
ground. The legs are raised up in a
single motion and put down behind
the head keeping knees unbent. The
chin should touch the chest. In this
exercise, the legs will remain straight
and breathing should be normal.
Hold this position for 30-50 seconds.
This asana stimulates blood
circulation and makes the spine
flexible and elastic.

Conclusion

6. Perfect state of health means attaining physical, mental and spiritual health.
Yogasanas are simple activities for keeping the internal and external parts of the body in
good health. However, Yogasanas must be learnt from qualified instructor to gain
maximum benefit.

SECTION-7

PHYSICAL AND MENTAL HEALTH

Introduction

1. Earlier doctors defined health simply as ‘an absence of disease or illness’.

However, after the formation of World Health Organization (WHO) in 1948, health is
defined as ‘a complete state of physical, mental and social well being and not merely the
absence of disease or infirmity’. The mind and body are actually single system. Charak a
renowned physician of ancient India has said that health is vital for artistic, ethical,
material and spiritual development of man.

279
Physical Health
2. Physical health is absence of disease and infirmity and it is assessed by taking
health state measurements of the body.
Mental Health
3. Mental health refers to the successful performance of mental function, resulting in
productive activities, fulfilling relationship with other people, ability to adopt to change
and cope up with adversities.
Elements of Good Health
4. Good health is essential condition for a purposeful existence. The main elements
of good health are:-

(a) Absence of disease.

(b) Ability to work hard with efficiency and enthusiasm.
(c) Ability to endure stress and strain.
(d) Cheerfulness.
(e) Courage.
(f) Freedom from anxiety.
(g) Self control and self confidence.
(h) Sense of well being.
(j) Wholesome mental attitude.

Objectives of Health Education

5. Objectives of health education formulated by WHO are:-

(a) To ensure that health is regarded as an asset in the community.

(b) To promote the development and proper use of health services.
Scope of Health Education

6. The scope of health education are:-

(a) Emergency and first aid.
(b) Food and its significance in the development of body.
(c) Physical exercise.
(d) Recreation, rest and sleep.
(e) Various ailments and disease.
(f) Sex hygiene.

280
Importance of Mental Health

7. It is of paramount importance to lay due emphasis to the development of mental

health of children. Any disregard to this may lead to mental disorder and conflicts which
ultimately may bring frustration, misery and unhappiness. Parents and teachers play a
major role in providing an environment in which children develop healthy mental
attitude.

Characteristics of Healthy Mind

8. Characteristics of healthy mind are:-

(a) Normal appetite.
(b) Calmness.
(c) Cheerful outlook.
(d) Good temper.
(e) Socially acceptable habits.
(f) Well regulated instincts.
(g) Normal physical vitality.
(h) Receptivity to new ideas.
(j) Sex consciousness.

Mental Disorder

9. Following causes mental disorder:-

(a) Undue anxiety.
(b) Embarrassment in presence of others.
(c) Lack of courage.
(d) Undeveloped habits and will.
(e) Low intelligence.
(f) Irritability.
(g) Depressed and pessimistic outlook.
(h) Moodiness.
(j) Bad temper.
(k) Full of prejudice.

Measures to Secure Mental Health

10. Following measures will help in securing mental health:-

281
 (a) Favourable home and school environment.
(b) Regular medical examination.
(c) Provision of educational and vocational guidance.
(d) Provision of co-curricular activities.

Health and Socio Economic Development

11. The relationship between health and socio economic development is very
important. Health component has an important bearing on the overall economic
development of a nation. Health not only affects the individual but also the community in
which he/she lives. Healthy people make a happy society and happy societies make the
nation economically and militarily strong.

SECTION-8

FRACTURES, TYPES AND TREATMENT

Definition

1 Fracture is a discontinuity or break in a bone, resulting in the dissolution

of the supporting frame work of the body.

Causes

2. The fracture can be caused due to the following:-

(a) Through Direct Violence. The bone breaks on the spot where direct
violence is applied by a kick, bullet, blow etc.

(b) Through Indirect Violence. The bone breaks at some distant place
from the spot of violence i.e. fracture of clavicle, base of skull etc, when the
force is on out stretched hands or other extremities.
(c) Through Forcible Muscular Contraction. Fracture of patella (knee
cap) by contraction of thigh muscle. Fracture of ribs may be caused by violent
coughing.

(d) Diseases of Bones. Certain diseases of bones make them weak and
easily breakable.

282
Varieties

3. A fracture is broadly classified into the following three categories:-

Fig 2
Fig 1

(a) Simple or Closed. The broken bones are covered with skin (Fig 1).

(b) Compound or Open. Skin overlying fracture is broken or ruptured and

sometimes the broken piece may protrude through it (Fig 2).

(c) Complicated. The broken bone damages the under lying structure like
blood vessels nerves, lungs, brain etc.

Symptoms & Signs

4. The Symptoms and signs are:-

(a) Pain, swelling and tenderness over the part and around it.
(b) Loss of power.
(c) Abnormal mobility.
(d) Deformity and irregularity of bones.
(e) Grating sound due to broken bones.

First Aid Measures for Fractures

5. The first aid measures to be adopted are:-

(a) Reassure the patient and make him comfortable.

(b) Apply splints to immobilise the fracture with any common article
like stick, rifle etc.

283
 (c) Relieve him of discomfort and pain. Keep the patient warm.

(d) Do not meddle with the fracture.

6. In Case of Compound Fracture. The first aid measures in Compound

Fractures are:-

(a) Bleeding should be stopped.

(b) Remove foreign objects, if any, but do not meddle too much.

(c) Cover the wound with a clean pad and light bandage.

(d) Apply appropriate splints.

(e) Transfer to the nearest hospital immediately.

Treatment of Fracture

7. Fracture of Jaw Bone

(a) Apply Barrel Bandage. Place the centre of a narrow bandage

under the patient’s chin. Tie a single hitch on the top of the head. Draw
one loop forward and one loop backward until they form a horizontal turn
round the head, meeting the half hitch in front of the ear. Take the free
ends and tie them on the top of the head.

(b) Warn the patient not to speak.

(c) Instruct the patient to sit.

(d) In lying cases, place patient on his chest, his head projecting
outside the stretcher canvas, properly supported with bandages secured on
stretcher handle.

284
8. Fracture Clavicle. In fracture of the clavicle we need to:-
(a) Support the arm of injured side, around the centre of each arm pit,
pass a narrow fold bandage and tie it on the back of the shoulder, leaving
one end of the knot longer than the other. Pull the longer end towards the
other, thus drawing back the shoulders and tie them together.
(b) Put a pad in arm pit, apply greater arm sling and fix the arm with a
narrow fold bandage tied across the elbow to lower chest.
9. Fracture Ribs. When ribs are fractured following action is taken:-
(a) Uncomplicated. Restrict the movement of chest on fracture side
with broad-fold bandage, one above and one below the fracture side, half
over lapping each other. Support the arm of injured side with greater arm sling.
(b) Complicated. Put the patient on the affected side and support the
position by long fold blankets. Send the patient immediately to the nearest
hospital.
10. Shoulder Blade and Fracture of the Upper Limb. Fix the elbow to
the affected side and put the finger in a position touching the opposite shoulder.
Secure the hand in position by cuff sling. Secure the limb firmly to the chest by

285
two broad bandages one on shoulder and the other at the elbow level and knot
on opposite side.
11. Fracture Lower Limb.

(a) Fix the injured limb to the sound limb with four narrow folds.
(b) Apply long wooden splint from axilla to just beyond foot on each
side. Secure them by seven broad folds bandages tied at chest, pelvis, ankles,
both thighs below the fracture, both legs, and knees. The bandage on the ankles
should be tied in figure 8.
(c) In case of fracture of pelvis, apply Thomas splint if available, otherwise
the methods described in (a) and (b) should be used for immobilization of
lower limb before evacuation of injured person to the nearest hospital.
12. Fracture of the Spine. Fractures of Spine are to be very carefully handled, We
have to:-
(a) Treat any case of back injury as a fracture of the spine. There will be
severe pain and shock in all cases.
(b) Make the patient still. Do not allow the patient to move about.
(c ) If unconscious see that the tongue does not fall back and choke the patient.
(d) Get medical aid at the earliest.
(e) Apply broad bandages for thigh and knees.
(f) Carry patient face downwards on a board placed lengthwise on the
stretcher.
13. Fracture of the Skull. It may injure the brain, nervous system or the arteries and
cause concussion and compression. It may be caused by direct or indirect blow.
(a) If Breathing is Normal. Lay the casualty on back with shoulders and
head raised with cushions. Turn the head to one side.
(b) If Breathing is Abnormal. Lay the casualty in a three quarter prone
position. Apply pads under the chest and draw up the upper knee.
(c) Do not give anything to drink.
(d) Do not disturb the patient.
(e) Keep air passage clear.
(f) Treat for shock.
Dislocation

14. Dislocation means displacement of one or more bones at a joint. The joints
more frequently dislocated are shoulder, elbow, lower jaw, thumb and finger.

286
 (a) Signs and Symptoms

(i) Severe pain at or near the joint.

(ii) Fixity of the joint or loss of power.

(iii) Deformity of joint and un-natural position of the limb.

(iv) Swelling at the joint.

(b) First Aid

(i) Do not try to reduce the dislocation.

(ii) Tie sling or bandage to immobilize the joint, apply cold

compress to reduce the swelling.

(iii) Send the patient to the nearest hospital for early treatment.

Sprain

15. A Sprain is the wrenching of the ligaments and tissues around the joint.

(a) Signs and Symptoms

(i) Pain at the joint.

(ii) Inability to use the joint.

(iii) Swelling and later bruising.

(b) First Aid. Place the joint in a comfortable position and apply a
firm bandage . Prevent movements. Keep the bandage wet with cold water to
avoid swelling. Later gently massage over the muscle and apply a crepe
bandage. Analgesics should be given. Whenever you are in doubt whether
an injury is a sprain or dislocation or fracture, treat it as a fracture.

Strains

16. A strain is the over stretching of a muscle.

(a) Signs and Symptoms.

(i) There is sudden sharp pain.

(ii) There may be swelling or severe cramp.

(iii) Further exertion is difficult or impossible.

287
 (b) Treatment. Place the patient in the most comfortable position.
Support the injured part. Give cold compress.

17. Crepe Bandage. A crepe bandage is made of elastic material which

stretches and binds firmly around the joint to which it is applied. It thus helps
in reducing swelling and movements at the affected joint, thereby minimising pain
and giving it rest. It is used in sprains and strains around joints. It can be
washed and used agains.

SECTION-9

EVACUTION OF CASUALTIES

1. Introduction. Natural calamities like earthquake, cyclones, tsunami, floods,

land and snow slides occur unannounced leading to large scale causalities. More often
than not people in a large numbers become victim to train, aircraft and ship accidents.
Keeping in view of these facts, plans and preparation be made in advance to combat any
of such eventuality. Medical authorities make preparation with assistance and cooperation
from voluntary organizations like Red Cross Society, Saint Johns Ambulance Association,
Home Guards and Civil Defence and NCC cadets for evacuation and treatment of
casualties.
2. The first Aider plays an important life saving role when there is an accident or a
raid. It is their presence of mind, intelligence, resourcefulness, dexterity, alacrity and
determination which can minimize danger to the casualties.
3. On hearing of an accident or air raid having taken place, send a rescue party by
transport if available, to the scene of the incident to have the casualties immediately
brought to the First Aid Post.
Preparation
4. Before the casualties begin to arrive the following should be done:-
(a) If no First Aid Post is available transform a sheltered place, away
from the main road, into a first aid post.
(b) Collect as many First Aid Boxes as possible from the nearby offices or
institutions. Collect sterilized cloth and cotton from shops or nearby house.
Collect as much dressing material as can be collected from the nearby resources.
Collect some even twigs, sticks, umbrellas strings etc. to be used as splints and
tourniquets, whenever required.
(c) Collect some blankets, cots and durries.
(d) If possible, arrange for some clean drinking water and hot drinks, tea or
coffee, if available.

288
5. After a casualty arrives diagnose quickly and correctly by observing and promptly
take the following action:-
(a) The details of the site and the history of the accident, i.e is it a
scooter or motor accident or has a building or pillar fallen upon the person or
if there has been a fire, and so on.
(b) The signs of the suffering-whether the person looks pale or there is
bleeding, or swelling of the injured parts and deformity of a bone or the
person has fainted.
(c) The symptoms of the suffering i.e., the casualty complains of pain,
shivering , or has fainted.
6. Having quickly diagnosed the nature of the ailment, treat in the following
manner:-
(a) Reassure the patient, cheer him up and let him not get worse due
to worries.
(b) Ask on-lookers not to crowd and disturb the patient. Tell the relatives,
tactfully, not to upset the patient by making a fuss about the event.
(c) If bleeding profusely, plug and dress the wound and press the
nearest pressure point and give the patient lots of fluid.
(d) If bones are broken, apply splints and immobilizes the portions. Let the
patient rest.
(e) If it is a case of asphyxia, give artificial respiration.
(f) If it is a case of burning, cover the wounds with sterile dressing,
treat the patient for shock and give fluids.
(g) If it is a case of poisoning, try to remove the poison.
7. The First Aider should make all efforts to revive the patient so that the
condition does not get worse. Do not perform the functions of a doctor and must
quickly dispose off the casualty by sending it to the nearest hospital.
Prioritization of Casualties
8. All casualties to be classified into three following priorities for treatment and
evacuation:-

(a) Priority I – cases requiring resuscitation and urgent surgery.

(b) Priority II – cases requiring early surgery and possibly resuscitation.
(c) Priority III – All other casualties who require minor treatment.

289