Community Health Nursing 2k1wj

ENVIRONMENTAL SANITATION • Refers to all factors in man’s physical environment, which may exercise a deleterious effect on his health well-being and survival. • “Is a branch of public health that deals with the study of preventing illnesses by managing the environment and changing people’s behavior to reduce exposure to biological and non-biological agents of disease and injury” - John Tomarro

TRIAD: MAN – DISEASE AGENT - ENVIRONMENT

 Change the peoples behavior to manipulate environment and reduce their exposure to biological and non-biological disease agent

Food safety practices

Ingestion of clean foods and drinking H20

Prevention of disease

 Manipulate the manipulate environment to prevent production or presence of disease agents.

Treatment of waste water

Uncontaminated groundwater table in the environment

Safe and clean

drinking water available

 Increase man’s resistance or immunity to disease agents

Measles immunization in the community

Children in the community with resistance against measles

Herd immunity among children in the community

ENVIRONMENTAL SANITATION

Study of all factors in man’s physical environment, which may exercise a deleterious effect on his health well-being and survival.

COMPONENTS: Water Supply Sanitation Program Food and Sanitation Program Refuse and garbage disposal Excreta disposal Insect and Rodent Control Housing Air pollution Noise Radiological Protection Institutional sanitation Stream Pollution

Major Environmental Health and Sanitation Programs HEALTH AND SANITATION Environmental health and sanitation is still a health problem in the country.         

Diarrhea pneumonia Malaria Tuberculosis Infectious hepatitis Intestinal Parasitism Filariasis Schistosomiasis dengue hemorrhagic fever

• The DEPAR TMENT OF HEALTH has the authority to act on all issues and concerns in environment and health including the very comprehensive Sanitation Code of the Philippine (PD856,1978)

WATER SUPPLY AND SANITATION PROGRAM •

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Approved types of water supply facilities: LEVEL I (Point Source) – A protected well or a developed spring with an outlet but without a distribution system, generally adaptable for rural areas where the house are thinly scattered. A Level 1 facility normally serves around 15 to 25 households and its outreach must not be more than 250 meters from the farthest . The yield or discharge is generally from 40 to 140 liters per minute. LEVEL II (Communal Faucet System or Stand-Posts) – A system composed of a source, a reservoir, a piped distribution network and communal faucets, located at not more than 25 meters from the farthest house. The system is designed to deliver 40-80liters of water per capital per day to an average of 100 households, with one faucet per 4to 6 households. Generally suitable for rural areas where houses are clustered densely to justify a simple piped system. LEVEL III (Waterworks System or Individual House Connections) – A system with a source, a reservoir, a piped distributor network and household taps. It is generally suited for densely populated urban areas. This type of facility requires a minimum treatment of disinfection.

UNAPPROVED TYPE OF WATER FACILITY • Water coming from doubtful sources such as dug wells, unimproved springs, wells that need priming

WATER SUPPLY SANITATION PROGRAM • •

Access to safe and potable drinking water Water quality and monitoring surveillance

PROPER EXCRETA AND SEWAGE DISPOSAL PROGRAM Approved types of toilet facilities: LEVEL I • non-water carriage toilet facility • toilet facilities • requiring small amount of water. LEVEL II • on site facilities of the water carriage type with water

LEVEL III – water carriage types connected to septic tanks and/or to sewerage system to treatment plant. • •

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In rural areas, the “blind drainage” type of wastewater collection and disposal facility shall continue to be the emphasis until such time that sewer facilities and off-site treatment facilities shall be made available to clustered houses in rural areas. Conventional sewerage facilities are to be promoted for construction in “Poblacions” and cities in the country as developmental objectives to attain control and prevention of fecal-water-borne diseases; Other policies embodied in Code of Sanitation of the Philippines shall be pursued and enforced by the local government units.

Food Sanitation Program Policies: •

Inspection of all food sources, containers, transport vehicle.

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Compliance to sanitary permit requirements for all food establishment.

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Provision of update Health Certificate for food handlers, cooks, and cook helpers.

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DOH istrative Order no. 1-2006 requires all laboratories to use FORMALIN ETHER CONCENTRATION TECHNIQUE (FECT) instead of the direct fecal smear in the analysis of stools of handlers

Food Sanitation Program •

Destruction or banning of food unfit for human consumption.

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Training of food handlers and operators on food sanitation.

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Food establishment shall be rated and classified as EXCELLENT VERY SATISFACTORY,

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Household food sanitation are to be promoted and monitored and food hygiene education

4 RIGHTS IN FOOD SAFETY: 1. Right Source Always buy fresh meat, fish, fruits and vegetables. Always look at the expiry date. Use water only from clean and safe sources 2. Right Preparation Avoid between raw foods and cooked foods. Always buy pasteurized milk and fruit juices. Wash vegetables well if to be eaten raw such as lettuce, cucumber, tomatoes and carrots. 3. Right Cooking Cook food thoroughly and ensure that the temperature on all parts of the food should reach 70 degrees centigrade Eat cooked food immediately. 4. Right Storage All cooked foods should be left at room temperature for NOT more than TWOHOURS to prevent multiplication of bacteria. Store cooked foods carefully. Be sure to use tightly sealed containers for storing food.

RULE IN FOOD SAFETY: When in doubt, throw it out!

HOSPITAL WASTE MANAGEMENT PROGRAM

• Disposal of infectious, pathological and other wastes from hospital which combine them with the municipal or domestic wastes pose health hazard to the people.

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Most hospital utilize the municipal refuse disposal system for disposing hospital wastes·. At this point policies have been set to prevent the risk of contracting nosocomial diseases.

PO L I C I E S •

All newly constructed and existing government and private hospitals shall prepare and implement a Hospital waste Management Program as a requirement for registration of license.

• The use of appropriate technology and indigenous materials for HWM system shall be adopted. • Training of all hospital personnel involved in waste management shall be an essential part of hospital training program.

RECENT NATIONAL AND INTERNATIONAL ENVIRONMENTAL LAWS AND DOH POLICIES AFFECTING ENVIRONMENTAL HEALTH and SANITATION 1. Stockholm convention on persistent organic pollutants (POPS).These POPs are called the dirty dozen of pesticides, industrial chemicals and unintentional by-products of burning 2. R.A. 6969 Toxic substances and hazardous and nuclear waste control act of 1990nuclear waste control act of 1990 Regulating the of importation, use, movement, treatment and disposal of toxic chemicals and hazardous and nuclear waste in the Philippines. 3. R.A. 8749 Clean air act of 1999 provides a comprehensive air pollution management and control program to achieve and maintain healthy air.

4. R.A. 900 3Ecological Solid Waste Management Act of 2000 • it declares the adoption of a systematic, comprehensive, and ecological solid waste management program as a policy of the state. 5. R.A. 9275 Clean air act of 2004 • this law aims to established wastewater treatment facilities that will clean wastewater before releasing into the bodies of water like the rivers and seas.

6. SUPPLEMENTALIMPLEMENTING R ULES

A NDREGULATIONS OF CHAPTER II WATER SUPPLY OF THE CODE ON SANITATION OF THE PHILIPPINES(PD 856) this supplemental IRR provides the guidelines on the proper regulation of the water refilling stations

7. Supplemental IRR on Chapter XII on Sewage Collection

and Disposal Excreta Disposal and Drainage of the Sanitation Code of the Philippines

NURSING REPONSIBILITIES Health education Actively participate in the training component of the service . Assist in the deworming activities.  Effectively and efficiently coordinate with the other government and NGO. Acts as a advocate or facilitator. Participate in environmental sanitation campaign Be a role model for others Participate in the research Help in the interpretation and implementation  Assist in the disaster management

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