MASINDE MULIRO UNIVERSITY OF

SCIENCE AND TECHNOLOGY

EPM 413: MANAGEMENT OF HEALTH, SAFETY AND

SECURITY IN EDUCATIONAL INSTITUTIONS

SCHOOL OF EDUCATION

DEPARTMENT OF EDUCATIONAL PLANNING AND

MANAGEMENT

@ 2022

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 All Rights Reserved
Published By
MASINDE MULIRO UNIVERSITY OF SCIENCE AND
TECHNOLOGY PRESS
Department of Educational Planning and
Management

WRITTEN BY:

JUDAH MUALUKO NDIKU

Co - Authors:
ANTONY SANG
PAUL OGENGA
Editor: DR. PETER ODERA

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 Copyright © MASINDE MULIRO UNIVERSITY OF
SCIENCE AND TECHNOLOGY 2021

TABLE OF CONTENTS

Table of Contents Page

Acknowledgement……………………………………………………………………………

Table of content………………………………………………………………………………

Module introduction………………………………………………………………………..

Topic introduction……………………………………………………………………....

Topic objectives…………………………………………………………………………

Aim ………………………………………………………………………………………

Topic 1: The healthy individual (3hours)

1.1Essentials of good health

1.2Physical health
1.3 Mental health
1.4 Social and emotional health
1.5Health and environment
1.6 Common infections, symptoms, causes and treatment
Summary…………………………………………………………………………………

Self Check……………………………………………………………………………

Score Board………………………………………………………………………………………

Learning Outcome……………………………………………………………………………….

Topic 2: Handling Learning and Physical Disabilities (3 hours)

2.1Definition of terms
2.2 Whole spectrum of disability and adaptive mechanisms
Summary …………………………………………………………………………………

Self Check ……………………………………………………………………………

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Score Board………………………………………………………………………

Learning Outcome…………………………………………………………………

Topic 3: First Aid and handling common accidents (3 hours)

3.1 First aid essentials
3.2 Techniques and equipment
3.3Life saving procedures in case of accidents
Summary …………………………………………………………………………………

Self Check ……………………………………………………………………………

Score Board………………………………………………………………………

Learning Outcome…………………………………………………………………

Topic 4: Health and safety in the school (4 hours)

4.1School and public health
4.2school safety
Summary …………………………………………………………………………………

Self Check ……………………………………………………………………………

Score Board………………………………………………………………………

Learning Outcome…………………………………………………………………

Topic 5: The youth and family life (3 hours)

5.1 The concept of youth as a life cycle
5.2 Dating and courtship
5.3 Breaking up
5.4 Marriage
5.5 Family life
5.6 5.6 Challenges of the family

Topic 6: Drug and substances of abuse (4 hours)

 Definition of terms
 Commonly abused drugs and their effects
 Drug tolerance
Summary …………………………………………………………………………………

Self Check ……………………………………………………………………………

Score Board………………………………………………………………………

Learning Outcome…………………………………………………………………

Topic 7: HIV and AIDS and counseling (3 hours)

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 7.1 Pre-test counseling
7.2 Post test counseling

7.3 Stages in HIV/AIDS counseling

Summary …………………………………………………………………………………

Self Check ……………………………………………………………………………

Score Board………………………………………………………………………

Learning Outcome…………………………………………………………………

Topic 8: Modern technology and health (3 hours)

8.1The use of modern technological equipment

8.2 Health hazards associated with use of modern technological equipment
Summary …………………………………………………………………………………

Self Check ……………………………………………………………………………

Score Board………………………………………………………………………….

Learning Outcome…………………………………………………………………

Answers to self test…………………………………………………………………

Bibliography……………………………………………………………………….

Give your Comments

Dear learner,

This is the first issue of this module. We therefore call for your comments and observations upon
this module.

This is to enable us to make further improvement on the future issues and fulfill your needs.

We look forward to your feedback

Send your comments/suggestions to:

The Chairman, Department of Educational Planning and Management [email protected]

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Module Introduction

Dear learner

Challenges of modern lifestyles may yield health complications. Think of the

food we eat, the water we drink and the environment we stay in. Essentials
of healthy living enable us to be conscious of our health and the
environment. This module will expose you to health and First Aid issues
detailing the importance of developing healthy living in society and how to
care for the self. The module explains the procedures for handling First Aid
cases, health and safety in schools, family and the youth, drug and
substance abuse and modern technology and health. The module will cover
eight topics to address healthy and safety issues and how to care for

persons faced with healthy problems and challenges in society.

Aim
The module EDU 411E intends to equip you with knowledge, skills and attitudes required to
enable you to identify how to keep healthy physically, socially, mentally and emotionally and be
able to handle First Aid cases.

Objectives

By the end of the course, you should be able to:

1. Explain and practice good health and healthy living in society.

2. Handle First Aid and emergency cases in life.
3. Guide the youth and enable them to function in a healthy manner in the
family and in the society

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This module consists of eight topics namely;

1. The healthy individual

2. Handling Learning and Physical Disabilities

3. First Aid and handling common accidents

4. Health and safety in the school

5. The family and the youth

6. Drug and substances of abuse

7. HIV and AIDS and counseling.

8. Modern technology and health.

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 TOPIC ONE: THE HEALTHY INDIVIDUAL

INTRODUCTION

This topic presents the essentials of good health detailing healthy living, living in a healthy
environment and the procedures for identifying common infections, symptoms, causes and treatment.

TOPIC OBJECTIVES

By the end of this topic, you should be able to:

 Identify and describe the characteristics of persons who are physically,

mentally, socially and emotionally healthy.
 Identify the common infections, symptoms, causes and

Sections in the topic

This topic consists of three sections namely:
Essentials of good health
 Physical health
 Mental health
 Social and emotional health
Health and environment
 Environment and good health
 Food storage
 Refuse disposal
 Insects pests and health
Common infections, symptoms, causes and treatment

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Section 1: Essentials of good health

Introduction: This section discusses aspects of health including physical, mental, social and
emotional health. The essentials of how to care for the environment are also presented along with
the symptoms of common infections, causes and treatment.

What is the importance of good health?

Good health is very essential to every individual human being.

What is good health?

Good health entails a state of being well in the physical, mental, social and emotional being.
World Health Organization (WHO) defines ‘health’ as a state of complete physical, mental and
social well being and not merely the absence of disease or infirmity. This means that for one to
be considered healthy, he or she must be physically, mentally, and socially well.

What is physical health?

Physical Health is when the body systems are functioning well. These include; the digestive
system, respiratory, nervous, skeletal, lymphatic and excretory systems.
It should be noted that a healthy body is free from simple diseases such as cough, flu, headache,
among others and other defects.

Physically healthy individuals eat a balanced diet which must contain proteins, carbohydrates,
fats and fruits.

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It is important to note that for one to be physically healthy;
 He or she avoid junk food and fast food
 Avoid impulsive eating
 Have a regular routine exercise
 Have enough rest especially through sleep because sleep cools the tired nerves and
aching muscles. One should sleep at least 8 hours for grownups.
 Avoid smoking
 Drink alcohol either sparingly, or not at all.
If the above facts are not observed by an individual, then one is likely to develop physical
disease.

What are the causes of physical diseases?

Physical diseases may be caused in three ways:

i) Structurally as a consequence of physical damage. For example an individual may
have broken limbs and other body areas like the spinal vertebrae, skull among others.
ii) Disease causing organisms such virus, bacteria and parasites
Note: (details of viruses, bacteria and parasites will presented later in this module).
iii) Genetic complications such as sickle cell anemia.

In what ways can you improve physical health?

To improve on physical health, there are four different steps to be taken depending on the type
of ailment. These are: curative measures, preventive measures, palliative care and rehabilitative
action.
Let us try to list each of the measures.
a) Curative measures – these are measures taken to cure a disease. In case of sickness the
patient is required to establish the cause of the disease by carrying out an investigation, to
know the cause of disease then take measures to treat to cure.
b) Prevention measures- these are measures taken to prevent a disease before it is caused
or spreads. Prevention is usually carried out through immunization.
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 c) Palliative care - This is care given to improve health of people with terminal ailments
such as cancer.

List some of the homes/hospitals where palliative care is given in Kenya

d) Rehabilitative action- rehabilitative action involves restoring persons with injuries such
as broken limbs and alcoholics and drug addicts.

What is mental health?

Mental health is when a person is capable of coping with the normal responsibilities expected of
him. It is when a person is not mentally stressed, depressed or anxious and all his or her senses
are in working order. Such a person is well adjusted and interacts with smoothly with others in
the society without problems.
Mentally healthy persons:
 Are able to make rational decisions,
 Work to solve problems and have realistic solutions
 Are able to manage stress by employing relevant self help skills and strategies such as
exercise, listening to music among others.
 Read life enriching books
 Are able to realize and admit to their mistakes or failures and do not ignore problems
that may have been their fault.
 Do not allow their emotions to get out of control- even when the situation calls for it.

What are the causes of mental diseases in your community?

Mental diseases are caused by different factors, some of which are as follows:
- Diseases such as measles, polio, meningitis, may damage the brain.
- Injury to the brain either during child birth or afterwards may cause mental health.
- Stress due to various pressures in life can cause mental health

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 - Brain fatigue
- Drug abuse
- Hereditary factors
- Malnutrition in early childhood.
- Unrealistic demands by parents or guardians.

What prevention measures should be taken to handle mental

diseases?

There are various preventive measures that one can take to avoid mental diseases. These include:
Seeking assistance from counselor, if this does not work out then the counselor can refer one to
a psychiatrist for medical attention.
One should take part in physical exercises such as jogging, running, swimming, among others.
- Be helped by relatives
- Keep good physical health
- Eat balanced diet (Malnutrition in childhood can also interfere with maximum brain
development).
We hope you have studied the previous section without any problem. You are now welcome to
the next subsection entitled social and emotional health.

What is Social and Emotional health?

Social and emotional health is very much related to physical and mental health.
Social health refers to how people interact with others in areas around them. This affects their
physical, mental, emotional and spiritual health. To be socially healthy, one makes friends easily
and is able to work with people happily and friendly in a group.

Emotional health is closely tied to social development. It refers to the expression of one’s
feelings about the self, others, and the situations he or she will face in the world around him/her
as well as gaining control of his or her bodily functions, learning to focus, and pay attention.

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 What factors influence children’s Social and Emotional
Development?

There are many factors that may affect the way children express their social skills or emotional
competencies or the rate at which children acquire social skills or emotional competencies.

Factors that influence social and emotional development include; environmental risk factors,
family risk factors and within-child risk factors.
Environmental risk factors such as
 Living in an unsafe community
 Receiving care within a low-quality child care setting
 Lack of resources in the community or lack of policies supporting children and families
Family risk factors such as
 Maternal depression or mental illness in the family
 Parental substance abuse
 Family violence
 Poverty at family level among others

Within-child risk factors include

 Being temperamental,

 Delay in development especially caused by serious health conditions.

 All of these factors need to be taken into careful consideration when gathering
information to fully understand and support children's social and emotional health
through a comprehensive, ecological approach.

It is important to note that being socially unhealthy depends very much on

the following factors:

- Ones upbringing , that is the way one is brought up and socialized at family level
- The environment one has been exposed to (at home, school, community among
others)
- The level of education that is the level at which one has attained his education.
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 - Virtues instilled in a person, that is the positive attributes one has acquired such
as honesty, integrity, respect for others among others
- Poverty level
- Change in social trends.

How can we prevent social diseases?

To prevent social disease it is important to

- Expose the growing child to the right environment.
- Every individual child must receive education and subjects that encourage good
manners, honesty and good morals.
- Religious education should be highlighted in all schools.
- The society should to take care of the poor.
- Laws should be enacted to govern peoples’ social behaviour.

Section 2: Health and environment

Introduction
This section presents information on how to care for the environment both at home and the
school

Check! What is around you?

Yes! That is part of your environment!

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The environment refers to our surrounding. Surrounding includes air, plants, trees, houses,
furniture, vehicles, people, clothes, mountains, rivers etc. What is around us can contribute to
either good health or bad health.

Does the environment affect your health?

Yes! The environment can affect your health adversely!

For example:
- If your house is not kept clean
- When houses your house is not safely built and maintained.
- When the food you eat is not well stored in a clean place.
- When the compound and surrounding you live in is not kept clean.
- When refuse is not disposed off in the right manner.
- When human wastes is not well disposed.

Is living in clean houses necessary?

A house where people live should be kept clean and tidy by sweeping the floor and dusting.
Furniture should be dusted; utensils cleaned so as not to habour bacteria which may cause
diseases such as diarrheal to the children and adults. It is also important to eat clean food by
ensuring safety in food storage.

Why should you store food properly?

Proper food storage is important because it helps to avoid food wastage, and insects and vermin
do not have a chance to it.

How should food be stored?

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Storage of vegetables and fruits
Vegetables and fruits should be stored open to air to prevent rotting but protected by netting wire
where possible.
Storage of grain and its products
Grain and its products should be stored in containers with well fitting lids.
Food utensils

Food utensils should be kept either in closed cupboards or covered to protect them from dust.

How should cleanliness around the house be maintained?

The environment around the house should be kept clean by sweeping, picking rubbish and proper
refuse disposal.
Proper refuse disposal
Refuse must be disposed of properly to get rid of:
- Bad smells which can be offensive.
- Rodents such as rats which can spread diseases
- flies and other insects

Why is proper refuse disposal important?

This is because rodents and insects are responsible for various health problems. For example
flies cause eye diseases like conjunctivitis and trachoma diarrheal diseases such as dysentery,
typhoid and cholera. Rats cause plague fleas which cause the disease called plague.

Where should refuse be disposed?

To dispose refuse in a home or school environment one can:

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  Deposit it in a composite pit
 Burn
 Burry the refuse.
 In urban centers, garbage collection services are provided.

How can human waste be disposed?

Human waste includes faeces and urine. It contains diseases causing organisms and it is one of
the ways through which communicable diseases such as diarrhea, cholera, typhoid dysentery,
amoebiasis, bilhazia among others are spread. Flies act as vehicles in transporting germs from a
sick person to a healthy person.
Places for disposing human waste include pit latrines/ water closed toilets.

How should a pit latrine be constructed?

In rural areas, each household should have its own pit latrine for human waste disposal. Public
health officers instructions are that, pit latrines be built 30 meters away from any source of water
for human or animal consumption.
- A pit should not be built uphill from a source of water to avoid seepage.
- The pit should be 5-7 meters deep
- Cemented floors are recommended to enable users keep it clean. If it is not possible to
cement then wood should be used.
- The latrine should be always clean.
- The deeper the latrine the better to avoid flies to breed inside.
- The hole should be small so as not to allow children to fall into the pit.
- A little house for shelter and privacy while using the pit latrine should be built.
- Also, water closed toilets in towns, they should be kept clean.

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 Section 3: Common Infections- Symptoms, Causes and Treatment
In this section you will learn about the common infections, their symptoms, causes and
treatment.

What are the causes of common infections?

Common infections are caused by viruses, bacteria, parasites and fungi.

What is a virus?

A virus is a microorganism smaller than a bacterium, which cannot grow or reproduce. A virus
invades living cells and uses their chemical machinery to keep itself alive and to replicate itself.
It may reproduce with fidelity or with mutations.
The ability of a virus to mutate is responsible for the ability of some viruses to change slightly in
each infected person, making treatment more difficult. Viruses cause many common human
infections, and are also responsible for rare diseases.
In this section we will not discuss all the viruses but instead we will identify a few which cause
the common infections.Examples of viral illnesses include common cold, which is usually
caused by one of the rhinoviruses. Other viruses include Mononucleosis, Herpes Zoster
Ophthalmicus Bronchiolitis, Cytomegalovirus, West Nile Virus among others.

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Ophthalmicus (HZO)

What is HZO?

Herpes zoster ophthalmicus (HZO) is caused by the chickenpox virus. Herpes zoster is also often
referred to as shingles. It involves the skin around the eye and sometimes the eye itself. It is not
the same virus that causes herpes simplex.

What are the symptoms of HZO?

HZO can cause a rash with small blisters to break out on the forehead and around the eye on one
side of your face. Sometimes one will have pain in the same area of the face a few days before
the outbreak.

How can the doctor tell if one has HZO?

If one has HZO, he or she will probably have a rash that looks like chickenpox, but only on one
side of the face. Besides examining you, the doctor will not need to do any additional tests to see
if you have HZO. Sometimes herpes simplex infections can resemble HZO. However, the
patterns of the rashes are different and the doctor will be able to tell them apart.

How is HZO treated?

If one has HZO, he or she should see a doctor right away. Early treatment with antiviral
medicines can reduce pain and the duration of symptoms. Your doctor can give you advice about
treatment, but rest is also important. Cool compresses can ease the pain and rash. Pain relieving
medicine such as aspirin or acetaminophen may help.

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 Can one infect others with HZO?

If one has HZO, he or she can infect the virus that causes chickenpox to other people. Therefore,
one should avoid people who have not had chickenpox (especially pregnant women) and very
sick patients (such as patients with cancer or AIDS). If one lives with children who have not had
chickenpox, you should tell your doctor.
Another viral disease is common cold or flu. Let us learn more about flu.

Common cold/flu

What are the Symptoms of common cold?

The symptoms are:

 Running nose,
 Headache
 Tiredness
Note: It takes 7 days with treatment and 7days without treatment for flu to clear.

What is Hepatitis B?

Hepatitis B is a viral infection that attacks the liver and can cause both acute and chronic disease.
The virus is transmitted through contact with the blood or other body fluids of an infected
person - not through casual contact.

What are the symptoms of Hepatitis B?

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The symptoms of Hepatitis B are: fever, loss of appetite, general malaise and loss of
consciousness.
Prolonged suffering from Hepatitis B may lead to it turning cancerous and may lead to death.
HIV and AIDS- Though viral it is transmitted mostly through sexual intercourse. You will learn
more about HIV and AIDS in topic 7 in this module. Now let us study about measles.
Measles

What is Measles?

Measles is an infection of the respiratory system caused by a virus, paramyxovirus of the genus
Morbillivirus. Morbilliviruses, like other paramyxoviruses, are enveloped, single-stranded,
negative-sense RNA viruses.
Measles is mainly a childhood disease though it can affect grownups who were not immunized
against it.
Measles is a highly communicable disease.

What are the Symptoms of Measles?

Symptoms of measles include:

 Fever, cough, runny nose, red watery eyes, hoarseness of voice.
 After 3 days, typical measles rash at the back of ears, at the junction of the fore
head and hair then spreads to the whole body.
 The rush stays for 3 days then deepens the color, fades and gradually disappears.

How is measles transmitted?

Measles it is transmitted through the air ways

 Measles has no treatment
 Once a patient gets measles has to go through the full course.

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  Measles can develop complications and can cause death.
Complications in Measles
 Diarrhea and vomiting
 pneumonia
 eye infections which may lead to blindness
 inner ear infections which may lead to death
 Brain damages as a result of brain infections and convulsions.
 Malnutrition due to lack of appetite.

What is Mumps?

Mumps is a disease caused by a virus that usually spreads through saliva. It infects many parts of
the body, especially the parotid salivary glands.

What are the symptoms of Mumps?

 high fever
 Swelling and tenderness of one or more salivary glands.

Mumps is dangerous if it affects adolescents as it affects other glandular organs such as the
testicles for men and ovaries in women and as such it may cause infertility Mumps can also
affect the pancreas.
Mumps is controlled by isolation because it spreads by droplet and direct contact with saliva of
the patient.

b) Bacterial infections

What are some of the bacteria infections?

Some of the bacterial infections include: whooping cough, strep throat, urinary tract infections
in children, bacterial vaginosis , cat-scratch disease, otitis externa, tuberculosis ,tick-borne
diseases, lyme disease among others.
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Pneumonia

What causes pneumonia?

Pneumonia is caused by bacteria called streptococcus. It is common in children. The main

symptoms of pneumonia include; fever, sweating, pain in the chest, hard cough.

Pneumonia is treated through the advice of a qualified medical doctor with the right dosage of
anti-biotic.

Tuberculosis

What is tuberculosis?

Tuberculosis, or TB, is an infectious bacterial disease caused by Mycobacterium tuberculosis,

which most commonly affects the lungs. It is transmitted from person to person via droplets from
the throat and lungs of people with the active respiratory disease.

What are the symptoms of tuberculosis?

 The symptoms of active TB of the lung are coughing, sometimes with sputum or
blood, chest pains, weakness, weight loss, fever and night sweats.
 Tuberculosis is treatable with a six-month course of antibiotics.

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Another bacterial infection is typhoid fever.

What is Typhoid fever?

 Typhoid fever is a bacterial disease, caused by Salmonella typhi. It is transmitted

through the ingestion of food or drink contaminated by the faeces or urine of
infected people.
 Symptoms usually develop 1–3 weeks after exposure, and may be mild or severe.
They include high fever, malaise, headache, constipation or diarrhoea, rose-
coloured spots on the chest, and enlarged spleen and liver. Healthy carrier state
may follow acute illness.
 Typhoid fever can be treated with antibiotics. However, resistance to common
antimicrobials is widespread. Healthy carriers should be excluded from handling
food.

What are the Symptoms of Typhoid fever?

 Fever, headache, stomachache, vomiting, Body weakness,

 malaise, constipation or diarrhoea, rose-coloured spots on the chest, and enlarged
spleen and liver
 Typhoid fever can be treated with antibiotics
Cholera

What is Cholera?

 Cholera is an infection of the small intestine caused by the bacterium Vibrio

cholerae.
 It is a highly fatal disease contracted though contaminated food, water etc
 Flies can act as carriers of the disease.

What are the Symptoms of cholera?

 Profuse diarrhea and vomiting

 If not treated immediately one dies of dehydration.
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Let us learn more about Sexually Transmitted Diseases (STDs)
Sexually Transmitted Diseases (STDs)

What are Sexually Transmitted Diseases?

These are diseases which infect the sexual organs and the urinary tract.
 They are contagious diseases.
 Common ones include: Gonorrhea, syphilis among others.
Some major complications from STDs include:
 Primary and secondary infertility, painful conditions eg Pelvic Inflammatory
Diseases (PID).
 Urinary infections.
 Syphilis may affect liver, the heart and cause death.
 Foetal malformation and abortions
Parasitic infections

What is a parasitic infection?

Parasitic infection is a disease spread by a parasite such as protozoa.

 Some of the parasitic infections Include: Malaria, amoebiasis, yellow fever,
bilharzias, dysentery, asearis, hook warm, tape warm.
Malaria

What is Malaria?

Malaria is a parasitic disease caused by a parasite called Plasmodium, which is transmitted via
the bites of infected mosquitoes. In the human body, the parasites multiply in the liver, and then
infect red blood cells.
The symptoms of malaria include:
 High fever
 Chills
 Shaking
 Extreme sweating

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  Fatigue
 Discomfort (called malaise) and body aches
 Headache
 Nausea
 Vomiting

Where is Malaria most common?

Malaria is a health problem in many tropical countries. It can also be a problem for people
visiting these countries.

How can one protect the self from getting malaria?

One should do whatever is possible to avoid mosquito bites.

- Use a mosquito net over your bed.
- Spray the net with permethrin (one brand name: Elimite). (Permethrin is a spray
that repels mosquitoes.)
- Avoid going outdoors without protection in the evening, when mosquitoes are
typically more active.
- Medicine is also available to help prevent malaria.
Fungus
Fungal infections include: Tenea group: tenea capitis: affecting the head, tinea carporis
affecting the body, tinea cruris- athlete foot, candiadisis- sexual organs
Other infections
 Eye infections – conjunctivitis, trachoma (can lead to blindness).
 Ears otitis media- infection inside the ear.
 throat- upper respiratory tract infections.(URT I)
SUMMARY

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Good health entails a state of being well in the physical, mental, social and emotional being. To be
Please note that ‘health is wealth’ and for one to be healthy, it is important to
observe physical, mental, social and emotional health. Keeping the
environment clean and handling common infections clinically when you
notice the slightest of the symptoms.

ACTIVITIES

1. List the immunizable diseases and the ages at which the

immunization should be given

2. Visit a school counseling office or a social worker and identify the

common social and mental problems they handle.

3. Visit the nearest school and observe how refuse is disposed and areas
the school can improve on in refuse disposal.

FURTHER READING

Insel P. M. and Rolth W. T. EDS (2002). Core Concepts in Health. Boston. Mc Graw- hill

Republic of Kenya (2008). Nutrition training Manual.

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 Score board

Score Grade Comment

30 - 40 A Excellent proceed

21- 30 B Very good proceed

11- 20 C Fair- repeat the weak areas

1-10 D Weak- repeat

L0 Learning Outcome

You have now completed topic one and the learning outcomes are listed below

Put a tick in the column which reflects your understanding

SN Learning outcome Sure Not sure

1 I can now define health

2 I can discuss the characteristics of healthy persons in society

3 I can now be able to care for the environment effectively

4 I am able to explain how to dispose refuse in a school compound

5 Am able to identify the common infections, symptoms, causes and

treatment

If you have put a tick at the ‘not sure’ column, please go back and study the section in the topic
before proceeding.

If you have ticked ‘sure’ in all the columns you are ready to for the next topic.

Congratulations! Proceed to the next topic!

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TOPIC TWO: HANDLING LEARNING AND PHYSICAL DISABILITIES

INTRODUCTION

Welcome to the second topic in this module. In the last topic you covered the essentials of
good health, environment and health and how to identify common infections, their symptoms
and treatment.
By the In topic
end of this this topic you will
you should cover
be able to: disability and how to handle persons with
disability.
 Define terms used to identify disability
 Explain manifestations of different types of disabilities
 Handle persons with different types of disabilities

TOPIC OBJECTIVES

This topic consists of two sections as follows:

Definition of terms and causes of disability

The Full spectrum of impairment and adaptive mechanisms: Visual impairment, Hearing
impairment, Speech impairment, Physical disability, mental disability, deaf, blindness
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Definition of terms: impairment, disability and handicap
Introduction
In this section you will learn the definition of terms impairment, disability and handicap and the
full spectrum of the different types of impairment and different mechanisms how persons with
disability can adopt to the environment

In your own words define the terms impairment, disability and

handicap?

Well! Let us discover together the difference

According to World Health Organization (WHO) impairment, disability and handicap have been
systematically identified in relation to health condition to provide a unified and standard
language and framework for the description of human functioning and disability as an important
component of health.

The definition covers any disturbances in terms of “functional states” associated with health
conditions at body (impairment), individual (disability) and society level (handicapped).

At the body level, emphasis is laid on functions of the body system and the body structure, while
at the individual level; performance of activities is underscored (impairment).

At the individual level focus is on activities that cover a complete range of activities performed
by an individual (disability).

At the societal level, participation of the individual in the society is emphasised, that is,
classification is made on areas of life in which an individual is involved, has access to and has
social opportunities or barriers.
However, this classification does not cover the functional states that are not health related e.g.
those brought about by socio-economic factors independent of health conditions. A case in point
is the restriction in participation because of race, gender, religion among others.
Definition of disability

30
 How is disability defined?

According to the disability act 2003, disability is the; physical, sensory, mental, or other
impairment, including a visual, hearing or physical disability, which has a substantial long term
adverse effect on a person’s ability to carry out usual day to day activities.

From the above definition, disability is, viewed as a physical, mental, or psychological condition
or impairment that substantially affects a person’s daily activities or limits a person’s ability to
perform one or more major life activities (referred to herein as Activities of Daily Life- ADL).

Look at the following statistics and discuss what they inform you about disability in Kenya

1. According to WHO 10% of any populations has some kind of disability.

In Kenya according to 2009 National census the population stands at 38, 610, 097 persons. What
is the population of persons with disability?

2. 95% of people with disability come from poor families (those who live with less a dollar per
day.

3. 80% of the whole disabled people live in the developing countries

What are the causes of disability? Close this page and list them.

Did you list some of the following?

 Wrong medication or Management
 Lack of immunization,
 Diseases
 Domestic violence and fighting
 Environmental pollutants,
 Burns (domestic or industrial)
 Lack of breast feeding and poor nutrition.
 Accidents
 Use of drugs and alcohol during pregnancy among others
31
The Full spectrum of impairment and adaptive mechanisms

This section presents the full spectrum of impairment and the coping mechanisms of persons
with disability in a school environment.

What is the full the Full spectrum of impairment?

The full spectrum of impairment covers different types of disabilities which include the
following: (to include graphics of persons with those conditions)
• Visual impairment

• Hearing impairment

• Speech impairment

• Physical disability

• Mental disability

• Deaf blindness

• Autism (mental condition characterized by great difficulty in communicating with others

and in using language and abstract concepts)

 Albinism

• Epilepsy

• Cerebral palsy: a condition marked by impaired muscle coordination and spastic paralysis
caused by damage of the brain before or after birth

• Behaviour & emotional problems

• Learning difficulties

• Multiple disabilities

Let us explain the main ones especially the ones which have not been explained above.

32
 What is Visual impairment?

Visual impairment describes the various degrees of vision loss. The vision loss ranges from low
vision to total blindness.

• The definitions of what constitutes “low vision” vary, but generally low vision is defined
as inability to see objects that are small or distant objects.

• “Total blindness” is the complete absence of vision and light perception.

• A person is considered to have an eyesight or visual disability if he / she doesn’t have

normal vision even if he/she wears eyeglasses or contact lenses.

• Visual impairments are caused by injury, disease, through accident, nerve degeneration or
cataracts or are congenital.

How can you help persons with visual impairment to cope in a

school environment?

• By giving a thorough orientation and mobility training so that the learner can be able to
move and travel independently.

• By providing adaptive equipment, which include; Braille computers, collapsible cane,

magnifying glasses, and stenography, among others to aid the learners to adapt the
curricular in meeting their individual unique needs.

What is hearing impairment?

Hearing impairment refers to people who are completely deaf (the deaf) or has partial hearing
(the Hard of Hearing) in one or both ears.

Hearing impairment can be caused by;

 Injury or disease.
 In some cases extremely high frequency sound waves
33
  Genetic factors.


What are the adaptation mechanisms of persons who have hearing

impairment?

- Learners with hearing impairment need to access learning, the language of instruction as
well as that of social interaction when involved in analytical conversations.

- Therefore, the students with hearing impairment or hard of hearing require the use of sign
language or a total communication system to enable them obtain information that others
gain by listening.

- They may need technological aids such as amplifiers or hearing aids.

When formulating special programmes for these learners, areas of focus should be:

- First, exploit the learners´ capabilities so as to enable them to develop socially and
compensate for the loss of hearing.

- Secondly, achieve the personal development of the learner with an overriding aim of his
or her future life situations i.e. these learners should be prepared to evaluate their
disability positively so as to achieve self-esteem.

- The school staff need to learn sign language, for easy communication

What is Speech impairment?

Speech and language difficulties refer to problems in communication or difficulties in using

spoken language.
There are two main types of speech and language difficulties.
These are:
• Speech difficulties: Voice difficulties; fluency difficulties (stammering;
articulation difficulties)
• Language difficulties: receptive language difficulties (comprehension;
expressive language difficulties)
The difficulties might be characterized by an interruption in the flow or rhythm of speech, such
as stuttering.
• These delays and disorders range from simple sound substitutions to the inability to
understand or use language or use the oral-motor mechanism for functional speech.

34
 • Some causes of speech and language disorders include hearing loss, neurological
disorders, brain injury, drug abuse, physical impairments such as cleft lip or palate, and
vocal abuse or misuse.
• Persons with speech disabilities are often not able to communicate effectively with
others, therefore when dealing with them it is important to give them time, support and
encourage them to communicate.

Physical disability

What are the classifications of physical handicap?

Physically handicapped children can be classified into three major groups namely: Orthopaedic,
Neurological and Health Disabilities.

Let us explain each one of them

a) Orthopaedic: Orthopaedic disabilities include those children with poliomyelitis (an

infectious viral disease that affects the central nervous system and can cause temporary
or permanent paralysis), amputations, clubfoot, congenital dislocation of the hips,
Leprosy, leg-Calves, curvature of the spine, among others
b) Neurological: Neurological disabilities include cerebral palsy, spinal cord injury,
childhood muscular atrophy among others.
c) Health Disabilities. Health disabilities include epilepsy, juvenile diabetes, Haemophilia (a
medical condition in which the ability of the blood to clot is severely reduced, causing
severe bleeding from even a slight injury) Asthma, Heart diseases, Tuberculosis among
others.

How do you set up a School Environment for persons with Physical

disability?

- Schools where the physically challenged children are integrated should be barrier free.

- Physical facilities within these schools need to be extensively adapted to the needs of the
physically handicapped learners.

Most schools which are not adopted to accommodate persons with disabilities are found
in rural areas where learners not only cover long distances but lack proper transport to
schools. At the same time, these roads and paths are impassable during the rainy season.

35
 - To minimize the unfriendly nature of the built environment, professionals in construction
such as designers, architectures, engineers concerned should co-operate in putting up a
barrier-free physical environment to guarantee the health of the learners.
- Areas of emphasis should include classes, social rooms, sanitary facilities which should,
if possible, are accessed independently.

What are the main causes of physical impairment?

• Diseases such as polio

• Injuries,
• Muscular degeneration
• Muscular weakness,
• Muscular paralysis,
• Joint stiffness,
• Substance & drug abuse

What are the manifestations of persons with mental disability?

Mental disability affects peoples’ cognitive functioning and development (mental development)

• It also affects the ability to perform activities like other people of similar age group / age
groups (e.g. activities of daily living – dressing, eating, and toileting).

• Persons with mental disability may have difficulty of remembering things, reasoning,
decision making, concentrating or coordinating body movements and functions.

Mental impairment also includes difficulties in executing many different functions like:

• ability to pay attention,

• learn and retain information,

• solve problems,

• use language to express thoughts

• Executing simple tasks.

36
 What are the main causes of mental disability?

• Brain damage or genetic disorders.

• Drugs, lack of oxygen to the brain during delivery,

• Brain Developmental delay due to unknown factors.

What is Self care?

• Self care difficulties refer to difficulties carrying out personal daily activities like in:
dressing, bathing, eating, grooming and hygiene, toileting, getting around inside the
home.

• These difficulties may have arisen as a result of other disabilities such as physical or
mental disability.

• This type of difficulty may present in most disabilities. It may be more pronounced in
mental disability, severe physical disabilities and multiple disabilities.

Are you able to identify other disabilities?

These refer to any other disabilities not mentioned or covered above. They could be any of the
following:
• albinism
• epilepsy
• autism
• Cerebral palsy

37
 Different deficiencies in a child’s physical or mental structure and misfortunes
suffered in his/her upbringing do not make him/her a lesser human being.

It is important to:
 Know that whatever shortcoming we find in any human being is a challenge to alleviate
them or remedy them to the best of our ability.
 Teachers should try to identify the specific needs of each special person in order to
provide them adequately.
 the most important requirement of special needs person include:
- being loved and understood
- being appreciated as persons
- Being appreciated in what they do.
- attention given should be in a climate of true human affection
1.1 SUMMARY

In this topic you have learnt about impairment, disability and handicap where the three terms were
differentiated. You have also learnt the whole spectrum of impairment where a detail of how each one
manifests itself and the coping mechanisms for persons suffering from differnent impairments.

38
 Disability is not inability persons with disability do not require sympathy
but an enabling environment to cope.

ACTIVITIES

Visit a school where persons with impairments are integrated in a

normal school and identify the challenges those persons face.

In a class debate with your colleagues on the motion: “It is better to

teach children with disabilities in integrated schools than to
teach them in special schools”

1.7 FURTHER READING

1. Hint, N. (2002) Exceptional children and youth: An introduction to special Education (3rd ed.)
Boston. Houghton Mifflin Company

2. Kirk S. A. Gallargher, J. J. and Anastassiow, N. J. (2003). Educating exceptional children (10th

ed). Boston. Houghton Mifflin. 39

3. Learner J. (2000). Learning Disability Theories, Diagnosis and Teaching Strategies (8th ed.)
Boston, Houghton Miffin Co.
 SELF-TEST QUESTIONS

Score board

Score Grade Comment

11-20 A Excellent proceed

11- 15 B Very good proceed

5- 10 C Fair- repeat the weak areas

1-5 D Weak- repeat

L0 Learning Out come

You have now completed topic two and the learning outcomes are listed below
Put a tick in the column which reflects your understanding
SN Learning outcome Sure Not sure

1 I am able to define impairment, disability, handicap

2 I am able to identify causes of different types of disabilities

3 I am able to explain coping mechanism of persons with different types

of disabilities
4 I can explain how to set up a school environment to enable persons
with disabilities to cope

40
If you have put a tick at the ‘not sure’ column, please go back and study the section in the topic
before proceeding.

If you have ticked ‘sure’ in all the columns you are ready to for the next topic.

Congratulations! Move to the next topic!

41
TOPIC THREE: FIRST AID AND HANDLING COMMON ACCIDENTS

Introduction
Welcome to the third topic in this module. In the second topic you learnt about disability, the full
spectrum of disability and how to help persons with disability to cope. In this topic you will learn
about the essentials of First Aid, the techniques and equipment in First Aid and the life saving
procedures.

Objectives

By the end of the topic you should be able to:

 Define First Aid
 Explain its importance to a practicing teacher
 Define accident
 Identify some of the causes of accidents at home and school.
 Identify the common accidents at home and in school
 Explain the First Aid measures to be taken in cases of different accidents

This topic consists of two main sections:

 First aid essentials
 First AID Techniques procedures.

Let us discuss each one of them in details. (There are many illustrations in this topic some
will be given while others are being sought for).

What is First Aid?

First Aid is the usage of certain principles of treatment at an accident or when there is sudden
illness by making use of facilities and materials available at the time. It is a technique of
managing causality until one is taken to a doctor or to hospital if considered necessary.
42
 What is an Accident?

- An accident may be defined as an unfortunate event resulting from carelessness,

unawareness, ignorance or a combination of causes which usually result in injury or
injuries. The injuries could be:
 Fractures
 Wounds
 Burns
 Bites from animals, insects, snakes etc
- Accidents can lead to death if First Aid is not administered immediately.
- Accidents have many causes, with emphasis put on home accidents and in particular
those that happen to children.

What are some of the causes of home/school accidents?

- Children left alone to care for themselves.

- Children left in the care of inexperienced or very young caretakers.
- Keeping dangerous drugs, insecticides and cleaning materials within reach of children.
- Keeping dangerous implements and tools within reach of children e.g. knives, nails,
matches among others.
- Putting poisonous substances in beverage bottles so that children mistake the contents
and drink the kerosene.
- Large unplanned families who make it difficult for a mother or caretaker to pay attention
to each individual child.
- Mothers being too busy and unable to take care of all children particularly those in
crawling age.
- Having open fires or leaving hot pots or kettle where small children can pull over.
- Being untidy in the home and leaving things lying around that people can trip over.
- Careless in electrical wiring.
- Careless keeping of lab equipment and chemicals in schools.

You can list other causes of accidents!

Accidents that affect children can occur at home and school

- Children are naturally very curious.

43
 - They like to find things out for themselves.
- This unfortunately means they are exposed to danger e.g.
a) From fire
b) From chemicals
c) From medicine or other things kept at home

What should I do when an accident occurs?

- When an accident has occurred, simple First Aid can be given while help is being sought
for.

What are the First Aid Priorities?

- Assess the situation quickly and calmly. (illustrate)

- Protect yourself and the casualty or casualties.
- Comfort and reassure the casualties.
- Deal with any life threatening condition.
- Obtain medical aid if necessary.
- If you suspect a serious illness or injury call an ambulance.

3.2 Some Common Accidents and the First Aid Measures

Welcome to the second section of this topic. In this section common accidents will be presented
and the First Aid measures to handle them.

Burns and Scalds

What are Burns and Scalds?

- A burn is an injury that results from fire or a chemical agent.

- Injuries from hot liquids and steam are called scalds.
- Burns and scalds vary in depth, size and severity.
- They may damage the skin and the body under the skin.

What are the Causes of Burns and Scalds?

Burns can be caused by;

1. Carelessness with matches

44
 2. Badly constructed fireplace
3. Hot liquids
4. Defective cooking
5. Electrical equipment
6. Chemical e.g. caustic soda, strong acids and strong detergents.

Besides surface burns, other hazards of fire in a building include the following;

- Inhalation (breathing) of poisonous gases including carbon monoxide.

- Suffocation (asphyxia) from insufficient oxygen in the air.
- Harmful smoke (e.g. from burning plastics) as a result of fire.
- Falls and injuries from collapsing walls in burning buildings.

First Aid in Burns

What are the Objective First Aid tips in Burns?

 To limit the depth and severity of the burn.

 To relieve pain.
 To prevent infection.
 To treat for shock.

How can you recognize Burns?

 Reddened skin.
 Pain in the area of the burn.
 Swelling and blistering of the skin.

Precautions!

 Do not apply lotion, ointment or fat to a burn.

 Do not touch the burn or burst any blisters.
 Do not remove anything sticking to the burn.
 Keep cooling with water until help arrives.
 If the burn is caused by chemicals, cool for at least 20 minutes.
 Burns on sensitive parts of the body e.g. the face or the genital area,
serious
 burns of hands or feet and extensive or deep burns should be treated in
hospital.

45
 What action should be taken after burns?

 As quickly as possible, apply or pour cold water to the burnt part or submerge it in ice
cold water for at least 10 minutes.
 Carefully remove any clothing or jewellery from the area before it starts to swell.
However, do not remove any clothing that is sticking to the burn.

How do you prevent infection in a burn?

 In order to prevent infection, keep the burn as clean as possible using a dry sterile gauze
or clean cloth or non fluffy as protective dressing.
 Do not try to break blisters or remove shreds of skin.
 Do not use any antiseptic preparation, ointment or spray on a severe burn.
 Chemical burns are caused by acids and alkalis or other corrosive chemicals.
 When irritating chemicals come in contact with the skin, injuries begin instantly.
 In such circumstances, first aid is required quickly.

What are the essentials of First Aid in Chemical Burns?

- In chemical burns wash away the chemical as quickly as possible with large quantity of
water.
- Chemical burns should be cooled by water for at least 20 minutes. Put the injured part or
face under a tap to get a good flow of water to wash off the chemical.
- If chemical gets into the eye, it should be washed out as quickly as possible with plenty
water.

Fractures

What is a fracture?

A fracture is a break or a crack in a bone.

46
 What are the causes of fractures?

Mostly fractures are caused by:

 Motor vehicle accidents

 Falls
 Accidents related to sports and fighting.

Classifications of Fractures

There are two classifications of fractures namely: closed or simple and open or compound
fractures

What are closed or simple fractures? (Illustrate)

These are fractures where a bone is broken but there is no wound or break in the skin over or
near the fracture site.

What are open or compound fractures? (illustrate)

These are fractures with open wounds through which broken bone protrudes.

What are the Signs and Symptoms of fractures?

- Difference in the shape and length of the corresponding limb or other part on the two
sides of the victim’s body.
- Obvious deformities such as a bend or the bone showing under the skin.
- Crookedness, shortening or rotation of a limb.
- An open wound over the bone.
- Swelling and bruising over the fracture.
- Pain and tenderness on gentle pressure at the site of the suspected fracture.

47
 What are the First Aid essentials in Fractures?

- Stop bleeding if any by simple pressure over the injured part using a clean pad of cloth.
- Do not wash the wound.
- Do not probe it.
- Do not insert your fingers into it.
- If a fragment of bone is protruding, cover the entire wound with a clean cloth or towel.
- Apply a splint to the injured part to prevent movement (splint- a piece of rigid materials
applied along to the sides of the limb to prevent two broken ends of the bone from
moving.)
- Purpose is to reduce injury to the soft tissues and to keep the bone more or less aligned
and reduce pain.
- Raise the injured part slightly to reduce bleeding and swelling.

Wounds and Bleeding

What is a wound?

- A wound is a break or a tear in the tissue of the body.

- It may be internal where the body tear is not visible or external where the body tear is
visible.
- Wounds are classified as either open or closed.
- An open wound is where there is a break in the skin while a closed wound involves
underlying parts without a break in the skin.
- Open wounds allow blood and other fluids to be lost from the body and enable germs to
enter.
- In a closed wound, bleeding is confirmed within the body tissues.

Types of Wounds

- There are different types of wounds depending on the object that produced the wound
such as a knife, bullet among others.
- Each type of wound carries specific risks associated with the surrounding tissue damage
and infection as follows:

What is Laceration?

Laceration is caused by crushing or ripping force which results into tears or lacerations.
 These wounds bleed less profusely but may have more tissue damage.

48
  Lacerations are often contaminated with germs hence the risk of infection much
higher.

What is an Abrasion (graze) wound?

Abrasion is a superficial wound where:

- The topmost layers of the skin are scrapped off leaving a raw tender area
- It is caused by a sliding fall or a friction burn
- Abrasions may contain embedded foreign particles that may result in infection.

What are incised wounds?

- These may be caused by a clean cut from a sharp-edge object such as a razor.
- Blood vessels are cut straight across, hence bleeding may be profuse.
- Structures such as tendons, nerves, or arteries may be damaged.

What is Contusion (Bruise)?

- Is a wound brought about by a blunt blow or punches and can rupture capillaries beneath
the skin causing blood to leak into the tissues.
- The skin occasionally splits
- Severe contusion may indicate deeper damage such as a fracture or an internal injury.

What is Puncture wound?

A puncture wound is brought about by an injury such as stepping on a nail or being pricked by a
needle or sharp objects.
- It has a small entry side but a deep track of internal damage.

- This is because germs and dirt can be carried far into the body, hence the infection risk is
high.

49
 What is Stab wound?

- This is a wound caused by along or bladed instrument usually a knife penetrating the
body.
- Stub wound to the trunk must always be treated seriously because of the dangers of injury
to vital organs or life threatening internal bleeding.

What is a Gunshot wound?

- A bullet or other missile may drive into or through the body causing serious internal
injury, and sucking in clothing and contaminants from the air.
- The entry wound may be small and neat and the exit wound may be large and rugged.

What are the Causes of Wounds?

From the types of wounds you realize that, wounds are as a result of physical force.

The most common causes of wounds therefore are:

1. Motor-vehicle accidents
2. Falls
3. Mishandling of sharp objects e.g. nails, needles, razor blades
4. Mishandling of tools such as jembes, knives
5. Machinery
6. Weapons such as guns

What are the effects of wounds?

Wounds may cause the following damages

1. Destruction of tissues
2. Loss of blood
3. Nerve injury
50
 4. Contamination with foreign material
5. Inability to use the part or inability for the part to function normally.
6. Death

First Aid in Wounds

The main objective of first aid in wounds is to:

i. Asses the casualties condition

ii. Control bleeding by applying pressure on elevating the injured part
iii. Keep the wound clean
iv. Comfort and reassure the casualty
v. Minimize shock
vi. Obtain medical help, if necessary
vii. Call an ambulance if you suspect a serious illness or injury

When there is a wound and the bleeding is severe it can be dramatic and distressing. Shock is
likely to develop and the casualty may loose consciousness. If bleeding is not controlled, the
casualty’s heart could stop.

- Bleeding at the face or neck may impede the flow of air to the lungs
- When treating severe bleeding check first to ensure there is no object embedded in the
wound. Take care not to press the object

How can you control bleeding?

1. Put on disposable gloves if available

2. Remove or cut clothing as necessary to expose the wound.
3. Apply direct pressure over the wound with your fingers and palm preferably over a sterile
dressing on non fluffy, clean pad
4. Raise and support the injured limb above the level of the casualty’s heart to reduce blood
loss.
5. Help the casualty to lie down on a blanket if available to protect him/her from cold
6. If you suspect shock may set in, raise and support the legs so that they are above the level
of his/her heart.
7. Secure the dressing with a bandage that is tight enough to maintain pressure but not so
tight that it impairs blood circulation
8. If further bleeding occurs apply a second dressing on top of the first
9. If blood seeps through the dressing remove both dressing and apply a fresh one.

51
 What are Bites?

Bites are wounds or injuries caused by tearing or piercing by teeth or fangs or sucking organ of
an insect

Human bites

All human bites that break the skin may become seriously infected because human mouths have
a variety of harmful bacteria.

Animal bites

A bite of any animal whether it is a wild animal or a pet may result in a dangerous
wound.
Dogs, cats and other pets may have rabies.
Tetanus is an added danger in animal bites.
Any animal bite carries a great risk of infection. It is therefore important to ensure that
the wound from the bite is treated by cleaning with water to wash away the poison,
bandage and seek for medical help.

What is rabies?

Rabies is an infectious disease caused by a virus

It is transmitted through the infected saliva of a rabid animal to another animal or human being
Rabies is usually transmitted to human beings by dogs
However the disease is also carried by cats, jackals, mongoose and other wild animals.
The infection is spread when an animal with rabies bite even if it makes a scratch or licks an
existing open wound.

What are the First aid tips in rabies?

Clean the bite with soap and lots of water and take the victim to hospital immediately so that
he/she can be given a series of anti-rabies injections.

If it is not clear whether the animal such as a dog was rabid or not, it should be tied up and
watered.

A dog with rabies usually dies from the disease within ten days.
52
A rabid animal to must be killed and where possible the head of the animal be taken to public
health authorities for examination.

What should you do to prevent and Control rabies?

Kill any animal suspected of having rabies,

Cooperate with local authorities to vaccinate dogs every year

Keep children away from animals that seem sick or act strange.

After any animal bite go to the clinic for treatment and advice.

Snake bite

What are the First aid measures in snake bites?

Keep the victim as calm as possible preferably in a lying position.

Do not move the part that has been bitten because the more it is moved the more rapidly the
poison will spread through the body.

A person who has been bitten on the foot should not walk but should be carried on a stretcher is
possible. Where possible tie the upper part of the leg to prevent the poison from spreading to the
other parts of the body quickly.

A bite from a poisonous snake is dangerous.

Transport the victim to hospital as soon as possible taking the dead snake with you if possible.

What are the First Aid measures in insect bites?

For minor stings and bites wash in cold water and apply a soothing cream or jelly like Vaseline.

For a bee sting, scrap the sting off quickly

No not try to pull the sting out because then you compress it and force more venom into the
victim

If a person has been stung by many bees he or she should be taken to hospital.

Other venomous insects are spiders, scorpions, wasps, ants among others.
53
 What is Nose bleeding?

Nose bleeding occurs when a small blood vessel in the inside of the nose is injured and starts to
bleed.

At times there may be no reason but nose bleeding can also result from injury, disease such as
high blood pressure or after a cold or strenuous exercise.

What are the First aid measures in nose bleeding?

Keep the victim calm

Put him/her in a sitting position leaning forward whenever possible.
Press the bleeding nostril towards the midline for five minutes
Obtain medical assistance if bleeding continues.

Poisoning

What is poison?

A poison is any substance – solid, liquid or gas that can impair health or cause death when
introduced into the body or on the skin.

What Causes poisoning?

Poisoning occurs in various ways such as:

Swallowing or inhaling a harmful substance.

Sometimes poisoning results from taking an overdose of drugs whether deliberately or

accidentally.

What are the First aid measures in poisoning?

54
The objective of first Aid in poisoning is to:

 Get rid of the poison as quickly as possible

 Maintain breathing
 Treat for shock
 Give medical assistance without delay

To get rid of the poisons give the victim water to dilute the poison.

Try to get the victim to vomit unless the poison is kerosene, acid, alkali or any other chemical
which burns the skin

Note: acids and alkalis which burn the skin change the colour of the lips and tongue.

It is important to identify the poison taken by saving the container label of the suspected poison
to show the doctor.

Maintain breathing

If the victim is unconscious keep the air ways open by laying him/her on one side and holding
the jaw forward.

What is Suffocation?

Suffocation occurs when normal breathing is prevented or stops or breathing is reduced such that
oxygen intake is insufficient to support life.

What are the Causes of poisoning?

Poisoning is caused by blockage of the air passage by an object stuck in the airways

When breathing air is too little or there is a lot of smoke from fire

Air containing carbon monoxide

Poisonous gas

Drowning

Strangulation

Food chocking

55
 What are the First aid measures in suffocation?

Food Chocking

Food chocking occurs when food gets stuck in the throat and stops the victim from breathing. .

When food gets stuck in the throat and stops a person from breathing do the following:

 Stand behind the victim and put your arms around the chest

 Clasp your hands together against the persons stomach above the navel

 Press inwards with a sudden strong upward jerk

 Repeat several times

 If it is a baby, then hold the baby with leys upside down for a while. This allows the
chocking substance to come out of the nose or mouth.

Summary

In this topic you have been able to learn about First Aid where the terms First
Aid and accident were defined. You also learnt about the causes of accidents and the common
accidents in schools and homes. You were also able to learn about first aid measures in burns,
fractures, wounds, bites, nose bleeding, poisoning and suffocation.

Activities

Practice how to give first aid to various victims as discussed in this topic with your class mates.

During your school sports day prepare a First Aid box and report to the class members the
contents of a First Aid box

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 Further reading

St. John Ambulance/British Red Cross/ St. Andrews Ambulance Association First Aid
th
Manual (8 Edition)

SELF-TEST QUESTIONS

1. What are the essentials of First Aid? (5 marks)

2. Why is it important to leave children with careful care givers? (5marks)
3. Explain the First Aid tips in snake bite, wounds, fractures burns, (20 marks)

Score board

Score Grade Comment

20-30 A Excellent proceed

16- 20 B Very good proceed

6- 15 C Fair- repeat the weak areas

0-5 D Weak- repeat

LO Learning Outcome

You have now completed topic THREE and the learning outcomes are listed below

Put a tick in the column which reflects your understanding

SN Learning outcome Sure Not sure

57
1 I am able to define accident and First Aid

2 I can explain the basic essentials of First Aid

3 I am able to identify causes of accidents at home and school

4 I am able to administer First Aid to persons with burns, fractures,

wounds, bites, nose bleeding, poisoning, suffocation among others
If you have put a tick at the ‘not sure’ column, please go back and study the section in the topic
before proceeding.
If you have ticked ‘sure’ in all the columns you are ready to for the next topic.

Congratulations! You can proceed to the next topic.

58
TOPIC FOUR: HEALTH AND SAFETY IN THE SCHOOL

INTRODUCTION
This topic presents the role of public health services in society and the healthy and safety
standards detailing how to ensure safety in the school environment. In the topic the standards
measures to be met in the construction of different structures in a school are discussed and the
disaster risk reduction measures in a school.

Objectives
By the end of this topic, you should be able to:
 Explain the role of public health in society
 Identify the healthy and safety standards for a school
 Apply disaster risk reduction procedures in a school to ensure safety

This topic is divided into two sections as follows:

 Public health
 School safety

Public Health

What is Public Health?

 Public health is the art and science of prevention of disease to prolong life while
promoting health. This is done through organized effort of people or society, or
communities by informed choices.

59
  Public health is important because when people are informed, they are aware of
problems/diseases which can be in the environment.

What is the Purpose of public health?

Public health in Kenya was established under an act of parliament Cap 242 to empower people to
take care of their own health.

What does public health deal with?

Public health deals with the prevention, promotion, rehabilitation, contamination, sanitation and
housing.

What prevention activities does public health involve itself with?

 Public health deal with notifications to alert the public about disease outbreak. Some of
the outbreaks are malaria, cholera among others.

 Public health officers give health education messages e.g. the use of mosquito nets, how
to control spread of HIV and AIDS etc

 Quarantine – when there is a plague.

 Immunization of common diseases.
 Vaccination to prevent spread of certain diseases.

School safety

What is School safety?

School safety are measures undertaken by the learners, staff, parents and other stakeholders to
either minimize or eliminate risky conditions or threats that may cause accidents, bodily injury,
emotional and psychological distress. There are many things that a person can experience that

60
can be categorized as emotional distress. These include fear, shock, and indignity. Psychological
distress refers aspects of sadness, frustration, anxiety, and a number of other negative mood
states.

What are the objectives of school safety?

The objectives of school safety are to:

 Provide opportunities for the learner to exploit and maximize potential for learning,
growth and development.
 Provide opportunity for the learner to participate in enhancing school safety.
 Promote, maintain and contribute to the understanding of child and staff safety.
 Provide a benchmark for monitoring and appraising the safety status of schools.
 Empower members of the school community to handle disasters and thus minimize risks.
 Provide first line emergency services to learners and staff who become victims of injury
or are taken ill.
 Counsel, guide and advice learners and staff on issues relating to school safety.
 Empower the school to liaise with parents, members of the community and other partners
in order to increase awareness about issues related to school safety.
 Forge alliances and networks that enhance school and child safety.

What are the threats to school safety?

Threats to school safety include:

1. Accidents- the main causes of accidents in schools are human related that is
accidents caused through carelessness, inattentiveness, ignorance,
irresponsibility, or negligence.
2. School violence and harassment- violence in schools takes the form of
teacher-on- learner violence and learner on learner violence among others.
3. Lack of adequate healthcare and nutrition.
4. Lack of sensitivity to sexual maturation challenges for both boys and girls.
5. Armed conflicts and insecurity.

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 6. Hostile school environments eg a school environment that does not
accommodate the welfare of its learners or neglects the needs of its learners.

What are the components of safety standards?

The components of school safety standards are:

 Safety on school grounds.
 Safety of physical infrastructure.
 Health and hygiene safety.
 Safety in school environment.
 Food safety.
 Safety against drug and substance abuse.
 Safe teaching and learning environment.
 Socio-cultural environment of the school.
 Safety of children with special needs.
 Safety against child abuse.
 Transportation safety.

Let us go through each of the school safety components?

Safety on school ground

School grounds refer to the entire enclosure designated for use by the school for any of its
activities such as learning, playing, games or sports. Such grounds should be large enough to
house the required physical infrastructure, including classrooms, offices and latrines, playing
grounds and assembly walkways and many more.

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 What are the indicators of a safe school ground?

The indicators of a safe school ground include:

 A title deed well kept in a temper-proof facility and away from any risk or clearly
demarcated school compound pending documentation and issuance of title deeds.
 Registration documents such are registration certificate properly kept.
 Properly fitted and lockable gate or gates with a security office.
 Good security arrangements with provision for both night and day security personnel.
 Well maintained and clean learning rooms.
 Well maintained and clean desks and chairs in classrooms, offices and other relevant
places.
 Properly maintained playgrounds for various sporting activities and a free area for
general play.
 Properly arranged and maintained walkways, motorways and parking.
 Properly reinforced fence with appropriate mechanisms for repair and maintenance.

Safety of physical infrastructure

What are the physical structures in a school?

Physical infrastructure includes:

 Structures such as classrooms, offices, toilets, dormitories, libraries, laboratories, kitchen,

water tanks, playground equipment and many more.

 The structures should be appropriate, adequate and properly located, devoid of any risks
to users or to those around them.

 They should also comply with the provisions of the Education Act (Cap 211), Public
Health Act (Cap 242), and Ministry of Public Works building regulations/standards.

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 How should classrooms be constructed in a school?

Class rooms should observe the following:

 They should be of the right size that is; length and width should be as specified in the
ministry of education building specifications i.e. 7.5m x 5.85m. They should be able to
accommodate 30 learners on one seater desk and 40 in double seater desk.
 Doorways should be adequate for emergency, open outwards.
 For storey buildings stairways should be wide enough and located on both ends of the
building. Should be clear of any obstructions; provide needs for learners with disabilities,
hand rails in the stairs should be strong and firmly fixed.
 Corridors and classrooms should be well ventilated and lit.
 Windows should not have grills.
 Floors should be level and kept clean always.
 Each block should be fitted with serviceable fire extinguishers.
 Classrooms should be furnished with appropriate desks comfortable for both boys and
girls.
 Desks should be arranged in a way which allows for easy movement.
 Sockets should be placed beyond reach of young learners to avoid tempering.

What about dormitories?

Dormitories should:
 Be kept clean and well ventilated.
 Have space between beds should be at least 1.2 m and path ways not less than 2m.
 Have doorways that are wide enough at least 5 feet wide and open outwards.
 Have doors at both end and an emergency door at the middle.
 Be locked when students are away.
 Have windows be without grills.
 Be fitted with functional fire extinguishers.

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  Have beds that are firm and fitted with side-grills to protect young learners against
falling.

What about sanitation infrastructure?

Pit latrines should be:

 Built at least 10m away from tuition and boarding facilities and on the downwind
side.
 Where ablution block is attached to the dormitory, a high degree of cleanliness must
be maintained.
 Pit latrines should be at least 15m away from a borehole or well or water supply
point.
 Pit latrines should not be less than 6m deep and be regularly disinfected.
 In mixed schools sanitation points be separated and for girls sanitation areas offer
complete privacy.
 Each school to ensure safe and effective disposal of sanitary wear.
 Ratios: for the first 30 learners 4 closets are recommended. - The next 270 learners:
one extra closet for every 30 learners. – For every additional learner over 270
learners: one closet per 50 learners. 1/3 closets for boys be urinals.
 All closets should be kept clean, well ventilated and properly maintained.
 For staff at least one closet for 12 persons and with separate provision for ladies and
gentlemen.
 Care should be taken to accommodate learners with special needs and very young
learners.

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 How should Libraries look like?

Libraries should have:

 Adequate ventilation
 Wide alleys of passageways to facilitate evacuation.
 Specious room for easy movement.
 A programme of dusting books regularly preferably after 3 days.
 Properly reinforced and well spaced bookshelves.

How about the administration block?

The administration block is an important block in the school. It is the first station of call for all
visitors to the school. It is the store house for all important school records and equipment. An
ideal administration block should put into consideration the prevailing security situation of the
school environment and the needs of the school.

The following should be observed in constructing a school’s administration structure.

 Offices for key school personnel in the school.
 It should be centrally located and not far from classrooms.
 Door and windows should be burglar proof.
 Should have fire extinguishers.
 Provisions should be made to acquire fire-proof cabinets for storage of
essential office materials and documents.
 There should be provision for easy access to legal and administrative
documents.
 An ideal administration block should put into consideration the prevailing
security situation of the school environment and the needs of the school.

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 How should health and hygiene safety be maintained in a school?

To promote good health and hygiene among learners the school should:

 Impart knowledge, skills, practices and attitudes to learners in relation to health.

 Promote and maintain good health practices among the learners.
 Monitor and appraise the health status of the learners through health screening and
examinations.
 Provide first line emergency services to learners and teachers injured or take ill.
 Collaborate with health agencies, parents and communities on issues relating to
learners’ health.
 Counsel and give guidance to learners and parents on matters relating to health.

What is environmental safety?

Environmental safety refers to the proper and sustainable management of the physical
surroundings of the school. Proper management of the school environment entails appropriate
mechanisms of waste management, orderly use and replenishment of plants and animals within
the school compound and enhancing a sustainable balance of biodiversity.

A school environment should be safe to promote learners’ concentration on learning and to

facilitate the development of their social skills without compromising, in anyway, sustainable
biodiversity.

How should safety in the school environment be ensured?

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The school should strive for indoor and outdoor air quality by ensuring the following:

 Regular inspection and replacement of ventilation equipment/air ducts.

 Exterior and interior lighting is appropriate so as to make it difficult for intruders to go
undetected.
 Classrooms and occupied rooms are well lit to ensure that learners do not strain while
undertaking learning activities.
 Solid waste is properly disposed to avoid the spread of communicable diseases,
discourage the presence of pests and other vector and prevent human contact with
hazardous materials.
 Regular inspection of school facilities.
 Good sanitation practices and proper maintenance of structures and grounds to seal
structural cracks through which pests and rodents can enter.
 Adequate tuition and boarding facilities.

 Waste materials from the kitchen, laboratories, classrooms dormitories, construction sites
among others is done appropriately by: Dumping in isolated areas away from the learning
facilities, Different wastes are disposed differently, dump sites are fenced off and access
denied to unauthorized persons, provision of waste buckets in rooms etc.

What is Food safety?

Food safety refers to access and consumption of wholesome food that promotes health and
optimal body functioning. Learners in schools should have access to safe and wholesome food
for their proper physical and intellectual development.

What should schools do to ensure food safety?

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To ensure food safety schools should:

 Have adequate and safe storage facilities.

 Ensure illegal hawking food in school is denied.
 Food purchased for children in school is in good condition, fresh and safe for human
consumption.
 Food is protected from rodents, insects and bacterial contamination.
 Places where food is prepared are clean.
 Students and staff are encouraged to observe hygiene. For instance utensils should be
kept clean, hands should be washed with clean water before and after eating among
others.

What should schools do to ensure safety against drug and

substance abuse?

 Schools must endeavour to create a safe and caring environment where learners and staff
know the dangers of drug abuse, and strive to make the school a drug free environment
by:
 Mainstreaming drug abuse tips in their teaching subjects, advertisements, brainstorming,
displaying drug related information in bulletin boards, displaying posters and articles
among others.

What should schools do to ensure safe teaching and learning

environment?

Schools should provide and sustain a safe caring environment that promotes quality teaching and
learning by:

 Ensuring comfortable conditions that facilitate quality learning

 Encouraging instructional strategies that actively engage learners in the learning process
 Supporting efforts to promote child-centered approaches to teaching
 Identifying and attending to learners with special needs among others.

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 What is the Socio cultural environment of the school?

This refers to ensuring good working relationships and amicable interactions of all stakeholders.

How should the Socio cultural environment of the school be?

All interpersonal relationships between various stakeholders in and outside the school need to be:

 Cordial
 Cooperative
 Respectful and focused on promoting a conducive environment for teaching and learning.

Safety of children with special needs

Remember our discussions in chapter two about handling persons with

disability and note the fact that the government is keen that children with
special needs are enabled to access education at all levels without discrimination. The school
should thus have a learning environment that is safe and caring and caters for the requirements of
children with special needs.

Safety against child abuse

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 What is child abuse?

Child abuse is defined as subjecting children to suffering through physical, sexual, emotional or
neglectful behaviour. Child abuse may take place in schools, homes and in the community. Child
abuse may be physical, emotional, and sexual and child neglect.

What is Physical abuse?

Physical abuse involves non accidental injuries resulting from hitting/beating, shaking, throwing,
pinching, poisoning, burning or scalding, drowning or suffocating the child.

What are the Symptoms of physical child abuse?

The symptoms of physical child abuse may include the following:

 Unexplained injury or injuries.
 A repeated pattern of injuries.
 Scalds and burns with clear outlines.
 Bite marks.
 Untreated internal injuries or broken bones.
 Bruising on the face, buttocks and torso.
 Fingertip bruising, hand marks, grasp marks and marks of implements.
 Reluctance to discuss injuries.

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 What is emotional abuse?

Emotional abuse occurs when the child is denied basic needs like love, security, positive
regard, warmth, and praise among others.

What are the symptoms of emotional abuse?

The symptoms of emotional abuse include:

 Chronic absence of self-esteem and low self confidence.
 Immature emotional responses, regression and neurotic behaviour.
 Demanding behaviour, attention seeking, in appropriate behaviour towards non-parental
adults.
 Withdrawal behaviour.
 Fear of new tasks
 Developmental and learning delays.
 Outbursts of anger or distress.
 Indifferent or negative relationships with parents.
 Over-compliant behaviour, excessive desire to please.

What is Sexual abuse?

Sexual abuse takes the form of forcing or enticing a child into sexual activities.

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 What are the symptoms of sexual abuse?

 Bruise or bite marks around the genitals

 Unusual bleeding or discharge from the genitals.
 Inappropriate sexual behaviour towards adults or other children.
 Sexual knowledge inappropriate for the child’s age.
 Self harming.
 Eating and sleeping disturbances.
 Depression and low self-esteem.
 Poor achievement in a given task.
 Withdrawal symptoms in relation to a given activity.

What is Child neglect?

Child neglect involves failure to provide a child with basic needs like food, good levels of
hygiene and health, clothing, shelter and medical treatment when the child falls ill.

What are the symptoms of child neglect?

The symptoms of child neglect include:

 Poor growth and development,
 Learning delays, poor academic performance in school.
 Poor hygiene, inadequate clothing.
 Untreated medical conditions.
 Poor self-esteem.
 Chronic tiredness and hunger, falling asleep in class, voracious eating.
 Sores, poor health condition.
 Lateness to school, frequent non-attendance.
 Poor social relations.
 High levels of accident

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Disaster Risk Reduction

What is a disaster?

A disaster is an emergency event that occurs with little or no warning, causing extensive
destruction of property, lives and disruption of normal operations. Disasters can be divided in to
two main categories; natural and manmade disasters.

Natural disaster may include: earthquakes, floods, drought, landslides, winds, volcanic eruptions
among others.

Manmade disasters are calamities caused by actions of human being either directly or indirectly.
eg fires, oil spillage, industrial accident, pollutions, bomb blasts etc.

What is Disaster Risk Reduction?

Disaster Risk Reduction refers to actions designed to minimize destruction of life, property and
disruption of normal operations. The risk reduction strategy calls for the establishment of a
disaster Crisis Response Team with the mandate to prevent, mitigate and effectively prepare
against potential disaster hazards. It also includes organizing and carrying out rescue and
rehabilitation operations during and after a disaster has struck.

What is early warning in disaster management?

Early warning refers to careful monitoring and early warning actions to avert potentially
dangerous events or circumstances that can lead to emergency or disaster.

The purpose of monitoring and early warning is to enable remedial measures to be initiated and
to provide more timely and effective relief through disaster and emergency preparedness actions.

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Early warning mechanisms will provide the school community and other stakeholders with
relevant information to enable them make informed decisions for evacuation or relocation.

What should schools do to manage disasters?

The following should be observed to manage disasters in schools:

Schools should:
 Post evacuation maps at every entrance and exit to buildings.
 Schedule practice drill sessions for fire, earthquake, lockdowns etc
 Develop a telephone tree list of all employees.
 Maintain school emergency kit with items like; first aid kit, whistle, fire blankets, flash
torches, fire extinguishers, blueprint of school buildings.
 Observe safety measure during various types of disasters.

Measures to be observed during various types of disasters

What measures should be taken during floods?

 Parents should keep in touch with the local authorities to determine whether it is safe for
their children to go to a flood prone area.
 Student should avoid flood prone routes to school.
 After floods sockets and electric appliances should be checked before use.
 Drinking water should be treated before use.
 All buildings should be checked by experts before use after floods.

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 What should be done to ensure Safety during landslides?

 During heavy rains schools in land slide-prone areas should be on the lookout for unusual
land movement.
 On detecting unusual land movement alternative learning facilities should be identified.
 Rapid evacuation should be done when land slide takes place.

What should be done to ensure safety during thunderstorms and

lightening?
 Learners should remain in school and stay indoors.
 Learners be discouraged to take shelter in verandahs or open places.
 Learners be advised not to take shelter under trees or walk in rain.
 In areas prone to thunderstorms and lightening, schools should install lightning
arresters.

What should be done to ensure safety during earthquakes?

Though earthquakes are almost not experienced in Kenya, but, in case of such occurrences it is
necessary to do the following:
 Learners are in class t should be advised to take cover under tables and desks.
 They should not panic or attempt to rush outside or go near the window.
 If outside learners should not move near buildings.

What Safety measures should be taken during strong winds?

 If learners are in a classroom windows should be closed and also stay away from
windows.
 Be advised to take shelter under tables of desks.
 In open grounds learners should be advised to lie flat on the ground.

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 What measures should be taken to ensure safety during fire?

Fire prevention

The following measures should be observed to prevent disasters related to fire outbursts.

 All kinds of trash should be discarded as they tend to catch fire easily.
 Inflammable substances should be stored tightly in closed cans or containers.
 All wiring should be checked regularly.
 Learners should not carry or play with matches.
 Use of hurricane lamps in the dormitories should be properly regulated.
 Learners and staff should undertake periodic fire drills at least twice a term.
 Fire extinguishers should be located in strategic places in the school.

In case of fire outbreaks:

 Learners should leave the room immediately without creating panic rush.
 When going through a smoky area learners be advised to crawl.
 Doors that feel hot should not be opened as fire from the side could be blazing fiercely or
one could get killed by the burst of heat and smoke when the door is opened.
 One should not run on clothes that are on fire.
 Learners should not return to the classrooms or any other buildings.

Safety during chemical emissions and severe pollutions

 In case of chemical and gas emissions that are a threat to staff and learners inform school
authorities immediately.
 Once informed the authorities should inform gas or chemical experts immediately.
 Evacuation plans be quickly implemented in the schools.
 For affected individuals, school authorities should seek immediate emergency treatment
that is giving First Aid and refer the victims to a doctor.

SUMMARY

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In this topic you have learnt about health and safety where the role of public
health was discussed, objectives of school safety, threats to school safety,
 ACTIVITIES

Assume that you have been appointed to head a newly established

school. Draw a sketch map of the new school showing how you will site different
buildings in the school.

1.7 FURTHER READING

Ministry of Education (2010). Child Friendly Schools Manual

Ministry of Education (2008). Safety Standards Manual for Schools in Kenya

Njenga Frank (2010). What’s wrong with this child? A guide for Parents and Teachers. Nairobi: Oxford
University Press.

SELF-TEST QUESTIONS

1. What is the role of public health services in society? (5marks)

2. Discuss the essentials of health and safety
78 in a school (15 marks)

3. What is Disaster Risk Reduction and how can it be realized in a school?

(10marks)
 Score board

Score Grade Comment

20-30 A Excellent proceed

16- 20 B Very good proceed

6- 15 C Fair- repeat the weak areas

0-5 D Weak- repeat

L O
Learning Outcome

You have now completed topic four and the learning outcomes are listed below

Put a tick in the column which reflects your understanding

SN Learning outcome Sure Not sure

1 I am able to explain the role of public health services in society

2 I can explain the essentials of health and safety in a school

3 I am able to respond to reduce risks on the event of a disaster in a

school
4 I am able to identify symptoms of children who suffer from different
types of abuse

If you have put a tick at the ‘not sure’ column, please go back and study the section in the topic
before proceeding.

If you have ticked ‘sure’ in all the columns you are ready to for the next topic.

Congratulations! Proceed to the next topic!

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TOPIC 5: THE YOUTH AND FAMILY LIFE

INTRODUCTION

Welcome to the fifth topic in this module. In this chapter we will discuss youth and family issues
where the concept of youth will be presented, dating and courtship, marriage and family life
detailing the different types of families and the challenges of modern family life.

Objectives
By the end of the topic you should be able to:
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 Define the concept of youth as a life cycle
 Explain dating and courtship processes
 Explain the marriage processes and the inherent challenges
Topic five has three sections as follows:
8 The concept of youth as a life cycle
9 Dating and courtship
10 Marriage
11 Family life

The Concept of Youth as a lifecycle stage

Introduction

This section presents the concept of youth as a lifecycle stage.

What is youth?

Definition of youth

 Youth refers to a separate stage in the lifecycle between childhood and adulthood.

 It is a period of transition which involves complex interplay of personal, institutional and

macroeconomic changes that most young people have to negotiate.

In terms of age bracket, there are varied definitions of youth.

 In Africa for instance, some countries have adopted the United Nations (UN) definition
of youth (15 to 24 years) while others use the Commonwealth definition (15 to 29 years).

For policy purposes, the age range can be even wider.

 For instance in some African countries, such as Ghana, Kenya and Tanzania, the
definition of youth used for policy purposes ranges from 15 years to 35 years.

 In Nigeria however, it ranges from 12 to 30 years.

 South Africa’s National Youth Policy defines youth as any person between the ages of 14
and 35 years

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Be that as it may, the legal status of a young person for different purposes can also vary widely.
As such, legal minimum ages often vary not only by gender but also accordingly to the purpose
of the age limit - marriage, voting rights, criminal responsibility, military service, access to
alcoholic beverage, consent to medical treatment, consent to sexual intercourse, among others.

All in all, the changes that young people have to negotiate revolve around moving from
dependence to independence; which involve at least four distinct aspects.

The four aspects are:

 Leaving the parental home and setting up new living arrangements
 finishing full-time education;
 Settling into a more or less stable source of livelihood through employment and/or career
choice.
 Forming close stable personal relationships outside their family of origin, often resulting
into courtship and marriage.

Dating and Courtship

What is Dating?

Dating is the process of meeting people socially for possible mate selection.

It also implies a couple setting a specific date, time, and place to meet.

Dating is part of the marriage market, in which prospective spouses compare the assets and
liabilities of eligible partners and choose the best available mate

Why do people date?

People date for various functions. These are as follows:

1. Manifest functions
 Maturation - adolescent has reached puberty
 Recreation- about self-gratification where people date to satisfy their own needs.
 Companionship
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  Love and affection
 Mate selection

2. Latent functions
 Socialization - learning about gender roles, family structures
 Gaining social status - dating can enhance prestige
 Fulfilling ego needs by being asked out or accepted
 Opportunities for sexual experimentation and intimacy
 Big business - economic market for products and services

What is the dating Spectrum?

The dating spectrum includes the traditional and the contemporary patterns and dating in later
life.

Let us see each one of them.

Traditional Dating
In the traditional dating males and females follow culturally defined and clear gender role
scripts.

Contemporary dating
Contemporary dating patterns tend to be either casual or serious.
 Casual dating behaviors include : hanging out, getting together, pack dating and
hooking up

Dating in later life

 can provide companionship to those who are widowed or divorced it can be
daunting because of nervousness, worry, or bitterness

How do people meet dating partners?

Many people meet dating partners through friends and family.

Other avenues include:

 Personal classified advertisements—twice as many men place ads as do women.

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  Mail-order brides—American men often seek wives from Asian or Russian
countries.
 Professional matchmakers—people pay for “advice.”
 Speed dating—allows people to meet face to face in a short period of time, to
decide mutual interest.
 Cyber dating—the Internet allows people to interact before meeting, although it
has disadvantages as well.

When do harmful dating relationships occur?

Dating abuse isn’t an occasional argument or a bad mood; it is a pattern of controlling behavior
that someone uses against a girlfriend or a boyfriend.

The following are warning signs of this type of dysfunctional and harmful relationship:

 Giving up activities or hobbies that they previously enjoyed

 Withdrawing from family or friends
 Spending excessive time with only the person they are dating
 Signs of jealousy and possessiveness
 Constant contact by phone calls, texting or sending instant messages
 Signs of threats, insults, or inappropriate control of temper from the person they are
dating

Courtship

What is courtship?

Courtship is the period in a couple's relationship which precedes their engagement and marriage,
or establishment of an agreed relationship of a more enduring kind.
In courtship, a couple gets to know each other and decide if there will be an engagement or other
such agreement.
A courtship may be an informal and private matter between two people or may be a public affair,
or a formal arrangement with family approval.
Traditionally, in the case of a formal engagement, it has been perceived that it is the role of a
male to actively "court" or "woo" a female, thus encouraging her to understand him and her
receptiveness to a proposal of marriage. Within many modern societies, these distinct gender
roles have lost some of their importance and rigidity.
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 How many Phases are there in Courtship?

Courtship has five phases which include:

 Attention phase

 Recognition phase
 Conversation phase
 Touching phase
 Love-making phase
As noted earlier, courtship precedes engagement and marriage. However, some relationships end
up in break ups before marriage.
Breaking Up

What are the reasons for breaking up?

People in courtship breakup because of:

a) Individual reasons may include: communication problems, different interests, emotional

and physical abuse, obsessive “love” and controlling behavior, mismatched love and
sexual needs, Self disclosure that reveals repulsive attitudes, Disillusionment, Lowered
affectionate behavior, Infidelity, “Freeloading” without commitment.
b) Structural reasons such as: moving away, economic recessions that trigger unemployment
and arguments about finances, societal reactions that disapprove of relationships such as
those between younger and older people, those from different racial or ethnic and
religious backgrounds, or same sex couples.

 Ending relationships may be painful, but it can provide opportunity to find a better mate

Is breaking up healthy?

 Breakups are usually painful

 Men seem to get over breakups more quickly than women do

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  An important function of dating and courtship is to filter out unsuitable prospective
mates, thus breaking up is a normal process.
 It can be a great relief to end a bad relationship.
 Breakups should occur more often to provide opportunities to find a mate who may be
more suitable
Marriage

What is marriage?

Marriage is a social institution under which a man and a woman establish their decision to live
together as husband and wife by legal commitments, religious or traditional ceremonies.
A similar institution involving partners of same gender: gay marriage.
Many cultures limit marriage to two persons of the opposite sex, but some recognize same-sex
marriage.

What are the types of marriage recognized in Kenya?

In Kenya, the following types of marriages are given due recognition by law:
i. Statutory Marriages – marriage provided for under statute such as under the Marriage
Act, for instance, Civil Marriage, African Christian Marriage, Hindu Marriage,
Mohammedan Marriage
ii. Customary Marriages-marriage under traditional customs
iii. Presumed Marriages – long cohabitation recognized as presumed marriage
Selecting a marriage partner

Choosing well is the foundation for a good marriage. Yet choosing is one of the most neglected
pieces of the process of meeting, bonding, marrying, living life together and possibly having
children. Choose well: the good and the bad outcomes of your choise will shape your marriage,
whether a first or a second, a common law marriage, a mixed race marriage or same sex
marriage.

- One is more likely to have a successful marriage if he/she selects a marriage partner with
whom he/she is compatible and can grow close to over the years.
- To be compatible means to be able to get along together well.
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 What factors increase the likelihood of a compatible marriage?

 Similar values
 Clearly defined goals
 Similar intelligence and educational experience
 Families that have similar philosophies
 Ability to communicate with each other
 Physical attraction to one another
 Healthful attitudes about marriage and sex
 Equal sense of commitment to the importance of marriage
 Similar views about having and rearing children
 Compatible personality traits
 Adequate financial resources
 Similar age
 Compatible hobbies and interests
 Independence from parents
 Pre-marriage counseling and/or pre-marriage classes.

FAMILY LIFE

How do you define Family?

A family is a collective body of persons who live in one house, and under one head or manager;
a household, including parents, children, and servants.
It also refers to a group comprising a husband and wife and their dependent children, constituting
a fundamental unit in the organization of society.

What are the functions of a family?

(1) Stable Satisfaction of Sex need:

This is the Primary and essential function of family. Sex instinct is the natural urge of human
being. The satisfaction of this need requires that both male and female should live together as life
partners. It is the family where the husband and wife can satisfy their sex instincts easily and
comfortably. Without family the satisfaction of sex need is almost socially quite impossible. A
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family not only satisfies but also provides the appropriate mechanism through marriage to
regulate sexual behaviour of husband and wife.
(2) Reproduction or procreation:
Reproduction or procreation is another essential function of family. The family along with
regulating the sexual behaviour in relation to the satisfaction of sexual needs secures a legitimate
basis for procreation.
(3) Protection and care of the young:
Protection and care of the children is another essential function of family. It is regarded as an
institution par excellence for the production and rearing of children.
(4) Socializing Functions:
Family is one of the primary agents of socialization. Family members teach the child the norms,
value morals, beliefs and ideals of society.
(5) Provision of a home
Family makes a provision of a home or a common habitation for its members.
Types and Forms of Family
On the basis of marriage: Family has been classified into three major types:
 Polygamous family- arrangement where one man (husband) is married to many wives
 Polyandrous family- arrangement where there is one woman married to many men
 Monogamous family- arrangement where one man is married to one woman
On the basis of the nature of residence family can be classified into three main forms.
 Family of matrilocal residence- where family lives in the woman’s (wife’s ) maternal
residence
 Family of patrilocal residence- where family lives in the man’s (husband’s) paternal
residence
 Family of changing residence- where family chooses where to live depending on the
situation
On the basis of ancestry or descent family can be classified into two main types
 Matrilineal family- the name of the family follows your mother’s family tree e.g in
Scotland
 Patrilineal family- the name of the family follows your father’s family tree
On the basis of size or structure and the depth of generations family can be classified into two
main types.
 Nuclear – family group consisting of father, mother (husband and wife) and their children
 Joint family- extended family arrangement prevalent among Hindus of the Indian
subcontinent where parents, their children, and their children’s spouses and offspring stay
in one dwelling unit.
On the basis of the nature of relations among the family members the family can be classified
into two main types.
 The conjugal family which consists of adult members among there exists sex relationship.
 Consanguine family which consists of members among whom there exists blood
relationship- brother and sister, father and son etc.
Parenthood

Parenthood is the most important profession yet there is no formal training for one to be a
responsible, successful and satisfied parent. People learn about parenting by observing and
imitating their parents.

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 What are the Priorities of responsible parenthood?

Responsible parents:

 Set aside a quantity and quality time to spend with their children.
 Learn about the way children develop at different ages.
 Teach their children rules for health and safety.
 Give their children love and affection.
 Teach their children with a positive attitude, avoiding condemnation and criticism.
 Teach their children values.
 Teach their children self-discipline and self-control by example and by using effective
disciplinary techniques rather than child abuse.
 Provide economic security for their children.
 Recognize that their children have rights and respect those rights.
 Rear their children in a stable, secure family that is free from substance abuse (alcohol
marijuana, among others)

What are the emerging challenges to the family institution?

Teenage parenthood
It is challenging because teenagers are changing emotionally, and physically. Also one is gaining
skills he or she would need to become an autonomous adult.

Teenage mothers may also be stressed by:

Dropping out of school hence, their potential income is only half of those women who finish
high school before having a baby. Equally teenage fathers have similar stressors

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 Teenagers with children are more likely to separate and divorce than married teenagers without
children.

Family violence

Family violence harms the health of many family members through; physical injuries, murders,
and child abuse.

Battered spouses

A battered spouse is a person who is physically and emotionally abused by a marriage partner.

Although some abusers are women, the most common abusers are men. Reasons:

 The man has poor self-esteem

 A high level of frustration
 Needs to control others
 May have been physically abused as a child
The most common victim is a woman who has low self-esteem and feels that leaving her
husband would pose financial difficulties. She may also feel that she wants to maintain the
marital relationship for the benefit of the children.

Interventions can be made through the legal processes and counseling of couples.

Child abuse

- This is maltreatment of children. Research has shown that 85-90% of child abuse is by family
members.
- Teenage parents are most likely abusers. Perhaps they had not planned to have a baby or they have
financial pressures or are poorly trained in parenting skills.
- Parents who were abused as children are also much more likely to abuse their own children.
- Parents who are involved in substance abuse are less stable and more likely to abuse children.

Separation and Divorce

What is the difference between legal separation and divorce?

On one hand, a legal separation is a court decree recognizing that a married coup is living apart
and regulating the couple’s multual rights and liabilities. The most important factors are that the
couple is still married, can still hold their real property as tenants by the entity (if one dies, the
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property automatically belongs to the survivor), may each have right to make medical or funeral
decisions for the other, and each will be the surviving spouse of the other for purposes of
inheritance.

Divorce on the other hand changes a couple’s legal status in relationship to one another. Their
marriage is legally dissolved. Once the decree has been entered each other relinquishes any
future claims against the other or their estate except for matters related to child support. If the
couple owns property, the tenancy is reduced to a tenancy in common. That is, if one dies their
half interest passes to their heirs at law. A former spouse has no right of inheritance.

Separation and divorce create stress within a family. Each family member is affected in some
way. Research has shown that some family breakages affect adolescent children more than
young children. This is because the adolescents stop getting parental love, support and guidance
when parents go their separate ways.

What are the effects of family breakages among children?

 Depression and withdrawal

 Demonstrate angry and hostile behavior.
 Poor performance in school

1.2 SUMMARY

In this topic you have learnt about the youth as a life

cycle, dating and different types of dating, courtship, marriage and
different types of marriage, the family, different types of families,
functions of a family, parenthood and the challenges faced by the
family institution in modern times.

ACTIVITIES
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In a school of your choice, find out the numbers of children from
single parenthood and establish some of the reasons for single
parenthood.

In your class discuss the challenges facing children from single

parent families.

1.7 FURTHER READING

Holford K. (2004). The Family Book. England: Stan borough Press

Limited.

Mutie E.K and Ndambuki P. (2011). Guidance and counseling for

schools and colleges. Nairobi: OUP.

Makewa P.M. (2008). Developing youth: Nairobi: Uzima publishing

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 SELF-TEST QUESTIONS

1. Discuss the functions of a family in society (15 marks)

2. Discuss the challenges facing the family institution in modern

times (15 Marks).

Score board

Score Grade Comment

20-30 A Excellent proceed

16- 20 B Very good proceed

6- 15 C Fair- repeat the weak areas

0-5 D Weak- repeat

L O
Learning Out come

You have now completed topic five and the learning outcomes are listed below

Put a tick in the column which reflects your understanding

SN Learning outcome Sure Not sure

1 I am able to define, youth, dating, courtship, marriage

2 I can discuss the challenges facing the youth in the modern society

3 I am able to identify the functions of a family, and essentials of

responsible parenthood
4 I am able to discuss the challenges facing the family institution in the
contemporary society.
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If you have put a tick at the ‘not sure’ column, please go back and study the section in the topic
before proceeding.

If you have ticked ‘sure’ in all the columns you are ready to for the next topic.

Congratulations! Proceed to the next topic!

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TOPIC SIX: DRUG AND SUBSTANCE ABUSE

Introduction
Welcome to the sixth topic in this module. In the previous topic you learnt about youth and
family life. In this topic you will learn about drug and substance abuse. In detail, you will learn
the commonly abused drugs in Kenya, the effects of those drugs and drug tolerance.

Objectives

By the end of this topic you should be able to:

 Define; drug and drug abuse

 Identify the commonly abused drugs in Kenya
 Relate the effects of drug and substance abuse
 Explain what drug tolerance is and its manifestations

This topic is divided into three sections namely;

 Definition of terms
 Commonly abused drugs and their effects
 Drug tolerance

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 DRUGS

What is a drug?

A drug is any chemical substance which when taken in to the body modifies or alters the way the
mind and body function from their normal state.

Drugs can be orally administered, injected, chewed, sniffed, smoked or applied.

Drugs can also be classified as legal and illegal depending on the country.

What is drug abuse?

Drug abuse is the non-medical use of drugs, for example: the use of alcohol, cigarettes and other
chemical substances that destroy health and productive life of an individual.

Drug abuse can also be defined as the intentional use of psychoactive substances for purposes of
altering one’s psychological state without medical supervision.

Drug abuse often leads to pathological drug dependence, a condition in which the abuser is no
longer able to stop using the drug even when the habit is causing serious damages to him or to
others.

Drugs that are abused in Kenya

There are two types of drugs commonly abused in Kenya that is positive and negative drugs.

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 What are positive drugs?

Positive drugs: these are drugs that are useful to our health.
These are drugs bought over the counter in the chemists, in clinics and on the streets.
They are abused in the following ways:
 Overdosing
 Under-dosing
 Doctoring one self
 Wrong drugs
 Drugs for pleasure
 Taking drugs from non-drug experts

What are negative drugs?

Negative drugs: are drugs which are risky to our health.

They include:
 Tobacco
 Alcohol
 Bhang
 Miraa/Khat
 Inhalants e.g. Petrol, glue, nails polish, oil paint, turpentine, thinner, gum. These are
petrol oriented materials, have very strong smell which is very addictive.
 Kuber
 Hard drugs e.g. heroin, cocaine, madrax,

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 DRUGS COMMONLY ABUSED IN KENYA

What are the commonly abused drugs in Kenya?

Tobacco
 Is a broad leafed plant (Nicotiana taba cum) that has been known to man from far back as
3500BC.
 It was cultivated by the Indian tribes of south and Central America who perceived it as an
herbal remedy against toothache, snake and insect bites.
 The plant is now grown primarily in third world countries including Kenya.
 In the farm, the plant is poisonous and can harm the person handling it through the skin
hence it is used as a pesticide.
 In the raw form it is known to be used by farmers as a pesticide and weed killer.
 The leave is harvested, dried, and processed into cigarette, snuff, cigar tuber etc.
 When it is burnt, the smoke releases over 4000 substances, majority of which are
poisonous
 When it is chewed, these poisons cause cancer of the mouth and throat
 At least 40 of the chemicals contained in tobacco cause over twenty five types of cancer.
 Tobacco contains nicotine, a substance that causes addiction.
 The four thousand plus chemicals which tobacco smokers pump into the body include
poisons like.
1. Hydrogen cyanide (used in gas chambers)
2. Arsenic (rat poison).
3. DDT (insecticide) which is harmful
4. Cadmium (highly poisonous metal used in batteries)
5. Carbon Monoxide (lethal gas)
6. Methanol (Rocket fuel)
7. Ammonia (found in toilet cleaner)
8. Acetone (paint stripper)
9. Tar (clogs lungs stains nails, teeth)
10. Formaldehyde (used to preserve dead bodies)
11. Other many cancer causing agents.

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 How harmful is tobacco?

According to World Health Organization (WHO) and World Bank studies, Tobacco killed 4.9
million people around the world in the year 2002.

By 2030 this will rise to over 10 million people dying every year all over the world.

 This figure will be more than the combined death from Malaria, road accidents,
childhood diseases, HIV and AIDS and Tuberculosis put together.
 Seven out of ten of the deaths will occur in the developing countries, Africa and Kenya
included.
 For every stick of cigarette smoked, the smoker looses 6 minutes of his or her life.
 Passive smokers suffer even greater because they inhale unfiltered cigarette smoke.
 They loose 6 minutes of their lives for every stick of cigarette smoked by neighbours.
 Increased distance from smokers decreases the risk
 Panting processing and handling tobacco also causes harm
 Over 60% of patients in health centers in tobacco growing areas of Kenya suffer from
the effects of nicotine that has been absorbed through the skin.

What is nicotine?

 Is a colourless poisonous chemical present in tobacco

 It is highly addictive
 It is readily absorbed through the skin and mucous membrane
 It is a central nervous system stimulant
 If taken in large amounts it can cause fatal seizures.
 The addictive power of nicotine can be measured by the number of smokers who
have difficulties in stopping the use of drugs.
 The uptake of nicotine in the blood stream is instantaneous and the drug takes a
mere 7 seconds to reach the brain cells
 One needs to smoke the first five sticks of cigarette to get hooked forever.
 Nicotine is extremely toxic and addictive.
 It also causes the blood vessels to constrict leading to high blood pressure.

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  Long time use of nicotine especially in diabetics causes heart attack.
 Large amount of nicotine can kill by paralyzing the muscles of the lungs.

What are the health problems linked to tobacco chewing and

sniffing?

 Mouth cancer
 gum diseases
 throat cancer
 heart disease
 stroke

Thus, tobacco use is risky to one’s health

Smoking during pregnancy is also dangerous as follows;

 It can lead to increased risk of neonatal mortality or Sudden Infant Death Syndrome
(S.I.D.S)
 Babies of mothers who smoke during pregnancy are often smaller than normal
 It may lead to still birth, miscarriage and premature deliveries than women who do not
smoke
 Babies of smoking mothers have a high rate of pneumonia, asthma and bronchitis in their
first year
 The babies of mothers who smoke may experience impaired physical growth and low
academic attainment compared to children of non smoking mothers.

Can smoking be stopped?

Yes smoking can be stopped, however;

 Due to high nicotine level the body is used to, it is difficult but it is very possible
to stop
 stopping should be gradual
 reduce levels if one cannot stop at once
 smoking is learnt behaviour that can be unlearnt

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 Tips to help one stop smoking!

 A strong will to give up the habit, an inner power that causes you to overcome. This can
be cultivated by the correct understanding of the dangers of smoking and desire to live a
long healthy life.
 Learn about the dangers of smoking
 Be conscious of every cigarette smoked, the place one is likely to smoke and time. Keep
a record of these so as to identify the circumstances that trigger the craving and monitor
your progress.
 Write down the benefits of not smoking and reasons why you began smoking no matter
how obnoxious they may sound.
 If one is already dependent on cigarette, should reduce the intake gradually to avoid the
unpleasant effects of withdrawal.
 Where possible avoid places, events or people who trigger you to smoke. Avoid smokers
and occupy non smoking sections only.
 Eat fruits and drink plenty of water and fruit juice to flush out nicotine.
 Do exercises as this helps to stimulate the body, causes relaxation and helps relieve
stress.
 When craving arises, chew on low calorie nibbles like carrot or gum.
 Ask a non-smoking friend for moral support.
 Avoid having a lot of unstructured time.
 Medication is also valuable, consult a doctor.
 Use of Nicotine patches.
Alcohol

What is alcohol?

Alcohol is a chemical compound produced by fermentation of sugar using yeast.

Such sugars are derived from grains, coconut, fruit juice, sugar cane, potatoes, bananas, honey.
The chemicals interact with yeast to provide the active ingredient called ethanol amongst other
chemicals. For instance, beer and whisky is made from hops and malts; wine and brandy from
fermenting grapes; Changaa is made from various grains including millet and maize and Mnazi
from taping coconut juice.
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Generally, ethanol content in various alcoholic drinks is as follows though it varies from one
brand to another.
 beers 5%v/v
 wines 12%v/v
 spirits 40% v/v
 changaa 90% v/v

Sometimes the fermentation process is incomplete and other substances find their way into
alcoholic drinks e.g. methanol- a product of wood alcohol or isopropyl- alcohol which is used for
cleaning wounds.

Factors that affect alcohol absorption

 Alcohol is absorbed unaltered from both the stomach and the small intestines.
 Mixes in all quantities with water hence can reach all parts of the body systems
 It is absorbed and distributed faster in people with small body mass.

The factors which affect distribution include

 Concentration of alcohol in the alcoholic drink

 The quantity taken
 The rate at which it is taken

Drinking too fast does not allow the liver and body to metabolize the alcohol fast enough.

The liver can only break down once 28.35g of alcohol per hour and therefore only passage of
time will allow for complete elimination of alcohol from the body.

The presence of food especially fatty foods in the stomach slows down absorption of alcohol

Intake of carbonated drinks and poor nutritional status of a person may accelerate the absorption
of alcohol.

What are the dangers of taking alcohol?

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 Alcohol contains ethanol which is a very poisonous chemical that adversely affects body
organs immediately or gradually over the years.
 Organs such as the brain, liver, stomach, pancreas, kidney, skin and bones among others are
affected.
 Alcohol causes diabetes, heart failure, stomach ulcers, kidney failure, and brittle bones that
fracture easily.
 Alcohol can cause vomiting through its direct irritation of the sensitive stomach lining and
stimulation of the vomiting centre in the brain to some people.

Some brewers add some adulterants added to presumably make them more potent. These include
bhang, heroine, sisal juice, formaldehyde, battery acid, human urine, and other toxic substances.

These factors added, greatly to the unpredictability of the effects and damage from consumption
of these drinks.

The consumer can rarely be sure how strong or poisonous the adulterated drink is.

What are the effects of alcohol?

Most effects of alcohol when taken take place in an incremental way and are not noticed
immediately.
• Continued use of alcohol may lead to a false sense of security in matters regarding health
risks.
• When taken drinkers feel happy and are talkative
• Later they become drunk
• Makes all muscles numb
• Sharpness of sight is lost
• Personality changes are experienced-person becomes impatient and aggressive.
Mouth
• An increasing thickening of the tissues that line the mouth
• Gradual loss of taste
• Changes to the tissues may predispose to cancers of the mouth
Heart
• Inflames and damages heart-muscle
• Hardening of arteries

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 • Fatty degeneration
Pancreas
• Irritates the cells leading to swelling and bleeding causing diabetes
• Blocks flow of digestive enzymes
Stomach and intestines
• Alcoholic gastritis
• Causes stomach and duodenal ulcers
• Interferes with nutrition vitamin B1, B2 folic acid, fat and some amino
acids.
• Stomach lining shrinks.
Circulatory system
• Blood vessels dilate causing the individual to feel warm while actually
experiencing heat loss.
• Slows down circulation and action of the white blood cells thus delaying
the process of resistance to infection.
• Causes red blood cells clump together. This increases the risk of blood
clotting and it inhibits oxygen transportation to the tissues.
Liver
– Results to jaundice
– Cirrhosis of the liver
– Nutritional deficiencies are experienced
Sex glands
 Swelling of prostate gland this interferes with sexual performance
 Can lead to spontaneous abortion in women
Kidney and bladder
 Alcohol increase fluid loss and extra water is expelled
 The bladder is inflamed making it difficult to stretch and accommodate the extra
fluid.
Brain and spinal cord
 Causes gradual destruction of the cell of the cortex of the brain.
 Loss of control and reflex action
Kuber

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 What is Kuber?

It is a substance made from leftovers from cigarette manufacturing in India. It is swept from the
factory floor and packed in colorful sachets for export to Kenya and other African countries. It
contains 41% nicotine which is highly addictive. It also contains other unknown substances as it
is unregulated. By comparison, cigarette contains 14-21% nicotine. It is meant to hook young
users.

Kuber is banned in India its country of origin an indication that it is unfit for human
consumption.

Bhang

What bhang?

 Bhang is the leaves, flowering shoots, seeds and other parts of a plant called Cannabis
Stiva.
 Positively used it has been prescribed to relieve cancer patients chemotherapy side effects
 It has other 69 names of which are Ganja, Weed, Stone, Marijuana, Pot, Grass,Kizusha
Bongo, Holy Herb, Ngwai, Kaya, Maryjay, Joint, Spliff, Hashish, Dagga, Hemp etc.
 It is used by smoking and contains cannabinoids which are mind altering substances.
 It also contains delta a tetrahydrocannabinol (THC).
 The chemical can remain in the body for long time (36days or more) even when one has
stopped using bhang.
 It is against the law to grow, possess use or trade in Bhang in Kenya.
 Bhang has over 400 chemical substances most of which are harmful to the body
 Bhang smoke contains 50% more tar cancer causing substance than smoke from
cigarettes.
 The residual effects can last a lifetime and often leads to mental problems for some users.
 it is used by both male and female in schools

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 What are the short term effects of taking Bhang?

 Relaxation
 Delayed fatigue
 Distortions of time and space
 False bravery
 False confidence
 Delusion
 Unreasonable fear
 Weird dreams
 Restlessness
 Irritability
 Aggression
 Sleeplessness
 Nausea and cramps
 Narrow-mindedness
 Loss of coordination
 Sudden panic
 Lack of interest
 Poor judgment
 Detachment from reality.

What are the long term effects of Bhang?

Bhang consumed in high doses and for a long time can lead to:
• Impaired motor coordination.
• loss of steadiness in the hands and body movements
• Increased reaction time so that response to stimulus is slowed.
• Diminished short term memory
• Distorted sense of time.
• Impaired ability to conduct a logical conversation.

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 • Can lead to a motivational syndrome- this is a pattern of personality changes
characterized by apathy, lack of concern for future, loss of ambition and decline in school
and work performance.
• May harm lungs.
• Causes cancer
• Increases blood pressure
• Can lead to reduced testosterone level in men
• Reduced sperm count
• Abnormal menstrual periods and failure to ovulate
• poor immunity
• brain shrinkage
• red blood shot eyes
• urge to use other strong drugs
• can lead to insanity
• can lead to death

Bhang and crime

Does bhang contribute to crime?

Yes!

 Bhang has been referred to as a ‘focusing drug’

 One of its major effects is narrow mindedness i.e. thinking or concentrating on a single place
or thing. Such narrow mindedness enables bhang abusers to focus on any particular subject
with vigor, determination, and recklessness that borders on insanity. This at times may be
misinterpreted to mean confidence and success.
 Bhang also interferes with attention, concentration, memory and logical thinking so that an
individual’s ability to perform complex actions or to make sound judgment becomes altered.
 Such a person becomes violent and runs into serious problems.

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Miraa

What is miraa?

Miraa is a plant whose fresh leaves and soft twigs are chewed to release a juice containing
cathinone and cathine, the active chemicals that alter the mood of the abuser. Cathinone is a
stimulant, which is said to cause excitement, loss of appetite and euphoria. In 1980, the World
Health Organization (WHO) classified it as a drug of abuse that can produce mild to moderate
psychological dependence.

Consumers also refer to miraa using less familiar names such as Khat, Veve, Muguka, Goks,
Gomba, Mbachu, Mairungi, Alele, Giza or Halwa. (NACADA, 2010).

What Are The Effects of Chewing Miraa?

• Causes one to feel exited

• One feels healthy
• Lack of sleep
• Loss of memory of major events
• Poor concentration
• Instant poisoning

Long Term Effects of miraa?

• Irritability
• Difficult to please
• Impotence
• Natural ejaculation after 72hours (spermatorrhoea).
• Bad smell- mouth

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 • Mouth disease
• Constipation
• Infertility
• Irregular periods
Depresses bone marrow

Hard Drugs and soft drugs

From the above discussions of some of the drugs abused, we can deduce that some drugs are
acceptable to use but with reservations. These may be referred to as soft drugs as opposed to hard
drugs which are addictive and perceived to be damaging.

What is the difference between soft and hard drugs?

Hard and Soft drugs are terms to distinguish between psychoactive drugs that are addictive and
perceived as especially damaging and drugs that are believed to be non-addictive (or minimally
addictive) and with fewer dangers associated with their use. The term "soft drug" is considered
controversial by its critics because it implies that the drug causes no or insignificant harm.

What are the classifications of the hard drugs?

 Opiets (E.g.- morphine, Codeine, heroine, methadone)

• They are psychoactive drugs derived from the opium poppy plant or made synthetically.
• They induce sleep and reduce pain;
• Non medical use of opiets is illegal and dangerous.
• They are highly addictive
• A person dependent on opiets may have withdrawal symptoms.
• If a certain level of the drug is not maintained in the blood one develops flu like
symptoms.

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 • Further drop may result to weakness, nausea, vomiting, stomach pain, muscle pain.

Depressants
Drugs that slow the down the functions of the central nervous system
• Depressants that produce a calming effect, relax muscles or relieve tension are called
sedatives.
• Large doses of sedatives induce drowsiness leading to sleep.
• Drugs that have sleep inducing effects are called hypnotics.
• The combination term of sedative hypnotic describes the drugs in this section.
• Sedatic-hypnotic drugs produce a variety of effects when misused or abused.
• They can cause nausea, headaches, dizziness an drowsiness, withdrawal symptoms and if
not treated the symptoms can cause death.

Stimulants E.g.: amphetamines and cocaine

• Drugs that increase the functions of those organs controlled by the central nervous
system.
• Amphetamines are a group of synthetic chemicals that affect the areas of the brain that
control blood pressure, the heart, breathing rate, and metabolism.
Short term use can cause nervousness, elevated blood pressure and headaches.
• Long term use can result in sleeplessness, irritability, confusion, dizziness, elevated blood
pressure which can lead to burst of blood vessels, tolerance and psychological
dependence etc.
Cocaine
• Obtained from the leaves of the coca shrub
• Coca shrub grows in the Andes Mountains IN South America.
• Cocaine in most cases is illegally used.
• Cocaine enters the blood stream when sniffed. It can also be injected.
• One use of cocaine that is dangerous is freebasing.
• Freebasing is a chemical process in which cocaine powder is changed into a smokable
solution.
• Cocaine can cause restlessness, irritability, depression,. Elevated blood pressure, heart
damage, damage of the mucous membrane and the nose, disruption of eating and sleeping
habits and weight loss and cocaine psychosis.

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 What are the stages of the effects of drugs?

Stage I: causes euphoria where one feel exited. This is also called the trapping stage.
Stage II: Normal between abnormal.
In this stage the drug abusers get tolerance and dependency.
If one does not get the drug they get withdrawal syndrome.
(Can get phobia, can become violent, or is angered very fast).
Stage III: This is a visionary stage.
 One gets hallucinations, illusions, Derichams, nightmares, (can see angels and ghosts)
 can feel they are God
 can dream wildly and yell

Why do young people take drugs and get trapped?

• Family: copying from parents-this creates a subconscious desire for imitation.

• Poor family cohesiveness – especially when there is family break up or family members
especially parents who are busy to give attention to children.
• Friends – that is influence from friends in school or in the neighborhood
• Peer pressure – where one takes drugs so as to feel accepted by peers
• Ignorance – some take drugs out of lack of information especially when cheated by
friends.
• Curiosity- to taste what it feels
• Hero worship e.g. Rasta faris, Black- black people, Green- Green Bangi, Yellow- Jah
lovers, Red- oath of solidarity.
• Belief in three things: sex, freedom, smoking bhang or drug taking.
• Belief in fighting three people: parents, church, and authority.

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Physiological and psychological effects of drug and substance abuse

What are the physiological and psychological effects of drug and

substance abuse ?

Do you know what drug dependence is?

Drug dependence is a state of being enslaved by drugs. We have physiological and psychological
dependence. Physiological dependence means that if you remove the drugs the body cannot
function. If it functions, it will have great discomfort or feeling of sickness e.g.
 One cannot fall asleep without drugs.
 One can have diarrhea.
 One can have irregular heartbeat
 Pain
 Shaking of hands.

When you take the drug, the symptoms disappear temporarily until the levels fall once more.
Psychological dependence – is when the drug is taken for stimulation or pleasure.

What is Drug addiction?

Drug addiction is a state when drug dependency has developed to such an extent that, it has
serious detrimental effects on the user and often on their family as well.
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 - Addiction is characterized by loss of control over the use of the drug, one cannot do
without it.

- An addicted person is compelled to use drugs everyday to remain intoxicated and has
great difficulty in stopping.

- Drugs take over their life. The cells of the body become adapted to the presence of that
substance and without it they cannot function.

What is Drug Tolerance?

This is a condition in which the body requires increasingly large amounts of the drug to achieve
the same effect due to frequent and continuous use. For example, a person who has taken more
alcohol or to get high for long may require more to reach the desired effect. Tolerance is one
indicator of progression to addiction.

What are signs of drug abuse among the youth?

There many signs one can observe as signals of drug abuse among youth. They include the
following:
a) Possession of drug released paraphernalia
- Rolling paper called rizzla – small rectangular or mostly bright while paper in packs of
50.
- T-shirts shakers caps with a picture of bhang leaf or Bob Marley in red yellow and green
colours.
- Necklaces bearing signs of bhang leaf.
- Small bottles of nose and eye drops.
- Small Beltane to rules, lighters burnt spoon and candles.
- Syringes and needles.

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The other category of signs includes:

b) Possession of drugs or evidence of drugs for instance:

- Having Peculiar plants, bulbs, seeds leaves in ash tray or clothing pockets.
- Availability of Banana leaves and miraa-twigs.
- Traces of powder and round nostrils
- Empty bottles under their beds.
- Wearing sun glasses even in the house.
- Medicines to relieve constipation (laxatives).
- Odour of drugs.
- Cover up scents e.g. air and mouth fresheners, incense and aerosol sprays.
- Brushing teeth many times in a day.
- Constantly sucking oink and chewing gums.
- Wearing long sleeved shirts to cover needle marks.
- Blood short eyes, dilated pin pointed pupils drooping eyelids due to over sensitivity to
sunlight necessitating sunglasses, a running nose for no medical reason.
Others signs are related to:
c) Identification with drug culture such as
- Drug related magazines, slogans on clothing.
- Conversation and jokes that are pre occupied with drugs.
- Hostility in discussing drugs.
- Keeping company of known drug abusers and peddlers.

d) Other categories of signs are related to physical deterioration such as:

- Memory lapses, short attention span difficulty in concentration.
- Sexual problems which include lack of appeal, function and promiscuity.
- Disturbed sleep patterns including over-sleeping, marked drowsiness, moodiness,
fatigued look, restlessness.
- Poor physical co-ordination, slurred or incoherent speech.
- Chronic cough that does not respond to treatment.
- Unhealthy appearance.
- Indifference to hygiene and grooming.
- Burnt or stained thumb nails, burn holes on clothing.
- Track marks as evidence of using needles.
- Unpleasant skin rash

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 - Excessive sweating
- Complaints of headaches especially if they are associated with memory loss.
- Drop in appetite or sudden heightened appetite for food.

e) Other signs are dramatic changes in school performance categorized

in form of:
- Drastic downward trend in students’ grades.
- Increased withdrawal behaviour e.g. keeping to themselves.
- Generally being anti-social
- Work and assignments not completed.
- Increased absenteeism.
- Lacking in energy.
- Inattentiveness, lack of concentration losing touch with reality, low motivation with a
blank facial expression.
- Poor workmanship.
f) Lastly are signs to do with changes in behavior such as:
- Quarrelsomeness, outbursts of violence or unexplained anti-social behaviour.
- Chronic dishonesty, lying cheating stealing and trouble with police.
- Household items disappearing (sold to buy drugs).
- Changes in friends, evasiveness in talking about them and referring to them by their first
names e.g. Vic, Bob.
- Nervous mannerism – frequent lip liking, jittering, foot trapping.
- Demand for large amounts of money.
- Reduced motivation, energy, self discipline and self esteem.
- Diminished interest in extra-curricular activities and hobbies.
- Leaving home early and coming back late.
- Irregular class attendance, frequent requests to go out of schools that are made to sound
as a matter of life and death.
- Sudden laughter, outbursts for reasons not really worth it.
- Disorientation in time and space.

SUMMARY

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In this topic you have learnt about drugs and substance abuse, the commonly abused drugs in Kenya,
the effects of drug abuse, reasons people abuse drugs and the signs of youth/ students abusing drugs.
 2. Discuss the effects of drug and substance abuse among the youth (10 marks)

3. Discuss the common physical symptoms of youth under the influence of drugs?
(18 marks)

Carry out a survey to identify the commonly abused drugs in your community.

Identify the reasons for the abuse of those drugs in your community.

ACTIVITIES

Njenga Frank (2010). What’s wrong with this child? A guide for Parents and Teachers. Nairobi: Oxford
University Press.

Narcotic Drugs and Psychotropic Substances (Control) Act, 1994

Alcoholic Control Act, 2009

1.8 FURTHER READING

SELF-TEST QUESTIONS

Score board

Score Grade Comment

20-30 A Excellent proceed

16- 20 B Very good proceed

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6- 15 C Fair- repeat the weak areas

0-5 D Weak- repeat

L O

Learning Out come

You have now completed topic six and the learning outcomes are listed below

Put a tick in the column which reflects your understanding

SN Learning outcome Sure Not sure

1 I am able to define drug and substance abuse

2 I can explain the difference between positive and negative drugs

3 I am able to identify the commonly abused drugs in Kenya and their

effects
4 I am able to identify symptoms and sighs of drug abuse among the
youth
If you have put a tick at the ‘not sure’ column, please go back and study the section in the topic
before proceeding.

If you have ticked ‘sure’ in all the columns you are ready to for the next topic.

Congratulations! Proceed to the next topic!

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TOPIC SEVEN: HIV AND AIDS COUNSELLING

Introduction

Welcome to the seventh topic of this module, in the previous topic you learnt about drug and
substance abuse. In this topic you will learn about HIV and AIDS counseling. Remember in
your first year course CDM 100 you learnt about HIV and AIDS in detail. You are at liberty
to go through your previous notes. In this topic emphasis will be on HIV and AIDS
counseling.

Objectives

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 By the end of the topic you should be able to:
2. Define HIV and AIDS
3. Explain how HIV and AIDS is spread
4. Describe different modes of prevention of spread of HIV and AIDS
5. Describe the HIV counseling stages and process
6. Carry out HIV counseling and handle the challenges in HIV and AIDS
counseling.

Definition of terms

HIV stands for Human Immunodeficiency Virus (HIV)

AIDS is: Acquired Immunodeficiency Syndrome (AIDS)
 Acquired –means it is not hereditary
 Immune –refers to the body’s defence system
 Deficiency – means impairment of the immune system
 Syndrome – combination of signs and symptoms

MEANING: HIV and AIDS is a disease caused by deficiency in the body’s immune system.
It is a syndrome because there are a range of different symptoms which are not always found
in each case. It is acquired because AIDS is an infectious disease which is spread from
person to person, through various means.

How are HIV and AIDS spread?

HIV and AIDS are transmitted through: Sexual intercourse, blood transfusion and from
mother to child especially during birth.

a) Sexual transmission
 Requires direct contact between two people, in which the virus is transmitted from an
infected person to a susceptible person.
 Through heterosexual activity and homosexuality.

b) Transmission through blood

 Transfusion of blood
 Hemophiliacs and factor 8 – have a genetic deficiency that prevents blood from
clotting in cases of cuts and injuries.
 Infected drug users.
 Skin piercing

c) Mother to child transmission

Other factors which contribute to the spread of HIV and AIDS include:
i) Socio-cultural factors
 Absentee husbands
 Polygamy
 Wife sharing
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  Wife inheritance
 Traditional initiation rites
ii) Economic factors
 Kenya’s economic performance has not been good for some years.
 51% of the population the majority of whom are women, and ¾ of whom are in the
rural areas, where access to treatment is a challenge.

What are the models of prevention of spread of HIV and AIDS?

ABC Model of Prevention

A is for Abstinence - not engaging in sexual intercourse or delaying sexual debut. Whether
abstinence occurs by delaying sexual debut or by adopting a period of abstinence at a later stage,
access to information and education about alternative safer sexual practices is critical to avoid
HIV infection when sexual activity begins or is resumed.
B is for Being faithful (sometimes Be safer) - being faithful to one's sexual partner or reducing
the number of sexual partners. Having fewer sexual partners reduces the risk of HIV exposure.
However, strategies to promote faithfulness among couples only lead to lower incidence of HIV
when neither partner has HIV infection nor both are consistently faithful.
C is for Correct and Consistent Condom use - condoms reduce the risk of HIV transmission
for sexually active people, couples in which one person is HIV-positive, sex workers, and their
clients. Research has found that if people do not have access to condoms, other prevention
strategies lose much of their potential effectiveness.
A, B and C interventions can be adapted and combined in a balanced approach that will vary
according to the cultural context, the population being addressed, and the phase of the epidemic.
Source: 2004 Report on the global AIDS epidemic, UNAIDS

What is the SAVE model of Prevention?

S refers to safer practices - covering all the different modes of HIV transmission. For example:
safe blood for blood transfusion; barrier methods for penetrative sexual intercourse; sterile
needles and syringes for injecting; safer methods for scarification; and adoption of universal
medical precautions.

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A refers to available medications. - Antiretroviral (ARV) therapy is by no means the only
medical intervention needed by people living with HIV. Long before it may be necessary, or
desirable, for a person to commence ARV therapy, some HIV associated infections will have to
be treated. Treating these infections results in better quality of life, better health, and longer term
survival. Every person needs good nutrition and clean water, and this is especially true for people
living with HIV and AIDS.
V refers to voluntary counseling and testing. - Individuals who know their HIV status are in a
better position to protect themselves from infection; and if they are HIV-positive, from infecting
another. Someone who is HIV-positive can be provided with information and support to enable
them to live positively. People who are ignorant of their HIV status, or who are not cared for, can
be sources of new HIV infections.
E refers to empowerment through education. - It is not possible to make informed decisions
about any aspect of HIV or personal behavior without access to all the relevant facts. Inaccurate
information and ignorance are two of the greatest factors driving HIV and AIDS related stigma
and discrimination. Correct, non-judgmental information needs to be disseminated to all, both
inside and outside the church. This will assist people to live positively - whatever their HIV
status - and to break down barriers which HIV has created between people and within
communities. Education also includes information on good nutrition, stress management, and the
need for physical exercise.

What is HIV and AIDS counseling?

HIV and AIDS counseling is the provision of support and strength to individuals, couples,
families or groups by, competent persons, to help them cope with the knowledge that they are
infected or affected by HIV. It is an ongoing process that allows the individuals to develop a
sense of responsibility in meeting challenges posed by their infection. Counselling should also be
given to HIV negative individuals to promote behaviour change and condom use.

One of the facets of HIV and AIDS counseling is information giving. A thorough up to date
knowledge of facts related to HIV/AIDS is required by the counselor to enable clients to make
informed decisions and cope with HIV infection.

Various studies have proved that good counselling has:assisted people to make informed
decisions—such as whetherto have an HIV test; helped many other people living with HIVor

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AIDS to cope better with their condition and lead morepositive lives; and helped prevent HIV
transmission.

How is HIV counselling carried out?

HIV counselling is a confidential dialogue between a client and a counsellor aimed at enabling
the client to cope with stress and take personal decisions related to HIV/AIDS.

It concentrates specifically on emotional and social issues related to possible or actual infection
with HIV and to AIDS.

With the consent of the client, counselling can be extended to spouses, sex partners and relatives
(family-level counselling, based on the concept of shared confidentiality). HIV counseling has as
its objectives both prevention and care.

A counselor is a person trained in the skills of the job: listening to the client, asking supportive
questions, discussing options, encouraging the client to make his or her own informed decisions,
giving practical information and suggesting follow-up.

Counselling should be a process involving a series of sessions as well as follow-up. It can be

done in any location that offers peace of mind and confidentiality for the client. Two types of
counselling, according to site, are practiced.
 Clinic-based counselling is counseling provided in a formal session— in a
hospital, health centre or clinic—by a trained professional, such as a doctor, social
worker, nurse or psychologist.
 Community-based counseling is given in a non-formal environment, in a village
or urban neighbourhood—by one community member trained in counselling to
another community or family member.

What is pre - test counseling

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Pre-test counseling is
 HIV counselling is often given in connection with a voluntary HIV test. Such counselling
helps to prepare the client for the HIV test, explain the implications of knowing that one
is or is not infected with HIV, and facilitates discussion about ways to cope with knowing
one’s HIV status.
 It also involves a discussion of sexuality, relationships, possible sex- and drug-related
risk behaviours, and how to prevent infection.
 It helps correct myths and misinformation around the subject of AIDS. Whenever
resources permit, pre-test counselling should be made available to those who desire it.
People who do not want or do not have access to pre-test counselling should not be
prevented from taking a voluntary HIV test, however. In contrast, informed consent is
always required before an HIV test where the individual’s name will be linked to the
result.
 To allay anxieties while awaiting the test result, some individuals may seek support not
only from their own families or a knowledgeable community worker.

What is post- test counseling

 Post-test counselling helps the client understand and cope with the HIV test result.
 The two usually discuss ways to reduce the risk of infection or transmission. HIV test
results should always be given with counselling. The form of post-test counseling will
depend on what the test result is.

 Where it is positive, the counsellor needs to tell the client clearly, and as gently and
humanly as possible, providing emotional support and discussing with the client on how
best to cope, including information on relevant referral services. Ongoing counseling will
help clients accept their HIV status, and take a

 But counselling is also important after a negative result. While the client is likely to feel
relief, the counsellor must emphasize several points. First, because of the “window
period”, a negative result may not mean absence of infection, and the client might wish to
consider returning for a repeat test after 3-6 months. Second, counsellors need to discuss

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 HIV prevention, providing support to help the client adopt and sustain any new safer
practices.

STAGES OF COUNSELLING

What are the Stages in the Counselling process?

There are three stages in the counseling process these are: the beginning stage, middle stage
and terminal stage.

What does the beginning or relationship building stage involve?

This is the stage that influences the course of the counseling process.
 It is the first time the client and counseller are meeting
 The counseller should take the opportunity to assure the client of confidentiality
and trust
 Also includes history taking and exploration of the client problem and how the
client feels about it.

What is in the Middle or information gathering stage?

iii) When the client is sure that the counselor can be trusted, and will provide
information, guidance and support, the counseling enters the middle stage.
iv) During this stage of information gathering the counselor should:
1. Support the continuing expression and discussion of feeling
2. Promote the continuation of changes in behaviour
3. Help the person to move towards acceptance and control

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 What is in the terminal/ end stage?

At some point counseling has to end. Therefore this is the final stage in counseling.
v) It’s often difficult for clients who have built a close relationship with their
counselors
vi) The thought of ending the counseling relationship may be painful for buth
client and counselor
vii) The counselor should assure the client of continued help with handling future
problems

Psychological Reactions

What are the psychological reactions to HIV diagnosis?

As the HIV infection is fatal, being diagnosed HIV positive can create varying psychological
reactions in the individual. The following are some of the possible reactions:

 Shock – usually characterized by: silence, numbness, disbelief, despair and withdrawal
 Anxiety – physical symptoms, for example, elevated blood pressure, upset stomach,
and change in appetite, tension, headache etc or behavioural symtoms such as
decreased productivity, increased use of alchohol, drug and smoking, loss of interest in
usual activities, among others.
 Denial - clients diagnosed with HIV infection may say “this cannot happen to me” as
a sign of denial
 Anger – experienced after the initial shock and can be directed at a sexual partner or
oneself. Leads to: deliberate effort to spread the virus to others, abuse of achohol/drugs.
 Guilt – the fact that HIV is related to lifestyle, it causes self – examination of past
lifestyle or seen as a punishment from God.
 Depression – leading to: fatigue, loss of memory, weight loss, decreased social
interactions, feeling of worthlessness. Decreased libido.
 Hypochondria – an exaggerated concern over one’s health.

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  Bargaining – Prayer and appealing for magical power, seeking any form of healing
( traditional or faith healing), performing cultural rituals to appease the
 Acceptance – the realization that: one’s condition is inevitable, there is no cure, the
infection is permanent and the individual has to live with it.

Counseling Challenges

What are the commonly experienced challenges in HIV

counseling?

The challenges include but not limited to:

1. Poor selection of trainees for counselling
People are sometimes put on training courses simply because they are “due” for another course,
or to fill up the course, and not because they will be taking up positions as counsellors. This is
one reason why those trained in counseling often do not continue to practise it.

2. Lack of supervised practice and follow-up after training

Because counselling is a skill dependent on the personal qualities of warmth and understanding,
it is often mistakenly assumed to require little in the way of preparation and practical training.
For this reason, a 2-3-day workshop, without any supervised practice, is sometimes felt to be
enough to produce a trained counsellor.

3. Inadequate resources, facilities and organization

• Counselling is not considered an essential social service, and there are therefore no clear
policies on funding.
• Sometimes there is a lack of confidentiality.
• Counsellors often have an established job—such as nursing—which is regarded as taking
priority over counselling. Without priority or proper resources being given to counselling, many
counselors have to carry out home visits in their spare time, as a voluntary activity. The
consequent frustration can result in burnout.

4. Burnout
Burnout is a state of emotional exhaustion, which results when the counsellor has reached his or
her limit to deal with HIV and the emotional stress it causes. This may lead to a state of
irritability and anger, often directed at supervisors, colleagues and even clients.

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T

In groups discuss other possible challenges to counseling?

E WHAT Challenge
Suggested ways to overcome the challenges

The following are suggested ways to overcome the challenges

Establishing the role of HIV counselling

One way counselling can be accorded its proper respect is by conducting studies on its delivery,
quality and impact. Research findings on counselling can help convince decision-makers and
service managers to endorse and provide resources in support of counselling services.

Proper selection of trainees for counselling

Candidates for a counseling training course should satisfy a number of conditions. They must be
given a job description that specifies that they can provide counselling. They must have the
necessary agreed professional background—this may be as a social worker, health worker,
teacher, community worker, or a volunteer from a group of people living with HIV/AIDS.
Training workshop, followed by supervised practice
Most of the current effort in training takes the form of a single workshop, with no follow up
supervision. Instead, after the initial workshop the trained person should be placed in counselling
work, with support and good supervision, and should participate in a second training workshop
later.
Retention of trained counselors
In Tanzania, a study showed that of those who had received counseling training, less than a
quarter were reported to be practicing counseling. Counsellors often leave their jobs, most
probably because of burnout and lack of proper support.

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Summary

In this topic you have learnt about HIV and AIDS and counseling where HIV and AIDS have been
defined. The mode of transmission of how HIV and AIDS have been explained, different modes of
prevention of spread of HIV and AIDS explained and counseling process and stages. You have also learnt
how to carry out HIV counseling and handle the challenges in HIV and AIDS counseling.

Activity

Visit a VCT centre and establish the counseling stages and process and the challenges the counselors face
in the course of their duty.

Further reading
Salhan S. (2003). Women and HIV. Delhi: Lordson Publishers (P) Ltd.

K.I.E. (1999). AIDS Education. Facilitators Handbook. Nairobi K.I.E.

Mombe P.A. (2002), Rays of Hope. Managing HIV/AIDS in Africa.

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 SELF-TEST QUESTIONS

Score board

Score Grade Comment

20-30 A Excellent proceed

16- 20 B Very good proceed

6-1.15Explain the main stages in

C HIV counseling (9 marks)
Fair- repeat the weak areas

2. Discuss the modes of handling

0-5 D the challenges facedWeak-
by HIV and AIDS
repeat
counselors (12 marks)
L 3. Discuss
O why HIV and AIDS is wide spread in the developing countries (9 marks).

Learning Out come

You have now completed topic seven and the learning outcomes are
listed below
Put a tick in the column which reflects your understanding
SN Learning outcome Sure Not sure

1 I am able to define HIV and AIDS

2 I can explain the stages in counseling in HIV and AIDS

3 I am able to discuss the challenges facing counselors in HIV and

suggest ways of handling the challenges
If you have put a tick at the ‘not sure’ column, please go back and study the section in the topic
before proceeding. If you have ticked ‘sure’ in all the columns you are ready to for the next
topic.

Congratulations! Move to the next topic!

TOPIC EIGHT: MODERN TECHNOLOGY AND HEALTH

 The use of modern technological equipment

 Health hazards associated with use of modern technological equipment

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Introduction
In the previous topic you learnt about counseling as it relates to HIV and AIDS in this topic you
will learn about modern technology discussing the effects of modern technology on health
especially among school going age.

Objectives

By the end of the topic you should be able to identify the positive and negative effects of
modern technology in society.

All societies want to grow and prosper. For a society to prosper and advance, it requires; security
to defend itself against both internal and external threats to it individuals and to the entire
society. It also requires the economy to produce goods for consumption, provide services, and
improve the overall quality of life for its citizens and education to prepare its citizens so they can
benefit from what is already known and even add to the world’s body of knowledge. The above
mentioned are achieved through telecommunications where for example computers, the
manufacture of space technologies of satellites, space craft, and space station among others are
critical. Medicine and health care, agriculture, environmental management, entertainment, and
architecture.

To actualize the prosperity, utilization of technology is important. However, the use of the same
technology has positive and negative impacts to the people utilizing it.

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What are some of the effects of use of modern technology?

Technology has contributed to:

Longer Life

With new agricultural methods and equipment, the world is able to produce more food with less
work at a cheaper price. With better medicines and more effective treatments, people can survive
diseases that would have once easily killed them.
More Information
Improvement in communications technology, beginning with the invention of the printing press
in the 15th century and continuing up through the proliferation of the internet in the 1990s, has
allowed more people access to an amount of information that would have once been impossible.
It helps them to become better educated and more informed.

Form groups and discuss other positive aspects of using modern technology in society today.
Modern technology has also brought in adverse effects on society. Some of the negative effects
of modern technology include:
Mechanized Destruction
Use of modern weapons provides humans with the means of bringing themselves to a rapid
extinction. For example use of modern weapons in conflict and war is very destructive.
Isolation
Computers have significantly reduced the amount of face-to-face interaction people once
enjoyed. In place of the richness of human contact, many now settle for the comparatively pale
pleasures of computer social networking.

Access to the internet has exposed the youth to unintended information such as phonographic
information which influences the youth to indulge in sex at early stages in life which is a recipe
for the spread of HIV and AIDS.
Unintended Consequences
New technology brings with it a number of unpredictable side effects, some of which are good
and some of which are bad. For example, when asbestos was introduced, it was touted an
important technological development in fire safety. Decades after it was introduced, however,

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people learned that exposure to certain types of the substance could cause chronic health
problems in that such substances cause cancer.

Form groups and discuss other negative effects of using modern technology in society today.

Use of modern technological equipment at home

Modern technological equipment is used at home basically for cooking and entertainment. The
use the microwaves and other cooking devises are common in many modern kitchens. Whereas
use of modern equipment allows use of clean energy, some of the equipment like microwaves
has adverse effects on human health. It is being pointed out that food heated by micro wave may
cause cancer.

What are the effects of eating micro waved food and exposure to
micro waves?
The following is a list of some physical problems that can be caused by eating micro waved
foods and from being frequently exposed to microwaves.
 Changes in the blood
 Cancer
 Leukocytosis
 Breakdown in systems of digestion and elimination
 Deterioration of the life-energy field (aura)
 Degeneration of the nervous-system
 Brain damage
 Immune system deficiencies
 Loss of hormonal balance
 Brainwave and psychological disturbances, including
 Loss of memory and ability to concentrate
 Decreased intellect
 Emotional instability
 Sleep disturbances
 Passivity
The Television

What are the effects of use of the television set?

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Evidence has shown that too much watching of television causes health problems. For instance,
there are physiological changes, which are not good. As a medium of communication; the
television set
Brain development
Can negatively affect early brain development especially attention problems among children.
Research shows that television viewing among children less than three years of age is found to
have a negative effect on mathematical ability, reading recognition and comprehension in later
childhood. This harm may be due to the visual and auditory output from the television actually
affecting the child's rapidly developing brain.
Sleep problems
An increasing number of studies have found that children get less sleep than previous
generations had and experience more sleeping difficulties. New research has found a significant
relationship between exposure to television and sleeping difficulties in different age groups,
ranging from infants to adults. The number of hours of television watched per day was
independently associated with both irregular naptime and bedtime schedules.
The implications may be serious. Studies have shown that lack of sleep can significantly alter
levels of the hormone melatonin, an extremely powerful antioxidant. Reduced amounts of
melatonin may result in a greater chance that the cell DNA will produce cancer-causing
mutations.
Obesity
Television exposure is a factor in obesity. Beyond displacing physical activity, a new study has
reported a significant dose-response relationship in which the resting metabolic rate decreased as
average weekly hours of TV viewing increased.
One of the mechanisms by which television may induce us to eat more is through causing our
brain to monitor external non-food cues - the television screen - as opposed to internal food cues
telling us that we have eaten enough and can stop. Experiments have found that when distracted
in this way humans continue to salivate unnaturally in response to more and more food when
normally they would not. All of these observations occur at a time in our history when 75 per
cent of dinners are eaten in front of the television.
Other biological changes strongly associated with watching television range from a clinically
increased risk of abnormal glucose metabolism and new type two diabetes in adults, through
substantial increases in myopia (short sightedness), to increases in migration of coetaneous
immune system mast cells which also lost their granular content and the cytoplasm shrunk.
Social vices

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Some of the TV advertisements have contributed to vices such as alcoholism and drug use and
early sexual activity.
ACTIVITY

Discuss negative effects of watching different programmes of the Television?

Welcome to the next subsection entitled “cell phone”
The cell phone
The cell phone has revolutionarised modern communication. However, despite the ease of
communication brought by use of the cell phone, its use has brought with it many negative
effects.
Think about it! Supposing children were allowed to carry mobile phones in school; what will
teaching and learning be like?

ACTIVITY

Discuss the effects of use of mobile phone in society today.

The following are the physical problems caused by exposure to digital signals and emissions
from cell phones and cell phone towers:
 Increased cancer risk in many forms, especially breast cancer
 Unhealthy changes in blood levels of serotonin and melatonin, causing
 Defects in brain messaging
 Alterations of mood
 Sleep irregularities
 Immune system problems
 Headaches
 Poor memory
 Mental excitation
 Confusion
 Anxiety
 Depression
 Appetite disturbance
SUMMARY

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 You have learnt the use of modern technology and its effects on health especially among the
school going age. The effects of use of modern technological equipment such as computers, the
cell phone, micro waves and the television have been discussed.

Further reading
Makewa P.M. (2008). Developing youth. Nairobi: Uzima publishing house.
Strasburger VC (1993) Children, adolescents, and the media: five crucial issues. Adolesc Med:
State of the Art Rev 4:479–493.
Roberts DF, Foehr UG, Rideout VJ, Brodie M(1999) Kids and media at the new millennium: a
comprehensive national analysis of children's media use. (Kaiser Family Foundation Report,
November, Menlo Park, CA).
Jordan AB, Jamieson KH Mares M-L (1998) Children's use of VCRs. in Children and television.
Ann Am Acad Pol Soc Sci, eds Jordan AB, Jamieson KH 557:120–131
Newhouse c. (2002) The Impact of ICT on Learning and Teaching.

SELF TEST QUESTIONS

What are the positive and negative effects of use of ICT among students in Kenya today
(20 marks)

Score board

Score Grade Comment

10-20 A Excellent proceed

6- 10 B Very good proceed

3- 6 C Fair- repeat the weak areas

0-3 D Weak- repeat

L O 135
 Learning Out come

You have now covered the eighth and last topic of this module and the learning outcomes are
listed below

Put a tick in the column which reflects your understanding

SN Learning outcome Sure Not sure

1 I can discuss the effects of use of modern technology in society

especially at home and school
If you have put a tick at the ‘not sure’ column, please go back and study the whole topic.

If you have ticked ‘sure’ you have successfully covered the whole module

Congratulations!

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 ANSWERS TO SELF-TEST

1.1. Contributors to poor physical health

- Failure to feed on balanced diet

- Physical damage eg broken limbs, spinal vertebrae, skull etc.
- Infections from disease causing organisms eg virus, bacteria and parasites.
- Genetic complications eg Sickle cell anemia.
-
1.2. Characteristics of persons who are mentally ill
They are unable to:
- make rational decisions,
- Work to solve problems and have realistic solutions
- To manage stress Read good books
- To realize and admit their mistakes or failures and do not ignore problems that may
have been their fault.
- Lie, cheat or steal.
- Allow their emotions to get out of control- even if they are alone

2.1. State five causes of mental impairment. (5 marks)

• Brain damage

• Genetic disorders.

• Use of drugs and substances of abuse.

• lack of oxygen to the brain during delivery

• Brain Developmental delay due to other factors (unknown)

2.2. Identify coping mechanisms of persons with:

i. Visual impairment
 a thorough orientation and mobility training
 By providing adaptive equipment, which include; Braille computers,
collapsible cane, magnifying glasses, and stenography
ii. Hearing impairment
 Use of sign language

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  Uses of total communication systems to enable them obtain
information that others gain by listening.
 They may need technology such as amplifiers or hearing aids.

iii. Physical impairment in a school set up

 Schools where the physically challenged children are integrated should be

barrier free.
 Physical facilities within these schools need to be extensively adapted to
the needs of the physically handicapped learners.
 The built environment, should be barrier-free physical environment to
guarantee the health of the learners

3.1. What are the essentials of First Aid? (5 marks)

 Assess the situation quickly and calmly.
 Protect yourself and the casualty or casualties.
 Comfort and reassure the casualties.
 Deal with any life threatening condition.
 Obtain medical aid if necessary.
 If you suspect a serious illness or injury call an ambulance

3.2. Why is it important to leave children with careful care givers? (5marks)
 To be able to keep the baby neat
 To be able to feed the baby with the right food
 To be able to detect cases of accidents and administer First Aid.
 To be able to keep environment clean

3.3. Explain the First Aid tips in snake bite, wounds, fractures burns, (20 marks)

Wounds
 Assess the casualties condition
 Control bleeding by applying pressure on elevating the injured part
 Keep the wound clean
 Comfort and reassure the casualty
 Minimize shock
 Obtain medical help, if necessary
 Call an ambulance if you suspect a serious illness or injury

Fractures
 Stop bleeding if any by simple pressure over the injured part using a clean pad of
cloth.
 Do not wash the wound.
 Do not probe the wound.
 Do not insert your fingers into the wound .
 If a fragment of bone is protruding, cover the entire wound with a clean cloth or
towel.

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  Apply a splint to the injured part to prevent movement (splint- a piece of rigid
materials applied along to the sides of the limb to prevent two broken ends of the
bone from moving.)

Burns
 Do not apply lotion, ointment or fat to a burn.
 Do not touch the burn or burst any blisters.
 Do not remove anything sticking to the burn.
 If the burn is to face do not cover it.
 Keep cooling with water until help arrives.
 If the burn is caused by chemicals, cool for at least 20 minutes.
Burns on sensitive parts of the body e.g. the face or the genital area, serious
 As quickly as possible, apply or pour cold water to the burnt part or submerge it
in ice cold water for at least 10 minutes.

Snake Bites

 Keep the victim as calm as possible preferably in a lying position.

 Do not move the part that has been bitten because the more it is moved the more
rapidly the poison will spread through the body.
 A person who has been bitten on the foot should not walk but should be carried on
a stretcher is possible.(illustrate)
 A bite from a poisonous snake is dangerous.
 Transport the victim to hospital as soon as possible taking the dead snake with
you if possible.

4.1. What is the role of public health services in society? (5marks)

Public health deals with:

 Prevention
 Promotion
 Rehabilitation
 Contamination,
 Sanitation
 Housing.

4.2. Discuss the essentials of health and safety in a school (15 marks)

 Safety on school grounds.

 Safety of physical infrastructure.
 Health and hygiene safety.
 Safety in school environment.
 Food safety.
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  Safety against drug and substance abuse.
 Safe teaching and learning environment.
 Socio-cultural environment of the school.
 Safety of children with special needs.
 Safety against child abuse.
 Transportation safety.

4.3. What is Disaster Risk Reduction and how can it be realized in a school? (10marks)

 Actions designed to minimize destruction of life, property and disruption of normal

operations. It calls for the establishment of a disaster Crisis Response Team with the
mandate to prevent, mitigate and effectively prepare against potential disaster hazards. It
also includes organizing and carrying out rescue and rehabilitation operations during and
after a disaster has struck.
 Establish early warning systems
 Post evacuation maps at every entrance and exit to buildings.
 Schedule practice drill sessions for fire, earthquake, lockdowns etc
 Develop a telephone tree list of all employees.
 Maintain school emergency kit with items like; first aid kit, whistle, fire blankets, flash
torches, fire extinguishers, blueprint of school buildings.
 Observe safety measure during various types of disasters.
5.1 Discuss the functions of a family in society (15 marks)
 Stable Satisfaction of Sex need
 Procreation
 Protection and care of the young
 Socializing Functions
 Provision of a home
 Spiritual support
5.2 Discuss the challenges facing the family institution in modern times (15 Marks).
 Teenage parenthood
 Violence
 Battered spouses
 Child abuse
 Divorce, separation and dissolution
 Single parenthood
6.1. What is drug and substance abuse? (2marks)

 Drug abuse is the non-medical use of drugs, for example: the use of alcohol, cigarettes
and other chemical substances that destroy health and productive life of an individual.

6.2. Discuss the effects of drug and substance abuse among the youth (10 marks)
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  Ill health due to poisoning
 Poor socialization
 Can lead to self damage
 Can lead to social vices like crime and theft
 consumption of drugs can cause diseases
 Death etc

6.3. Common physical symptoms of youth under the influence of drugs?

(18marks)
- Memory lapses, short attention span difficulty in concentration.
- Sexual problems which include lack of appeal, function and promiscuity.
- Disturbed sleep patterns including over-sleeping, marked drowsiness, moodiness,
fatigued look, restlessness.
- Poor physical co-ordination, slurred or incoherent speech.
- Chronic cough that does not respond to treatment.
- Unhealthy appearance.
- Indifference to hygiene and grooming.
- Burnt or stained thumb nails, burn holes on clothing.
- Track marks as evidence of using needles.
- Unpleasant skin rash
- Excessive sweating
- Complaints of headaches especially if they are associated with memory loss.
Drop in appetite or sudden heightened appetite for food

7.1 Explain the main stages in HIV counseling (9 marks)

 the beginning stage,

 middle stage
 Terminal stage.

N B: Candidates give details

7. 2. Discuss the modes of handling the challenges faced by HIV and AIDS counselors (12
marks)

 Establishing the role of HIV counseling

 Proper selection of trainees for counselling
 Training workshop, followed by supervised practice
 Retention of trained counselors
 7.3 Discuss why HIV and AIDS is wide spread in the developing countries (9 marks
 Poverty
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  Ignorance
 Family separation due to economic activities
 Shortage of drugs
 Cultural factors, among others.
What are the positive and negative effects of use of ICT among students in Kenya today (20
Marks)
 Ease of communication
 Free flow/access to information
 Effect in research
 Ease in curriculum implementation strategies (variety)
 Increase in learner independence
 Promotes collaborative learning
 Tailoring learning to learners

Negative
Effects on health:
 Obesity, sight, among others.
 Access to unwanted sites (phonographic materials)
 Time wasting on social sites, among others.

BIBLIOGRAPHY

Berndt T. J. (1997). Child Development and Edition. London: MC Gaw Hill.

Chukwu C. N. (2003). Applied Ethics and HIV/AIDS in Africa. Eldoret: Zapf Chansery
Research Consultants and Publishers

Dyer E. D. (1993). Courtship Marriage and Family. Illinois. The Dovsey Press.

Denalo E. (1985). A guide to Family Planning. Nairobi. EAEP.

Goldernberg, I. and Goldenberg H (1991). The Family Therapy. California: Brooks/Cole

Publishing Company.

Insel P. M. and Rolth W. T. EDS (2002). Core Concepts in Health. Boston. Mc Graw
Hill.

Kanfman M. Ed (1997). Mothering Teens. Charlotteetown gynergy books.

K.I.E. (1999). AIDS Education. Facilitators Handbook. Nairobi K.I.E.

Liddeli L.A. (1989). Building Life Skills

Mombe P.A. (2002), Rays of Hope. Managing HIV/AIDS in Africa.

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Meeks L. Heit P. (2001). Sexuality and Character Education K-12. Chicago: Everyday
Learning Corporation.

Ndakwe P. (1993). The Great Calling of Motherhood. Nairobi: Kings Script.

Starfield P. Balldin B. and Verslyys Z. Eds (1999). Child Health; A Manual for Medical
and Health Workers in Health Center and Rural Hospitals. Nairobi
Hospitals. Nairobi AMFREF
Santrocic J. W. (2001). Adolescence 8th Ed. New York: Mc Graw Hill.

Salhan S. (2003). Women and HIV. Delhi: Lordson Publishers (P) Ltd.

St. John Ambulance/British Red Cross/ St. Andrews Ambulance Association First Aid Manual
(8th Edition)

COURSE OUTLINE

Topic 1: The healthy individual (3 hours)

 Essentials of good health

 Physical health
 Mental health
 Social and emotional health
 Health and environment
 Common infections, symptoms, causes and treatment

Topic 2: Handling Learning and Physical Disabilities (3 hours)

 Definition of terms
 Whole spectrum of disability and adaptive mechanisms

Topic 3: First Aid and handling common accidents (3 hours)

 First aid essentials
 Techniques and equipment
 Life saving procedures in case of accidents

Topic 4: Health and safety in the school (4 hours)

 School and public health
 school safety

Topic 5: The youth and family life (3 hours)

12 The concept of youth as a life cycle
13 Dating and courtship
14 Breaking up
15 Marriage
16 Family life
17 Challenges of the family

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Topic 6: Drug and substances of abuse (4 hours)
 Definition of terms
 Commonly abused drugs and their effects
 Drug tolerance

Topic 7: HIV and AIDS and counseling (3 hours).

18 Pre-test counseling
19 Post test counseling
20 Stages in HIV/AIDS counseling

Topic 8: Modern technology and health (3hours).

 The use of modern technological equipment

 Health hazards associated with use of modern technological equipment

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