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DECLARATION

I GOMA DANIEL.G declare that this Community Experience report is my own original work, and that all sources that I have consulted have been duly acknowledged. I further declare that this work has not previously been submitted by me for a degree at the University of Zambia or any other institution

been submitted by me for a degree at the University of Zambia or any other institution

Signature

Date:

-/ - /2013

i

TABLE OF CONTENTS

TABLE OF CONTENTS

ii

ACKNOWLEDGEMENTS

v

LIST

OF

FIGURES

v

LIST

OF

FIGURES

vi

ACRONYMS

vii

Community Experience as emanating from the fieldwork is comprised of activities that take place outside the classroom. It is regarded by many fields of study because of its nature of engaging students in the acquisition of direct experiences in the work environment. For that reason, the acquisition of such experience cannot take place in rigidly planned classroom activities where lecturers and text books are the sources of theoretical knowledge. After gaining much of theoretical knowledge there comes a time of applying the same in a real life situation, proving one a skilled workmanship. In the view of this, EE students in their fourth of study are required to secure a suitable work site related to the degree program objectives. viii

Following the objectives, a number of activities were done and are recorded in this report some of which were departmental related. Among them included: EHEP; Institutional Sustainability Assessment; writing of a handbook; opening of an email address for the department; inspections; and water quality monitoring. Such activities as stated contributed to the acquisition of various experiences during the period of Community Experience. It was from the experiences that transport systems of Zambia were said to be a threat to the Physical environment. In trying to find solutions to such issues, cycling was found to be one of the ways of reducing on environmental injustice. Through this programme, Community Experience, students are exposed to different work environments as they acquire

comprehensive skills

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CHAPTER 1

1

INTRODUCTION

1

1.2 Aim

2

1.3 Objectives

2

1.4 Expected Skills

2

PTER 2

2

2.1-Location Chelstone Health Centre is situated on the eastern part of Lusaka about 16km from Town Centre and 9.4km from the University of Zambia Clinic. It is along Baobab Street off Palm drive on the left side after the police station in Chelstone Township. The boundaries of the catchment area are hybrid turn off, the Great East Road up to the Airport turn off and part of Galaunia farm coming down to

ii

Kapwelyomba Basic School. The following is the map showing the location of Chelstone Health Centre

from the University of Zambia clinic

 

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2.2. The Organizational Structure

3

2.2.1

Functional Relationship at Chelstone Health Centre

3

2.2.2

The Institutional Departments

4

2.2.3

Defining

Environmental

Health

5

2.2.4

Departmental

Objectives

5

2.2.5

Principal Activities of the Department

5

2.2.5

Departmental Work Schedule

6

2.2.6

Assignments Undertaken

 

6

Chapter 3

 

8

DEPARTMENTAL ACTIVITIES DONE

8

3.1

Inspections

 

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Inspections in the department of Environmental Health are cardinal activities which require serious attention. In this view, Environmental Health workers, inspectors, are required to conduct routine and follow-up inspections. Not only that but also opening inspections for new food and water establishments, to ensure food safety as well as water quality procedures are in place. Such inspections should also include safety of workers in different institutions. EHIs are expected to conduct

investigations when they receive concerns from the public on food establishments for

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3.1.1

Inspected premises

8

3.1.2

The Importance of Inspections

8

3.1.2.1

Inspection of Food Establishments

8

3.1.2.2 Locations and Surroundings

10

3.2

Water Quality Monitoring

11

3.2.1

Why Water Quality Monitoring

13

3.3

Collection of Information on Services Offered by Private Clinics

14

Chapter 4

16

PERSONAL ACTIVITIES DONE

16

4.1

Environmental Health Education Programme

16

4.2

Sustainability Assessment Programme for Health Institutions (SAP-HI)

17

4.3

Opening of an Email Address

20

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Welcome CHELSTONE!

20

4.4

Writing of a Handbook

21

Chapter 5

22

EXPERIENCES

22

5.1

How Adults Learn

22

5.2

Time Management

23

5.3

Needs Identification and Assessment

23

5.4

Patience and Tolerance

23

5.5

Evaluations

24

5.6

Office Management

24

5.7

Inspection of Public Premises

25

Chapter 6

25

Chapter 6

26

ADDITIONAL EXPERIENCE

26

 

Chapter 7

27

Chapter 7

28

OVERALL EVALUATION OF THE WORK DONE

28

CONCLUSION

29

 

Chapter 8

30

CHALLENGES FACED

30

8.1

Recommendations to the Faced Challenges

30

REFERENCE

33

APPENDIX ……………………………………………………………………………………………………………………………………

33

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ACKNOWLEDGEMENTS

My gratitude to many individuals who have helped in going through this programme adequately be conveyed in a few sentences. However, I must record my immense indebtedness to friends who accommodated me in their home even when the University went on recess. It was not going to be an easy way to start over without them. Further, I would like to thank the LDHMT for the opportunity given to work in the institution, Chelstone Health Centre. Sincere gratitude goes to Nyambe C.K. (Mrs.) in her capacity as a field supervisor without forgetting Simukoko R.R.A. (Mr.) and Cheelo C. (Mr.) who played greater part as a supervisory team. Without them the most needed experience in the field of Environmental Health was not going to be attainable. Guidance rendered in all programmes assigned and willingness to impart their valuable knowledge, experience and skill to the writer can never be over emphasized. Above all, many more thanks goes to the Lord God almighty for sustaining me with the good health and the wisdom I enjoyed during the attachment period.

LIST OF FIGURES

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LIST OF FIGURES Figure 1.0 Map showing Chelstone Health Centre and Other Locations……………

3

Figure 2.0 Functional Relationship …………………………………………………

4

Figure 3.0 Environmental health problems…………………………………………

6

Figure 4.0 An incinerator with waste packs ready for incineration…………………

7

Figure 5.0 A butcher‟s work suit……………………………………………………

9

Figure 6.0 Water chemical test kit…………………………………………………

12

Figure 7.0 The road systems of Lusaka……………………………………………

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ACRONYMS

BFPs

Breast Feeding Promoters

CBGs

Community Based Groups

CHPs

Child Health Promoters

COs

Clinic Officers

DHO

District Health Office

EE

Environmental Education

EET

Environmental Education Trainee

EHD

Environmental Health Department

EHEP

Environmental Health Education Programme

EHT

Environmental Health Technicians

FIFO

First In First Out

LAB TECHs

Laboratory Technicians

LDHMT

Lusaka District Health Management Team

M ATT

Mortuary Attendant

MCH

Mother and Child Heath

NPs

Nutrition Promoters

NTRSTs

Nutritionists

ODS

Out Door Servants

OPD

Out Patients Department

P

EDTRs

Peer Educators

PHAR

Pharmacists

PHYSIO

Physiotherapists

PUBs

Public Utilities Boards

SAP-HI

Sustainability Assessment Programme for Health Institutions

TBAs

Traditional Birth Attendants

TBTPs

Tuberculosis Treatment Promoters

UNZA

University of Zambia

X RAY TECHs

X-Ray Technicians

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EXECUTIVE SUMMARY Community Experience as emanating from the fieldwork is comprised of activities that take place outside the classroom. It is regarded by many fields of study because of its nature of engaging students in the acquisition of direct experiences in the work environment. For that reason, the acquisition of such experience cannot take place in rigidly planned classroom activities where lecturers and text books are the sources of theoretical knowledge. After gaining much of theoretical knowledge there comes a time of applying the same in a real life situation, proving one a skilled workmanship. In the view of this, EE students in their fourth of study are required to secure a suitable work site related to the degree program objectives.

Following the objectives, a number of activities were done and are recorded in this report some of which were departmental related. Among them included: EHEP; Institutional Sustainability Assessment; writing of a handbook; opening of an email address for the department; inspections; and water quality monitoring. Such activities as stated contributed to the acquisition of various experiences during the period of Community Experience. It was from the experiences that transport systems of Zambia were said to be a threat to the Physical environment. In trying to find solutions to such issues, cycling was found to be one of the ways of reducing on environmental injustice. Through this programme, Community Experience, students are exposed to different work environments as they acquire comprehensive skills.

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CHAPTER 1

CHAPTER 1 INTRODUCTION As a way of responding to rapid changes in industrial and economic development

INTRODUCTION

As a way of responding to rapid changes in industrial and economic development posed by globalization, the education system needs to be reviewed to keep up with the changes and continue equipping students with relevant skills as a way of preparing them for the competitive industrial setting. To produce students who are capable of copping up with changes flexible skills, appropriate work attitude and professionalism for effective and productive contribution to their organizations are needed in them. In order to achieve this goal, different fields of study have recognized the need of industrial experience for the upgrade of pedagogical skills to industrial practices and procedures. However, the only way to gain industrial experience is through industrial attachment programmes or community experience. Students begin to learn the latest technologies at the same time gaining knowledge in other areas such as management, innovation, quality control circles, best practice and interpersonal skill through real working exposure in industries or related organizations. As part of training requirements every Environmental Education Students goes on Community Experience (CE) for one full semester.

1.1 Background Community Experience is an industrial training given to every Environmental Education student in their fourth year of study. It is normally undertaken in the first semester lasting for a minimum period of three months. The stated industrial attachment considers relatedness of the courses done at the University of Zambia beginning from first year of one‟s study. For this matter, as students of EE, everyone is sent into different institutions related to the programme of study involving both the private and public institutions to gain industrial skills.

This, therefore, confirms how important Industrial attachments are in preparing students for active, real-life employment situations, cultivating their professionalism, ability and attitude, adaptive, interpersonal and collaborative skills. They are placed in real-life situations working alongside with experienced industrial professionals. By so doing, the final-year students are enabled to put into practice their theoretical knowledge and skills, gaining the required experience even before they graduate. This helps to prepare them for ready absorption into various industries.

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1.2

Aim

The aim of Community Experience is to:- Prepare students for ready absorption into the workforce and contribute to the growth of socially and environmentally sustainable institutions in Zambia and the world as a whole.

1.3 Objectives

In order to achieve the stated aims, the following are specific objectives:-

a) Observe qualified and experienced workers doing their daily jobs.

b) Relate aspects of the University of Zambia (UNZA) courses to work situation.

c) Apply basic skills from the courses covered at UNZA to the needs of the work situation.

d) Study in detail and establish job description of the department.

e) Try to identify practical educational issues in need of addressing and whose roots are environmental.

f) Plan and execute an investigation to explore an environmental issue of the department.

g) Demonstrate investigative skills on an environmental topic arising from the daily, ordinary departmental work.

h) Innovate new ways of environmental education nature for the department.

i) Learn about new ways from the department.

1.4 Expected Skills

a) Develop a plan (scheme of work) for carrying out environmental education activities.

b) Assist the department to explore environmental opportunities related to the departmental job description.

c) Facilitate the department to pay attention to EE.

d) Participate in all co-curricular activities in the department.

e) Keep clean, tidy and neat record of EE activities in one file.

f) Learn new things about EE programme.

PTER 2

2

Chapter 2

Chapter 2 DESCRIPTION OF THE INSTITUTION 2.1-Location Chelstone Health Centre is situated on the eastern part

DESCRIPTION OF THE INSTITUTION

2.1-Location

Chelstone Health Centre is situated on the eastern part of Lusaka about 16km from Town Centre and 9.4km from the University of Zambia Clinic. It is along Baobab Street off Palm drive on the left side after the police station in Chelstone Township. The boundaries of the catchment area are hybrid turn off, the Great East Road up to the Airport turn off and part of Galaunia farm coming down to Kapwelyomba Basic School. The following is the map showing the location of Chelstone Health Centre from the University of Zambia clinic.

Health Centre from the University of Zambia clinic. Figure 1.0 Map showing Chelstone Health Centre and

Figure 1.0 Map showing Chelstone Health Centre and other locations (Author, 2013)

2.2. The Organizational Structure

2.2.1 Functional Relationship at Chelstone Health Centre

Chelstone Health Centre has a centralized system of command. This process begins from the Nursing Sister down to the general community. Different members of staff are assigned with particular duties under the supervision of the Nursing Sister. In their operations they relate to each other as shown in the figure below.

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Figure 2.0 Functional Relationship (Author, 2013) 2.2.2 The Institutional Departments The attaching institution has the

Figure 2.0 Functional Relationship (Author, 2013)

2.2.2 The Institutional Departments

The attaching institution has the following as its departments;

1. Pharmacy

2. Dental

3. EHD

4. X-ray

5. Physiotherapy

6. OPD

7. IPD

8. ART

9. Nutritional

4

10.

MCH and

11. Psychotherapy

Among the listed departments, Environmental Health Department (EHD) was the area of attachment. As different other departments are headed by different staff as shown in figure 2.0, Environmental Health too falls under the control of the staff called Environmental Health Technicians (EHTs). For the sake of knowledge, it is important, however, to state the meaning of environmental health.

2.2.3 Defining Environmental Health Environmental Health is the branch of public health concerned with all aspects of natural and built environments that may affect human health as defined by Conant and Fedem, (2008). The state of environment at all times is a potential threat to human health. Such threats as this may come as biological, chemical, physical, psychological and cultural agents.

2.2.4 Departmental Objectives

The objectives of the department are to:-

i. Inspect food quality and premises thereof

ii. Provide the community with education on public health

iii. Increase the proportion of persons served by community water systems that meets the regulations of the Safe Drinking Water Act.

iv. Reduce waterborne disease outbreaks arising from water intended for drinking among persons served by community water systems.

v. Minimize the risks to human and environment health posed by hazardous substances.

vi. Reduce indoor allergen levels.

2.2.5 Principal Activities of the Department In health institutions, Environmental Health as a department has a direct linkage with the community. Its main role is to assist in the provisioning of Community-based environmental health needs some of which include:-

i.

Health Care Waste Management

ii.

Water and Sanitation

iii.

Epidemic prevention

iv.

Food and Premises Inspection

v.

Vector and Rodent Control

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2.2.5

Departmental Work Schedule

Work schedule for Environmental Health workers at the institution of attachment directly

depended on the prevailing situations in the community. In all situations the department

works on the preventive level than curative. However, to ensure there is order in the daily

operations, the department had a work schedule as presented in the appendix.

Monday being a day for management meetings and other administrative issues, it was entirely dedicated to weekly planning. Inspection of public premises such as shops and other selling points was done every Tuesday, Wednesday and Thursday. The activity was coupled with water quality monitoring and sampling as indicated in the work schedule. Friday was dedicated to water sampling and report compilation based on the weekly activities. These were weekly reports based on activities done. As indicated in the Appendix, malaria active infection detection follow-ups were as well done on each Saturday every week. This was done following malaria cases diagnosed at the Centre. Therefore, the above presented table gives a summary of all the activities planned by the Environmental Health Department at Chelstone Health Centre.

2.2.6 Assignments Undertaken

While on attachments, a couple of the activities were assigned. The collection of information

on services provided by private clinics and malaria active infection detection follow-ups done

within the week were among other assignments. Overall, before going into the field each day,

inspection of the Health Centre was done to ensure the Centre was clean, both in and outside

as well as proper disposal of waste matters in the interest of protecting the public, members of

staff and environmental health. It was, therefore, through inspections conducted that problems

of waste management, non-functioning facilities and cracks on the buildings were identified at

the Centre as indicated in the pictures below.

(a) Poor waste management (b) A urinary out of use (c) A crack on OPD

(a) Poor waste management

(a) Poor waste management (b) A urinary out of use (c) A crack on OPD building

(b)

A

urinary out of

use

(a) Poor waste management (b) A urinary out of use (c) A crack on OPD building

(c)

A crack on OPD building pillar

Figure 3.0 Environmental health problems (Author, 2013l).

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Waste in figure 3.0 (a) was supposed to be incinerated instead open air burning was under

practice. In relation to the identified problem, the concerned parties were constantly given

Environmental Health Education until they learned to use plastics following color coding

system as shown in the figure 4.0. Color coding helps in categorizing waste matters according

to their level of toxicity and how they are to be disposed of. Besides waste management, daily

inspections done with a goal of putting up efficient maintenance system exposed non-

functioning clinical facilities as indicated in figure 3.0 (b).

Above all, safety of infrastructure was constantly monitored. In this case deep cracks were

identified in most of the buildings as figure 3.0 (c) indicates which was finally reported to the

relevant authorities. Therefore, as a way of avoiding accidents such as those that involve the

collapsing of buildings, building inspection was not given a closed eye since Environmental

Health is concerned with public and occupational health protection. These were among many

other assignments undertaken during the attachment period.

other assignments undertaken during the attachment period. Figure 4.0 An incinerator with waste packs according to

Figure 4.0 An incinerator with waste packs according to their categories ready for incineration (Author, 2013).

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Chapter 3

Chapter 3 DEPARTMENTAL ACTIVITIES DONE 3.1 Inspections Inspections in the department of Environmental Health are cardinal

DEPARTMENTAL ACTIVITIES DONE

3.1 Inspections Inspections in the department of Environmental Health are cardinal activities which require serious attention. In this view, Environmental Health workers, inspectors, are required to conduct routine and follow-up inspections. Not only that but also opening inspections for new food and water establishments, to ensure food safety as well as water quality procedures are in place. Such inspections should also include safety of workers in different institutions. EHIs are expected to conduct investigations when they receive concerns from the public on food establishments for example.

In the similar instance, violation of food codes should as well call for food facility follow-up inspections. Since EHD is concerned with the protection of public health, it works hand in hand with institutions such as the Council. Where the council issues out trading permits with expectation that the traders will abide by the regulations provided, the EHD ensures regulations are acted upon by the owners of the establishments. It is here where the issue of law comes in, hence, EHD operating as a law enforcing department in the Ministry of Health. The law says, for example, any person who sells any food that is rotten or is otherwise unfit for human consumption shall be guilty of an offence according to Cap. 303 article 3 of the Zambian Laws Index 1996. This law covers prohibition against sales of health threatening food staff which can only be identified by means of routinely inspection of food premises.

3.1.1 Inspected premises

The Environmental Health Department inspected all food selling establishments of Chelstone catchment area, recreational facilities such as swimming pools and water points. Among the food selling premises were facilities specialized preparing, processing, serving and selling of food as well as drinks to the consumers. These included: butcheries; bakeries; restaurants;

bars; and other premises such as shops and super markets. All these premises inspected by EHD were expected to meet safety and sanitation requirements.

3.1.2 The Importance of Inspections

3.1.2.1 Inspection of Food Establishments

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Food being a familiar topic to all humans, most people buy and prepare food. Therefore, every person knows something about food, which is a good thing. A greater percentage of consumers, nevertheless, have little or no concept of where food comes from or how it gets to the grocery store shelf. Today there is a new interest in food production, preservation and preparation. The great number of varied food currently witnessed in malls is testimony to today‟s increased interest in food.

Food when consumed in a diversified and balanced manner is vital to good health. Just as it is a source of nutrients for humans the same applies to other animals including microorganisms. When abused, miss-handled, or under-processed, the best nutrient-giving food can cause illnesses or even deaths. Humans through hands are in most cases the first transmitters of food stuff contaminants. For this reason, serious attention was paid to the food handlers‟ cleanness, their hand washing system and conformity of hand washing facilities. Within the circles of cleanness, food handlers in butcheries, restaurants and bakeries were expected to be in required work suits. If, for example, a work suit has white in it as shown in the figure below it becomes easier to tell when one has to wash it for hygiene purposes.

easier to tell when one has to wash it for hygiene purposes. Figure 5.0 A butcher

Figure 5.0 A butcher’s work suit (Author, 2013).

In ensuring food handlers fitness to serve the community, medical examinations were done by the health Centre in conjunction with the council. The move was made to determine who to handle food without contaminating as far as transmissible diseases like Tuberculosis (TB) and other related air-borne infections. For this reason, medical examinations were made mandatory to all food handlers.

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Apart from inspecting levels of hygiene under food safety, chemical content was also inspected. This was mostly done in salt. Under this action iodine levels were the target. Salt with little or no iodine in it, was being seized for destruction. This was to protect the health of the public from infections such as growing goiters. This follows the declarations of the World Health Organization as presented in (Holman, 2003) that all salt to be consumed by people should have enough iodine in it.

Besides iodine test, checking of the expiry dates was not given a blind eye. Some food categories are considered as potentially hazardous. The fact that processed foods are made for long shelf life does not mean long human life. As stated by (FDH, 2003) once preservatives in them expire, they turn into poison, becoming a threat to human health. The targeted food products included those milk and dairy products (meat, poultry, fish or sauces) and canned plant foods (cooked rice, beans, or vegetables).

Whenever expired foods were found on shelf shopkeepers were commanded to shelf them off and have them destroyed for the sake of the public health. A point of advice given in such case to avoid loses of similar kind next time was for them to use FIFO. What is ordered first should be sold first then expiration of products (foods) while on shelf is avoided. Dented tins were as well seized as a way of preventing people from consuming metal coatings which may have reacted with food inside. Such are metals that cause health problems like cancer in humans.

3.1.2.2 Locations and Surroundings Food Establishments were expected to be located away from environmentally polluted industrial areas which produce disagreeable odor, fumes, excessive soot, dust or smoke emissions and pollutants that pose a serious threat of contaminating food. Sells of food on the streets without proper sanitary facilities such as running water and toilets were illegal. On this condition clients became more compliant except a few of the community members, street vendors. The non-complying were being advised through public health education on the spot and Environmental Health Education through EHEP at the health Centre.

The main concern of the department lied on two aspects, public and environmental health enhancement. In other words, the second aspect was based on promoting a clean Chelstone. The approach provoked partnership between the Health Centre and Chelstone main market.

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The composition consisted Environmental Health Inspectors and the market management to bring sanity in the market through routinely done Environmental Health Education.

Surrounding areas of the establishments were expected to be clean in and outside. The targeted groups here were restaurants, butcheries, bakeries and Public Utilities Boards (PUBs). Many were the identified issues when it came to the aspect of cleanness. As a standard, Means (2010) in his work, ‘Why We Should Not Relax Food Inspection Rules’ points out that these premises are expected to be extremely clean in terms of walls, floors, and ceilings. Such premises were also expected to be free from vectors such as flies and cockroaches. Clients found operating below the required standard were obliged to reach the expected standards. For example, in restaurants, operating in dirt walls were told to either to clean or repaint them where it was the issue of flies infestation, owners were too directed to spray and use window and door screens especially butcheries.

For Public Utilities Boards, toilets were the most targeted aspect. This was to ensure that people do not urinate and defecate in undesignated places. In addition to specific requirements as these, food business operators were helped in identifying steps to ensure safety to critical food stuffs. When identified, these procedures were being implemented, maintained and reviewed periodically. These were some of the serious aspects that required attention. All these were, however, made possible through the duties of inspectors, hence, proving the importance of food premises and pub inspection.

3.2 Water Quality Monitoring Water while being an absolute necessity for life can be a carrier of many diseases. To the contrary, the readily availability of the same makes possible personal hygiene measures that are essential to prevent the transmission of intestinal diseases. The likely infectious water- related diseases can, however, be categorized as waterborne, water-hygiene, water-contact and water-habitat vector diseases.

Some of these diseases may fall into more than one category. Infectious diseases come where pathogens or causative organisms are present in water and ingested by man. Most of the pathogens involved are derived from human faeces. Apart from water being faecally contaminated, it can also be contaminated by other things such as chemicals. Health effects of chemicals in water occur when an individual consumes water containing a harmful amount of toxic substances. This includes excess consumption of consumable chemicals. For instance, chlorine which is really considered as helpful to humans for water treatment, when applied in

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excess, it has negative health effects. The effects include various types of cancer, kidney and

liver damage, immune system dysfunction, disorders of the nervous system, hardening of the

arteries and birth defects according to WHO (2003). Such occurrences as these call for a

continuous water quality monitoring.

Since water quality largely depends on water sources thereof, inspections conducted in

Chelstone recorded a number of water sources which included boreholes, taps and shallow

wells. Among the identified sources were those vulnerable to pathogen contamination or poor

chemical content. For this reason chlorine, alkalinity and acid demand tests were routinely

undertaken.

Depending on the results that obtained, where results showed undesired chemical content

water suppliers were always informed to address the matter. For example, suppliers such as

the Lusaka Water and Sewerage Company (LWSCo.) were notified whenever acid demand

test in their water showed red as in the figure below. Yellowish was at least tolerable.

Appropriate action advised in such matters was the neutralization of water to reach normalcy

to avoid public health complications.

Other than the supplied pipe water, community members too were being advised on proper

management of water sources found within the catchment area as per obtained results.

Chlorine residue test was carried out using the third tube in the test kit. Where the color

remained white as shown in the figure below, chlorine content was absent. Under such

observations community members were being advised to add acceptable amount of chlorine

to water starting from the period of test. This was also applicable to pipe water suppliers.

1 s t tube measures acidity 2 n d tube measures alkalinity 3 r d

1 st tube measures acidity

2 nd tube measures alkalinity

3 rd tube measures chlorine residue

Figure 6.0 Water chemical test kit. (Author, 2013)

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3.2.1 Why Water Quality Monitoring Water quality monitoring was one of the activities done in the Department of Environmental Health. Such activities as water quality monitoring undertaken in the department served the following purposes:

a) Classification of a Water Body

Water quality monitoring was done on a weekly basis. Factors of interest included the use of

the existing water sources. The obtained results after each analysis were basic in deciding appropriate classification of a water body whether fit for human consumption or not. The same information was further used in generating advice to the public. In this instance, the community was advised to use specific and safe water bodies for domestic purposes.

b) Tendency Check for Compliance to Water Body‟s Designated Use

Water quality was monitored at a regular frequency to check if the water bodies found in the

catchment area were meeting the guideline values for their classification. The results were used as basis for decision-making, for example, whether to institute management interventions to improve water quality, or to direct the community to use a water body for other purposes.

c) Monitoring to Identify Causes and Sources of Water-Related Problems

In the occurrence of water-related cases like diarrhea and typhoid brought at the Centre, water quality monitoring was undertaken at the victims‟ residences. This was done to identify

specific cause of the problems and their sources. The results were used as a basis for identification of a problem management and intervention strategies.

d) Monitoring for Baseline Data and Scientific Studies

Specific water quality parameters were analyzed for a specified period of time to serve as

baseline data or for certain studies. Baseline data was mostly compiled in the recently upgraded residential areas such as Kamanga Township where hand-dug water wells were used. Data collected was used to compare the rates of water related infections when people used hand-dug wells for domestic water and now that they use piped water.

The exercise helped in health living of the community members through reduced number of water-related diseases such as cholera, typhoid and other diarrheal diseases. It also included the prevention of negative effects from excess chemical content in water. Generally, the exercise addressed the issues such as: food safety (expiries, dents and other safety concerns);

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tidiness of the food premises; the recommended work suits in restaurants and bakeries; and water quality (Chemical and hygiene levels). Wherever issues were identified required education was given.

3.3 Collection of Information on Services Offered by Private Clinics

The collection of information was done to know what services were being provided by the private clinics. All clinics (private) within the control of Chelstone Health Centre were visited. The information as demanded by the District Health Office was to help in coming up with reasonable ways of unifying the public and private health care operations. What the private health institutions are not providing to be supplemented by the public and vice-versa, thereby, enhancing a comprehensive public health.

3.4 Administrative and Neighborhood Health Committee Meetings During the Student Industrial Work Experience (SIWE) period, the following were the meetings attended:

a) Tuberculosis (TB) treatment promoters;

b) Staff; and

c) Performance Assessment (PA) meetings including

d) A meeting with the market management

Purpose of the Attended Meetings The neighborhood health committee meetings were conducted every month. Members in attendance were the community neighborhood health committee executive and environmental health personnel. The central purpose of the meetings, a mandate to every environmental health member of staff, was to ensure a well-coordinated community workforce with the supervision of environmental health office at the Centre. In this case planning and reviews of monthly community health activities were done. Besides the NHC meetings conducted on a monthly basis, there were staff meetings. It was in the staff meetings that operational faults by staff members were corrected. Not only were the meetings for fault correction, but also for planning and evaluation purposes. All issues to do with punctuality were rightly addressed in these meetings.

Apart from monthly meetings, there also were quarterly ones. After every three months Performance Assessment (PA) meetings were conducted. It was during such meetings when evaluations of the planned activities were done. In areas of insufficiency, adequate solutions were suggested. Differences between workers and difficulties they faced were too addressed.

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Lastly but not the least, on a number of meetings attended was the meeting held at Chelstone main market with the market management. The core purpose of it was to unify operations between the market management and EHD of the Chelstone Health Centre concerning sanity in the market.

Unpleasant state of the market during inspections conduct attracted such unification as suggested by the management itself. From the meeting a couple of strategies were suggested. Among others was the arrangement of days for the education of marketers on environmental health as a way of promoting sanity. Apart from education for sanity promotion, plans included education on the importance of medical examinations of all food handlers. The meetings conducted can, however, be said to have aimed at improving workmanship both at the clinic and the surrounding community.

Author’s Role Played in the Meetings Conducted Since some of the meetings were only conducted once, the author had a privilege to write down minutes for the meeting conduct with the Chelstone main market management. In other words the author was a secretary.

15

Chapter 4

Chapter 4 PERSONAL ACTIVITIES DONE During the Student Industrial Work Experience a couple of activities were

PERSONAL ACTIVITIES DONE

During the Student Industrial Work Experience a couple of activities were done. These comprised expected skills set by the course coordinator. In accomplishing them, the following activities were done.

4.1 Environmental Health Education Programme Environmental Health Education Programme (EHEP) was identified as a way to reaching desired goals which included attitude change. In achieving the aspect of attitude change, it had in it environmental, health and educational purposes. Where environmental aspect had much to do with the surrounding areas of the people concerned, health was about the wholesomeness of those surrounding areas in support of sound human life.

In times when people become negligent concerning proper environmental management, education which in health terms is referred to as sensitization, brings about awareness and the required attitude change in community members. In general terms, Environmental Health Education Programme targeted community members to help them have right attitude towards their surrounding areas, thereby, promoting health living.

The emphasized attitude change was observed when residential areas and other public premises visited during inspections were well taken care of. The places included: business premises; schools; homes and streets. Therefore, Environmental Health Education Programme was designed to lift people‟s lives through proper environmental management.

Furthermore, EHEP was deliberately formulated to present environmental and other issues identified in the field back to the community with the motive of involving community members in the process of coming up with lasting solutions to the identified problems. Its formulation was to raise awareness, motivate decision-making and secure commitments from members to support long-term community change as a way of giving them required skills in addressing health conditions associated with environmental exposures.

16

Curbing such conditions before their manifestation, community involvement was highly needed. Unless people become aware of what they are to be part of, there can never be such an involvement. However, the need for awareness programmes that would prompt people‟s actions towards proper environmental management. This is where EHEP which is environmental health and environmental education came to play an important role. Though being a new programme, it was founded on the existing health education programme of the health institutions.

In its implementation, EHEP had its own requirements. One of them was the findings from

daily field work. It was from the same findings that topics as listed below were established:

i. Food Hygiene;

ii. Water Hygiene;

iii. Hands Hygiene;

iv. Vector Infestation (Cockroach in particular) and Human Health;

v. Cholera;

vi. Malaria Control; and

vii. Food Safety.

While some lessons on the topics listed had only a single goal, others had twin-goals. Those with twin-goals included food and water hygiene, vector infestation and human health, cholera and malaria control. Such lessons on these topics were directed to deal with public and environmental health directly. For example, during a presentation on vector infestation and human health, proper disposal of the remaining chemicals after indoor residual spraying was discussed. From the discussion, spilling of chemicals in water bodies was discouraged for they are threats both to environmental and human health.

The programme Environmental Health Education sort to provide community members with community environmental health education products that would increase environmental health literacy. These products included information about specific types of exposures to environmental hazards, exposure routes and pathways, health effects and how to prevent or minimize them. In this view, EHEP was more of preventive than curative, directed to prepare community members avoid the causes and dangers of any environmental hazard.

4.2 Sustainability Assessment Programme for Health Institutions (SAP-HI)

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The presence of man in all aspects of life influences the need for green living leading to the introduction of the concept, sustainability. The term is derived from a Latin word sustinere (tenere, to hold; sus, up) as stated by (Smith, 2008). The derivative, sustainability can, therefore be defined as having enough provision of what is needed for something to continue living or existing. The definition reflects the aspects of maintenance; support; and endurance.

Though sustainability seems to have its roots in the economic world, recently it has been thought of in different institutions one of which being health. The underlying principle in health care applies to all hospital operations after the assessment on how centres manage waste, use energy and water and purchase medical requirements. This assessment, however, helps in evaluating facilities‟ sustainable operations, identify opportunities for improvements and enhance environmental and other programs.

During the period of Student Industrial Work Experience (SIWE), an institutional sustainability assessment was done through Sustainability Assessment Programme for Health Institutions (SAP-HI). Under the programme were questions designed to encourage health workers think about new ways of managing and identifying opportunities for eliminating waste for example, and the associated costs. The assessment tool (guide) included questions on how facilities manage solid waste, hazardous waste and other things such as water and energy use.

SAP-HI was intended to provide a set of examples in assessing the facilities‟ operational status, prioritized goals, and assist in the development of sustainable action plans of the Health Centre as a whole. As the Health Centre starts to engage these efforts, the assessment would help the concerned to reflect changes in the institutions through baseline records provided. Below is part of what was contained in the assessment guide.

SECTION 4

WASTE REDUCTION, RECYCLING, AND REUSE

Data Collection and Program Assessment

1)

Total amount of materials Recycled/Reused Annually (tons):

2)

Recycling Program cost per year K

3)

If you recycle paper, does the recycler guarantee paper destruction for confidentiality?

Yes No

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4)

Do you know how recycling revenues are used (applied to general revenues, donated to charity, etc.)?

 

Yes No

5)

Do you have a comprehensive list of all recycling vendors?

Yes No

6)

Do you have an Environmental Preferable Purchasing Policy to encourage:

Waste reduction through reduced use of individually wrapped items?

Yes No

Elimination of duplicate forms?

Yes No

Increased use of reusable items?

Yes No

NOTES

19

As one of the content in a particular course undertaken in the third year of study, Institutional Sustainability Assessment was done to assess how sustainable the Centre was in terms of waste management, energy and water conservation. Final results were that the Centre was trying its best in as much as sustainability is concerned though with difficulties in most of the areas especially waste management. Much was desired to be done in the area of waste management.

4.3 Opening of an Email Address

The idea of opening a stated address came about after the conducted SAP-HI from which findings showed that the institution had no sustainability strategies on stationery. The department, Environmental Health, at Chelstone Health Centre used to report all of its duties executed to both, the in-charge office at the Centre and the District Health Office. Reporting to local management had no issues for reports were being written and submitted directly to the office the same day. The situation was different when it came to the delivery of the same reports to the DHO. Many were challenges the department faced, especially in relation to transport. Funds allocated were not adequate to carter for all departmental needs including

transport. For this reason, a suggestion was given to EHTs to consider opening an email account so that work may be done at the Centre and sent to the district through the same. A suggestion was accepted and a go ahead was given. After a suggested email account was successfully opened the following was an approval sheet.

Welcome CHELSTONE!

Now you‟re ready to search, create, and share across lots of Google products. Check out your new account in the upper right (click your photo to edit your profile, access Google+, review account settings, and view or adjust settings for web history). We‟ve also sent you an email to show you how to get even more out of Google.

Your new email address is chelstoneenvtalhealthoffice@gmail.com.

Thanks for creating an account. Have fun!

Approval sheet. www.gmailaccounts.com

The opened email account serves not only the purpose of reduced transport costs, but also saving on the use of paper. By them welcoming a suggestion on the basis of reducing cost on transport, the office indirectly accepted to „go green’ through reduced quantity of paper used.

20

When there is a reduction in the use of stationery, trees are greatly saved, hence, promoting sustainability.

4.4 Writing of a Handbook

While on industry attachment, an Environmental Education handbook was written. The handbook was intended to provide brief information about Environmental Education being a newly introduced field of study in Zambia. Information provided in the handbook introduces the programme to departments that may not have a clear understanding of the stated field. With a clear understanding of what Environmental Education is all about, the intention of the author was, therefore, to help EHTs understand particular roles of an EET besides the department‟s daily activities.

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Chapter 5

Chapter 5 EXPERIENCES Field experience provides students with an opportunity to combine their theoretical studies with

EXPERIENCES

Field experience provides students with an opportunity to combine their theoretical studies with the practical application of the acquired knowledge in a work environment. It is an important aspect of the student‟s academic program since it not only allows the student to apply the knowledge learned in lectures, but also enables them to continue learning under the supervision of professionals in the field. In the view of this, following were some of the experiences acquired from the fieldwork:

5.1 How Adults Learn With experience gained from lessons given to learners on different topics, it was clear that adults sometimes know more than a facilitator does. They are not empty vessels. Teaching adults as alluded to by Helen (2010) isn‟t like teaching children. Where children have little real world experience upon which to base their learning, adults have a great deal of accumulated experience that enriches their learning. They can compare and contrast new knowledge against past learning. This, though learnt in one of the lectures, was confirmed during a presentation of a lesson on cholera.

Since it was understood that cholera has its starting point from human extractor, learners that time discussed the ways of ascertaining purity of water in shallow wells when there is a toilets nearby. In their discussion they concluded that paraffin or diesel was the best determinant when poured into a toilet. If the scent of these substances is detected in water drawn from a well, then there is spread of waste into a same well. This, however, was a confirmation that adults are not empty vessels as children may be.

In this view one would learn that dealing with adults does not need to aim at proving that they themselves as facilitators are right but convincing learners on the importance and effects of practices they know. As learnt from a lesson on hygiene where the aged had different attitudes towards new hand washing practices, a facilitator should be able to help his or her learners integrate the old ways of living and the modern ones.

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5.2

Time Management

Time is a finite resource, all organizations want employees to work as efficient as possible to

increase output and minimize costs. Unfortunately, engaging effective time management techniques is mostly easier said than done. However, good time management skills can have a far greater impact on an organization than just increased output. In view of this, (Clouse 2009:1) contributes by saying, “A clear schedule for the day eliminates the uncertainty of whether or not there will be time to complete all projects. In turn, employees can relax knowing they will not miss vital work deadlines, hence, reducing stress and one‟s ability to reclaim personal life.

Since time is alleged to be a finite resource, meetings attended during the period of attachment mostly highlighted the importance of time management. The aspect was considered as an indicator of one‟s commitment and how that they love or hate what they do. Having out patients as a target that were always attended to starting from 08:00 hours, proper time management helped in having Environmental Health Education presentations made on time. All the presentations were made before 08:00 hours. It was going to be difficult if the improvised time was not managed properly. All this proves the importance of tie management in any institution.

5.3 Needs Identification and Assessment

During the period of attachments there is usually no time enough for one to go into the field

or come up with a programme besides departmental duties. In this respect one has to make his or her own plans on how to manage such. From this a lesson learnt was on identifying community needs. Since time was not there to come up with an independent community programme on Environmental Education, the same time for field work was maximized on.

Information collected from inspections and other activities became the basis for need identification and assessment. Since needs are with people in the community, confirming the fact that a community worker has the office in the community. In other words, an office for a community worker should be a place for planning with most of his or her time spent with concerned people as the only way of establishing their needs.

5.4 Patience and Tolerance

When dealing with people of different character tolerance was learnt to be the most cardinal aspect of a field worker. A field worker in this respect is a researcher who gets information

from people. His or her clients are community members making the success of any research

23

dependent on them. For a researcher to be given that most needed information he or she has to humble. Some people may show unwillingness to issue out the information but through a humble approach they become willing. Taking people harshly in most cases lead to them hiding the truth.

Patience and tolerance in the field were experienced at the time we were sent to correct information on services offered by private clinics. In the first place information was not given due to lack of prior appointment and the fact that the clinic management was not willing to share any of their information out. The acceptance of their reasoning was in the first place considered with patience. Negotiations were made and the needed information was given while the colleagues failed simply because they frustrated their clients. In all this the baseline information is that a field worker must work in agreement with people who are his or her clients.

5.5 Evaluations

Evaluation in any project provides checks and balances to the same. It at the same time provides information as to whether one has to go ahead with what they are doing or not. While at Chelstone Health Centre, evaluations were done through Performance Assessment Meetings and daily office reviews. Office reviews were done every time before any other duties could commence. The previous day‟s activities were the basis of the reviews. Punctuality was also one of the issues discussed under. If things were not done properly in the

previous outings reviews became an opportunity to correct them before going for the other. However, evaluations conducted both during Performance Assessment Meetings and daily office reviews were learnt to be vital as far as normal progress in any project is concerned.

5.6 Office Management

Office management deals with administrative handling, controlling and maintaining a balance process of work inside the office of an organization. It involves planning, organization, and

the controlling of secretarial aspect of the organization which includes the preparation, communication, coordination and storage of data to support production and other important operations. It is through the same aspect that monitoring of work processes and evaluation of the outcome are done. Office management is therefore necessary in the achievement of the administrative goals (Haddock, 2007).

In association with Haddock‟s ideas a close observation on filling system was made. The filling system involved report writing and storage. Every activity done both in the field and at

24

the Centre was penned down into reports. These were later submitted to higher authorities such as the in-charge‟s office at the Centre and the LDHMT. Other copies were kept the fills for future reference. All these constituted experience on office management.

5.7 Inspection of Public Premises Inspections conducted provided an important experience having worked with the Health institution under EHD. In this department, inspections were learnt to be the backbone of all its operations. Being concerned with public health protection inspections were used as a tool for identifying health threatening issues. The most identified areas of concern in the community were market places, shops, water points, PUBs and restaurants including swimming pools.

Inspections of the public premises served in the interest of protecting public and occupation health. Occupational health protection in that workers‟ safety was one of the targeted aspects. This was confirmed when an employers of a certain establishment had his employees from an enclosure which happened to be a locked bakery. Since doors were locked from outside workers‟ lives were threatened to death if any accident like fire arising from hot ovens or electric faults was to occur. It was on such matters as this that inspections were used in the interest of protecting occupation as well public health.

From such duties one would learn the importance of inspection tours conducted in public premises. If for example water used in the swimming pool is contaminated, users of the facility may develop health complications. In this case inspections through water quality monitoring becomes so important.

Chapter 6

25

Chapter 6

Chapter 6 ADDITIONAL EXPERIENCE Under additional experience falls the transport system. Day in day out automated

ADDITIONAL EXPERIENCE

Under additional experience falls the transport system. Day in day out automated transport machines are brought into Zambia. As much as people consider such as a blessing to the larger extent they have threatened environmental health. This has become a problem not only to Zambia but also the world as a whole. Different modes of transport such as cars, buses, trains and others cause noise and heavy air pollution disturbing the cause of nature.

Today the world‟s major problem being pollution, thoughtful ideas have come up in terms of ecofriendly modes of transport systems. In this view, cycling has been recommended especially for distances within cities. However, during the period of community experience, cycling was one of the most enjoyed activities. It neither needed fuel nor did contribute to the emission any poisonous gases.

Where huge sums of money was required for bus fares every day only a little amount was reserved for the purchase of a bicycle, an eco-friendly mode of transport. Apart from being cost effective and eco-friendly, it also saves on time. In times of traffic congestion cycling becomes the best mode of transport. It allows one to start off a trip and reach destination without being delayed by some forces beyond is or her control. Besides such convenience cycling in relation to the writings of the Bicycle Association (1995) has social benefits. Nowadays become too busy with work having no time for physical exercises leading to illnesses like heat attacks and obesity. If one can take up the approach of cycling every day to and from the workplace they are already exercising.

Cycling provides a good solution to some social, economic and environmental problems faced. To the contrary, challenges faced within this system of transport acts as setbacks to most potential cyclists especially in the less developed countries. Among other challenges, road systems of such countries do not support cyclists, they do not have specific lanes for bicycles as shown figure 7.0 (a) below. This brings about demotivation on those who would want to use bicycles especially on the most congested roads found in towns like Lusaka. All the time people report late for work with an excuse of being caught up in traffic which should have been avoided by using alternative transports. The growing increase in motor vehicle use

26

is, however, burdening our towns with increasing problems and costs related to congestion, accidents, loss of space, noise, poor quality of life, pollution leading to poor urban air quality and adverse effects on the natural environment.

(a) Old road system of Lusaka (The University of Zambia) (b) Modern road system of

(a) Old road system of Lusaka (The University of Zambia)

(b) Modern road system of Lusaka (Thabo Mbeki Road)

Figure 7.0 The road systems of Lusaka (Author, 2013)

The Bicycle Association continues by saying, Instead of serving the cities, traffic is consuming them.Though this being the case, no one even those in higher authorities give adequate attention to such arising matters. They keep planning on how to reduce traffic congestion by opening up new roads instead of working towards encouraging the use of eco- friendly transport systems.

Bicycling plays an important role in finding solutions to a wide range of issue starting from economic, social including the most delicate, environmental. As a way of motivating potential cyclists, the existing roads should be upgraded. They should include bicycle lanes to ensure safety of the cyclists as the one in figure 7.0 (b) indicated by a green arrow.

Chapter 7

27

Chapter 7

Chapter 7 OVERALL EVALUATION OF THE WORK DONE During the period of attachment with Chelstone Health

OVERALL EVALUATION OF THE WORK DONE

During the period of attachment with Chelstone Health Centre, many were the recorded achievements as per required by the set course objectives. Among the achievements was the development of a scheme of work and lesson plans. This was made possible through the programme of Environmental Health Education offered under health education. Besides that, participate in all departmental activities was done. This included inspection of food selling premises, education of food handlers, water quality monitoring were experiments never done at school became the most interesting aspect, follow ups on some identified issues such as water quality including malaria cases and attending of the staff meetings. From the meetings attended the importance of punctuality at work was learnt.

The stated were not the only activities done by the department; the collection of information concerning services offered by private clinics was among them. It is from this outing where the characteristic of a researcher was learnt. As a researcher, one has to be persuasive to allow them get the needed information from clients.

In assisting the department explore environmental opportunities related to departmental job description, the process of choosing which topics to include in EHEP was the best answer to the concerned objective. It was upon field work that issues identified were finally presented to the office as opportunities for community based environmental health education. For example, during inspections some restaurants were found operating below required environmental health standards, putting the public at risk of disease outbreaks. In cases as this, owners of such premises were given the required education. If it required them cleaning or stopping unnecessary damping of waste, they were being ordered to do so. The public also educated on how a place to have meals from should be like through EHEP. In facilitating the department to pay attention to Environmental Education (EE), a handbook was written to give a brief explanation concerning EE.

Still under the industrial attachment programme, it was learnt that Environmental Health can be considered as a research tool for Environmental Education along sides its normal

28

operations. This follows Environmental Health capability to identify community environmental health issues through field work which can later be acted upon using Environmental Education. A lesson from this was that one who deals with the community must frequently be in the field. This is to share with them in their experiences. From there it becomes easy to come up with educative activities. An Environmental Educator is a community worker who has to make decisions through research in the field and not only relying on the internet. Above all, filling of EE activities was systematically done.

CONCLUSION Though challenges faced, many were the achieved objectives in the three months period of Community Experience (CE). During this programme the author of the report was able to put into practice the knowledge and skills acquired from courses done at the University of Zambia. A platform was given to apply them to real-life working environment, gaining the required experience even before graduation. Among others planning, implementation and evaluation of the executed roles are the experiences acquired. In the view of this, the author was able to establish the relationship between the two fields including the importance of Environmental Education in Environmental Health Department of the Health sector. The Community Experience has, therefore, a great influence on the author‟s preparation for absorption into the industry.

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Chapter 8

CHALLENGES FACED

Environmental Health as a branch of public health has its planning done in the office at the Centre. The implementation thereof is community based. This, however, proves the fact that Environmental Health Departments are proactive in preventive than curative measures, they are interested in attending to community needs in their residential areas than patients at the Health Centre. They have more to do with tackling root causes of community issues. This demands Environmental Health Officers going out in the field to assess community happenings and give sensitization to members on various environmental health issues.

Nevertheless, challenges faced in ensuring effective sensitization were the inadequacy of funds. Since funding was never adequate to cater for transport and other necessities, reaching out to far places of the catchment area from the Centre was greatly compromised. In view of the same, most of the activities set to be done in such places were never successful, hence, working in the locality of the Centre only. This on the other hand limited the author‟s exposure to some of the community issues found in the unvisited places as a student on attachment.

Besides inadequate funding, among the visited selling premises were vendors who never wanted to comply with the set regulations of prohibiting street vending. Their non-compliance was based on the statement by the head state who stated that, “The harassment of vendors and car wash operators should immediately come to an end,” (Nkonde, 2011:1). Such was one of the greatest hindrances faced that confined departmental mandate in dealing with them consequently. They could not be directed to designated selling points even when alternatives were provided by the government itself through the building of markets.

In addition to the stated health institutional challenges the education institutional ones can never be ignored. It was difficult to find acquire accommodation in the field adding that there was no money to pay for rentals. Not only accommodation, but also transport to and from work place, hence, getting into unwanted loans.

8.1 Recommendations to the Faced Challenges Even when there was inadequate funding, the department of Environmental Health used to go on executing its required duties related to the field. Nevertheless, coverage mattered. To reach out to distant places of the catchment area, there was need for the availability of transport.

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This points back to the need for adequate financing of departmental activities as a way of ensuring environmental health issues are addressed throughout the catchment area and not only those around the Centre. This called for the relevant authorities such as the management and DHO to ensure adequate funding of the departmental needs for the health of the general public.

Solving the problem of street vending which has brought about environmental injustice in Chelstone and other townships of Lusaka, the customers must be involved. Though markets are available traders fail to occupy them for others trap customers of the same goods they have right from the streets. This, however, calls for political will taking its course. The Government through local authorities such as the Councils needs to declare areas apart from markets non-business areas. Anyone, both buyers and sellers, found transacting business in those areas should be charged. Once streets are freed everyone else will be able to go into the built markets since their businesses will not be blocked by street vending.

In relation to education institutional challenges, it is recommended that the relevant authorities looking after our financial wellbeing should ensure that project allowances are given in order that the required work in the field is done effectively and not for having done the work. There are many things that come about in the field which need funds. If funds are given after the projects then it defeats the purpose of being called allowances.

8.2 Recommendations to Environmental Education Unit EE being a new field of study many individuals and institutions are not aware of it. Appreciation be rendered to EHD at Chelstone Health Centre for defining EE as an alternative to Environmental Health. As the programme is gaining its identity with the Zambian institutions, it may be a good direction to give it a teaching course. This would at least help those who want to join the Ministry of Education (MoE) be certain of what is expected of them. In addition to that, for the sake of those who would want to join the Ministry of Health (MoH), Environmental Health related courses should take a scientific approach for intense practical experience.

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GLOCERY

Butcher A butcher is a person who cuts and sells meat in the butchery.

Catchment area A region from which a hospital‟s patients are drawn.

Environment Environment refers to the surroundings or conditions that influence lives and development of animals, plants and organisms.

Environmental Education This is a field of study that is focused on creating awareness and understanding concerning environmental issues that leads to responsible individual and group actions.

Environmental Health Environmental Health is a branch of public health concerned with all aspects of natural and built environment that may affect human health

Inspection The process of assessing the quality of something or a place.

In Patients These are people that are admitted at the health Centre for special care by the medical officers.

Out Patients These are people that seek medical attention while coming from home.

Pedestrians People who walk on the road rather than travelling in a vehicle.

Routine inspections These are assessment of the quality of something or a place done on a regular basis.

Waste Any material that has been and is of no use in its original state.

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Bicycle

Association

REFERENCE

(1995).

Cycling’s

Potential

and

Association: Coventry.

How

to

Achieve

it.

Bicycle

Clouse K (2009). Handling Employees Who Habitually Report for Work Late. www.cdklawyers.com/Keith Clouse Dallas Texas employment law attorney. Access on 04/04/2013 at 12:34 PM GMT.

Conant J and Fedem P (2008) A Community Guide to Environmental Health. Hesperian Foundation: Berkeley.

Helen W. (2010). What Every Trainer Needs to Know About Adult Learning Styles. PACER Center.

Holman, J.C.M. (2003). Iodized Salt. The World Health Organization (WHO): www.who.org. Accessed on 09/05/2013 at 08:43 AM GMT.

Means, W. J. (2010). Why We Should not Relax Food Inspection Rules. The Wyoming Farm Bureau Federation.

Nkonde, F (2011). Celebrations follow Sata's Directive on Street Vending in Ndola. The Zambia Dailymail: Lusaka.

Smith T (2008) What is Sustainability? Retrieved from http://acwi.gov/swrr on at 16:37 GMT.

15/04/2013

WHO (2003). Guidelines for drinking-water quality: Chlorine in Drinking-water. World Health Organization: Geneva

www.gmailaccounts.com 19/09/201, 14:15 Pm GMT.

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EHTS’ Work Schedule

APPENDIX

S/N

DAY

PROGRAMME OF THE DAY

 

STAFF ON COVERAGE AT THE CENTRE

1.

Monday

Management

meeting

and

other

 

administrative issues

_

2.

Tuesday

Inspection of public

premises /

CHEELO, C. (MR)

Breast Milk Substitute (BMS)

monitoring

 

3.

Wednesday

Inspection of public premises / water sampling/ Breast Milk Substitute (BMS) monitoring

NYAMBE, C. (MRS)

4.

Thursday

Inspection of public premises / water sampling

SIMUKOKO,

R.R.A.

(MR)

5.

Friday

Water sampling / report compilation

_

6.

Saturday

Malaria

active

infection

detection

 

follow ups

_

34