HOUSING FOR BETTER HEALTH DR.APURBA PANDIT

DR.APURBA PANDIT
M.B.B.S, M.C.P.S 

In an enciant time man live in cave.
But now a days man has become civilized. House is not only the surrounding of a man but also the first shelter, living standerd, place of social life, beeing developed as well as total correspondent with the society. With a homely environment, room of muddy has replaced by paper, steel then bricks, glasses. Have made a home of peace beauty and love.
House has altered its idea also its definitions and planing. Housing in the modern concept includes not only the physical structure providing shelter, but also the immediate surrounding and the related services and facility.

A who expert group on public health aspects of housing prefers to
Use term 'residential environment' which is defined as the physical structure that man uses the environ of the structure including all necessary services, facilities, equipment and devices needed or desired for the physical and mental health and the social well-being of the family and the individual

THE FOLLOWING CRITARIA FOR HEALTH FULL HOUSING

1, provides physical protection and shelter.
2. Provides adequately for cooking, eating washing and excretory function3, designed, constructed, maintained and used in a manner such as to prevent the spread of communicable diseases
4,provides for protection from hazard of exposure to noise and pollution.
5,is free from the unsafe physical arrangements due to construction or maintenance, and from toxic or harmful materials; and
6. Encourages personal and community development, promotes social relationships, reflect a regard for ecological principles, and by these means promotes mental health.

HOUSING STANDARDS

With the broadening concept of housing, the concept of housing standards has also changed. The standards are no longer confined to narrow health criteria like per capita space and floor space. Social and economic characteristics such as family income, family size and composition, standard of living, life style, stage in life cycle, education and cultural factors must be taken into consideration in determining housing standards.

HOUSING AND HEALTH

Housing is part of the total environment of man and being a part, it is to some extent responsible for the status of man's health and well-being. It is difficult to demonstrate the specific cause and effect relationships because housing embraces so many facets of environment. By deductive reasoning, a strong relationship can be established between poor housing and the following conditions:
1.Respiratory infection : common cold, tuberculosis, influenza, diphtheria, bronchitis, measles, whoopingcough, etc.
2.Skin infection; scabies, ringworm, impetigo, leprosy.
3.Rat infestation ; plague.
4.Arthropodes ; house flies, mosquitoes, fleas and bugs.
5.Accidents; from flexible housing material, electric wiring,week base
And caused by some defect in home and its environment
6. Morbidity and mortality; where housing condition is substandard high morbidity and mortality rate is observed.
7.Psychosocial effects; the sense of isolation felt by people living on the upper floor and also on the densely populated area lead to neurosis and behavior disorders.
If the definition of health given by who is applied, we have also to take into consideration the border aspects of mental and social well being of individual's families, i.e., factors related to satisfaction of physiological, psychological and social needs.

OVERCROWDING

For low socioeconomic condition and especially in the urban area due to lack of space and adequate knowledge overcrowding is a serious problem of housing. Overcrowding refers to the situation in which more people are living within a single dwelling than there is space for, so that movement is restricted, privacy secluded, hygiene impossible, rest and sleep difficult. It may promote the respiratory infections such as tuberculosis, influenza and diphtheria. High morbidity and mortality rates are observed where housing condition is substandard. Children are said to be more effected. In short it is a psychosocial stress, leading to unhappiness and very probably to psychosomatic and mental disorders.
On natural disaster
Planned housings a must for life in our country we are in already in a threat of earthquake. For poor housing we may be finished even in a small earthquake along 50 miles around Dhaka city. Flood is a common for our country. Every year our cities are flooded. Due to unplanned housing and construction life is on a great risk on cyclone, typhoon tornado etc
Indicators of housing
In recent years the use of indicators has become widespread for the measurement of quality of life. The indicators for housing may be classified as;
1) physical: these are based on floor space, cubic space, room height, persons per room, room per dwelling, environmental quality (eg, air, light, water, noise, sewage disposal, etc.)
2) economic indicators: these are cost of the building, rental levels, taxes, expenditure on housing etc.
3) socials indicators: the following were proposed at an inter-regional seminar on the social aspects of housing, organized by the UN in 1975.
1. Indicators related to prevention of illness:
2. Frequency of illness due to inadequate sewage and garbage collection.
3. Frequency of illness associated with contaminated water source.
4. Frequency of insect borne diseases
5. Frequency of illness due to overcrowding.
6. Frequency of illness due to accidents.
7. Frequency of illness due to proximity to animals.
8. Access to medical facility. B) indicators related to comfort:
9. Thermal comfort
10. Acoustic comfort
11. Visual comfort
12. Spatial comfort
C) Indicators related to mental health and social well-being
13. Frequency of suicides in the neighbourhood
1) Neglected and abandoned youth in the neighbourhood
2) Drug abuse(including alcohol) in the neighbourhood

So for life and health better housing must be a propaganda for man.

Reference :

1) WHO (1961). Techn. Rep. Ser., No.225
2) WHO (1965). Techn. Rep. Ser., No.297
3) WHO (1974). Techn. Rep. Ser., No.544
4) Park's text book of preventive and social medicine- 15th edition
5) Govt. Of india (1949). Report of the environment hygiene committee, ministry of the health, new delhi.
6) Bookhive's 8th five year plan (1992-97) by e. Chandran, issues of current interest series no.4
7) Un (1977). The social impact of housing, report of an interregional seminar, depart of economic and social affairs.
American public health

association (1959). Am. J. Public health, 59, 841.

Introduction:
In Bangladesh groundwater accounts for about 97% of rural drinking water (UNICEF, 1999). Groundwater often provides a water supply that is more reliable in quantity and more stable in quality than surface water and thus has economic and operational advantages due to reduced treatment requirements (Robins, 1990).
Until the early 1970s, the more than 100 million inhabitants of Bangladesh and neighboring West Bengal drank from shallow hand-dug wells, rivers and ponds. But pollution was causing epidemics of diarrhea, amebiasis, polio, typhoid and other water-borne diseases. This persuaded aid agencies such as UNICEF and others to provide of millions of dollars for sinking tube wells - steel pipes fitted with simple hand pumps- to tap the plentiful and apparently clean water in the sand and silt of the Ganges flood plain. Following this example, the rural people of Bangladesh later sank many more tube wells privately. The number of tube wells present today is estimated between 3-5 million whereas it was only about 50,000 during the British colonial rule (UNICEF 1999). But the recent discovery of arsenic in groundwater has ruined this decade-long success and the access to safe drinking water has now dropped to almost 80% (UNICEF, 1999). Collin Devis, Chief of Water and Environmental Sanitation of UNICEF rightly mentions that Bangladesh has become the victim of its own success (Independent, 2000). Therefore, it is very important that any environmental policy be developed according to proper scientific and socio-economic foundations otherwise things may go wrong at a tremendous expense without achieving any gain (Trudgill, 1990).

Discovering Arsenic Problem:
First sample of arsenic contaminated water was detected only recently in 1993 in connection to the examination of tube well water samples in some southern districts of Bangladesh by the Public Health Engineering Department of the Government of Bangladesh. Later several government and non-government organizations conducted more surveys, and according to the latest estimate there is arsenic contamination in at least 46 districts out of 64.There are about 4.5 million tube wells in Bangladesh and water samples from 30,000 have been examined so far. Arsenic contamination has been found in 19.4% samples. Arsenic levels well above acceptable range have been found in tube well water of 155 Thanas (Sub district) belonging to 44 districts. The acceptable level of arsenic in drinking water has been agreed to be 0.05 mg/L for Bangladesh. Arsenic level above the acceptable range has been only found in low bored tube well water; but deep tube well water did not show arsenic contamination as yet. The districts have been categorized as more contaminated, less contaminated and contamination free depending upon the water level of arsenic.

!.MD, MS, FIAGP, FCGP, Deputy Director/ Associate Professor, Dhaka National Medical College Hospital, 53/1 Johnson Road, Dhaka 1100 ; 2. MBBS, Asstt. Registrar, Medicine Unit-1, Sylhet Medica College Hospital, Sylhet.

Source of Arsenic contamination of drinking water in Bangladesh:
The source of arsenic in soil water is still a controversial issue and yet to be resolved. Scientists say that sedimentation with arsenic laden soils began in this region about 25,000-80,000 years back in the Quaternary era which was most popularly known as the Younger Deltaic Deposition or YDD. Sedimentation continued years after years and pockets and rocks of arsenic have been created in specific zones of the country. Bangladesh is situated at the lower end of the three great river systems: the Ganges, Brahmaputra and the Meghna and their total catchment area is around 1.5 million square kilometers comprising the Himalayan Mountain System, the Indian Shield, the Shilong Plateau, and the great Gangetic Plains. The area produces huge amount of sediments each year due to geologic reason. An estimate says that the three great rivers carry over 2.4 billion tons of sediments each year through Bangladesh. Frequent floods in Bangladesh have a link with this process. Holocene and recent sediments mostly cover Bangladesh and almost all sediments contain arsenic compounds. Both national and expatriate experts assume that irrational over utilization of soil water for irrigation purpose have caused dissociation of arsenic from the compounds with consequent water contamination.

Toxic Effects of Arsenic in Humans:
Arsenic is a poison and its lethal dose for human is 125 milligram. It is 4 times as poisonous as mercury. Toxicity depends on the amount of arsenic intake, which is classified into acute, sub-acute and chronic toxicity respectively. Drinking water contamination causes the last variety of toxicity. Most of the ingested arsenic is excreted from the body through urine, stool, skin, hair, nail and breath. In excessive intake, some amount of arsenic is deposited in tissues and inhibits cellular enzyme activities. Almost all organs are affected; but clinical symptoms appear insidiously after 6 months to 2 years or more depending upon the amount of arsenic intake. Chronic toxicity of arsenic is best discussed in terms of organ systems affected, viz. skin, liver, nervous system, cardiovascular system and respiratory system.