Higher GeographyGlobal Issues

Key Concept

• Inequality of social and economic development is a major feature of the contemporary world.

• It exists on various scales and is measurable in several ways.

• Levels of health and the incidence of disease are major indicators of levels of development. Such indicators may be explained geographically by reference to a variety of interacting processes.

WE WILL

• Understand a range of social, economic and composite methods of measuring spatial inequality of development e.g.

birth rate, death rate, per capita Gross Domestic ProductPhysical Quality of Life Index

Development is any improvement in the

standard of living of the people living in a

country. It is measured using development

indicators

Indicators of Development

Social• Average life expectancy at birth

in years

• Birth Rate per 1000 of population

• Access to water %

• Adult literacy rates (percentage)

• Infant mortality rates per 1000 live births

Economic

• Gross Domestic Product per capita US$

• Average Annual Income per capita US$

• GNP per capita US$

• Vehicles per 1,000 people

• Telephones per 1,000 people

• Percentage of People Employed in Agriculture

Social IndicatorsAdvantage

• Large range of indicators

• Can show Governments ability to supply basic services.

Disadvantage

• Difficult to quantify

• Difficult to collect

• Some are averages

• Regional differences

A single indicator should never be used to show

development as a country may have a good rating in

one section and not in another.

Composite Indicators of Development

• PQLI – Physical Quality of Life Index (life exp., literacy and infant mortality)

• HDI – Human Development Index (adjusted income per capita, educational attainment, life exp. At birth) A rating of 0-1

http://hdr.undp.org/en/content/table-1-human-development-index-and-its-components

Internet Activityhttp://www.bbc.co.uk/scotland/education/int/geog/health

• Click on the side menu (development – social indicators)

• Click on the side menu (development – economic indicators)

• Read the information – make notes around a blank world map and try the exercise.

Explain why such indicators of development may fail to provide an accurate representation of the true

quality of life in an economically less developed country.

Problems with Indicators Essentially these indicators are just too broad/ generalised.

They are averages which disguise or distort wide internal variations eg a few immensely wealthy families but the majority of the population may be living at subsistence level.

Some regions/areas of a country may be much better off than others – ‘north/south’ divides; urban/rural contrasts. E.g. Brazil North East compared to South East

GNP figures in some cases are grossly inflated by oil revenues. E.g. Saudi Arabia

Certain indicators are perhaps irrelevant to the real quality of life in many poorer subsistence-based economies. E.g. number of cars/TV sets/telephones etc per 1000 people.

GIVE EXAMPLES – BRAZIL, KENYA

Question – 2008 6a(i)

• Describe clearly two economic and two social indicators of development which could be used to produce a map such as this.

(8 marks)

ANSWER

Economic indicators

• Gross Domestic Product per capita

• Average Annual Income per capita

• Percentage of working population employed in, say, the Primary sector.

Social indicators

• adult literacy rates (%)

• average life expectancy at birth

• infant mortality rates per 1000 live births

• number of cars/TV sets/telephones etc per 1000 people.

2010

• “Life expectancy in Chad is only 47 years.”

• Suggest the physical and human factors which may have led to this low life expectancy.

Lesson Review What is meant by development?

Name 3 social indicators.

Name 3 economic indicators.

Why is the HDI one of the best composite indicators?

How can these indicators help Governments?

2014• It is clear from looking at all these development indicators that Southern

India is the most developed region (1 mark)

• With Eastern India and The Plains vying for the least developed regions (1 mark).

• For % Literacy Rate, it could be noted that only 9% separates all the regions so there is not a great difference between them all. However, South India has the highest literacy rate at 83%, whereas Eastern India has the lowest at 74%.

• For Infant Mortality Rate, it could be noted that South India has the lowest (best) figures at 29, whereas The Plains has the highest (worst) infant mortality at 47 (a difference of 18 live births per 1000).

• For Birth Rate, it could be noted that South India has the lowest at 16, whereas The Plains has the highest birth rate at 23.

• For % households using electricity for lighting, South India is again the best with 94%, whereas Eastern India has only 62% (a difference of 32%).

Differences between ELDCs

WE WILL

• Describe and explain differences in levels of development between and within countries

• e.g. differences between newly industrialising countries (eg Pacific Rim countries) and other ELDCs (eg Bangladesh)

• http://www.bbc.co.uk/learningzone/clips/factors-which-disrupt-development/6986.html

Internet Activity

http://www.bbc.co.uk/scotland/education/int/geog/health

• Click on the side menu to find out about both physical and human factors in development. (it will take you to a map to clip on specific case studies)

• Take notes to make these into case studies you can use.

______________ – Areas such as the Sahara have extremely dry climates. Burkina Faso is a good example. Soils tend to be poor, it is difficult to grow crops and there is always the danger of famine.

Because of the difficult conditions it is very hard to attract industry to

these regions

Resources – Diamonds and gold can fetch a good price when sold abroad. Other resources such as oil and coal can be useful in attracting industry to a region. Some countries

have little or no resources to export or use to attract industry. This makes development very hard.

Relief – Mountainous regions the world over, such as

_______________, can cause major barriers for development. It can be very difficult and expensive to build

roads and rail networks. This means that it is hard to establish businesses

where transportation is important. Mountainous areas tend to have poor

soil and this means that agriculture doesn’t tend to be that productive.Natural disasters – Areas such as

__________________ are prone to typhoons, hurricanes and floods. The

cost of repairing the damage from these disasters alone is enough to keep

some countries poor. Homes and businesses are destroyed and transport

links can be damaged regularly

Trade – With little industry, most developing countries have few high value goods to export abroad. Most exports from developing countries

consist of low-cost primary goods such as minerals and foodstuffs. When they do have higher value goods to export,

such as _________________ products, cars and washing machines, they often

find that developed countries set up trade barriers to protect their own

industries.

Population growth – The rate of population growth in developing countries is considerably higher than in developed countries. The UK has a population of 59 million people. Due to its low population

growth it will take around _____ years for the UK to double its population. Ghana has a population of around 18 million. It

will take around _____ years for Ghana to double its population. Extra mouths to

feed put a terrible burden on poor countries. Governments struggle to

provide jobs; education and medical care for rapidly increasing populations.

Political turmoil – Political unrest, corruption and civil wars are a major hindrance to a country’s development. It can disrupt and

destroy domestic businesses and also scare off foreign industries from setting up factories in the country. A major international company

would not risk spending millions of pounds setting up a factory in an ___________

country only to see the factory destroyed in a war. Israel and the Middle East region are

examples of areas that are troubled by unrest.

_____________________ – Agriculture does not create high value goods. It is

industry that creates wealth for a nation. In the UK only 2% of people are employed in agriculture. In India 67% of the workforce is

employed in agriculture. In developing countries to work in agriculture is basically

the only way of feeding a family. Click on the exercise button to work though the reasons

why a lack of industry can hinder development.

Activity

• Read pages 167-179

• Make a spider diagram of factors influencing development (page 168)

• Take notes (especially the case studies on Singapore and Kenya)

• Complete questions 8,9 and 10 on page 179

Activity• You will find a newspaper article/you tube video to use as a case study for each

of the following:

• China, South Korea – manufacturing (labour force)

• Bangladesh - floods/cyclones • Thailand – tourism

• Saudi Arabia – oil

• Zimbabwe – political instability

• Brazil - manufacturing

Make a poster to show the reasons for different levels of development betweeen ELDCs

GDP Life exp. Infant Mortalit

y

Literacy

China

Bangladesh

Thailand

Saudi Arabia

Zimbabwe

Brazil

Exam Style Question• Referring to named developing countries

that you have studied, suggest reasons why there is such a wide range in levels of development between developing countries.

10• Suggest reasons for the wide variations

in development which exist between Economically Less Developed Countries (ELDCs). You should refer to named ELDCs you have studied.

Point Reason FactNatural

Disasters  

Political instability

Newly Industrialising Countries

(NICs)

Resources

Tourism  

Manufacturing

Point Reason FactNatural

Disasters  

Restrict development/hamper progress eg - drought in sub Saharan Africa (Mali, Chad, Burkina Faso ...) - floods/cyclones in Bangladesh - hurricanes in the Caribbean - tsunamis in Sri Lanka, Indonesia

The worst floods in Bangladesh in 1998 killed more than 3,500 and destroyed crops and infrastructure worth more than $2 billion.

Political instability

Recent disruptive civil wars in places such as Sudan/Rwanda/Somalia/Liberia/Sierra Leone or larger-scale conflicts in Iraq or Afghanistan have also had a negative impact. Widespread corruption and mismanagement have accounted for the marked decline of Zimbabwe’s economy and are a continuing problem in many other African nations.

Around three million people have been displaced within Sudan.

Since the beginning of the conflicts of70,000 people have died during both the conflict and period of displacement

Newly Industrialising Countries

(NICs)

Newly Industrialising Countries (NICs) eg China, South Korea, Taiwan are able to earn substantial amounts from steel-making, shipbuilding, car manufacturing, electrical goods, toys, clothing etc. They have been able to benefit from their population’s entrepreneurial skills and low labour costs

China’s automotive production grew from 2 million cars in 2000 to over 13 million cars in 2009.

Resources Oil-rich countries such as Saudi Arabia, or to relatively well-off countries like Malaysia which are able to export primary products such as tropical hardwoods, rubber, palm oil and tin as opposed to poorer nations such as Burkina Faso or Chad which lack significant resources

Proven oil reserves in Saudi Arabia are the second largest claimed in the world, estimated to be 267 billion barrels

Tourism The expansion of tourism has helped to improve living standards/create new job opportunities in countries like Thailand, Jamaica, Kenya, Malaysia, Sri Lanka and earns valuable foreign currency  

13.5 million visitors in 2009 accounted for 6.5% of Thailand's gross domestic product

Manufacturing

Some countries such as Brazil and Malaysia have both resources and growing manufacturing industries

Manufacturing accounts for about one-fifth of the GDP of Brazil and more than one-tenth of the labour force.

Fact

The worst floods in Bangladesh in 1998 killed more than 3,500 and destroyed crops and infrastructure worth more than $2 billion.

Around three million people have been displaced within Sudan.

Since the beginning of the conflicts of70,000 people have died during both the conflict and period of displacement

China’s automotive production grew from 2 million cars in 2000 to over 13 million cars in 2009.

Proven oil reserves in Saudi Arabia are the second largest claimed in the world, estimated to be 267 billion barrels

13.5 million visitors in 2009 accounted for 6.5% of Thailand's gross domestic product

Manufacturing accounts for about one-fifth of the GDP of Brazil and more than one-tenth of the labour force.

Newly Industrialising Countries (NICs) eg China, South Korea, Taiwan are able to earn substantial

amounts from steel-making, shipbuilding, car manufacturing, electrical goods, toys, clothing etc.

They have been able to benefit from their population’s entrepreneurial skills and low labour costs

Many countries are afflicted by recurring natural disasters which restrict development/hamper progress

eg - drought in sub Saharan Africa (Mali, Chad, Burkina Faso ...) - floods/cyclones in Bangladesh - hurricanes in the Caribbean - tsunamis in Sri Lanka,

Indonesia Political instability – eg recent disruptive civil wars in places such as Sudan/Rwanda/Somalia/Liberia/Sierra Leone or larger-

scale conflicts in Iraq or Afghanistan have also had a negative impact. Widespread corruption and mismanagement have

accounted for the marked decline of Zimbabwe’s economy and are a continuing problem in many other African nations.

Oil-rich countries such as Saudi Arabia, or to relatively well-off countries like Malaysia which are

able to export primary products such as tropical hardwoods, rubber, palm oil and tin as opposed to

poorer nations such as Burkina Faso or Chad which lack significant resources

Some countries such as Brazil and Malaysia have both resources and growing manufacturing industries

The expansion of tourism has helped to improve living standards/create new job opportunities in countries like

Thailand, Jamaica, Kenya, Malaysia, Sri Lanka and earns valuable foreign currency

• Oil-rich countries such as Saudi Arabia, Brunei, the UAE or to relatively well-off countries like Malaysia which are able to export primary products such as tropical hardwoods, rubber, palm oil and tin as opposed to poorer nations such as Burkina Faso or Chad which lack significant resources.

• Newly Industrialising Countries (NICs) eg China, South Korea, Taiwan are able to earn substantial amounts from steel-making, shipbuilding, car manufacturing, electrical goods, toys, clothing etc. They have been able to benefit from their population’s entrepreneurial skills and low labour costs.

• Some countries such as Brazil and India have both resources and growing manufacturing industries.

• The expansion of tourism has helped to improve living standards/create new job opportunities in countries like Thailand, Jamaica, Kenya, Sri Lanka and earns valuable foreign currency.

• Many countries are afflicted by recurring natural disasters which restrict development/hamper progress eg drought in sub Saharan Africa (Mali, Chad, Burkina Faso…) – floods/cyclones in Pakistan/Bangladesh – hurricanes in the Caribbean – tsunamis in Sri Lanka, Indonesia.

• Political instability – eg recent disruptive civil wars in places such as Sudan/Rwanda/Somalia/Liberia/Sierra Leone or larger-scale conflicts in Iraq or Afghanistan have also had a negative impact. Widespread corruption and mismanagement have accounted for the marked decline of Zimbabwe’s economy and are a continuing problem in many other African nations.

Exam Style Question

• Suggest reasons for the wide variations in development which exist between Economically Less Developed Countries (ELDCs)

You should refer to named ELDCs you have studied.

(6 marks)

You should not be asked about this in the final exam unless it is a data style

question. This was in the old Higher course.

WE WILL

• Describe and explain differences within ELDCs (eg between south-east and north-east Brazil).

• Study Brazil but you can also use the information about Kenya as a case study if you prefer.

Causes of problems in AfricaArid continent – deforestation,

overgrazing, soil erosion and desertification.

High population growth – family planning

had little impact

Disease – loss of economically active members

of the country, strain on health system.

Civil wars – military expenditure and

political instability

Exploitation of resources – little development of

manufacturing industries

Post independence struggle – poor leadership, failed large scale

projects

Poor infrastructure

External debt – G8 working towards cancelling debt

Lack of natural resources

KenyaFactor Example

Arid North Kenya semi arid plains and deserts are prone to drought

Population density

Central Highlands are the most fertile and have 85% of population

Agriculture Only one fifth of country suitable for agriculture

Climate Succession of droughts resulted in overgrazing, land degradation, and soil erosion.

Industry Kenya is East Africa’s most industrialised country, however, growth is hampered by lack of fuel. Suffers from frequent power cuts.

Infrastructure Kenya needs to improve infrastructure due to increased pressure from growing population and increased tourism

Corruption In 1997 the IMF suspended loans to the country because of government corruption.

Reasons for Differences Within Kenya

Relief Climate

Land use

potential

Accessibility

ContrastNorth and East

• Dry bushland, desert – harvests fail on average 3 out of 5 years.

• Accessibility is poor

• Mostly Nomadic people (Masai) with herds of cattle.

• Neglected by Kenyan Government

• Poorly Served by health and family planning clinics.

South and West

• Coastal plain or upland

• Fertile soils

• Land – medium to high capacity

• Over 28 million people live in the area

• Produces majority of crops

• Focus of development – large scale irrigation schemes

• Health and family planning clinics freely available

Only 30% live in urban areas.

70% in urban areas have access to clean

water compared to 50% in rural areas.

The bottom 9 countries out of 175 in terms of HDI are all in

Africa.

Contrasts Within Urban Areas

Nairobi Centre

• Tall modern buildings

• Areas of good quality housing

Surrounding Slums

• Growing Rapidly

• Water supply is inadequate

• Many unable to afford food or education

• Few sewage systems

• Disease spreads rapidly

• Unemployment rate 50%

• Concentration of industry and commerce in the “Golden Triangle” of Sao Paulo, Rio de Janeiro and Belo Horizonte.

• Best transport system in Brazil

• the greatest number of services

• benefited most from Government help

• coffee growing has long been carried out on the rich terra rossa soils around Sao Paulo producing job opportunities and creating wealth for the area and the national economy Rio de Janeiro

• a good natural harbour which encouraged trade, immigration, industry, and more recently, tourism.

South East

North EastDisadvantaged by more ‘negative’ factors such as • periodic droughts• Fewer mineral resources• Shortage of energy supplies

All of which have encouraged outwards migration

The North (Amazonia) • Peripheral location• Inhospitable (Rainforest) climate• Poor soils• Dense vegetation• Inaccessibility• Lack of government investment

Not surprisingly, it is the poorest of Brazil’s five main regions

Rural• population often

illiterate/isolated/more scattered communities

• lack of basic medical provision

• vicious circle of poverty

• water more likely to be contaminated

• greater occurrence of disease

• dependent on subsistence farming

• low standard of living

• wars and natural disasters have severe consequences in rural areas

• isolated from political decision making.

Urban areas• greater

opportunities/more jobs

• better health care/education/housing

• better services

• more aid given to urban areas

• greater reliance on industry.

Provision of safe water and sanitation

Urban Sanitation72% served

28% unserved

Rural Sanitation49% served

51% unserved

• Differences in living standards which exist between relatively wealthy and better provided for urban areas compared to poorer more isolated rural areas and to the contrasts that can be found within urban areas

• eg hillside favelas such as Rocinho in Rio versus the prosperous

apartments overlooking Copacabana Beach.

Question – 2008 6a(iii)

• There are often considerable differences in levels of development and living standards within a single country.

• Referring to a named ELDC which you have studies, suggest reasons why such regional variations exist.

(10 marks)

Activity

• Make a poster to show the differences in levels of development within Brazil

Suggest reasons for the differences in the figures

below. 6 Marks

South-East Amazonia (North East)84% adult literacy 58% adult literacy

57% of Brazil's wealth 4% of Brazil's wealth

42% of Brazil's energy use 1% of Brazil's energy use

In what ways does the information given in the table suggest that the eight provinces of Kenya are at different levels of development?10 Marks

Sample Answer

The eight provinces are at different levels of development as the percentage of females with no education in North Eastern is 87% while in Nairobi it is 10%. This shows that Nairobi is more developed than the North Eastern in that respect.There are 5 provinces with more than half their population below the poverty line showing that they are less developed.In North Eastern province, 92% of children 12-23 months are without vaccinations suggesting they cannot afford them and they will die because of it. The most developed province is Central as all their percentages are below 40%.

Sample Answer

The eight provinces are at different levels of development as the percentage of females with no education in North Eastern is 87% while in Nairobi it is 10%. This shows that Nairobi is more developed than the North Eastern in that respect.There are 5 provinces with more than half their population below the poverty line showing that they are less developed.In North Eastern province, 92% of children 12-23 months are without vaccinations suggesting they cannot afford them and they will die because of it. The most developed province is Central as all their percentages are below 40%.

eg 1

eg 2

eg 3

7/10

WE WILL

• Understand the physical and human factors involved in the levels of health and the incidence of disease, eg factors related to:

climate water supply wealth nutrition remoteness

Physical FactorsHot Wet Conditions

• Encourage the spread of infectious diseases

• Ideal breeding ground for vectors

Drought and Arid Conditions

Affect water supply – increase in disease due to contaminated water.

Diarrhoea is one of the most common illnesses related to contaminated water supply.

Diarrhoea due to infection is

widespread throughout th

e

developing world. In Southeast

Asia and Africa, D

iarrhoea is

responsible for a

s much as 8

.5%

and 7.7% of all deaths

respectively.

Mountainous Areas

• Poor communications

• Remote/isolated

• Difficult to access health care

Human FactorsPoverty

• Living in slum conditions – lack water and sanitation.

• Homelessness

Lack of Education

• If people are unaware of hygiene and how to live a healthy lifestyle (diet, exercise) then they are more susceptible to disease.

Poor Nutrition“Malnutrition essentially means “bad nourishment”. It concerns not enough as well as too much food, the wrong types of food, and the body's response to a wide range of infections that result in malabsorption of nutrients or the

inability to use nutrients properly to maintain health. Clinically, malnutrition is characterised by inadequate or excess intake of protein, energy, and micronutrients such as vitamins, and the frequent infections and disorders that

result.”

• Unable to afford a healthy diet.

• People who are undernourished are more susceptible to disease.

Chronic food deficits affect a

bout 792

million people in th

e world (FA

O

2000), including 20% of th

e

population in developing countri

es.

Worldwide, m

alnutrition affects o

ne in

three people and each of its m

ajor

forms d

warfs m

ost other d

iseases

globally (WHO, 2000).

More than 70% of

children with protein-

energy malnutrition live in

Asia, 26% live in Africa,

and 4% in Latin America

and the Caribbean (WHO

2000).

Over one billion (one-fifth

of the total world

population) lack adequate

food, clean water,

elementary education and

basic health care.

Activity

• Pick on case study country and complete the table with information you could use when writing about the physical and human factors which impact on health.

• This information will also help with other questions in the exam.

If you finish share you information with someone in the class who has selected a different country – then you will each have

two case study countries

Factor Statistic Analysis (what does this figure mean/ How might it impact on

health)

HDI

GDP

Disease level – Malaria, HIV/AIDS, cholera…

Climate

Water Supply

Sanitation

Remote/ Isolation

Communication Links

Access to health care

Poverty

Education

Nutrition/ diet

Other

Lesson Review• Can you describe one physical factor which impacts on

health?

• Can you describe one human factor which impacts on health?

• Explain why poverty links so many of the factors impacting on health.

• State one statistic relating to:MalnutritionWater related disease

CfE Higher GeographyGlobal Issues

Malaria

WE WILL

• Understand what Malaria is and the symptoms.

• Be able to describe the physical and human factors which contribute to the spread of Malaria.

Malaria is a life-threatening disease caused by Plasmodium parasites

that are transmitted to people through the bites of infected Anopheles

mosquitoes "malaria vectors“ which bite mainly between dusk and dawn.

http://www.bbc.co.uk/learningzone/clips/the-malaria-cycle/6989.html

In 2008, there were 247

million cases of malaria and nearly one

million deaths – mostly among children living

in Africa.

90% of all malaria cases

are in sub-Saharan Africa where it is the main cause of death and a

major threat to child health

Worldwide, a child dies of malaria

every 20/30 seconds.

https://www.youtube.com/watch?v=d5J72xdavT4

Symptoms• Symptoms appear seven days or more (usually 10–15 days) after the

infective mosquito bite.

• The first symptoms – fever, headache, chills and vomiting – may be mild and difficult to recognise as malaria.

• If not treated within 24 hours, P. falciparum malaria can progress to severe illness often leading to death.

• Children in endemic areas with severe disease frequently develop one or more of the following syndromic presentations: severe anaemia, respiratory distress.

• In adults, multi-organ involvement is also frequent.

• Clinical relapses may occur weeks to months after the first infection, even if the patient has left the malarious area. These new episodes arise from "dormant" liver forms (absent in P. Falciparum and P.malariae), and special treatment – targeted at these liver stages – is mandatory for a complete cure.

Cycle of Malaria

Physical and Human Factors Contributing to the Spread of Malaria

The parasitic disease is present in 90 countries and infects one in 10 of the world's population

http://www.bbc.co.uk/learningzone/clips/the-climactic-and-human-factors-which-affect-the-distribution-of-malaria/6990.html

Ideal breeding grounds for mosquitoes – still, shallow water.

Mosquitoes will breed in small puddles, even in animal hoof prints, empty cans and bomb craters.

A jar containing mosquito larvae.A jar containing mosquito larvae.

A high risk area – people, vegetation cover and stagnant water during the wet season.

Areas of shade in which the mosquito can digest human

blood

Suitable breeding habitat for the female anopheles mosquito –

areas of stagnant water such as irrigation channels, water barrels,

padi fields, puddles etc

Temperatures of between 15°C and

40°C

Hot wet climates such as those experienced in the tropical

rainforests or monsoon areas of the world

Settlements to provide a ‘blood reservoir’

Increase in Cases• The disease is becoming resistant to traditional treatments.

In some areas of Asia, none of the major drugs are effective in fighting malaria.

• Mosquitoes are developing resistance to the main insecticides which have been used to control the spread of the disease.

• Political and social upheaval has led to large numbers of people moving into new areas where disease is spread more easily.

• Changes to the environment, caused by road-building, mining and irrigation projects, have created a good breeding ground for malaria.

Exam Style Question

• Describe the environmental and Human factors which put people at risk of contracting malaria

6

ANSWEREnvironmental factors:

• Suitable breeding habitat for the female Anopheles mosquito – areas of stagnant water to lay eggs in

• Hot and wet climates such as those experienced in the Tropical Rainforests or Monsoon areas of the world

• Temperatures between 15°C and 40°C

• Areas of shade in which the mosquito can digest blood.

Human factors

• Nearby settlements to provide a ‘blood reservoir’

• Encouraged by bad sanitation and poor irrigation or drainage that leaves standing water uncovered eg tank wells, irrigation channels, water barrels, padi fields.

Lesson Review

Post-it summary

On your post-it write one physical and one human factor that contributes to the spread of Malaria.

Write one question for something you would like t know about Malaria.

WE WILL

• Be able to describe the methods used to control the spread of Malaria.

• Assess how effective each measure is in controlling the spread of Malaria.

Previous Lesson

• What are the physical and human factors that contribute to the spread of Malaria?

Activity

Each station has information about methods to control malaria.

Complete either the table or spider diagram by noting:

The method

A description of the method

Comment on the effectiveness of the method

Method Description Effectiveness

Quinghaosu Plant extract used as a traditional cure in China for

centuries.

Now in pill form so is easy to take – may be the long awaited

breakthrough.

Methods to Control the Spread of Malaria

Quinghaosu

Plant extract used as a traditional cure in China for centuries.

Now in pill form so is easy to take – may be the long awaited

breakthrough.

Mosquito Nets

A mosquito net offers protection against mosquitos,flies, and other insects, and thus against the diseases they may carry. 

They are relatively cheap.

Insecticides

Insecticides can be sprayed in homes to kill mosquitoes e.g. Malathion.

Effective but expensive as it is petroleum based. Also smells bad and stains walls yellow.

Mustard Seeds

Mustard Seeds are put on water surfaces as they become sticky when wet. They drag mosquito eggs under water and drown them.

This is difficult to maintain & seems wasteful in ELDCs.

Fish

Larvae-eating fish introduced to padi fields.

These are effective PLUS a useful source of protein to be added to peoples diet.

An example is the Muddy Loach

Egg Whites

Spraying Egg Whites also kills larvae on stagnant water as it suffocates them by clogging up their breathing tubes.

This also seems wasteful in ELDCs as a food source.

Coconuts

Bti bacteria in coconuts is eaten by larvae and destroys their stomach lining. Coconuts are left to ferment for a few days, broken open & thrown into ponds.

Effective 1. 2/3 coconuts ‘control’ a pond for 45 days2. Cheap to produce & plentiful3. Bacteria is not harmful to humans or

animals

Draining Swamps

Drainage of swamps & irrigation channels.

This is effective but not always practical in tropical places as it rains a lot.

Also very expensive.

Release Dams

Release water from dams to drown larvae.This is successful but has to be done every 7-10 days to fit in with breeding cycle.

Planting Eucalyptus trees to absorb excess water from the soil helps drain breeding

sites.

Planting Eucalyptus trees to absorb excess water from the soil helps drain breeding

sites.

Eucalyptus Trees

Anti-malarial Drugs

Chloroquine: Easy to use and cheap but mosquitoes are becoming resistant to it.

Larium: Powerful and effective but can have harmful side-effects.

Malerone: Most effective anti-malarial. Little or no side effects present. However, this is the most expensive by far.

Lesson Review

• Each person in the class has a card it either has the method or the description of the method.

• You must find your matching card.

• When you find your partner you need to think of one reason it is effective and one reason why it may not be effective.

Can you think of any other strategies used to control Malaria?

Eucalyptus Trees

I absorb excess water from the soil and help drain

breeding sites.

Anti-malarial DrugsI am easy to use but

sometimes I can have harmful side-effects. Mosquitoes are becoming resistant to some

forms of me.

Release DamsI drown larvae but have to be done every 7-10 days to fit in with breeding cycle.

Draining Swamps

I am not always practical in tropical places as it rains a lot.

Coconuts (Bti Bacteria)

I am eaten by larvae and I destroy their stomach lining.

Egg WhiteI am sprayed on stagnant water and I suffocate the

larvae by clogging up their breathing tubes.

Fish

I am introduced to padi fields to eat larvae.

I am also a source of protein to be added to peoples diet.

Mustard Seeds

I am put on water surfaces and I drag mosquito eggs

under water and drown them.

Insecticides

I can be sprayed in homes to kill mosquitoes and I stain

walls yellow.

Mosquito Net I offer protection against mosquitoes, flies, and other insects, and thus against the diseases they may carry.

Best Solution• No one solution has been found.

• A combination of strategies/control methods, combined with increasing public awareness/education programmes (eg WHO’s ‘Roll Back Malaria’ – a global campaign aimed at halving the number of malaria cases by 2010) will be needed just to keep malaria in check.

• Some progress may be made thanks to the millions which the Bill and Melinda Gates Foundation has set aside for research into a cure.

Disney clip

• Now person A must re-draw all the reasons for the spread of malaria.

• Then person B must draw the methods used to try to control the spread of malaria.

Now you must both turn the pictures into bullet points.

• Areas of stagnant water mosquito lay larvae

• Stagnant water drained or flushed.

•Larvae eating fish introduced.

Strategies• Insecticides eg DDT – however this is environmentally harmful – impacts

on the food chain and is supposed to be banned as a result. In addition the mosquitoes build up a resistance to chemical insecticides through time and they become less effective

• Newer insecticides such as Malathion – these are oil-based and so more expensive/difficult for ELDCs to afford – also stains walls and has an unpleasant smell – so not popular!

• Mustard seed ‘bombing’ – become wet and sticky and drag mosquito larvae under the water drowning them

• Egg-white sprayed on water – suffocates larvae by clogging up their breathing tubes (as with mustard seeds – wasteful, costly and fairly impractical)

• BTI bacteria grown in coconuts. The larvae eat the bacteria and have their stomach linings destroyed! Cheap, environmentally friendly and 2/3 coconuts will control a typical pond for up to 45 days.

• Larvae eating fish – effective and a useful additional source of protein in people’s diets

• Drainage of swamps – requires much effort – not always practicable in the Tropics.

• Drugs: - Chloroquin – easy to use/cheap but mosquitoes are developing a resistance to it - Larium – powerful, offers greater protection but can have harmful side effects - Malarone – fairly new drug – said to be 98% effective – few side effects but very expensive

• Quinghaosu extracted from the artemesian plant – a traditional Chinese cure

• Vaccines – still being developed/not yet in widespread use (eg Dr Manuel Pattaroya’s in Colombia)

• ITN – Insecticide treated nets – cheap method and can protect people whilst they sleep.

• Genetic engineering eg of sterile males – complicated, costly and difficult on a large scale.

ANSWERTrying to eradicate the mosquito:

• insecticides eg DDT and now Malathion

• mustard seeds thrown on the water that become wet and sticky so dragging the mosquito larvae under, drowning them

• egg-white sprayed on the water creates a film which suffocates the larvae by clogging up their breathing tubes

• bti bacteria grown in coconuts – the fermented coconuts are broken open after a few days and thrown into the mosquito infested ponds. The larvae eat the bacteria and have their stomach linings destroyed

• larvae eating fish introduced to ponds

• draining swamps, planting eucalyptus trees that soak up excess moisture, covering standing water

• genetic engineering eg of sterile males

Treating those suffering from malaria:

• drugs like chloroquin, larium and malarone

• quinghaosu extracted from the artemesian plant – a traditional Chinese cure

• continued search for a vaccine – not available as yet

• education programmes in – the use of insect repellents eg Autan covering the skin at dusk when the mosquitoes are most active

• sleeping under an insecticide treated mosquito net

• mesh coverings over windows/door openings

• WHO ‘Roll back malaria’ campaign

• the Bill and Melinda Gates Foundation

Sample AnswerFor malaria there are two ways of combating the disease: attack the mosquito and attack the parasite. For attacking the mosquito (the female anopheles mosquito) the most common thing to do is to have bed nets, and keep all limbs covered between dawn and dusk as that is when the mosquito feeds. Also, many insecticides have been used. DDT was very common and works really well, but was discovered to be harmful to the environment and was globally banned in 2007. Now the main one is malerone, it is not as popular because it smells of rotten cabbage, stains walls and has to be done every 6 months.Sweeping the compound and not leaving any rubbish lying for water to collect in also works as it drains the water and the mosquito has nowhere to lay her larvae. Planting eucalyptus trees which are fast growing and soak up water is also effective. Throwing mustard seeds in water is effective as it sticks to larvae and drags it down drowning it but is wasteful. As is egg yolk on the surface of the water suffocates the larvae. Throwing in coconut milk is also wasteful but effective. The larvae eat the coconut and the bti bacteria eats the lining of their stomachs. Genetically engineering sterile males, effective but fidly. For attacking the parasite there are Chinese remedies eg. Quinghaosu. But there isn’t a vaccination yet, but the Bill Gates Foundation is researching it now. There are drugs such as quinine but they aren’t always effective.

Sample AnswerFor malaria there are two ways of combating the disease: attack the mosquito and attack the parasite. For attacking the mosquito (the female anopheles mosquito) the most common thing to do is to have bed nets, and keep all limbs covered between dawn and dusk as that is when the mosquito feeds. Also, many insecticides have been used. DDT was very common and works really well, but was discovered to be harmful to the environment and was globally banned in 2007. Now the main one is malerone, it is not as popular because it smells of rotten cabbage, stains walls and has to be done every 6 months.Sweeping the compound and not leaving any rubbish lying for water to collect in also works as it drains the water and the mosquito has nowhere to lay her larvae. Planting eucalyptus trees which are fast growing and soak up water is also effective. Throwing mustard seeds in water is effective as it sticks to larvae and drags it down drowning it but is wasteful. As is egg yolk on the surface of the water suffocates the larvae. Throwing in coconut milk is also wasteful but effective. The larvae eat the coconut and the bti bacteria eats the lining of their stomachs. Genetically engineering sterile males, effective but fidly. For attacking the parasite there are Chinese remedies eg. Quinghaosu. But there isn’t a vaccination yet, but the Bill Gates Foundation is researching it now. There are drugs such as quinine but they aren’t always effective.

Sample AnswerFor malaria there are two ways of combating the disease: attack the mosquito and attack the parasite. For attacking the mosquito (the female anopheles mosquito) the most common thing to do is to have bed nets, and keep all limbs covered between dawn and dusk as that is when the mosquito feeds. Also, many insecticides have been used. DDT was very common and works really well, but was discovered to be harmful to the environment and was globally banned in 2007. Now the main one is malerone, it is not as popular because it smells of rotten cabbage, stains walls and has to be done every 6 months.Sweeping the compound and not leaving any rubbish lying for water to collect in also works as it drains the water and the mosquito has nowhere to lay her larvae. Planting eucalyptus trees which are fast growing and soak up water is also effective. Throwing mustard seeds in water is effective as it sticks to larvae and drags it down drowning it but is wasteful. As is egg yolk on the surface of the water suffocates the larvae. Throwing in coconut milk is also wasteful but effective. The larvae eat the coconut and the bti bacteria eats the lining of their stomachs. Genetically engineering sterile males, effective but fidly. For attacking the parasite there are Chinese remedies eg. Quinghaosu. But there isn’t a vaccination yet, but the Bill Gates Foundation is researching it now. There are drugs such as quinine but they aren’t always effective. 18/18

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For malaria or any other water-related disease that you have studied:(a) explain the methods used to try and control the spread of the disease; and(b) evaluate the effectiveness of these methods.

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• The female anopheles mosquito acts as a vector for the transmission of malaria, so one method used was to spray pesticides/insecticides such as DDT in an attempt to kill the mosquitoes by destroying their nervous systems. (1 mark)

• Breeding genetically modified sterile mosquitoes and mercenary male mosquitoes were also attempts to kill off the mosquito for good, and so stop the spreading of the disease. (1 mark)

• Another method was to use specially designed mosquito traps, which mimic animals and humans by emitting a small amount of carbon dioxide in order to lure the mosquitoes into the trap where they are killed. (1 mark)

• BTI bacteria can be artificially grown in coconuts and then, when the coconuts are split open and placed in a stagnant pond, the larvae eat the bacteria which destroy the larvae stomach lining, killing them. (1 mark)

• Putting larvae-eating fish such as the muddy loach into stagnant ponds or• paddi fields can also help to reduce the larvae as the fish eat the larvae. (1 mark)• Other methods were aimed at getting rid of the stagnant water required for mosquitoes to lay their

eggs, eg draining stagnant ponds or swamps every seven days as it takes longer than this period of time for the larvae to develop into adult mosquitoes. (1 mark)

• Planting eucalyptus trees, which soak up excess moisture in marshy areas, was also an attempt to prevent the formation of stagnant pools. (1 mark)

• Covering water storage cans/small ponds was also used as an attempt to stop mosquitoes from reproducing successfully. (1 mark)

• The increased use of insecticide-coated mosquito nets at night was an attempt to stop the mosquitoes from biting people and passing on the disease as they slept. (1 mark)

• Attempts were also made to cure people once they had contracted the disease by killing the plasmodium parasite once people had been contaminated with it. Drugs like Quinine, Chloroquine, Larium and Malarone were all developed in an attempt to kill the parasite. (1 mark)

• A drug developed from the Chinese herb Artemisia, and an artificial version of this called Oz‘, appears to work in some parts of the world at least, by reacting violently with the iron in the parasite and killing it before the parasite can adapt. (1 mark)

Possible comments on the effectiveness might include:

• Insecticides to kill the mosquito were effective at first and helped to eradicate the disease in Southern Europe and Florida, however the mosquito became resistant to DDT and alternative insecticides are often too expensive for developing countries. (1 mark)

• Mosquito traps have been effective at a small scale, but mosquitoes breed so quickly that it is impossible to trap them all. (1 mark)

• The approaches aimed at killing the mosquito larvae have had only limited success (and only at a local scale) and have been criticised for causing pollution/changing the ecosystem of water courses. (1 mark)

• The BTI bacteria in coconuts is a cheap and environmentally friendly solution, with 2/3 coconuts clearing a typical pond of mosquito larvae for 45 days. (1 mark)

• Draining stagnant ponds is impossible to be effective on a large-scale, especially in tropical climates where it can rain heavily most days. (1 mark)

• Using mosquito nets at night/covering up exposed skin is effective as mosquitoes are often most active during dusk and dawn. (1 mark)

• Drugs to kill the parasite once inside humans have been effective for a spell, but the parasite often adapts and becomes resistant — this is true even of the Artemisia-based drugs in SE Asia. (1 mark)

• Anti-malarial drugs often have unpleasant side-effects such as nausea, headaches and in some cases hallucinations. (1 mark)

• They are also expensive to research, develop and produce, making them often too expensive for people living in developing countries. (1 mark)

• Attempts are ongoing to develop a vaccine that could eradicate malaria for good, but so far this has not been successful. (1 mark)

Economic Impact of Malaria

• Economic impact of the disease is immense, causing many lost days of work and loss of tourism and investment.

• Malaria can decrease gross domestic product by as much as 1.3% in countries with high disease rates.

Benefit of controlling

Malaria

Funds can be diverted elsewhere in the health sector or transferred to other

budgets that help development National debt can be reduced

Workforce will be fitter (eg farmers better able to produce food), thus also helping to raise health levels and contribute to

economy

Productivity will increase as the

workforce takes less sick leave/life

expectancy increases

Area will become more attractive to tourists, foreign

currency income can be generated and this will also assist in developing tourism related services/industries

Possible reduction in birth rates as a result of a fall in

infant mortality rates.

World Malaria Day

April 25 each year

• Gives people the chance to promote or learn about the efforts made to prevent and reduce Malaria around the world.

What Happens

• Organizations such as the World Health Organization (WHO), which is the United Nations’ (UN) directing and coordinating authority for health, actively play a role in promoting and supporting World Malaria Day.

• The activities and events that take place on or around World Malaria Day are often joint efforts between governments, non-government organizations, communities and individuals.

• How could you promote Malaria day at Charleston Academy?

Exam Style Question

• Explain how the eradication or control of the disease would benefit ELDCs (6 Marks)

ANSWER• funds can be diverted elsewhere in the Health sector or

transferred to other budgets that help development

• national debt can be reduced

• the workforce will be fitter (eg farmers better able to produce food), thus also helping to raise health levels

• productivity will increase as the workforce takes less sick leave/life expectancy increases

• the area will become more attractive to tourists, foreign currency income can be generated and this will also assist in developing tourism related services/industries

• a possible reduction in birth rates as a result of a fall in infant mortality rates.

Lesson Review

WE WILL

• Discuss what primary health care is.

• Give examples of primary health care in developing countries.

• Discuss the benefits of PHC.

barefoot doctorsChina and Ethiopia• Chinese barefoot doctors are farmers who received minimal basic medical and

paramedical training and worked in rural villages in the country. They brought health care to rural areas where urban-trained doctors would not settle, promoting basic hygiene, preventive health care, and family planning.

• China had estimated that there were about 40,000 physicians trained in Western and Soviet medicine in the country, serving a population of 540 million people. Worse yet, most of these physicians worked in large cities; 80 percent of the population were rural peasants.

• One doctor for every 10,000 people in Kenya – they need an additional solution for rural communities.

• "In fact, some of the countries making progress in Africa like Ethiopia for example, have really borrowed the lessons they have from China," she said. "They have created a health extension with health extension workers that they have quickly trained and deployed in the rural areas. That is the major lessons they have really looked for and learnt from China. "

• Ethiopia – scheme which started 5 years ago, involves the training 30,000 female health extension workers nationally, including 1,800 in Tigray

Vaccination programmes

• Vaccination programmes can be cost effective and prevent countries from have to spend more on treatment of disease as they have been prevented.

Global use of rotavirus vaccines recommendedVaccines can protect millions of children from diarrhoeal disease

News release • 5 June 2009 | Geneva/Seattle - WHO has recommended that rotavirus vaccination be included in

all national immunization programmes to provide protection against a virus that is responsible for more than 500 000 diarrhoeal deaths and 2 million hospitalizations every year among children. More than 85% of these deaths occur in developing countries in Africa and Asia. This new policy will help ensure access to rotavirus vaccines in the world’s poorest countries.

• The new recommendation by WHO's Strategic Advisory Group of Experts (SAGE) extends an earlier recommendation made in 2005 on vaccination in the Americas and Europe, where clinical trials had demonstrated safety and efficacy in populations with low and intermediate mortality. New data from clinical trials, which evaluated vaccine efficacy in countries with high child mortality, has led to the recommendation for global use of the vaccine. This is reported in the Weekly Epidemiological Record published on 5 June 2009.

• “This is a tremendous milestone in ensuring that vaccines against the most common cause of lethal diarrhoea reach the children who need them most,” noted Dr Thomas Cherian, Coordinator of the Expanded Programme on Immunization in the WHO Department of Immunization, Vaccines and Biologicals.

• “This WHO recommendation clears the way for vaccines that will protect children in the developing world from one of the most deadly diseases they face," said Dr Tachi Yamada, President of the Global Health Program at the Bill & Melinda Gates Foundation. “We need to act now to deliver vaccines to children in Africa and Asia, where most rotavirus deaths occur.”

Emergency vaccination programme launched against polio

Aid agencies in Central Africa will launch an emergency vaccination programme on Friday against a deadly strain of polio which is already thought to have killed up to 100 people.

The aim of the programme, led by the World Health Organisation and supported by UNICEF, is to vaccinate around three million people starting in the coastal town of Pointe Noire in the Republic of Congo, before moving on to the Angola border and the Democratic Republic of Congo. The outbreak was confirmed last week and the latest figures suggest that 226 people have been paralysed and 97 people have died.

Polio, which is transmitted through faeces, normally affects children under five and kills no more than 20 per cent of the people it paralyses.

The latest outbreak has mainly hit people aged between 15 and 29, suggesting a large number are at risk as until now those vaccinated against it have been mainly young children.

UNICEF's Regional Director for West and Central Africa, Dr Gianfranco Rotigliano said adults and children would be vaccinated alike regardless of their past immunisation status.

ORT (Oral Rehydration Therapy)

• ORT is the giving of fluid by mouth to prevent and/or correct the dehydration that is a result of diarrhoea.

• As soon as diarrhoea begins, treatment using home remedies to prevent dehydration must be started.

• If adults or children have not been given extra drinks, or if in spite of this dehydration does occur, they must be treated with a special drink made with oral rehydration salts (ORS).

Health Education

• Educating communities about hygiene, family planning, disease etc.

Building of small local health centres

Ethiopia.

• The scheme, which started 5 years ago, involves the training 30,000 female health extension workers nationally, including 1,800 in Tigray. Supported by the Ethiopian government, the Global Fund to Fight AIDS, TB and Malaria, UNICEF and other partners, it also involves the building of more than 3000 heath centres.

• Programmes such as this help put health care in the hands of the local community. Not only is primary health care less costly, but its impact can be huge. By eliminating the risk of the disease it helps reduce the costs of diagnosis, treatment and follow up

Small scale clean water supplies and Blair toilets/pit latrines

Water.org’s projects • In Ethiopia they are located in

the regions of Tigray and Amhara.

• The need for water and sanitation in Ethiopia is severe. Only 42% of the population has access to an improved water supply, and only 11% of the population has access to adequate sanitation services. In rural areas, these numbers drop even further

Benefits of PHC

• Cost effective

• Smaller scale projects are manageable

• Reach remote areas

Activity

• Complete the thought shower by using the textbook and the internet.

• Give a description of the different types of strategies, explain why they would be effective, examples/statistics.

Primary Health Care Strategies

Health Education – often for specific groups in the

community

Vaccination Programmes

Training of health workers/barefoot doctors –

recognise minor ailments and prevention

Traditional methodsCommunity projects – water pumps etc

Primary Health Care – Case StudyExtend the spider diagram by researching specific examples of each point – you should also consider how effective these strategies are.

Exam Style Question

“Resources need to be targeted at improving Primary Health Care if we are ever going to improve the health of people in ELDCs.”

Aid worker

• Describe some of the strategies involved in Primary Health Care and explain why these strategies for improving health standards are suited to people living in ELDCs. (10 marks)

Answer• Use of barefoot doctors – trusted local people who can carry out treatment for more common

illnesses – sometimes using cheaper traditional remedies

• use of ORT (Oral Rehydration Therapy) to tackle dehydration – especially amongst babies. This is an easy, cheap and effective remedy for diarrhoea/dehydration

• provision of vaccination programmes against diseases such as polio, measles, cholera. Candidates may also refer to PHC as based on generally preventative medicine rather than (more expensive) curative medicine

• the development of health education schemes in schools, community plays/songs concerning AIDS, with groups of expectant mothers or women in relation to diet and hygiene. Oral education being much more effective in illiterate societies

• sometimes these initiatives are backed by the building of small local health centres staffed by doctors (like GPs)

• PHC can also involve the building of small scale clean water supplies and Blair toilets/pit latrines – often with community participation

• The use of local labour and building materials is often cheaper, it also provides training/transferable skills for the participants and gains faster acceptance/ usage in the local and wider community.

“The ultimate goal of Primary Health Care is better health for all.” (World Health Organisation)

Describe some specific Primary Health Care strategies that you have studied and explain why these strategies are suited to Developing Countries. 8

Local health workers are effective as they are a trusted member of the local community. It only takes 6 weeks training and they can teach other people in the village about sanitation eg. Wash hands before eating. They also know of ways to reduce the risk of catching malaria eg. Sweeping the compound everyday. They can treat minor illnesses such as dioreha with ORT (oral rehydration therapy) which is a mixture of salt, sugar and water. They also teach their local village with songs and chants that mothers can pass on to their children. This takes pressure of hospitals and health centres, and if there is a serious case, the health worker can refer the patient on to the health centre or hospital. It is an effective PHC as the village chooses the person so she is a trusted member and people are willing to listen to her and learn. It is also cheap as the training only takes 6 weeks.Money is being spent on vaccinations for children as prevention is cheaper than cure. The pills are in their most basic form which also cuts down on cost. The local health worker can also teach people about the prevention of HIV and AIDS.

“The ultimate goal of Primary Health Care is better health for all.” (World Health Organisation)

Describe some specific Primary Health Care strategies that you have studied and explain why these strategies are suited to Developing Countries. 8

Local health workers are effective as they are a trusted member of the local community. It only takes 6 weeks training and they can teach other people in the village about sanitation eg. Wash hands before eating. They also know of ways to reduce the risk of catching malaria eg. Sweeping the compound everyday. They can treat minor illnesses such as dioreha with ORT (oral rehydration therapy) which is a mixture of salt, sugar and water. They also teach their local village with songs and chants that mothers can pass on to their children. This takes pressure of hospitals and health centres, and if there is a serious case, the health worker can refer the patient on to the health centre or hospital. It is an effective PHC as the village chooses the person so she is a trusted member and people are willing to listen to her and learn. It is also cheap as the training only takes 6 weeks.Money is being spent on vaccinations for children as prevention is cheaper than cure. The pills are in their most basic form which also cuts down on cost. The local health worker can also teach people about the prevention of HIV and AIDS.

Sample AnswerLocal health workers are effective as they are a trusted member of the local community. It only takes 6 weeks training and they can teach other people in the village about sanitation eg. Wash hands before eating. They also know of ways to reduce the risk of catching malaria eg. Sweeping the compound everyday. They can treat minor illnesses such as dioreha with ORT (oral rehydration therapy) which is a mixture of salt, sugar and water. They also teach their local village with songs and chants that mothers can pass on to their children. This takes pressure of hospitals and health centres, and if there is a serious case, the health worker can refer the patient on to the health centre or hospital. It is an effective PHC as the village chooses the person so she is a trusted member and people are willing to listen to her and learn. It is also cheap as the training only takes 6 weeks.Money is being spent on vaccinations for children as prevention is cheaper than cure. The pills are in their most basic form which also cuts down on cost. The local health worker can also teach people about the prevention of HIV and AIDS.

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Reading Check Up

Question 1

Climate impacts of health by:

a) Hot, wet conditions encouraging the spread of disease.

b) Certain conditions providing ideal breeding conditions for vectors.

c) Both of the above

Question 2

• In the developing world what percentage of households lack access to clean water?

a) 27%b) 50%c) 75%

Question 3

• How many children die each year due to diarrhoea?

a) 4 millionb) 400,000c) 14 million

Question 4

• Which of the following are human factors which result in poor health?

a) Povertyb) Poor farming methodsc) Overcrowdingd) All of the above

Question 5

• How many people does Malaria affect each year?

a) 200-500millionb) 5 millionc) 15 million

Question 6

• In the past 15 years how many people have died from Malaria?

a) 15 millionb) 50 millionc) 150 million

Question 7

• Which of the following is an insecticide used to eliminate malaria?

a) Malarionb) Malathionc) DDTd) Both b and c

Question 8

• Why was there a 500% rise in cases of Malaria in Kenya in 1998?

a) Droughtb) Lack of educationc) Flooding

Question 9

• What is the advantage of the new treatment to prevent malaria (combination of drugs and extract of Chinese herb)

a) 95% success rateb) Cheapc) Both of the above

Question 10

• Who donated $100 million for malaria research?

a) Cheryl Coleb) Bill Gatesc) Both of the above

Question 11

• What are barefoot doctors?

a) Doctors who do not wear shoesb) Local people trained as medical auxillariesc) Specialist doctors

Question 12

• In what ways are charities providing primary health care?

a) Equip local people with medical kitsb) Educate local peoplec) Both of the above

Question 13

• What are the problems with large scale schemes such as immunisation programmes and establishment of clinics.

a) Require foreign interventionb) Not cost effectivec) Only helps a small area

Question 14

• What was one of the main problems Chogoria Hospital in Kenya face in providing health care.

a) Too remoteb) Not enough trained staffc) Financial difficulties

Question 15

• Why is primary health care central to the services provided by Chogoria Hospital in Kenya.

a) Large population to try to treatb) Specialist medical staff can visit areas in

rotation.c) Both of the above.

Answers1 c 9 c

2 b 10 b

3 a 11 b

4 d 12 c

5 a 13 a

6 b 14 c

7 d 15 c

8 c