Chapter 6: Health and Environment

6.1 Introduction
Our “Live-in-Field Experience (LFE)” study investigates about the health and environmental
condition of the rural areas. Our study area is the Moddho Para of Pakamura Village in
Comilla. Health implies, “A State of complete physical, mental and social well-being, and not
merely absence of disease or infirmity, so that each citizen can lead a social and economically
productive life”. Environment is the full set of surround things, conditions, or influences that
affects the existence or development of someone or something. So it can be defined as the
sum of all physical and biological aspects and systems which make the surroundings of
human. Actually environment includes land, water, air, atmosphere, wildlife, trees and many
other things. Though health and environment are two different terminologies, but for human
society these two are inseparable. Environment contributes better health condition of people.
Health sometimes affects the environment. Unhealthy mass cannot generate good
environment. As reality, a common person does not realize the strong bond between these
two. Good environment ensures better life. In this part of our study, we tried to find out
several factors affecting the health and environment condition of our village.

6.2 Our objectives of the study:

We were assigned in the village of Pakamura in Comilla district. The main objective of our
study is to highlight and find causes about health and environment related issues in our
assigned area. Some objectives to find were,

• The sources of water used in various activities.

• Types of toilet facilities adapted by the residents.
• Waste disposal place used by the households.
• Types of fuel are being used for cooking.
• Preferences of health care facilities by the people.
• Problems related to government health care facilities.
• Coverage of immunization for the children is taken.
• Extent of health consciousness of villagers.
• How responsive the GO and NGO organization about health.
• Knowing the environmental conditions affecting the healthiness of people.
• Find out issues causing health and environmental impact.

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6.3 Sources of Water for Domestic Use

Water is synonymous to life. Our human body constitutes more or less 90% of water. One
can starve but cannot survive without drinking water. So without it life cannot be imagined.
We need water not only for drinking but also it is essential for industrial activities, growing
crops, fisheries etc. Scarcity for water yields enormous loss of crops. It is also unavoidably
important for wildlife. Animals’ habitats are driven by the affects of water pollution. Many
seasonal birds are shifting out from Bangladesh. It is one of the important aspects of human
heath and environment. The major cause of illness of people living in developing and under
developing countries is due to lack of safe drinking water. Polluted water can cause many
water borne diseases such as cholera, typhoid, dysentery, diarrhea and other skin diseases.
The rate of emergence of these diseases can be drastically reduced if safe water for public use
is ensured. Our human body is so sensitive to the change of quality in water that the slightest
alteration of the distribution of minerals resides in water takes a lot of time to adjust in our
human body. So the assurance of pure drinking water needs exaggerative attention. Whatever
the source of water, it should be checked if it is free of pollution.

Table 6.1: Sources of Water for Domestic Use (Positive Response Counted)

Sources
Purposes Tube-Well Pond
No. % No. %
Drinking 25 100% 0 0%
Cooking 24 96% 1 4%
Washing 13 52% 12 48%
Bathing 5 20% 20 80%
Source: Structure and Program, Live-in-Field Experience, Spring-2008

6.1 Pictures

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1) Washing Vegetables 2) Washing Utensils 3) Tube-Well

6.3.1 Analysis
From the table shown above, almost all people in the village uses tube well water for drinking
purpose. According to the survey the respondents think water is the most important natural
resource consumed regularly. If the water is polluted, it will cause a lot of trouble in health.
For bathing purpose, they do not take much measure for hygiene. They use pond water for
bathing and also washing cattle. We found some latrines nearby the ponds which is
alarmingly dangerous for health. Mixed response found in case of washing household things.
Very few people use pond water as a cooking input. After overall observation we found that
people are more conscious about using water in various purposes. Most of the ponds are full
of dirt. Because there are some people who have in house tannery and they wash animal skins
in the pond whichever they like. We found the ponds smelly even in the winter season. We
asked the respondents what happens when it comes to rainy season. In reply they informed us
that at that time they suffer unbearable air pollution. Roads and fields are flooded with dirty
water. Children and the old usually have fewer antibodies than regular adults. So they are
affected by various skin diseases. We have also asked them about the initiatives taken against
the inconsiderate dwellers. Answering the query they said that they are very rude and
aggressive to them. We found prove observing the body language and non cooperation of
those people. The respondents are aware about the problems of arsenic which is the route of
slow poisoning. There is no arsenic affected tube well found in our studied area. As WASA
does not have the coverage of piped water supply, there is no piped water source found and
there is no well we have found.

6.4 Toilet Facilities of the Respondents

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Health and sanitation are interrelated to each other. Proper sanitation is required to ensure
good heath condition. Sanitation is defined as safe toilet and safe disposal of excreta.
Sanitation system is an important aspect of health and environment. Unhygienic sanitation
and contaminated drinking water are responsible for the most environmental hazards in the
rural area. After defecation people do not wash their hands. There are four types of toilet
facilities are being used in our country. Pit latrine is a type of latrine installed through digging
a hole in the soil and placing two bricks in sides to keep the feet. Ring slab is one kind of
portable pit latrine. There is a concrete made pit and a ring is being placed on the top of the
open side. Hanging latrine is made of bamboo and there is no collecting facility of the
excreta. Septic tank is a type of latrine that is found in the cities. The latrine is connected with
long plastic pipe to a large tank with chambers. The type of latrines that villagers use depends
on their economic condition.

Table 6.2: Distribution of the Types of Toilets the Respondents Use

Type No. %
Ring Slab 10 40%
Pit Latrine 7 28%
Hanging Latrine 5 20%
Septic tank 3 12%
Total 25 100%
Source: Structure and Program, Live-in-Field Experience, Spring-2008
6.2 Pictures

1) Ring Slab 2) Pit Latrine

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3) Hanging Latrine 4) Drainage System

6.4.2 Analysis
From the above table, the distribution of the types of toilet facilities of the respondents shows
that 28% of them use pit latrine facility because it requires a little economical efforts but yet
reduces air pollution. In the rainy season the users face problem regarding to the respective
toilet facility they establish. Rain water fills up the pit. As a result of it all exerts are flooded
outside the toilet. After the rain stops, temperature of soil stars rising due to sunshine, then
people suffers from serious air pollution. On the other hand people using hanging latrine does
not require significant monetary effort but completely dangerous for health. As per observing
the toilet and its nearest area, we found the climate unbearably smelly. Unlike the situation of
pit latrine, hanging latrine yields air pollution throughout every season in a year. Most of the
hanging latrines are installed near ponds or ditches. In those ponds people washes clothes and
take bath which can cause a lot of water borne diseases. Concerning the ditches, tons of
human soil is accumulated emitting such a bad smell that affects severe health and
economical hazards. People have comparatively better earning capacity install ring slab in
their toilet. They think it does not cause that much hazards as the hazards mentioned about
prior facilities discussed. They face problem cleaning the concrete barrels 3-4 times a year.
Finally, people who are solvent and also health conscious uses septic tank. This facility gives
them optimal level of hygiene and environmental security. Al last anticipated that everybody
should adopt healthy and environment friendly toilet facility whatever their economic
condition is.

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6.5 Cooking Place

Cooking place or kitchen is one of the important parts of the house. It contributes with
significant capacity regarding health and environment conscious people. Neat and clean
kitchen is always anticipated by every person. Regardless to the income level, every person
must have separate kitchen. Ashes and utensils must be cleaned before cooking and taking
the meal. Unhealthy food can cause worm implantation, food poisoning and many other
various troubles. Fume while cooking can cause breathing problem.

Table 6.3: Distribution of Cooking Place:

Cooking Place No. Percentage

In the Kitchen 17 68%
Outside the room 5 20%
Inside the living room 3 12%
Total 25 100%
Source: Structure and Program, Live-in-Field Experience, Spring 2008

6.3 Pictures

1) Separate kitchen 2) Kitchen outside the living room

6.5.2 Analysis
Most dwellers in our study have their own kitchen for cooking. They prefer separate space for
cooking. They feel that their meals have extra protection against dust and domestic animals if
they cook in separate kitchen. It is also reduce chance of physical loss if any accident of fire

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occurs. Mothers also can keep their children away from any accident. On the other hand,
people have cooking place inside the living room comparatively poor than the people have
separate kitchen. They also prefers separate kitchen for the mentioned heath and safety
issues. One major thing is that residents who are not taking part in cooking inhale smoke. It is
consequential health loss of dwellers. The living room becomes hot. Some respondents do not
have either separate kitchen or cooking place inside house. They cook in open place in
backyard of household. They face problem in the rainy season. At that time they starve or
seek help to neighborhood for cooking. Their meals most probably contaminated with various
diseases as it is situated in the open place many dusts and insects falls into the meal. Animals
can have access to the meals. There is no storing facilities to keep uncooked or after cooked
meal safe from environmental threat. From overall observation, we found that respondents do
not clean the ashes produced from burning equipments while cooking. This can cause a lot of
problem in human respiratory system.

6.6. Waste Disposal System of the Households

Disposal of waste is the worldwide problem because for the sake of industrialization in
developing countries and unavoidable growth of population. Inappropriate disposal of waste
pollutes surrounding environment and causes harmful diseases. Thus, disposal of wastes
should be environmentally safe. Environment conscious society always demand safe disposal
of waste. That is why urban areas have dustbin system. But in the rural area the system has
not been introduced yet.

Table 6.4: Distribution of waste disposal places by the respondents

Disposal Places No. %

In the hole beside house 11 44
In the near by ditch 8 32
In a specific place 4 16
No specific place 2 8
Total 25 100
Source: Structure and Program, Live-in-Field Experience, Spring-2008.

6.6.2 Analysis

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According to our survey concerning distribution of waste disposal places of the peoples’
household in our assigned area we found that most people prefers digging a hole beside the
house and dump all household wastes. As a consequence of this action, there is significant
chance of people getting affected by many insect borne diseases such as dengue, malaria etc.
The household of the respondents do not even cover the hole when it is filled up with waste.
This type of place is the birthplace of dengue mosquito. Some households dispose waste in
the ditches. They do not clean those ditches regularly but dumping wastes for years. Some
wastes are not naturally rotting such as plastic foils but people are not selective in waste
material dumping in the ditches. Some households, especially large joint families share a
single ditch nearby the house. Some of them burn the wastes after several time of dumping. A
few of the respondents are not conscious about health and environmental issues arise from
dumping wastes into the open place. Their level of negligence shows the utmost limit because
they dispose their household waste here and there. From the overall observations, we found
no selective waste dumping to prevent soil pollution and obnoxious smell emits from the
ditches which causes air and water pollution. During rainy season, the wastes are spread all
the places and pollutes the soil, air and harms the crops.

6.4 Pictures

1) Specific place for waste disposal 2) Waste disposal nearby household

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3) Waste disposal in ditch 4) Gangrene, the affect of pollution

6.7 Fuel Use for Cooking

The use of use is one of the important aspects of health. According to Clegg A Mackean
(1994), “In the less developed countries cooking takes up a major part of the energy
consumed”. In Bangladesh 80% of population is poor and they are living in the villages. In
our studied area, population is poor. They are not using the appropriate kind of material as
fuel. Inappropriate use of fuel is very dangerous for both health and environment.

Table 6.5: Distribution of Fuel Use For Cooking

Fuel Type No. %

Straw 25 100%

Leaves & Twigs 20 80%

Firewood 10 40%

Cow dung 1 4%

Kerosene 0 0%

Gas 0 0%
Source: Structure and Program, Live-in-Field Experience, Spring-2008

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6.5 Pictures

1) Use of cow dung for fuel 2) Firewood for fuel

6.7.2 Analysis
From the above table shown, the respondents use multiple types of burning materials. Most
people use straw as fire equipments. Because it is easy to lit and requires almost no cost to
collect. The second preferred fire equipment is leaves and twigs. Especially people use these
for fuel who have cattle to rise. Straw is used to feed those. Some people use firewood has
better economic condition than the others. They use it to avoid excessive smoke. Another
benefit in using firewood is that, it requires less volume for cooking. According to the
respondents, the preference of using firewood as a fuel is becoming reduced because of the
increasing price of that material. A few respondent use cow dung as fuel because most cow
dung is used in the field for fertilizer. Kerosene is used in night for night watch or during load
shedding as a lamp. There is no gas facility available in the village. Our suggestion for fuel
material is gas. Because it the most environment safe. Other things that we have found the
respondents use as fuel, contributes to the environment pollution at a large scale. Fire woods
should not be used because deforestation imbalances normal ecology. Smoke that is produced
from wood materials causes eye irritation, dizziness, headache and other respiratory disease.
From the overall observation, we found the respondents are eager to cylinder gas as fuel for
cooking at a suitable price. Their low earning is a barrier to choose better fuel option.

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6.8 Vaccination of Children

Today’s children are the workforce of future. A healthy workforce ensures a great deal of
productivity in the nation. Sick and unhealthy children are burden to the economy. We all
know prevention is better than cure. It is the preferable rule of Bangladesh health policy.
Immunization is one of the major focuses of World Health Organization (WHO) to the
underdeveloped or developing country. There are six major diseases cause disaster to our
infants. One third of our infant mortality is caused by six diseases such as tetanus, polio,
measles, whooping cough, diphtheria and chicken pox. All new babies should be immunized.
After all disease prevention is the key to public health.

Table 6.6: Distribution of the respondents by their Immunization status

Name of Diseases Yes

No. %
Polio 25 100%
Diphtheria 25 100%
Whooping Cough 25 100%
Measles 25 100%
Tetanus 25 100%
Chicken Pox 25 100%
Source: Structure and Program, Live-in-Field Experience, Spring-2008

6.6 Picture

1) An adult polio patient 2) Vaccination card

6.8.2 Analysis

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From the above table shown, 100% vaccination is ensured in our studied area. The
respondents are very much aware of immunization of their children. According to their
explanation about the immunization of children is that, in the past decades, many children
died due to non vaccination. Families were interested in taking babies but ignoring the
mothers’ capability to give birth. Financial distress arises due to the illness of children. NGO
campaign promotes the intention of parents to vaccinate their children. In past years, the
education level of the parents was poor which cause high negligence about immunization of
children from many various diseases. Now a day’s communication and education level is
increasing day by day and building the awareness of child vaccination.
Some names of vaccines and correspondent diseases are shown below:

Table 6.7: Vaccines for the Related Diseases

Name of Diseases Vaccines
Hepatitis-A Havrix
Hepatitis-B DPT/ Tritanrix
Polio OPV
Measles Priorix
Chicken Pox Varilrix
Typhoid Typherix
Tetanus TT
Diphtheria Hiberix
Tuberculosis BCG
Source: World Health Organization (WHO)

6.9 Preferences of Health Care Center

Public health care facility is one of the major requirements for a healthy nation. Every human
wants to keep his\her child safe. The coverage and services of public health care facility is
not adequate related to the density of population our country has. In our studied area there is
no government health care facility available nearby. For the patient who is seriously ill, needs
to go to ‘Comilla Sadar Haspatal’ or even ought to come to Dhaka for better treatment. As
people are likely to get sick on the context of our country, people in our para prefer various
destinations as a treatment center at their suitability.

Table 6.8: Distribution of Respondents Preferences of Health Care Center

Destination Number Percentage
Local pharmacy 12 48%

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Public health care facilities 10 40%

Homeopath 1 4%
Herbal treatment 1 4%
Local priest (Hujur) 1 4%
Local public health worker 0 0%
Local NGO health worker 0 0%
Others 0 0%
Source: Structure and Program, Live-in-Field Experience, Spring-2008

Table 6.9: Preference of Health Care Center According to Type of Disease

Destination Disease Type

Public Health Care Diseases which cannot be treated at home.
Local Public Health worker Child delivery, worm infection
Local Pharmacy Acidity, Gastric and other small diseases
Homeopath Arthritis
Herbal Treatment Anemia, skin diseases etc.
Ojha Snake Bites

6.9.2 Analysis
According to our survey, we found mixed preferences with regards to respondents’
preference of health care center. In the first table, respondents’ preference of health care
center is generalized. We generally ask them where they usually go for medical attention. In
the second table, their preference for specific set of problem or diseases is reflected.
According to the general survey about health care center preferred among the respondents,
most people goes to local pharmacy and public health care facilities. Local pharmacy is
situated in Kalirbazar which is somewhat near to their living place. On the other hand,
Government Hospital on Comilla city is preferred for low cost. We found a few people prefer
local priest, homeopath and herbal treatment. But their choices are narrowed due to the
categories of diseases. They do not always prefer local priest, homeopath and herbal
treatment. In analyzing preference according to type of diseases, they go to public health care
services when the disease is complicated and not curable through only taking medicines such
as physical damage (Accident, burn etc.), typhoid. For child delivery and worm infection of
children, mothers consult with local public health worker. They are satisfied about the service
of public health worker. General problem such as fever, acidity, gastric and other small
diseases people go to local pharmacy. They apply herbal treatment for mild anemia, skin
disease etc. They only go to ojha if there is a case of snake bites. Necessary measures should

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be taken by the government in order to improve the service quality of local public health care
centers. Women always need more medical attention than that of men, so more women public
health worker should be employed in our area. Midwives should be properly trained for the
assistance of delivery.

6.10 Problems related to Government Health Care Center

Facilities

As we know the majority of our Bangladeshi people lies below from the poverty line. Our
assigned area of field survey is not exempt from that. The earning capability of the people is
definitely insufficient to live solvent. That is why in almost every area our government tried
to develop low cost and easy reachable health care facility. We have asked people about some
probable problem regarding to the facilities concerning government health care center which
is situated in Comilla Sadar.

Table 6.10: Problems related to Government Health Care Center Facilities

Problems Yes Percentage No Percentage

Not close to home 25 100% 0 0
Waiting hours are too long 25 100% 0 0%
Medicine cost is too high 25 100% 0 0%
Transports are not available 20 80% 5 20%
Staffs/Service providers are not
20 80% 5 20%
friendly
Timing of the clinic is not suitable 19 76% 6 24%

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Medicine is not available 17 68% 8 32%

Facility is not clean 15 60% 10 40%
Offers no privacy 0 0% 25 100%
Source: Structure and Program, Live-In-Field Experience, Spring-2008

6.10.1 Analysis
The government health care facility must offer many different aspects which can be
convenient for poor mass. In reality, according to the respondents we came to know
completely opposite picture. The most significant problems are highlighted. They are
positional, waiting hours of patients, costs etc. The treatment center is far distant from the
village and usually people are taken there who needs serious medical attention. So, closer
treatment center is anticipated. Medicine costs are as like as we find in cities. This is the most
important problem amongst all problems are listed. This is because government supplies are
being trafficked into the local market. Patients have to wait for hours and hours to consult
with the doctor. Most of the time physicians are found absent in their working place. The
facility has very few ambulances to carry patients. Some of those remain always out of order.
Patients suffer a lot for the negligence of the authority. The hospital stuffs offer very little
delegation to their duties. They always look for bribes from the patients. Timing is the very
important factor for the female patients according to our survey. There is always conflict
between their regular household activity timing and doctors’ consultancy timing. Another
thing is availability of some critical medicine or other medical instruments. Sometimes
patients have to rush to Comllia city in order to find those. Hospitals give us the pictures as
like those should be neat and clean but not. According to the respondents every floor contains
flies and bad smell. Even a healthy person becomes unhealthy going there.

6.11 Conclusion
A healthy life is one of basic the fundamental rights of human. The right should be protected
implementing every resource available. Health is considered as a wealth of human. Poverty is
one of the factors constrains better health and environment. Poor people cannot do many
things for good health and environment even if they want to. Not only the government body
but also local communities, privet sectors and NGO should put optimum level of efforts to
mitigate health and environmental problems in Bangladesh. One major practice is needed to

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be noticed that, over fertilization and excessive use of pesticides by the farmers because it
causes soil pollution and health problem. In our studied area, people are only aware about
children immunization. They should be aware of the other aspects discussed in this chapter
for a better life and better environment. The condition of the government health care facilities
is not satisfactory. Bio-gas plant should be used as a cooking material rather than leaves and
twigs, firewood, straw etc. It reduces and environmental hazards. In addition, good sanitation
and safe water must be available.

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