UNIT 5: HEALTH AND SANITATION
Key unit competence: To use language learnt in the context of health
and sanitation.Introductory activity
Look at the pictures above, answer the questions below:
1. What are the most common illnesses in Rwanda?
2. State at least three transmissible diseases.
3. Which sickness can be caused by the insect in fig.2?
4. What do you think is described in fig.3?
5. What does the term coronary disease refer to?6. The man in fig.4 is very fat. Do you think it is a health-related problem? Explain.
5.1 Describing the difference between illnesses/diseases
and pandemics
5.1.1 Learning activities: Reading and text analysisText 1: The difference between a pandemic, an epidemic, endemic,and an outbreak
Not all infectious disease terms are created equal, though often they’re
mistakenly used interchangeably. The distinction between the words
“pandemic,” “epidemic,” and “endemic” is regularly blurred, even by medical
experts. This is because the definition of each term is fluid and changes asdiseases become more or less prevalent over time.
While conversational use of these words might not require precise definitions,
knowing the difference is important to help you better understand public healthnews and appropriate public health responses.
To understand the difference, let’s start with basic definitions: An epidemic is a
disease that affects a large number of people within a community, population,
or region while a pandemic is an epidemic that’s spread over multiple countriesor continents.
Endemic, on the other hand, is something that belongs to a particular people
or country. A disease outbreak is endemic when it is consistently present
but limited to a particular region. This makes the disease spread and ratespredictable. For example, malaria is endemic to parts of Africa.
An outbreak is a greater-than-anticipated increase in the number of endemic
cases. It can also be a single case in a new area. If it’s not quickly controlled,an outbreak can become an epidemic.
A simple way to know the difference between an epidemic and a pandemic is
to remember the “P” in pandemic, which means a pandemic has a passport. A
pandemic is an epidemic that travels.The difference between epidemic and endemic is that an epidemic is actively
spreading; new cases of the disease substantially exceed what is expected.
More broadly, it’s used to describe any problem that’s out of control, such as
“the opioid epidemic.” An epidemic is often localized to a region, but the
number of those infected in that region is significantly higher than normal. For
example, when COVID-19 was limited to Wuhan, China, it was an epidemic.The geographical spread turned it into a pandemic.
Adapted from (Intermountain Healthcare, 2020)
Comprehension questions
1. Why do people have difficulties distinguishing between the words
“pandemic,” “epidemic,” and “endemic”?
2. Do you think accountants need to know the difference between the
words pandemic, epidemic and endemic? Justify your answer.
3. Differentiate an epidemic from a pandemic?
4. After COVID-19 reached Rwanda in 2020, was it an epidemic or a
pandemic disease? Explain.Vocabulary
Give the meaning of the following words and expression as used in the above
passagea) Infectiousb) Blurredc) Prevalentd) Predictablee) The opioid epidemicText 2: Types of diseases in Rwanda
There are different types of diseases in Rwanda. Some diseases affect the
majority of Rwandans. Others affect only a small number of the population. The
most common diseases in Rwanda today are malaria, HIV/AIDS, tuberculosis,
typhoid or typhoid fever. Many Rwandans also suffer from amoebic dysentery,
Hepatitis B and C and the common cold.
Some transmissible diseases, like typhoid and amoebic dysentery, are
waterborne. This means you get these diseases when you drink water that
is not clean and boiled. Diseases like tuberculosis and the common cold are
airborne. The bacteria or viruses are ejected into the air via coughs or
sneezes. When you breathe in this air, you become infected.
Hepatitis B and C and HIV/AIDS are transmitted through body fluids.
Infections and diseases, such as hepatitis are most often carried through the
semen and blood of infected persons. Malaria is transmitted through the bite
of a female anopheles’ mosquito. It injects infected blood into your body when
it bites you.
Transmissible diseases are caused by causative agents. Typhoid, amoebicdysentery and tuberculosis are caused by bacteria. Hepatitis B and C, HIV/
AIDS and the common cold are caused by viruses. Malaria is caused by a
parasite called plasmodia.
Other diseases are sometimes referred to as lifestyle diseases. These are
steadily increasing in Rwanda. The best examples are coronary disease, cancer,
diabetes, obesity and mental illnesses.
Coronary diseases, diabetes, obesity and mental illnesses can be caused by a
combination of genetics and lifestyle. Cancer results from the malfunctioning
of body cells. The substances that cause cancer are called carcinogens. A
carcinogen may be a chemical substance, such as certain molecules in tobacco
smoke. The cause of cancer may be environmental agents, viral or genetic
factors. We should bear in mind, though, that in the majority of cancer cases wecannot attribute the disease to a single cause.
Comprehension questions
1. List three of the most common diseases in Rwanda.
2. What are transmissible diseases?
3. What is a ‘causative agent’?
4. What causes malaria?
5. How can you avoid getting typhoid fever or amoebic dysentery?
6. How can you avoid getting Hepatitis B or C and HIV/AIDS?
7. Which diseases are steadily increasing in Rwanda?
8. Name two lifestyle diseases.9. What is meant by ‘lifestyle diseases’?10. What disease is caused by body cells that malfunction?
Application activity 5.1.2
Vocabulary, sentence writing, composition writing anddebate
1. Vocabulary
Use the dictionary and thesaurus to look up the missing meanings of the
words/phrases in the table below. Copy the table into your book and fill inthe blank spaces.
2. Sentence writing
Write one sentence for each word/phrase to illustrate how they are used.
3. Composition writing
Write a short composition explaining what transmissible diseases are and
how they can be prevented.
4. Debate on the following motion:
Schools should conduct mandatory HIV testing on their students. (refer to
notes on debate provided in unit 1)
5.2 Talking about sanitation and related tools5.2.1 Learning activities: Reading and text analysis
TEXT: Robotic surgery
Robotic surgery, or robot-assisted surgery, permits surgeons to perform
numerous sorts of complex procedures with more accuracy, flexibility and
control than is with routine strategies. Robotic surgery is ordinarily related with
minimally invasive surgery -methods performed through minor incisions.
It is additionally some of the time used in certain traditional open surgical
procedures.
Robotic surgery has been quickly embraced by hospitals in Europe and USAfor use in the treatment of different conditions.
The most broadly used clinical robotic surgical system incorporates a camera
arm and mechanical arms with surgical instruments joined to them. The surgeon
controls the arms while seated at a computer console close the working table.
The console gives the surgeon a high-definition, amplified, 3-D view of the
area to be operated. Other team members who assist during the operation are
led by the surgeon.In a lot of procedures, it is evident that the robotic system helps surgeons who
use it to enhance precision, flexibility and control during the operation and
allows them to better see the site, compared with traditional methods. By using
robotic surgery, surgeons can perform delicate and complex procedures that
will have been troublesome or inconceivable with other methods.Regularly, robotic surgery makes minimally invasive surgery possible. TheAdapted from robotic surgery by Mayo clinic.
benefits of minimally invasive surgery include fewer complications, such as
surgical site infection, less pain and blood loss, quicker recovery and smaller,
less noticeable scars.Comprehension questions
1. Which advantage does robotic surgery have on conventional techniques/
routine strategies as described in paragraph one?
2. Find, in the passage, a sentence that has a meaning similar to the
following one: It is also sometimes used in certain traditional open
surgical procedures.3. Which parts of the world that rapidly adopted robotic surgery?
4. What does the most widely used clinical robotic surgical system include?
5. Enumerate the benefits of minimally invasive surgery
Application activities 5.2.2Vocabulary and summary writing1. VocabularyFind meanings of the following words and expressionsa) Robotic surgeryb) Accuracyc) Minimally invasive surgeryd) Embracee) Incorporatef) High-definitiong) Delicate2. Summary writing
Summarise the above passage in not more than 90 words.5.3 Talking about health, sanitation and related businesses
5.3.1 Learning activities: Reading and text analysis
Text 1: Five drinking water start-ups that are making a difference in
Africa
Access to clean water is one of the top challenges on the African continent.
In sub-Saharan Africa, barely 24% of the population has access to this basic
right, according to a United Nations report of 2019. In order to change this
figure, African governments are increasing the number of drinking water
projects. In addition to these initiatives, there are start-ups, particularly African
and foreign ones. Some of them are positively illustrated by the originality ofthe proposed solutions. This is the case of Water Access Rwanda, WaterKioskAfrica, Boreal, Mascara, and Grino Water Solutions.
On the occasion of World Water Day, Afrik 211 looks at the urgent need to
improve access to drinking water in Africa. In addition to the limited amount of
available resources, some countries on the continent are facing severe water
stress, which is expected to increase further, according to the United Nations(UN), affecting 75 to 250 million people by 2030.
In order to avoid a situation of total shortage of drinking water, African
governments are setting up various projects. These initiatives, which are
generally few in number due to a lack of funding or adequate expertise, are
complemented by the efforts of some start-ups specialising in the water sector.
Among the most active are Water Access Rwanda, WaterKiosk Africa, Boreal,
Mascara, and Grino Water Solutions. The systems offered by these start-upsrange from simple drinking water kiosks to solar-powered desalination systems.
In Rwanda, for example, 43% of the population has no access to drinking water,
according to the United Nations Children’s Fund (UNICEF). This situation
forces this segment of the population to draw water from the Nyabarongo, one
of the largest rivers in the East African country. But the water drawn from the
river is not drinkable, which leads to a number of diseases (cholera, typhoid,polio and diarrhea).
To alleviate this problem, the start-up Water Access Rwanda has been
installing water filtering devices (kiosks, filters and pumps) in the country’s
localities since 2014. The installations of the start-up, founded in 2014 by
Christelle Kwizera, have so far provided 47,612 people in Rwanda with access
to drinking water via 86 mini-grids. “A single kiosk can supply a community
of 2,000 people with drinking water and at a lower price than other water
vendors,” explains Christelle Kwizera, the founder of Water Access Rwanda in
2020. Water Access Rwanda’s kiosks are expected to cover 30 districts in the
country by 2022, supporting the Rwandan government in its policy to provideclean water to its entire population by 2024.
Another African start-up that is making a name for itself in water treatment
is WaterKiosk Africa. The Kenyan company offers more targeted solutions,
particularly in the field of desalination. The Kenyan start-up WaterKiosk Africa
is involved in a project to build 40 solar-powered desalination systems in Kenya,
which was launched in March 2020. The systems will eventually remove salt
and other minerals from brackish groundwater in 13 Kenyan counties facing
water shortages The desalinated water will be distributed to the population via
kiosks.Adapted from (Magoum, 2021)1 The first daily, bilingual news site on the green economy and the
environment in Africa, the AFRIK 21 site reports on the proliferation of initiatives
across the continent: policy initiatives, projects, achievements, investments,innovations…
Comprehension questions
1. What is referred to as “basic right” in the first paragraph?
2. How are African governments addressing the issue of clean water
shortage?
3. Why are the initiatives of addressing the issue of clean water shortage
still few in number?
4. How has Water Access Rwanda been trying to solve the problem of
water shortage?5. In few words, describe WaterKiosk Africa.
5.3.2 Application activities: Vocabulary and composition
writing
1. Vocabulary
Use the following words and expression in your own sentences
a) start-ups
b) clean water
c) barely
d) drinking water
e) initiative
f) severe
g) expertise
h) mini-grid
i) alleviate
j) vendors
k) to make a name
l) desalinationm)brackish
2. Composition writingSanitation refers to conditions relating to public health, especially the provision
Write a composition of 250 to 300 words about any businesses related to
health and/or sanitation.Text 2: Water and sanitation are human rights
of clean drinking water and adequate sewage disposal. Universal access to
safe water, sanitation and hygiene services are priorities in Rwanda. Washing
hands is critically linked to improved nutrition, good health, gender equality,
economic growth, and environmental management.
Poor sanitary conditions promote diarrhea and intestinal parasites and
environmental enteropathy and have complex and reciprocal links to
malnutrition in children. Existing evidence demonstrates that poor sanitation
and hygiene conditions can affect a child’s nutritional status via at least
three direct pathways (i) diarrheal diseases; (ii) intestinal parasites; and (iii)
environmental enteropathy. Malnutrition weakens the body’s defenses and
makes children more vulnerable to diseases. At the same time, diarrhea and
intestinal parasites contribute to malnutrition by causing decreased food intake,impaired nutrient absorption and direct nutrient losses.
In Rwanda, only 57 per cent of the population access safe drinking water that
is within 30 minutes of their home. When children are forced to spend time
collecting water, it keeps them out of school. This is an issue especially for girls,
who are often expected to take on the majority of household tasks.
Even if water is available near the home, that water is often not safe to drink.
When children drink contaminated water, they risk severe illness and even
death from water borne diseases.
Basic sanitation means that every household has its own toilet and does not
share with another household. These toilets should also keep human waste
out of contact with people. Only 64 per cent of the population in Rwanda have
access to these sanitation services.
Just 5 per cent of households in Rwanda have a place for family members to
wash their hands with soap. Hand washing with soap at critical moments is
essential for good health, especially in children.
As a solution UNICEF’s WASH programme in Rwanda aims to ensure that more
households and communities use safe and sustainable water and sanitation
services, and that children and families practice good hygiene.
UNICEF supports the Government of Rwanda to ensure that every household:
Uses safe and clean water near the home, a hygienic and private latrine and
practices hand washing with soap, especially after using the toilet and beforehandling food.
Comprehension questionsAdapted from (UNICEF, 2020)
1. How do you think hand washing can be linked to improved nutrition?
2. Explain the consequences of using dirty water.
3. Which consequences school children who don’t have water near their
homes are likely to face?
4. What does “basic sanitation” mean?5. What are the critical moments of washing hands?
Application activities 5.3.3
Vocabulary and sentence writing
1. Vocabulary
Give the meaning of the following words as used in the above passage.a) hygiene… (paragraph one)b) enteropathy… (paragraph two)c) malnutrition… (paragraph two)d) nutrient… (paragraph two)e) contaminated water… (paragraph four)f) latrine… (paragraph seven)
2. Sentence writingWrite one sentence for each of the words to illustrate how they are used
5.4 Language structure: Conditionals
Notes:
Conditionals are sometimes called ‘if clauses’. They describe the result of
something that might happen ‘‘Real situations” (in the present or future) or might
have happened but didn’t ‘‘Unreal situations” (in the past). They are made using
different English verb tenses. There are four main kinds of conditionals: The
Zero, first, second and third conditional.
Nevertheless, not all clauses introduced by “if” can express a condition:
Examples:– Would you mind if I bring you more coffee? (Offer)– Gatera doesn’t know if Aunt Isimbi comes or not. (Wonder)– The old man wanted to know if people can get diseases from Umuganurawine. (Reported speech)5.4.1. The zero conditional: General truths
The zero conditional is a structure that uses “if”, but which expresses no
condition at all.
This conditional is used when the result will always happen.
Example:
– If you heat water to 100 degrees, it boils.
– If children drink dirty water, they get sick.
– I f you touch fire, you get burned.
– If bacteria get into the body, they cause infection.5.4.2. The first conditional: Real/Possible (Present) and its
Probable Condition
Example: If you don’t wash your hands properly you will fall sick.
The first conditional is used to talk about things which might happen in the future.
Of course, we can’t know what will happen in the future, but this describespossible things, which could easily come true.Here are more examples:– If it rains, I won’t go to the park.– If I study today, I’ll go to the party tonight.– If I have enough money, I’ll buy some new shoes.– She’ll be late if the train is delayed.– She’ll miss the bus if she doesn’t leave soon.– If I see her, I’ll tell her.5.4.3. The second conditional: Imaginary/hypotheticalcondition and its probable result.
Examples: If my hands were clean, I would test this food.
In formal writing ‘were’ is used instead of ‘was’ with ‘I’ and ‘he/she/it’.
The second conditional has two uses:First, we can use it to talk about things in the future that are probably not going
to be true. If one is imagining some dream for example.– If I won the lottery, I would buy a big house. (I probably won’t win thelottery)– If I met the Queen of England, I would say hello.– She would travel all over the world if she were rich.– She would pass the exam if she ever studied. (She never studies, sothis won’t happen)Second, we can use it to talk about something in the present which is impossible,
because it’s not true. Have a look at the following examples:– If I had his number, I would call him. (I don’t have his number now, soit’s impossible for me to call him).5.4.4 The third conditional: Impossible condition/unreal– If I were you, I wouldn’t go out with that man.
past condition and its probable result in the Past
Example: If they had taken Kalisa to the hospital on time, he would not have
died.
The third conditional talks about the past. It’s used to describe a situation that
didn’t happen, and to imagine the result of this situation.– If she had studied, she would have passed the exam, but, we reallyknow she didn’t study and so she didn’t pass)– If I hadn’t eaten so much, I wouldn’t have felt sick (but I did eat a lot,and so I did feel sick).– If we had taken a taxi, we wouldn’t have missed the plane.– She would have become a teacher if she had gone to university.Type III inverted form
The Type III If-Clause can also be expressed by Removing ‘If ‘and inverting the
operator (first auxiliary verb) ‘had’ and the subject.
Examples:– If she had studied, she would have passed the exam.(Had she studied; she would have passed the exam.)Replacement of if
Some expressions can replace if in the sub-clause, these are for example: in
case, suppose (that), supposing (that), on condition (that), …– Supposing that I don’t arrive till after midnight, will the guest-house stillbe open? (Imagine if I don’t arrive till after midnight …)– Supposing you lost your passport, you’d have to go to the embassy,wouldn’t you?– Supposing he hadn’t recognised us – he might never have spoken tous.– Suppose we asked Mary to baby-sit, do you think she’d do it?– Supposing someone else wrote the essay, how would we know?– Suppose we hadn’t brought our umbrellas; wouldn’t we have becomewet? (We did bring our umbrellas)– Supposing they had closed the road, would that have been a goodidea? (They didn’t close the road.)– You will pass on condition that you study hard.– I will start a bigger company in case I get more capital.Application activities 5.4.55.5 Spelling and pronunciationFilling in gaps using the correct form of the verbComplete the Conditional Sentences using the correct form of verbs in
brackets. Decide whether to use first, second or third conditional.
1. If I had time, I…shopping with you. (go)
2. If you…English, you will get along with them perfectly. (speak)
3. If they had gone for a walk, they…the lights off. (turn)
4. If she…to see us, we will go to the zoo. (come)
5. I would have told you, if I…him. (see)
6. Would you mind if I…the window? (open)
7. If they…me, I wouldn’t have said no. (invite)
8. My friend…me at the station if he gets the afternoon off. (meet)
9. If I…it, nobody would do it. (do)
10. If my father…me up, I’ll take the bus home. (pick)
Use a dictionary and thesaurus to look up the missing pronunciation of the
words/phrases in the table below. Copy the table into your book and fill in
the blank spaces and practise reading them.
End of unit assessment 5.6i) Complete the Conditional Sentences using the correct form of verbs
in brackets.1. If we meet at 9:30, we…plenty of time. (have)2. Mukamana would find the milk if she…in the fridge. (look)3. The zookeeper would have punished her with a fine if she…theanimals. (feed)4. If you spoke louder, your classmates…you. (understand)5. Dan…safe if he drove slowly. (arrive)6. You…no trouble at school if you had done your homework. (have)7. If you…in this lake, you’ll shiver from cold. (swim)8. The door will unlock if you…the green button. (press)9. If Keza…her teacher, he’d have answered her questions. (ask)
10. I…the office if I were you. (call)
ii) Choose the right word to fill in blanks in the following paragraph
Hepatitis B and C and HIV/AIDS are transmitted through body…….
(muscles/fluids). Infections and diseases, such as hepatitis are most
often carried through the semen and blood of……….. (infected/healthy)
persons. Malaria is transmitted through the……. (excrement/bite) of a
female anopheles… (fly/mosquito). It injects infected …..… (blood/semen)
into your body when it bites you.
iii) Write a 250-word composition on a person you saw who got a
transmissible disease and use conditional sentences to explain what
they would have done to avoid it.