Fishing and Health

Fishing is the activity of trying to catch fish. Fish are normally caught in the wild. Techniques for catching fish include hand gathering, spearing, netting, angling and trapping.
The term fishing may be applied to catching other aquatic animals such as molluscs, cephalopods, crustaceans, and echinoderms. The term is not normally applied to catching aquatic mammals, such as whales, where the term whaling is more appropriate, or to farmed fish.
According to FAO statistics, the total number of commercial fishermen and fish farmers is estimated to be 38 million. Fisheries and aquaculture provide direct and indirect employment to over 500 million people. In 2005, the worldwide per capita consumption of fish captured from wild fisheries was 14.4 kilograms, with an additional 7.4 kilograms harvested from fish farms. In addition to providing food, modern fishing is also a recreational pastime.

Recreational fishing
Recreational and sport fishing describe fishing primarily for pleasure or competition. Recreational fishing has conventions, rules, licensing restrictions and laws that limit the way in which fish may be caught; typically, these prohibit the use of nets and the catching of fish with hooks not in the mouth. The most common form of recreational fishing is done with a rod, reel, line, hooks and any one of a wide range of baits or lures such as artificial flies. The practice of catching or attempting to catch fish with a hook is generally known as angling. In angling, it is sometimes expected or required that fish be returned to the water (catch and release). Recreational or sport fishermen may log their catches or participate in fishing competitions.
Big-game fishing describes fishing from boats to catch large open-water species such as tuna, sharks and marlin. Sport fishing (sometimes game fishing) describes recreational fishing where the primary reward is the challenge of finding and catching the fish rather than the culinary or financial value of the fish's flesh. Fish sought after include marlin, tuna, tarpon, sailfish, shark and mackerel although the list is endless.

The Health Benefits of Fishing
There are many reasons that people fish. Some fish for pleasure, some fish for food, and some fish to make a living.Of all the possible reasons for fishing, fishing for pleasure is probably the most enjoyable because
people do it as a matter of personal choice. There is no pressure in pleasure fishing. There are no adverse consequences for not catching fish. Maybe a small measure of disappointment, but that's it. In addition to the pleasure of actually catching fish, there are many other benefits. Most of these are good for one's physical health as well as one's mental health.

Physically, fishing is not all that demanding. It doesn't take a lot of strength and stamina to fish. However, fishing does incorporate the exercising of the lungs, heart and various muscle groups. After all, one does have to get to a place from which they can fish. That generally includes walking, possibly some minor climbing, and carrying one's gear to the favorite fishing spot. These are all physical activities which burn calories and exercise various muscle groups, all of which is good for one's health. The various activities involved in readying oneself for fishing are also good exercise for the muscles of the fingers, hands, wrists and forearms. Assembling a reel to one's rod, attaching hooks, sinkers, bobbin's and even the bait are all activities which work these muscles to some degree. Then, there is the casting of the bait into the water. This activity exercises the muscles of the upper arm, shoulder and back. One probably won't get a good cardio workout from fishing, but one will get enough exercise to maintain a degree of dexterity and maybe some muscle tone.
Fishing is also good for the lungs and skin. After all, fishing is mostly an outdoor sport. Being outdoors gives one an opportunity to get plenty of fresh air into one's lungs. Fresh air is healthy air. It contains
plenty of oxygen which is fundamental to a healthier physical and mental state. Sunshine is another health benefit derived from fishing. Although some people like fishing enough to brave inclement weather, most prefer a nice sunny day to fish. Sunshine, in moderation, is good for one's health. It produces a number of beneficial attributes for maintaining a healthy body and appearance.

Mentally, fishing requires very little effort. Attach some form of bait to a hook, cast it into the water, and wait for the fish to bite. That doesn't sound like it requires the use of many brain cells, does it? Certainly not, and that is the biggest health benefit of all. Because fishing doesn't require a huge amount of brain power, all those brain cells get to kick back and relax for a while. Fishing allows one to rest and relax one's mind. No pressure, no deadlines, nobody wanting this or that, no noisy machines or people; just fresh air, sunshine and plenty of rest and relaxation. A brain vacation! Of course, one needn't lapse into a comatose state while fishing. It is sufficient to just clear one's mind and wonder or daydream. All that's lacking is a couple of sandwiches, a thermos of coffee or a jug of iced tea, and maybe a few other snacks to keep one's appetite in check. Fresh air, sunshine and exercise work on one's appetite, so it is always a good idea to take some appetite appeasing food on any fishing trip.

In conclusion, fishing is a great recipe for a healthier body and mind. Take a little exercise, mix it with sunshine and fresh air, and add a few snacks and something to wash them down with, then do it frequently and enjoy better health. And there is one more benefit. With a little luck, one may catch a fish for dinner, and everyone knows that eating fish is very healthy.

Fishing for health - eliminating isolation
The Department of Health describes social isolation and exclusion, as a ‘breeding ground for poor heath.’ In Charleville a group of health professionals is working to overcome that.

Jill Carroll was part of a team who instigated the Charleville District Health Service Fishing Club. The project helps socially isolated people to participate in group activities, by providing a small group setting - culturally appropriate to the area.

Participants chose fishing as their group activity, and the project hasn’t faltered.
“It was what they wanted to do. It was purely client driven.”

Jill says mainstream activities only reach those who are socially competent and self-motivated. “It’s an opportunity for those who don’t ‘fit’ in general social situations to gain a social comfort zone.

“Fishing was the perfect choice. It was something they had been involved in during the days when they used to be included in society; something they had in common.”

She said Club members’ enthusiasm was encouraging, and the catches were typically ‘big!’

“The social implications of the project have been great. The fishing trips are giving these people a more positive outlook on life, and there’s been a decrease in doctor and hospital admissions.”

And despite limited health funding, Jill said the fishing group was sustainable. “If it’s a small project, it works. A lot of programs find it difficult getting funding. We’re sustainable because it doesn’t cost much for us to keep going.”

Local indigenous women elders will be the next group to take to the river, and plans are in the making to expand the project to include mental health and disability patients.

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Pitaya or Dragon Fruit

A Pitaya (pronounced /pɨˈtaɪ.ə/) or pitahaya (English pronunciation: /ˌpɪtəˈhaɪ.ə/) is the fruit of several cactus species, most importantly of the genus Hylocereus (sweet pitayas). These fruit are commonly known as dragon fruit – cf. Chinese huǒ lóng guǒ 火龍果/火龙果 "fire dragon fruit" and lóng zhū guǒ "dragon pearl fruit", or Vietnamese thanh long (green dragon). Other vernacular names include strawberry pear.
If not otherwise stated, this article's content refers specifically to the pitayas of Hylocereus species, or "dragon fruit".

Distribution
The vine-like epiphytic Hylocereus Pitaya producing cacti are native to Mexico, Central America, and South America. They are also cultivated in Asian countries such as Taiwan, Vietnam, Thailand, the Philippines, Sri Lanka, Malaysia and more recently Bangladesh. They are also found in Okinawa, Hawaii, Israel, northern Australia and southern China.
Hylocereus blooms only at night; the large white fragrant flowers of the typical cactusflower shape are among those called "moonflower" or "Queen of the Night". Sweet pitayas have a creamy pulp and a delicate aroma. It is also grown as an Ornamental plant, used in gardens as a flowering vine, and a house plant indoors.

Varieties
Stenocereus fruit (sour pitayas) are of more local importance, being commonly eaten in the arid regions of the Americas. They are more sour and refreshing, with juicier flesh and a stronger taste, and are relished by hikers. The common Sour Pitaya or pitaya agria (S. gummosus) in the Sonoran Desert has been an important food source for Native American peoples. The Seri people of northwestern Mexico still harvest the highly appreciated fruit,[3] and call the plant ziix is ccapxl – "thing whose fruit is sour". The fruit of related species, such as S. queretaroensis and Dagger Cactus (S. griseus),[4] are also locally important food. Somewhat confusingly, the Organ Pipe Cactus (S. thurberi) fruit (called ool by the Seris) is the pitahaya dulce ("sweet pitahaya") of its native lands, as dragon fruit are not grown there in numbers. It still has a more tart aroma than Hylocereus fruit, described as somewhat reminiscent of watermelon; it has some uses in folk medicine.
Fruits of some other columnar cacti (mainly Cereeae) are also called "pitayas" – for example those of the Peruvian Apple Cactus (Cereus repandus), which are very rare.

Cultivation
After thorough cleaning of the seeds from the pulp of the fruit, the seeds may be stored when dried. Ideally, the fruit must be unblemished and overripe. Seeds grow well in a compost or potting soil mix - even as a potted indoor plant. Pitaya cacti usually germinate between 11 and 14 days after shallow planting. As they are cacti, overwatering is a concern for home growers. As their growth continues, these climbing plants will find something to climb on, which can involve putting aerial roots down from the branches in addition to the basal roots. Once the plant reaches a mature 10 lbs weight, one may see the plant flower.
Pitaya cacti flower overnight, usually wilting by the morning. They rely on nocturnal creatures such as bats or moths for fertilization by other pitaya. Self-fertilization will not produce fruit. This limits the capability of home growers to produce the fruit. However, the plants can flower between three and six times in a year depending especially on growing conditions. Like other cacti, if a healthy piece of the stem is broken off, it may take root in soil and become its own plant. This is a much shorter route to reproduction. The plants handles up to 104oF and very short periods of frost, but does not survive long exposure to freezing temperatures. The cacti thrive most in USDA zones 10-11, but may survive outdoors in zone 9a or 9b.
Hylocereus has adapted to live in dry tropical climates with a moderate amount of rain. The dragon fruit sets on the cactus-like trees 30–50 days after flowering and can sometimes have 5-6 cycles of harvests per year. There are some farms in Vietnam that produce 30 tons of fruit per hectare every year.

Pests and diseases
Overwatering or excessive rainfall can cause the flowers to drop and fruit to rot. Birds can be a nuisance. The bacterium Xanthomonas campestris causes the stems to rot. Dothiorella fungi can cause brown spots on the fruit, but this is not common.
Fruit
Sweet pitayas come in three types, all with leathery, slightly leafy skin:
Hylocereus undatus (red pitaya) has red-skinned fruit with white flesh. This is the most commonly-seen "dragon fruit".
Hylocereus costaricensis (Costa Rica pitaya, often called H. polyrhizus) has red-skinned fruit with red flesh
Hylocereus megalanthus (yellow pitaya, formerly in Selenicereus) has yellow-skinned fruit with white flesh.
Early imports from Colombia to Australia were designated Hylocereus ocampensis (supposedly red fruit) and Cereus triangularis (supposedly yellow fruit). It is not quite certain to which species these taxa refer, though the latter is probably the red pitaya.
The fruit can weigh from 150 to 600 grams; some may reach one kilogram.

Consumption
To prepare a pitaya for consumption, the fruit is cut open to expose the flesh.
The fruit's texture is sometimes likened to that of the kiwifruit due to the presence of black, crunchy seeds. The flesh, which is eaten raw, is mildly sweet and low in calories.[10] Dragon fruit should not be used to accompany strong-tasting food, except to "cleanse the palate" between dishes. The seeds are eaten together with the flesh, have a nutty taste and are rich in lipids, but they are indigestible unless chewed. The fruit is also converted into juice or wine, or used to flavour other beverages. The flowers can be eaten or steeped as tea. The skin is not eaten, and in farm-grown fruit it may be polluted with pesticides.
Ingestion of significant amounts of red-fleshed dragon fruit (such as Costa Rica Pitaya) may result in pseudohematuria, a harmless reddish discoloration of the urine and faeces.

Nutritional information
The typical nutritional values per 100 g of raw pitaya (of which 55 g are edible) are as follows:
Water 80-90 g
Carbohydrates 9-14 g
Protein 0.15-0.5 g
Fat 0.1-0.6 g
Fiber 0.3-0.9 g
Ash 0.4-0.7 g
Calories: 35-50
Calcium 6–10 mg
Iron 0.3-0.7 mg
Phosphorus 16 – 36 mg
Carotene (Vitamin A) traces
Thiamine (Vitamin B1) traces
Riboflavin (Vitamin B2) traces
Niacin (Vitamin B3) 0.2-0.45 mg
Ascorbic acid (Vitamin C) 4–25 mg
-The aforentioned figures are subject to change as per cultivation conditions.-
The fatty acid compositions of two pitaya seed oils were determined as follows:
• Particularly red-skinned pitayas are a good source of Vitamin C.
• Pitayas are rich in fiber and minerals, notably phosphorus and calcium. Red pitayas seem to be richer in the former, yellow ones in the latter.
• The seeds are rich in polyunsaturated fatty acids, and in particular Red Pitayas contain very little saturated fat.
• Pitahayas also contain significant quantities of phytoalbumin antioxidants, which prevent the formation of cancer-causing free radicals.
• In Taiwan, diabetics use the fruit as a food substitute for rice and as a source of dietary fibre.

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Pineapple

Pineapple (Ananas comosus) is the common name for a tropical plant and its edible fruit which are coalesced berries. Pineapples are the only bromeliad fruit in widespread cultivation. It can be grown as an ornamental, especially from the leafy tops. Some sources say that the plant will flower after about 24 months & produce a fruit during the following six months while others indicate a 20-month timetable.
Pineapple is eaten fresh or canned or juiced. It is popularly used in desserts, salads, as a complement to meat dishes and in fruit cocktail. The popularity of the pineapple is due to its sweet-sour taste containing 15% sugar and malic and citric fruit acids. It is also high in vitamin B1, B2, B6 and C. Its protein-digesting enzyme bromelain seems to help digestion at the end of a high protein meal.
In the Philippines, pineapple leaves are used as the source of a textile fiber called piña.

Etymology
The word pineapple in English was first recorded in 1398, when it was originally used to describe the reproductive organs of conifer trees (now termed pine cones). The term pine cone for the reproductive organ of conifer trees was first recorded in 1694. When European explorers discovered this tropical fruit, they called them pineapples (term first recorded in that sense in 1664 because of their resemblance to what is now known as the pine cone).
In the scientific binomial Ananas comosus, ananas, the original name of the fruit, comes from the Tupi (Rio de Janeiro, Brazil) word nanas, meaning "excellent fruit", as recorded by André Thevet in 1555, and comosus, "tufted", refers to the stem of the fruit. Other members of the Ananas genus are often called pine as well by laymen.
Many languages use the Tupian term ananas. In Spanish, pineapples are called piña "pine cone" in Spain and most Hispanic American countries, or ananá (ananás in Argentina) (see the piña colada drink). They have varying names in the languages of India: "Anaasa" (అనాస) in Telugu, "Sapuri-PaNasa" (ସପୁରି ପଣସ) in Odia language,annachi pazham (Tamil), anarosh (Bengali), and in Malayalam, kaitha chakka. In Malay, pineapples are known as "nanas" or "nenas". In the Maldivian language of Dhivehi, pineapples are known as alanaasi. A large, sweet pineapple grown especially in Brazil is called abacaxi [abakaˈʃi].

Botany
The pineapple is a herbaceous short-lived perennial plant which grows to 1.0 to 1.5 metres (3.3 to 4.9 ft) tall. The plant only produces one fruit and then dies. Commercially suckers that appear around the base are cultivated. It has 30 or more long, narrow, fleshy, trough-shaped leaves with sharp spines along the margins that are 30 to 100 centimetres (1.0 to 3.3 ft) long, surrounding a thick stem. In the first year of growth the axis lengthens and thickens, bearing numerous leaves in close spirals. After 12 to 20 months the stem grows into a spike-like inflorescence up to 15 cm long with over 100 spirally arranged, trimerous flowers, each subtended by a bract. Flower colours vary, depending on variety, from lavender, through light purple to red.
The ovaries develop into berries which coalesce into a large, compact, multiple accessory fruit. The fruit of a pineapple is arranged in two interlocking helices, eight in one direction, thirteen in the other, each being a Fibonacci number.
Pineapple carries out CAM photosynthesis, fixing carbon dioxide at night and storing it as the acid malate and then releasing it during the day, aiding photosynthesis.

Pollination
Pollination is required for seed formation, but the presence of seeds negatively affects the quality of the fruit. In Hawaii, where pineapple is cultivated on an agricultural scale, importation of hummingbirds is prohibited for this reason. Certain bat-pollinated wild pineapples only open their flowers at night.

Nutrition
Raw pineapple is an excellent source of manganese (45% DV in a 100 g serving) and vitamin C (80% DV per 100 g).
Pineapple contains a proteolytic enzyme, bromelain, which breaks down protein. Pineapple juice can thus be used as a marinade and tenderizer for meat. The enzymes in raw pineapples can interfere with the preparation of some foods, such as jelly or other gelatin-based desserts, but it is destroyed during cooking and the canning process. The quantity of bromelain in the fruit is probably not medically significant, being mostly in the inedible stalk.

Folk medicine
There are myths that pineapple has benefits for intestinal disorders or serves as a pain reliever.

Distribution
The plant is indigenous to South America, though little is known about the origin of the domesticated pineapple (Pickersgill, 1976). M.S. Bertoni (1919) considered the Parana—Paraguay river drainages to be the place of origin of A. comosus. The natives of southern Brazil and Paraguay spread the pineapple throughout South America, and it eventually reached the Caribbean. Columbus discovered it in the Indies and brought it back with him to Europe. The Spanish introduced it into the Philippines, Hawaii (introduced in the early 19th century, first commercial plantation 1886), Zimbabwe and Guam. The fruit was cultivated successfully in European hothouses, and pineapple pits, beginning in 1720.
The pineapple was introduced to Hawaii in 1813; exports of canned pineapples began in 1892. Large scale pineapple cultivation by U.S. companies began in the early 1900s on Hawaii. Among the most famous and influential pineapple industrialists was James Dole, who started a pineapple plantation in Hawaii in the year 1900. The companies Dole and Del Monte began growing pineapple on the island of Oahu in 1901 and 1917, respectively. Maui Pineapple Company began pineapple cultivation on the island of Maui in 1909. In 2006, Del Monte announced its withdrawal from pineapple cultivation in Hawaii, leaving only Dole and Maui Pineapple Company in Hawaii as the USA’s largest growers of pineapples. Maui Pineapple Company markets its Maui Gold brand of pineapple and Dole markets its Hawaii Gold brand of pineapple.
In the USA in 1986, the Pineapple Research Institute was dissolved and its assets were divided between Del Monte and Maui Land and Pineapple. Del Monte took variety 73-114, which it dubbed MD-2, to its plantations in Costa Rica, found it to be well-suited to growing there, and launched it publicly in 1996. (Del Monte also began marketing 73-50, dubbed CO-2, as Del Monte Gold). In 1997, Del Monte began marketing its Gold Extra Sweet pineapple, known internally as MD-2. MD-2 is a hybrid that originated in the breeding program of the now-defunct Pineapple Research Institute in Hawaii, which conducted research on behalf of Del Monte, Maui Land & Pineapple Company, and Dole.

Cultivation
Southeast Asia dominates world production: in 2001 Thailand produced 1.979 million tons and the Philippines 1.618 million tons, while in the Americas Brazil produced 1.43 million tons. Total world production in 2001 was 14.220 million tons. The primary exporters of fresh pineapples in 2001 were Costa Rica, 322,000 tons; Côte d'Ivoire, 188,000 tons; and the Philippines, 135,000 tons.
Since about 2000, the most common fresh pineapple fruit found in U.S. and European supermarkets is a low-acid hybrid that was developed in Hawaii in the early 1970s.
In commercial farming, flowering can be induced artificially, and the early harvesting of the main fruit can encourage the development of a second crop of smaller fruits. Once removed during cleaning, the top of the pineapple can be planted in soil and a new plant will grow. Slips and suckers are planted commercially.

Cultivars
There are many cultivars. The leaves of the commonly grown 'Smooth Cayenne' are smooth.[14] and is the most commonly grown world wide. Many cultivars have become distributed from its origins in Paraguay and the southern part of Brazil. and later improved stocks were introduced into the Americas, the Azores, Africa, India, Malaysia and Australia. Varieties include:
'Hilo': A compact 1–1.5 kg (2-3 lb) Hawaiian variant of 'Smooth Cayenne'. The fruit is more cylindrical and produces many suckers but no slips.
'Kona Sugarloaf': 2.5–3 kg (5-6 lb), white flesh with no woodiness in the center. Cylindrical in shape, it has a high sugar content but no acid. An unusually sweet fruit.
'Natal Queen': 1–1.5 kg (2-3 lb), golden yellow flesh, crisp texture and delicate mild flavor. Well adapted to fresh consumption. Keeps well after ripening. Leaves spiny. Grown in Australia, Malaysia, and South Africa.
'Pernambuco' ('Eleuthera'): 1–2 kg (2-4 lb) with pale yellow to white flesh. Sweet, melting and excellent for eating fresh. Poorly adapted for shipping. Leaves spiny.Grown in Latin America
'Red Spanish': 1–2 kg (2-4 lb), pale yellow flesh with pleasant aroma; squarish in shape. Well adapted for shipping as fresh fruit to distant markets. Leaves spiny. Grown in Latin America
'Smooth Cayenne': 2.5–3 kg (5-6 lb), pale yellow to yellow flesh. Cylindrical in shape and with high sugar and acid content. Well adapted to canning and processing. Leaves without spines. This is the variety from Hawaii, and the most easily obtainable in U.S. grocery stores. Both 73-114 and 73-50 are of this cultivar.


Ethno-medical usage
Both the root and fruit are sometimes eaten or applied topically as an anti-inflammatory and as a proteolytic agent. It is traditionally used as an antihelminthic agent in the Philippines.

Pests and diseases
Pineapples are subject to a variety of diseases, the most serious of which is wilt disease vectored by mealybugs. The mealybugs are generally found on the surface of pineapples, but can also be found inside the closed blossom cups. Other diseases include pink disease, bacterial heart rot, and anthracnose.

Storage and transport

Some buyers prefer green fruit, others ripened or off-green. A plant growth regulator Ethephon is typically sprayed onto the fruit one week before harvest, developing ethylene, which turns the fruit golden yellow. After cleaning and slicing they are typically canned in sugar syrup with added preservative.
For home use, green pineapples will ripen naturally at room temperature, though they can quickly over ripen.

Usage in culture
In some cultures, the pineapple has become associated with the notion of welcome, an association bespoken by the use of pineapple motifs as carved decorations in woodworking.

Pineapple cutter

A pineapple cutter is a hand-held cylindrical kitchen utensil with a circular blade at the end designed for cutting pineapples. A knife is required to remove the top off the pineapple before using the pineapple cutter. The cutter will cut the flesh of the pineapple into a spiral and also removes the core. Different sizes are available so as not to cut into the skin of the pineapple or cause too much to be wasted.
A simpler version known as a pineapple corer removes only the core of the pineapple. These appear identical to the pineapple cutter but do not include the cutting blade.
Nutritional value per 100 g (3.5 oz) Energy 202 kJ (48 kcal) Carbohydrates 12.63 g Sugars 9.26 g Dietary fiber 1.4 g Fat 0.12 g Protein 0.54 g Thiamine (Vit. B1) 0.079 mg (6%) Riboflavin (Vit. B2) 0.031 mg (2%) Niacin (Vit. B3) 0.489 mg (3%) Pantothenic acid (B5) 0.205 mg (4%) Vitamin B6 0.110 mg (8%) Folate (Vit. B9) 15 μg (4%) Vitamin C 36.2 mg (60%) Calcium 13 mg (1%) Iron 0.28 mg (2%) Magnesium 12 mg (3%) Manganese 0.9 mg (45%) Phosphorus 8 mg (1%) Potassium 115 mg (2%) Zinc 0.10 mg (1%)

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Water supply and sanitation in Indonesia

adopted from wikipedia.org

Water supply and sanitation in Indonesia is characterized by poor levels of access and service quality. Over 100 million people in Indonesia lack access to safe water and more than 70 percent of the country’s 220 million population relies on water obtained from potentially contaminated sources. With only 2% access to sewerage in urban areas is one of the lowest in the world among middle-income countries. Pollution is widespread on Bali and Java. Women in Jakarta report spending US$ 11 per month on boiling water, implying a significant burden for the poor.
The Government of Indonesia has stated its commitment to achieving the Millennium Development Goals (MDGs). In order to do so, an estimated 78 million more people will require improved water supply and 73 million improved sanitation services between 2000 and 2015, not to mention necessary improvements in service quality for those already shown as having access. Current levels of investment of only US$2 per capita and year are insufficient to attain the MDGs. Furthermore, policy responsibilities are fragmented between different Ministries and local utilities that operate and maintain urban water systems remain weak.
Since decentralization was introduced in Indonesia in 2001 local governments (districts) have gained responsibility for water supply and sanitation. However, this has so far not translated into an improvement of access or service quality, mainly because devolution of responsibilities has not been followed by adequate fund channelling mechanisms to carry out this responsibility.

Water resources and use
Indonesia has over 5,590 rivers, most of them short and steep. Because of high rainfall intensities most rivers carry large quantities of sediment. Average rainfall is above 2,000 mm on most islands, except for the Lesser Sunda Islands where it is 1,500 mm. 80% of rain falls during the rainy season (October to April). While water resources are quite abundant in Sumatra, Kalimantan, Sulawesi, Maluku and Irian, water shortages occur during the dry season in parts of Java, Bali and the Lesser Sunda Islands. In particular in Java, the dry season flows are inadequate to meet the demand, leading to irrigation shortages. Irrigation accounts for 93% of water use. The total storage capacity amounts to only 5% to 6% of the river flows. Construction of reservoirs is constrained by lack of good reservoir sites, high density of population at possible reservoir sites and expected short reservoir lifetimes due to siltation. Groundwater potential in Indonesia is very limited. However, much of the eastern islands depend on groundwater because of surface water scarcity. Groundwater overxploitation occurs in heavily populated coastal areas of Java, including in Jakarta and Semarang. In Jakarta it has caused seawater intrusion up to 10 km from the coast and land subsidence at a rate of 2–34 cm/year in east Jakarta. In Semarang land subsidence occurs at a rate of 9 cm/year.
Water utilities abstract water from rivers and lakes (60%), springs (25%) and groundwater (15%). For example, the main water source for Jakarta is the Jatiluhur Dam on the Citarum River 70 km southeast of the city. For those who are self-supplied or receive water from community-based organizations, shallow groundwater and springs are by far the main sources of water on most islands. On Sumatra and Irian, however, rainwater harvesting is also an important water source.
Pollution. Domestic sewage, industrial effluents, agricultural runoff, and mismanaged solid waste are polluting surface and groundwater, especially in Java. Indonesia ranks among the worst countries in Asia in sewerage and sanitation coverage. Few Indonesian cities possess even minimal sanitation systems. The absence of an established sanitation network forces many households to rely upon private septic tanks or to dispose of their waste directly into rivers and canals. The commonality of the latter practice, together with the prevalence of polluted shallow wells used for drinking water supply in urban areas, has led to repeated epidemics of gastrointestinal infections.

Access
Data on access to water and sanitation in Indonesia vary significantly depending on the source consulted and the definition of access. According to the Joint Monitoring Program for Water Supply and Sanitation by WHO and UNICEF (see table above) access to an improved water source stood at 80% and access to improved sanitation at 52% in 2008. However, according to Indonesia's 2004 socio-economic survey (SUSENAS) only about 47% of the population has access to water from improved sources considered relatively safe. That includes 42% of the urban and 51% of the rural population. In the 8 years from 1994 to 2002, this figure increased by only 10% in rural areas and 9% in urban areas. At this rate, by 2015, only about 56% of the rural population can be expected to gain access to an improved water sources, when the MDG target for the whole country is 73%.
Access to improved sanitation in rural areas has remained stagnant at around 38% since 1985 according to the Joint Monitoring Program. More than 40% of rural households use unsanitary open pits or defecate in fields, beaches and water bodies. According to the World Bank, urban sanitation is the least well addressed of major policy issues in Indonesia. Poor sanitation in cities and small towns is posing health hazards through pollution of both ground and surface water sources used by urban populations for a variety of purposes. Disposal and treatment of sewage is available for less than 2% of the population.

Service quality
No data are available on the average continuity of water supply in Indonesian cities. However, in Jakarta 92% of users received continuous water supply in 2001.
Concerning drinking water quality, about 30% of the water distributed by water companies in the country is contaminated with E. coli or fecal coliforms and other pathogens. The results of drinking water quality tests are not made public. Most Indonesians do not dare drink water directly from the tap and boil water of buy bottled water, if they can afford it.

Health impact of inadequate water supply and sanitation
Unsafe drinking water is a major cause of diarrhea, which is the second leading killer of children under five in the country and accounts for about 20% of child deaths each year. Every year, at least 300 out of 1,000 Indonesians suffer from water-borne diseases, including cholera, dysentery, and typhoid fever, according to the Ministry of Health.
Economic losses due to inadequate sanitation alone were estimated at 2.4% of GDP in 2002. Significant damage to the country's future potential in terms of infant mortality and child malnutrition in low-income areas of Indonesia is greatly associated with inadequate access to safe water and basic sanitation.
Household-level drinking water treatment
People in Jakarta spend significant resources on boiling water to make it drinkable. Indonesian women report spending more than 100,000 rupiahs or 11 US dollars a month on kerosene for boiling water. However, a new system to treat drinking water at the household level without boiling has cut down on these costs and reduces health risks among women and children.
The system, called “Air RahMat” or “gift water,” is produced by a private-public partnership called Aman Tirta. Members of Aman Tirta include the Johns Hopkins University Center for Communication Programmes and CARE International Indonesia. The brand name refers to a liquid 1.25% sodium hypochlorite (bleach) solution which is effective in deactivating micro-organisms such as E. coli in water. The solution is originally developed as part of the Safe Water Systems program of the U.S.-based Centers for Disease Control and Prevention. When used correctly in conjunction with proper storage, the water treatment solution has been shown to reduce the risk of diarrhea up to 85%. Air Rahmat is also able to protect water for two to three days from recontamination. The solution is easy to use by adding three milliliters of Air Rahmat for every 20 liters of water, shaking or stirring for 30 seconds, and waiting for at least 30 minutes until the water is ready to drink.

Responsibility for water and sanitation
Policy and regulation
Policy and regulatory responsibilities for the water and sanitation sector are shared among several ministries. While the Ministry of Health is responsible for water quality-related aspects, and to a certain extent rural services, responsibility for the urban sector is shared between the Ministry of Home Affairs and the Ministry of Public Works. The National Development Planning Agency (Bappenas) has a role in planning investments. The Ministry of Industry and Trade also has some responsibilities for the regulation of bottled water. A National Water Supply and Environmental Sanitation Working Group (Pokja AMPL) coordinates between departments and with donors and other stakeholders. The working group does not have a legal basis, nor secure funding.
Most strategies for the sector are being created at the national level. Capacity problems, funding constraints and political factors at the sub-national level often mean national strategies are not well implemented. Furthermore, law enforcement is weak, especially for environmental sanitation. In 2008 the Health Ministry launched a National Strategy for Community-Led Total Sanitation, emphasizing peer pressure and shame as drivers for rural sanitation instead of public investment. The Government’s National Program for Community Empowerment (PNPM—Program Nasional Pemberdayaan Masyarakat) also has the potential to improve water and sanitation services through block grants, technical assistance and training to communities. However, similar programs have in the past only allocated around five per cent of funds to water and sanitation.
Legal framework. Relevant laws include Law No. 7/2004 on water resources; Law No. 22/1999 on local government; Law No.32/2004 on Regional Government; and Law No.33/2004 on Fiscal Balance between the Center and the Regions. The water resource law aims at integrated and sustainable water resources management and clarifies the responsibilities of the central government as well as provincial and district governments in terms of water resources management, such as the granting of water abstraction licenses. The local government law was a landmark in terms of decentralization in Indonesia after the fall of Suharto, making the previous rhetorical commitment to decentralization a reality by transferring all powers except certain specifically enumerated powers to local government.The fiscal balance law greatly increased the revenue base for local government.Relevant implementing regulations include Government Act No.16/2005 "on the development of the water supply system", which allows private sector participation in water supply; two decrees by the Ministry of Public Works from 2006 and 2007 to establish a National Water Board; and the Ministry of Home Affairs Decree No. 23/2006 on guidelines for water tariff setting. The latter stipulates that tariffs should fully recover costs including a rate of return of 10 percent. The decree No.47/1999 of the Ministry of Home Affairs on guidelines for evaluating the performance of water service providers (benchmarking) has now lost some of its teeth because of the subsequent decentralization policy. Decrees by the Ministry of Health as well as the Ministry of Industry and Trade regulate the quality of bottled water, as well as for water kiosks that refill large water bottles.

Service provision
Urban areas
The provision of water services in urban areas is the responsibility of PDAMs (Perusahaan Daerah Air Minum), Local Government Owned Water Utilities. There are 319 PDAMs in Indonesia. Two (Jakarta and North Sumatra) operate at provincial government level. All others operate at district government level, meaning at the level of a regency (of which there are 349) or a city (of which there are 91) (see List of regencies and cities of Indonesia) Most PDAM are very small, with less than 10 000 connections: only four per cent have more than 50 000 connections. Institutional responsibility for wastewater and sewerage is at the district government level; departmental responsibility varies between districts. Very few urban utilities provide sanitation services. Sanitation utilities are called PD-PAL or Local Government Owned Wastewater Utilities.
Utilities are associated in Perpamsi, the national association of water utilities. In 2002 it initiated a performance benchmarking program with support from the World Bank. The data base currently contains 80 Water Utilities (PDAM) in Indonesia, including most of the larger ones.

Rural areas
Rural Indonesia has a long history of community-managed water supply services using naturally occurring springs, rainwater and groundwater sources. However, community capacities to sustain such water systems over long periods have tended to be limited. Past rural water supply and sanitation projects have often not invested sufficiently in building community capacity to plan, implement, operate and maintain services in ways that benefit and satisfy all sections of rural societies, conditions necessary for service sustainability. Rural consumers have not consistently been offered voice and choice in decisions related to establishing and managing services and paying for them. Services have often been provided in a top-down manner by agencies external to the community, using public sector or donor funds and contractors answerable to government agencies rather than to the users of services. This has led to mismatches between what the users want and get, a lack of community ownership of rural water supply and sanitation facilities and unclear responsibilities for maintenance.
In 2003 the government endorsed, but did not adopt a National Policy for the Development of Community-Managed Water Supply and Environmental Sanitation Facilities and Services that provides a road map for sector reform, by:
• Changing the policy goals for the sector, from achieving "coverage targets" counted in terms of construction of systems facilities, to the twin goals of sustainability and effective use of water supply and sanitation services;
• Espousing strategies such as empowerment of communities to choose, co-finance, construct and manage and own their water systems;
• Requiring the use of gender-and poverty-sensitive approaches in working with and empowering user communities to ensure poverty targeting and impact on local poverty;
• Building stakeholders' understanding at all levels concerning service sustainability;
• Measuring success in terms of sustained population access to services, and effective use of those services, i.e. hygienic and health - promoting use of services by all sections of communities and improved sanitation and hygiene behaviors among various age-sex groups of the population.
The community participation and cost recovery under the new approach has led to greater sustainability of services. For example, an evaluation of a Rural Water Supply and Sanitation Project supported by the Asian Development Bank that did not yet use the new approach revealed that less than four years after project completion, only 30 per cent of the water supply facilities and 30 per cent of sanitation facilities constructed by the project were still functioning. However, according to a Ministry of Health report that reviewed the functionality of water infrastructure in five districts that had implemented the World Bank-supported WSLIC project from 2001 to 2006, the average functionality of public taps was 72 per cent. The significant differences in functionality between the ADB and WSLIC activities has been largely attributed to the participation of communities in the construction of infrastructure and the communities recovering monthly fees to cover maintenance costs of water and sanitation systems.
However, in peri-urban areas or rural areas that are increasingly absorbed in urban conglomerations, community management alone may not be an adequate arrangement. According to the World Bank, newer models of support and responsibility sharing between user communities and local governments or local private sector agencies are needed.

Civil society
Civil society groups, both local and international, play a vital role in the sector. Some are implementing water and sanitation programs in districts that have not yet received any form of government support in the sector. Despite their diversity, most are harmonised in their approach. Very few, however, work through government systems. Other civil society groups, including religious leaders in village communities, play a significant role in the success of community-based approaches. Religious leaders support community cohesion and influence and encourage clean and healthy behaviours to complement water and sanitation infrastructure..

History and recent developments
The first water utilities in Indonesia, called PDAM after their Indonesian acronym, were set up during the colonial period at the beginning of the 20th century. Following independence in 1945 they became part of local government. In the 1970s the central government became more involved in their financing and management. In 1987 a government act nominally handed water supply back to local governments, but in reality central government remained very involved. Only after the fall of Suharto in 1998 a serious effort at decentralization was made with the local government law of 1999 that effectively handed over responsibility for water supply to local governments.
Jakarta privatization. In June 1997 two 25-year water concessions were awarded without bidding to serve the city of Jakarta beginning in February 1998. A subsidiary of The French firm Ondeo (now Suez), called Palyja, was awarded the concession for the western part of the city and a subsidiary of the British firm Thames Water International called TPJ was awarded a concession for the eastern part.
Policy for rural water supply and sanitation. In 2003 the government adopted a National Policy for the Development of Community-Managed Water Supply and Environmental Sanitation Facilities and Services that provides a clear route map for sector reform (for details see above).

Efficiency
Non-revenue water (NRW) in Indonesia’s best utilities stands at only 20%, while the worst quartile of utilities participating in Perpamsi’s benchmarking exercise have NRW of 43%. However, NRW data is generally unreliable as many PDAMs do not have meters installed to accurately measure NRW. In terms of labor productivity, the best performing utilities have a staff ratio of 4 per 1000 connections, while utilities in the worst quartile have more than 9 staff per 1000 connections. Labor productivity for water utilities is considered to be at acceptable levels if it is below 5 per 1000 connections. In Jakarta the level of non-revenue water was 51% in 2001, one of the highest levels in Indonesia. However, in terms of labor productivity the two utilities in Jakarta fare relatively well with only 5.3 employees per 1000 connections.

Cost recovery and tariffs
The Ministry of Home Affairs Decree No. 23/2006 sets out a policy of full cost recovery through tariff revenues for water utilities. The decree prescribes an increasing-block water tariff with a first subsidized tariff block for a consumption of up to 10 cubic meters per household, and a break-even tariff for higher consumption. Commercial and industrial users can be charged higher tariffs with higher blocks at the full-cost tariff. However, in reality, few utilities recover their costs. According to a 2005 study by the Department of Public Works, most PDAMs faced financial problems. Only about a third increased tariffs between 1998 and 2005. One third of utilities had foreign debt, whose value in local currency increased substantially due to the devaluation of the rupeeh in the 1998 financial crisis. Many PDAMs defaulted on loans they had received from the Ministry of Finance. As of 2009 renegotiation of these loans (principal, interest and penalties) was still underway, thus cutting off the utilities from new government loans
According to the Asian Development Bank, in Jakarta the average tariff in 2001 (average of residential and commercial users) was US$ 0.29/m3, compared to production costs estimated at only US$ 0.11/m3. 98% of revenues billed were collected. According to these figures, at least the Jakarta utility managed to recover its costs. Since then tariffs have been increased several times and, according to the International Benchmarking Network for Water and Sanitation Utilities, reached US$ 0.77/m3.
As in many other countries, those not connected to water supply networks pay the most for water. A survey in North Jakarta found the price of water in the early 1990s was $2.62/m3 for vendor customers, $1.26/m3 for standpipe customers, $1.08/m3 for household resales customers, and only $0.18/m3 for connected households.

Investment and Financing
The water and sanitation sector is not given a high priority at the national or sub-national level, partly because of competing priorities from other sectors such as health and education. Few local governments use their own resources to implement water and sanitation activities and when given funding through open-menu infrastructure programs, local governments and communities rarely choose water and sanitation as the main activity. Most funding for the sector comes from the national level and the level of sub-national funding is often hidden as it occurs in several government departments. Funding estimates for the sector in 2008 were around one to two per cent of local government budgets.
Public investment. Total infrastructure spending in Indonesia was 55 trillion Rupiah in 2005 (US$ 5.7 billion). These expenditures were financed mainly by the local (23 trillion Rupiah) and central government (also 23 million Rupiah), followed by the provincial government (9 million Rupiah).
While it is not entirely clear how much of this sum has been invested in water supply and sanitation, the ADB estimates that only US$ 124m per year (average of 2004-2005) from the regular national budget were allocated to water supply and sanitation.
Since decentralization in the year 2001, local Governments have typically invested less than 2% of their annual budgets on water supply, even less on sanitation and almost nothing on improving hygiene practices. Assuming that 2% of local government (provincial and district) budgets are spent on water and sanitation, local government investments in water and sanitation were 3.6 trillion Rupiah or US$375m or about three times higher than the US$124m financed through the central budget. Total investments thus can be very tentatively estimated at about US$500m, or slightly more than what has been estimated by one source as the required investments to meet the MDGs, or US$450 million per year At about US$2 per capita and year these investments still remain far lower than investments in water and sanitation in other middle-income countries.
The economic crisis of the late 1990s had severely curtailed investment in infrastructure. Central government spending on development dropped from US$14 billion in 1994 to US$5 billion in 2002, within which the share of infrastructure spending further declined from 57 to 30% over the same period. Moreover, according to the World Bank, poor institutional and regulatory frameworks and rampant corruption in the infrastructure sector, which were prevalent even before the crisis, continued without serious sector reform efforts by the government until today.
Utility financing. Loan financing to PDAMs faces numerous challenges. For example, the Ministry of Finance requires its loans to be channeled through regional governments whose legislatures have to pledge future central government transfers as collateral. Since regional legislatures are reluctant to do so, central government lending to utilities is not likely to re-emerge even after the issue of old debt would be settled. Two efforts at promoting the issuing of corporate bonds by creditworthy utilities, one supported by partial guarantees by USAID and the other by KfW, have failed "because of the risk-averse culture which is so pervasive in Indonesian central and regional governments", according to a USAID report. Under a 2009 Presidential decree, however, state banks can provide partial credit guarantees of 70% of loans to creditworthy PDAMs plus an interest subsidy. As for direct lending by the Ministry of Finance, regional governments have to provide partial guarantees for these loans, which they are reluctant to provide.
Thus PDAMs are likely to be limited in their access to finance largely to grants, which are scarce. In 2009 there were three primary sources of national government grant funding for water supply:
• Matching grants (hibah) to regional governments. Water supply is expected to receive Rp 3 trillion of hibah from the national budget between 2010 and 2014, complemented by funds from external donors.
• a Special Allocations Fund (DAK), which accounted for 2.4% of the national budget in 2009, of which about 5% were directed towards the water supply sector, especially village community-based systems.
• Grants by the Ministry of Public Works for raw water supply and treatment.
Microfinance. Bank Negara Indonesia provides small loans to community-based organizations (CBOs) engaged in water supply in Java. The pilot project is part of a national program called Kredit Usaha Rakyat that provides loans for community and small scale enterprises. The World Bank's Water and Sanitation Program in collaboration with the AusAID-funded Indonesia Infrastructure Initiative (INDII), the Ministry of Public Works, and Directorate of Public Private Partnership Development of the National Development Planning Agency provide technical assistance to the CBOs.

External cooperation
External support to the water and sanitation sector in Indonesia is provided through multilateral (World Bank, Asiand Development Bank and UN) as well as bilateral cooperation with individual countries. Most external partners have focused their cooperation on rural areas, or work exclusively there. Most of the support for urban areas comes from Japan, the Netherlands and the United States.

Multilateral cooperation
Asian Development Bank. The Community Water Services and Health Project, approved in 2005, aimed at providing clean water and sanitation facilities to about 1,500 communities of rural Indonesia, including tsunami-affected areas. The Directorate General of Communicable Disease Control and Environmental Health of the Ministry of Health is the executing agency of the project
UNICEF. UNICEF supports the Indonesian government in developing and implementing strategies that improve drinking water and sanitation conditions across the country. UNICEF also assists the government in improving relevant planning mechanisms, monitoring systems and databases.
World Bank. The World Bank's Third Water Supply and Sanitation for Low Income communities Project, approved in 2006, aims to increase the number of low-income rural and peri-urban populations accessing improved water and sanitation facilities and practicing improved hygiene behaviors. The project supports community driven development (CDD) planning and management of water, sanitation and hygiene improvement programs, builds stakeholder commitment and aims to expand the capacity of central, provincial and district government agencies. It provides participating communities with a menu of technical options for rural water supply and public sanitation infrastructure. The project is implemented by the Ministry of Health.

Bilateral cooperation
Australia. Australia has supported efforts to improve rural water supply and sanitation in Indonesia, particularly Eastern Indonesia, for almost 30 years. AusAID's support is in the form of grants for technical assistance to the Water Supply and Sanitation Policy Formulation and Action Planning Project (WASPOLA) of the World Bank's Water and Sanitation Program (WSP), as well as to the Second Water and Sanitation for Low-Income Communities program (WSLIC2), also funded mainly by the World Bank. A 2009 evaluation by the Australian government concluded that Australian aid to the water sector "has been strategic, flexible and appropriate" and has assisted in "providing sustainable piped-water supply to some 4.6 million people and has dramatically improved sector coordination at national and sub national levels." The evaluation also noted that there has been much less focus on sanitation, although the Government has begun to replicate the innovative Community-Led Total Sanitation approach in an attempt to achieve open defecation free (ODF) communities. The report also noted that a "national working group established through WASPOLA has strengthened government capacity in research, communications, marketing and public relations", but that these approaches are less well integrated at the sub-national level. It also notes that "despite its relatively low funding for this sector compared to that of some other donors and multilateral agencies, Australia is seen as a lead donor." It also notes that AusAID-supported technical assistance has "relied heavily on external consultants and have not built enough technical capacity into government to ensure sustainability." Female participation at the local level was mandatory in the project, but once project handover occurred women’s participation often dropped. The community-managed approach "enhanced transparency and accountability", but districts are not using this model in their own projects due to lack of capacity and political will.

Canada. CARE Canada and the Canadian International Development Agency (CIDA) support the CARE-Sulawesi Rural Community Development Project (SRCD). CARE uses the "community management approach", by which communities are heavily involved right from the very beginning, from the design through construction, implementation, operation and maintenance. The approach works by establishing a village water committee and a series of sub-committees: for example, sanitation, construction and finance. The village itself decides how it will raise the amount of money needed for its contribution to the project. This is usually done by monthly levy whereby each family contributes a small amount of money over the course of four to six months. The village construction committee also organizes the labour to install the system. All the labour is done manually without the use of heavy machinery, which means a low environmental impact and lower cost. With water close at hand, most households are also building their own simple latrines.
The Netherlands. The public Dutch water company Water Supply Company Drenthe (WMD) and Dutch development aid support various water companies in Eastern Indonesia. Joint venture contracts have been concluded with four companies (Ambon, Bacau (Maluku), Biak, Sorong (Irian Jaya/Papua). Negotiations are going on with seven other companies in North Sulawesi, Maluku and Papua. The WMD has reserved 3.4 million euros for the project.

United States. Since early 2005 USAID has provided technical assistance to water utilities (PDAMs) in Java and Sumatra on issues related to full cost recovery tariffs and improved technical operation, with the objective of improving their creditworthiness and ability to borrow to meet network expansion needs. USAID is also looking at ways to use its partial credit guarantee mechanism to further increase local water utilities’ access to commercial financing.

READ MORE - Water supply and sanitation in Indonesia

BUGS: THE NATURAL WAY TO KEEP THEM AT BAY

Adopted from : Botanical.com

Andrea Candee, MH, MSC
Bugs! Do I respect them as part of Nature’s miraculous design…yes. Do I like them…not really. Despite daily intake of supplements reputed to be bug deterrents (i.e. garlic, B vitamins), many of us are still sweet meat for the little critters. Acknowledging the skin’s ability to absorb substances into the bloodstream (modern medicine’s example of this biological fact is the invention of skin patches for delivering pharmaceutical drugs into the body) encourages us to seek out natural alternatives to chemical insect repellants.

Ticks and Lyme Disease
Dogs and cats are often the carriers of Lyme infected ticks. To fully protect one’s self and family from being bitten, the family pet must also be protected. A successful program for preventing any tick from attaching itself to your pet includes garlic powder and brewers yeast sprinkled liberally on their food every day (found in a convenient powdered combination in health food stores) and oil of eucalyptus. The essential oil of eucalyptus, derived from the leaf of the tree, contains naturally occurring chemicals repellent to ticks and fleas. A most effective method is to dip a thin rope into the undiluted oil, wrap it in a bandanna and tie it around your pet’s neck (fashionable, as well). The rope can be refreshed twice a week or more often, if necessary. The oil is quite potent and should not be applied directly to the skin as it may cause irritation. Mixing 1oz oil of eucalyptus into one pint of water in a spray bottle also enables you to spray your pet’s coat on a daily basis. But why save all the good protection for your pets? Before gardening or hiking, scent yourself with “eau de eucalyptus.” The oil/water combination can be sprayed on skin and/or clothing before an outdoor excursion, gardening, or romp in the grass. Eucalyptus diluted in a vegetable oil (e.g. almond, sesame, sunflower) can safely be applied to the skin for longer lasting protection.

Mosquitoes and black fly take wing!
Dilute 1oz essential oil of pennyroyal in 16oz vegetable oil to effectively repel mosquitoes. Keep a vial of this dilution with you when headed for a picnic, swing in the hammock or anywhere mosquitoes hang out. Oil of Pennyroyal has protected campers in the swampiest of areas by directly applying the dilution to exposed areas of skin. (Note: you may have difficulty locating oil of pennyroyal. It can be purchased from the website below.)
Black flies ruining a relaxing day in the park? Check out the surrounding area for aromatic evergreen trees, break off a branch, mash it with a rock and apply to arms and legs. The released essential oils will repel those bothersome bugs. The essential oil of lavender, which CAN be applied directly on the skin, can also repel black flies.

Don’t be the local attraction for stinging insects.
Bees, wasps, and yellow jackets are attracted by sweet smells and bright colors. If you don’t want them to think you are a delectable flower to explore, avoid wearing perfumes and scented hair and body care products, as well as brightly colored clothing. Neutral colors such as tan and white are least likely to attract unwelcome visitors. Cover sugary food and drink at picnic sites.
The easiest, most non-invasive way to remove embedded stingers or body parts of insects (splinters and thorns, too!) is to tape on an over-ripe banana peel (pulp side facing skin), overnight. The enzymes in the banana will painlessly draw to the surface any foreign object.

Stopping the itch and swelling.
If you ventured out into the great outdoors without protection and got bitten or stung, safe, non-chemical solutions can prevail. The oil of a vitamin E capsule punctured with a pin and applied to a bee sting can relieve pain and swelling. A juicy slice of onion rubbed on or taped into place will relieve the itch and swelling of an insect bite.
The common weed, plaintain, when mashed with a rock or chewed to break down its capillary walls (only chew if you are certain it has not been chemically treated) and poulticed (affixed) directly on the affected area, pulls out the toxins of an insect sting or bite and relieves swelling. A paste of baking soda and water or mud and water will calm the area. It all depends upon where you are and what’s available. Usually, what you need is right at hand. You just need to be able to recognize its healing benefits. Keep in mind that more than one application may be necessary so use what is convenient for the moment and follow up a few more times that day with what seems to provide the most comfort.

House moths, the unwelcome guests.
Those bothersome moths moved right into your clothes closets and food pantry without invitation - or did you unwittingly invite them? Residues of odors and stains on clothing attract moths to your closets. Open bags of cereals, grains and flours are comparable to putting out the welcome mat. The easiest way to deal with the food items is to refrigerate them during summer months. Clean clothing before storing. Additional protection can be provided by placing muslin bags in your closets filled with combinations of dried, aromatic herbs and essential oils such as tansy, peppermint, rosemary, eucalyptus, cedar, sage, thyme, cinnamon and clove.

Keeping houseplants bug-free.
Infected houseplants often respond well to a strained spray of water blended with a few fresh cloves of garlic. The eucalyptus/water spray described above can also be applied to houseplants.
In centuries past, aromatic herbs were strewn on the floors of homes to repel insects. Instead, branches of herbs can be hung in doorways, arranged creatively in containers or crumbled into potpourris creating pleasant pest-repellent aromas. Essential oils can waft throughout the home in electric or candle diffusers. Cotton balls infused with essential oils can be strategically placed.
Let us peacefully co-exist with the insect world without polluting ourselves and our fragile environment by using Nature’s bountiful gifts.

Copyright Andrea Candee
All rights reserved

Andrea Candee, MH, MSC, is a master herbalist with a consultation practice in South Salem, NY. She lectures throughout the country for schools and corporate wellness centers about taking charge of your health naturally. Her book, Gentle Healing for Baby and Child (Simon & Schuster), was awarded The Seal of Approval by The National Parenting Center. She may be contacted through her website, www.AndreaCandee.com or by mail at PO Box 171, South Salem, NY 10590.

READ MORE - BUGS: THE NATURAL WAY TO KEEP THEM AT BAY

Hair Loss

Hair Loss Overview

The loss of hair (alopecia) is a natural phenomenon in all hair-baring animals that normally occurs during the hair growth cycle. It is estimated that most individuals (assuming they have a full head of hair) lose about 100 scalp hairs over a 24-hour period. Hair loss can become a cosmetic problem when it occurs in the wrong place at the wrong time in the wrong individual. True hair loss should be distinguished from damage to the hair shaft, which may cause breakage close to the scalp. This sort of damage is most often caused by exogenous chemicals used to alter the physical characteristics of the hair shaft (hair dye, etc.), but certain genetic diseases can alter its strength and durability.

* Physicians divide cosmetically significant hair loss into two categories.


1. Scarring alopecia: This sort of irreversible hair loss is characterized by damage to the underlying skin which results in scarring that destroys the hair follicle and its potential for regeneration. A simple visual examination is usually sufficient to diagnose this problem, although occasionally a biopsy may be necessary. Certain skin diseases as well as physical trauma produce this sort of damage.

2. Non-scarring alopecia: This potentially reversible type of hair loss is very common and can be due to many causes, including certain diseases, drugs, aging, diet, as well as a genetic predisposition for hair loss called androgenetic alopecia (common balding).

* There are three cycles of hair growth: growing (80% of follicles), resting, and shedding. In human hair, each follicle cycles at its own individual rate as opposed to most animals, where these cycles change with the season, and all hairs are in the same part of the cycle at the same time. This is why animals grow a thicker coat in the fall and shed most in the spring and why human beings do not shed.


o Unlike most animals, in humans, each hair has its own pattern of growing, resting, and shedding.


+ Each person sheds hair and regrows hair every day.


+ When this balance is disturbed and more hairs are shed than are regrown, alopecia or hair loss results.

Hair Loss Causes

* Common causes of hair loss


o Male-pattern baldness, a non-scarring alopecia (androgenetic alopecia), is genetically determined. In afflicted postpubertal individuals, hair follicles in the center of the scalp and over the temple begin to miniaturize, producing small, fine hairs which are difficult to see. This process is due to the metabolism of testosterone by an enzyme in the hair follicle. Generally, hair follicles over the ears and around the posterior of the scalp do not possess this enzyme so a fringe of normal hair is maintained.


o Female-pattern baldness is very similar to its male counterpart although it is rarely as complete, more diffuse, and often a frontal hairline is maintained.


o Alopecia areata, a non-scarring alopecia, is thought to be an autoimmune disease and is characterized by distinct, localized, sharply marginated areas of hair loss. This characteristically spontaneously remits but occasionally can result in the loss of 100% of all body hair.


o Medications such as allopurinol (Zyloprim) and warfarin (Coumadin)


o Poor nutrition


* Uncommon causes of alopecia


o Infections such as syphilis and fungal infections


o Skin diseases such as lupus and lichen planus


o Skin cancers


o Hormone problems


o Kidney failure


o Liver failure


o Thyroid disease


Hair Loss Symptoms and Signs

* Most people notice hair loss when looking at themselves in a mirror or when it is brought to their attention by others.


* You may also find many hairs on your pillow in the morning or in your hairbrush or comb.


* A woman may notice a decrease in the size of her ponytail or the widening of her part.

Hair Loss Treatment

If hair loss is caused by an illness, treatment of the illness is the best treatment for hair loss. The decision to treat androgenetic alopecia depends upon its emotional effect on the patient's sense of well-being. Many different therapies to stop hair loss and to regrow hair are promoted; you should discuss these options with your physician to establish their validity.

Treatment options include grooming techniques, wigs and hairpieces, medications, and surgery.

* Styling hair to cover the areas with the most hair loss is effective for mild cases. Washing and styling the hair will not cause further hair loss.


* For more severe hair loss, wigs and hairpieces can provide good results if you are willing to try them. Either of these options can be used in combination with medications or surgery if the results of styling or the hairpiece alone are not satisfying.

Medical Treatment

Androgenetic alopecia

* Finasteride (Propecia): a pill taken once daily that blocks the activity of an enzyme that metabolizes testosterone to substance that inhibits hair growth. Any regrowth is not permanent. Finasteride is not currently used for the treatment of hair loss in women.


* Minoxidil (Rogaine, Loniten): A medication you rub directly onto your scalp. This medication enlarges hairs and makes them grow for a longer period.


o It works for both men and women.


o It works best for balding at the top and back of the head and less well for the front area of the scalp.


o Stopping this medication can result in loss of the hair that developed during its use.

Alopecia areata

Intralesional injection of steroids directly into the areas of involved skin can mitigate the hair loss for a short period of time.

Hair Loss Prevention

Prevention can be accomplished only by early treatment. Sometimes what you think may be hair loss is actually just hair breakage from overuse of hair dryers, curling irons, dyes, and styling products.

READ MORE - Hair Loss

Gallstones

Gallstones Overview

Gallstones (commonly misspelled gall stones or gall stone) are solid particles that form from bile in the gallbladder.

* The gallbladder is a small saclike organ in the upper right part of the abdomen. It is located under the liver, just below the front rib cage on the right side.

* The gallbladder is part of the biliary system, which includes the liver and the pancreas.

* The biliary system, among other functions, produces bile and digestive enzymes.

Bile is a fluid made by the liver to help in the digestion of fats.

* It contains several different substances, including cholesterol and bilirubin, a waste product of normal breakdown of blood cells in the liver.

* Bile is stored in the gallbladder until needed.

* When we eat a high-fat, high-cholesterol meal, the gallbladder contracts and injects bile into the small intestine via a small tube called the common bile duct. The bile then assists in the digestive process.

There are two types of gallstones: 1) cholesterol stones and 2) pigment stones.

1. Patients with cholesterol stones are more common in the United States; cholesterol stones make up approximately 80% of all gallstones. They form when there is too much cholesterol in the bile.

2. Pigment stones form when there is excess bilirubin in the bile.

Gallstones can be any size, from tiny as a grain of sand to large as a golf ball.

* Although it is common to have many smaller stones, a single larger stone or any combination of sizes is possible.

* If stones are very small, they may form a sludge or slurry.

* Whether gallstones cause symptoms depends partly on their size and their number, although no combination of number and size can predict whether symptoms will occur or the severity of the symptoms.

Gallstones within the gallbladder often cause no problems. If there are many or they are large, they may cause pain when the gallbladder responds to a fatty meal. They also may cause problems if they move out of the gallbladder.

* If their movement leads to blockage of any of the ducts connecting the gallbladder, liver, or pancreas with the intestine, serious complications may result.

* Blockage of a duct can cause bile or digestive enzymes to be trapped in the duct.

* This can cause inflammation and ultimately severe pain, infection, and organ damage.

* If these conditions go untreated, they can even cause death.

Up to 20% of adults in the United States may have gallstones, yet only 1% to 3% develop symptoms.

* Hispanics, Native Americans, and Caucasians of Northern European descent are most likely to be at risk for gallstones. African Americans are at lower risk.

* Gallstones are most common among overweight, middle-aged women, but the elderly and men are more likely to experience more serious complications from gallstones.

* Women who have been pregnant are more likely to develop gallstones. The same is true for women taking birth control pills or on hormone/estrogen therapy as this can mimic pregnancy in terms of hormone levels.

Gallstones Causes

Gallstones occur when bile forms solid particles (stones) in the gallbladder.

* The stones form when the amount of cholesterol or bilirubin in the bile is high.

* Other substances in the bile may promote the formation of stones.

* Pigment stones form most often in people with liver disease or blood disease, who have high levels of bilirubin.

* Poor muscle tone may keep the gallbladder from emptying completely. The presence of residual bile may promote the formation of gallstones.

Risk factors for the formation of cholesterol gallstones include the following:

* female gender,

* being overweight,

* losing a lot of weight quickly on a "crash" or starvation diet, or

* taking certain medications such as birth control pills or cholesterol lowering drugs.

Gallstones are the most common cause of gallbladder disease.

* As the stones mix with liquid bile, they can block the outflow of bile from the gallbladder. They can also block the outflow of digestive enzymes from the pancreas.

* If the blockage persists, these organs can become inflamed. Inflammation of the gallbladder is called cholecystitis. Inflammation of the pancreas is called pancreatitis.

* Contraction of the blocked gallbladder causes increased pressure, swelling, and, at times, infection of the gallbladder.

When the gallbladder or gallbladder ducts become inflamed or infected as the result of stones, the pancreas frequently becomes inflamed too.

* This inflammation can cause destruction of the pancreas, resulting in severe abdominal pain.

* Untreated gallstone disease can become life-threatening, particularly if the gallbladder becomes infected or if the pancreas becomes severely inflamed.

Gallstones and Diet

The role of diet in the formation of gallstones is not clear.

* We do know that anything that increases the level of cholesterol in the blood increases the risk of gallstones.

* It is reasonable to assume that a diet with large amounts of cholesterol and other fats increases the risk of gallstones, but it is also important to remember that the amount of cholesterol in your bile has no relationship to your blood cholesterol.

* Loosing weight rapidly seems to increase the risk of gallstones and so does skipping meals.

* Obesity is a risk factor for gallstones.

* Eating a fatty or greasy meal can precipitate the symptoms of gallstones.

Gallstones Symptoms

Most people with gallstones (60% to 80%) have no symptoms. In fact, they are usually unaware that they have gallstones unless symptoms occur. These "silent gallstones" usually require no treatment.

Symptoms usually occur as complications develop. The most common symptom is pain in the right upper part of the abdomen. Because the pain comes in episodes, it is often referred to as an "attack."

* Attacks may occur every few days, weeks, or months; they may even be separated by years.

* The pain usually starts within 30 minutes after a fatty or greasy meal.

* The pain is usually severe, dull, and constant, and can last from one to five hours.

* It may radiate to the right shoulder or back.

* It occurs frequently at night and may awaken the person from sleep.

* The pain may make the person want to move around to seek relief, but many patients prefer to lay still and wait for the attack to subside.

Other common symptoms of gallstones include the following:

* nausea and vomiting,

* fever,

* indigestion, belching, bloating,

* intolerance for fatty or greasy foods, and

* jaundice (yellowing of the skin or the whites of the eyes).

Gallstones Treatment

Self-Care at Home

After a diagnosis of gallstones, the patient may choose not to have surgery or may not be able to have surgery right away. There are measures the patient can take to relieve the symptoms to include:

* intake of only clear liquids to give the gallbladder a rest,

* avoid fatty or greasy meals, and

* take acetaminophen (Tylenol, etc.) for pain.

Call a health care practitioner if symptoms worsen or if new symptoms appear. Abdominal pain with vomiting, fever, or jaundice warrants an immediate visit to a doctor's office or a hospital emergency department.

Gallstone Medical Treatment

There is no permanent medical cure for gallstones. Although there are medical measures that can be taken to remove stones or relive symptoms, they are only temporary. If a patient has symptoms from gallstones, surgical removal of the gallbladder is the best treatment. Asymptomatic (producing no symptoms) gallstones do not require treatment.

Extracorporeal shockwave lithotripsy (ESWL): A device that generates shock waves is used to break gallstones up into tiny pieces.

* These tiny pieces can pass through the biliary system without causing blockages.

* This is usually done in conjunction with ERCP to remove some stones.

* Many people who undergo this treatment suffer attacks of intense pain in the right upper part of the abdomen after treatment.

* The effectiveness of ESWL in treating gallstones has not been fully established.

Dissolving stones: Drugs made from bile acids are used to dissolve the gallstones.

* It may take months or even years for the gallstones to all dissolve.

* The stones often come back after this treatment.

* These drugs work best for cholesterol stones.

* They cause mild diarrhea in many people.

* This treatment is usually offered only to people who are not able to have surgery.

If an individual goes to an emergency department, an IV line may be started, and pain medication and antibiotics may be given through the IV.

If the patient's health permits it, the health care practitioner will probably recommend surgery to remove the gallbladder and the stones. Surgical removal helps prevent future episodes of abdominal pain and more dangerous complications such as inflammation of the pancreas and infection of the gallbladder and liver.

* If there is no infection or inflammation of the pancreas, the operation to remove the gallbladder can be performed immediately or within the next several days.

* If there is inflammation of the pancreas or infection of the gallbladder, the patient will most likely be admitted to the hospital to receive IV fluid and possibly IV antibiotics for several days prior to the operation.

Gallstone Prevention Diet

A low-fat, low-cholesterol diet can prevent symptoms of gallstones but cannot prevent formation of stones. It is not known why some people form stones and others do not.

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Kidney Stones

Kidney Stones Overview
The kidney acts as a filter for blood, removing waste products from the body and making urine. It also helps regulate electrolyte levels that are important for body function. Urine drains from the kidney through a narrow tube called the ureter into the bladder. When the bladder fills and there is an urge to urinate, the bladder empties to the outside through the urethra, a much wider tube than the ureter.
In some people, chemicals crystallize in the urine and form the beginning, or nidus, of a kidney stone. These stones are very tiny when they form, smaller than a grain of sand, but gradually can grow over time to 1/10 of an inch or larger. Urolithiasis is the term that refers to the presence of stones in the urinary tract, while nephrolithiasis refers to kidney stones and ureterolithiasis refers to stones lodged in the ureter. The size of the stone doesn't matter as much as where it is located and whether it obstructs or prevents urine from draining.
When the stone sits in the kidney, it rarely causes problems, but when it falls into the ureter, it acts like a dam. As the kidney continues to function and make urine, pressure builds up behind the stone and causes the kidney to swell. This pressure is what causes the pain of a kidney stone, but it also helps push the stone along the course of the ureter. When the stone enters the bladder, the obstruction in the ureter is relieved and the symptoms of a kidney stone are resolved.

Kidney Stones Causes

There is no consensus as to why kidney stones form.

* Heredity: Some people are more susceptible to forming kidney stones, and heredity may play a role. The majority of kidney stones are made of calcium, and hypercalciuria (high levels of calcium in the urine) is a risk factor. The predisposition to high levels of calcium in the urine may be passed on from generation to generation. Some rare hereditary diseases also predispose some people to form kidney stones. Examples include people with renal tubular acidosis and people with problems metabolizing a variety of chemicals including cystine (an amino acid), oxalate, (a type of salt), and uric acid (as in gout).


* Geographical location: There may be a geographic predisposition, and where a person lives may predispose them to form kidney stones. There are regional "stone belts," with people living in the southern United States having an increased risk of stone formation. The hot climate in this region combined with poor fluid intake may cause people to be relatively dehydrated, with their urine becoming more concentrated and allowing chemicals to come in closer contact to form the nidus, or beginning, of a stone.


* Diet: Diet may or may not be an issue. If a person is susceptible to forming stones, then foods high in calcium may increase the risk; however, if a person isn't susceptible to forming stones, diet probably will not change that risk.


* Medications: People taking diuretics (or "water pills") and those who consume excess calcium-containing antacids can increase the amount of calcium in their urine and potentially increase their risk of forming stones. Taking excess amounts of vitamins A and D are also associated with higher levels of calcium in the urine. Patients with HIV who take the medication indinavir (Crixivan) may form indinavir stones. Other commonly prescribed medications associated with stone formation include dilantin and antibiotics like ceftriaxone (Rocephin) and ciprofloxacin (Cipro).


* Underlying illnesses: Some chronic illnesses are associated with kidney stone formation, including cystic fibrosis, renal tubular acidosis, and inflammatory bowel disease.

Kidney Stones Symptoms and Signs

When a tubular structure is blocked in the body, waves of pain occur as the body tries to unblock the obstruction. These waves of pain are called colic. This is opposed to non-colicky type pain, like that associated with appendicitis or pancreatitis, in which movement causes increased pain and the patient tries to hold very still.

* Renal colic (renal is the medical term for things related to the kidney) has a classic presentation when a kidney stone is being passed.


o The pain is intense and comes on suddenly. It may wax and wane, but there is usually a significant underlying ache between the acute spasms of pain.


o It is usually located in the flank or the side of the mid back and may radiate to the groin. Males may complain of pain in the testicle or scrotum.


o The patient cannot find a comfortable position and often writhes or paces with pain.


* Sweating, nausea, and vomiting are common.


* Blood may or may not be visible in the urine because the stone has irritated the kidney or ureter. Blood in the urine (hematuria), however, does not always mean a person has a kidney stone. There may be other reasons for the blood, including kidney and bladder infections, trauma, or tumors. Urinalysis with a microscope may detect blood even if it is not appreciated by the naked eye. Sometimes, if the stone causes complete obstruction, no blood may be found in the urine because it cannot get past the stone.

Kidney Stones Treatment

Kidney Stone Home Remedy

* Prevention is always the preferable way to treat kidney stones. Remaining well hydrated keeps the urine dilute and helps prevent kidney stones from forming.


* Those who have never passed a kidney stone may not appreciate the severity of the symptoms. There is little a person can do at home to control the debilitating pain and vomiting that can occur with a kidney stone other than to seek emergency care. If this is the first episode and no previous diagnosis has been established, it is important to be seen by a health-care provider to confirm the diagnosis.


* For those who have a history of stones, home therapy may be appropriate. Most kidney stones, given time, will pass on their own, and treatment is directed toward symptom control. The patient should be instructed to drink plenty of oral fluids. Ibuprofen may be used as an anti-inflammatory medication if there is no contraindication to its use. If further pain medication is needed, the primary-care provider may be willing to prescribe stronger narcotic pain medications.


* Please note, if a fever is associated with the symptoms of a kidney stone, this becomes an emergency, and medical care should be accessed immediately. Urinary tract infections associated with a kidney stone often require urgent assessment and may need intervention by a urologist to remove or bypass the stone.

Medical Treatment

* In the emergency department, intravenous fluids may be provided to help with hydration and to allow the administration of medications to control pain and nausea. Ketorolac (Toradol), an injectable anti-inflammatory drug, and narcotics may be used for pain control, with the goal being to relieve suffering and not necessarily to make the patient pain free. Nausea and/or vomiting may be treated with anti-emetic medications like ondansetron (Zofran), promethazine (Phenergan), or droperidol (Inapsine).


* The decision to send a patient home will depend upon the response to medication. If the pain is intractable (hard to control) or if vomiting persists, then admission to the hospital is necessary. Also, if an infection is associated with the stone, then admission to the hospital will be considered.


* Pain control at home follows the lead of the hospital treatment. Over-the-counter (OTC) ibuprofen is used as an anti-inflammatory medication, and narcotic pain pills may be provided. Anti-nausea medication may be prescribed either by mouth or by suppository. Tamsulosin (Flomax, a drug used to help urination in men with an enlarged prostate gland) may be used to help the stone pass from the ureter into the bladder.


* Because of their size or location, some stones may not be able to be passed without help. If the stone is high up in the ureter, near the kidney, and is large, then a urologist may need to consider using lithotripsy, or shock wave therapy (EWSL), to break the stone up into smaller fragments to allow those small pieces to pass more easily into the bladder. Shock waves work by vibrating the urine surrounding the stone and causing the stone to break up. Stones that are lodged nearer the bladder do not have surrounding urine to allow this procedure to work successfully.


* If the stone is not located in a place where lithotripsy can work or if there is a need to relieve the obstruction emergently (an example would include the presence of an infection), the urologist may perform ureteroscopy, in which instruments are threaded into the ureter and can allow the physician to place a stent (a thin hollow tube) through the urethra, past the bladder, and into the ureter to bypass the obstructing stone. This stent may be left in place for a longer period of time. Occasionally, the urologist may be able to use instruments to grab the stone and remove it.

Complications

* Since most patients have two kidneys, a temporary obstruction of one is not of great significance. For those patients with only one kidney, an obstructing stone can be a true emergency, and the need to relieve the obstruction becomes greater. A kidney that remains completely obstructed for a prolonged period of time may stop working.


* Infection associated with an obstructing stone is another emergent situation. When urine is infected and cannot drain, the situation is like an abscess that can spread the infection throughout the body (sepsis). Fever is a major sign of this complication, but urinalysis may show an infection and cause the urologist to consider placing a stent or removing the stone to relieve the obstruction.

Kidney Stone Prevention

* While kidney stones and renal colic probably cannot be prevented, the risk of forming a stone can be minimized by avoiding dehydration. Keeping the urine dilute will not allow the chemical crystals to come out of solution and form the beginning nidus of a stone. Making certain that the urine remains clear and not concentrated (dark yellow) will help minimize stone formation.


* Medication may be prescribed for certain types of stones, and compliance with taking the medication is a must to reduce the risk of future episodes.

READ MORE - Kidney Stones