Health Behaviors Are The Beliefs And Actions Regarding

Health behaviors are the beliefs and actions regarding your personal well being. These behaviors often stem from adolescence. Observing your mother’s sedentary behavior or watching your father eat a family-size bag of chips in one sitting easily becomes second nature as you grow older. Luckily, it is easy to examine and alter negative behaviors with today’s technology. There are many documentaries, books, and quizzes (among many other means) offering a way to drop a negative habit and pick up a healthy one. After taking the â€Å"Evaluate Your Lifestyle† quiz, my results stated I possess good health habits. My scores ranged from nine to ten points in each category. Being a health conscious person, this made me happy with my†¦show more content†¦In my early late teens to early twenties I started to limit my intake of soda after learning about the damage it would potentially cause inside my body. I first realize I needed to drink more water after a visit t o my local salon to get my eyebrows waxed. While I thought nothing of it, the esthetician questioned my water intake. After stating I drank very little, she said she knew by my skin. As a woman, this thought blew up in my head. If she could notice my limited water intake by looking at my skin – I wondered what my insides looked like. Naturally, I raced home to chug enough water to fill a bathtub. After a few days, this practice ceased and I continued to not drink nearly enough water for my body. Water may not provide energy, but it is essential to our survival. The benefits include: the balance of bodily fluids, flushes out toxins in body, clearer skin, and overall hydration. Hydration improves performance (Liquid Energy 2005). The recommended water intake for a female my age and size is seventy-two fluid ounces (Water 2014). Low water intake can induce levels of the hormone vasopressin go up with dehydration, and may cause blood sugar to rise (Environmental Nutrition 2012). Symptoms of stress, which can be overcome with a balanced diet and by drinking enough water in a day (Combat Stress 2013). Some of my current health issues related to water intake include acne, allergies, and my mentality. For one week, I chose toShow MoreRelatedLow Income Black And Hispanic Adolescent Females Essay1532 Words   |  7 Pagesspecifically focusing on teens who live in the south? Well, Geography matters! According to the national center for health statistics teen pregnancy is highest in the southern states vs. the Northeastern or Midwestern states. While the average teen birth rate was 24.2% nationwide it was between 30-39% in the southern United States. Currently, only 18 states and D.C. require that education regarding contraception is included in a sex education curriculum. Many southern states such as Florida, Georgia, andRead MoreThe Health Of Free Tuberculosis Screenings1694 Words   |  7 PagesThe health belief model was developed in the 1950’s and is considered one of the most recognized health behavior theories in the field (NIH, 2005). The model was initially created by social psychologists Hochbaum, Rosenstock, and Kegels for the U.S. Public Health Service to determine why free tuberculosis screenings were not successful. The model’s usage has grown to incorporate the long and short term behaviors in individuals with HIV/AIDS, diabetes, and osteoporosis. The health belief model’sRead MoreThe Health Belief Model Is Used For Healt h Promotion And Health Education738 Words   |  3 PagesThe Health Belief Model is commonly used for health promotion and health education. Its’ underlying concept is that health behavior is explained by perception of the disease and the strategies available to lower its occurrence. 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In a study done by Kelly Rhea MacArthur evaluating the role of trust in HPV vaccine decision making among college students, it was found that perceived severity and perceived efficacy are two barriers that can be addressed by forming a trusting relationship with a health care provider (MacArthur, 2017)Read MoreThe Health Belief Model ( Hbm ) Essay1486 Words   |  6 Pagesaddressed with the Health Belief Model (HBM), which encourages preventive health actions in order to prevent unwanted adverse conditions, with the idea that action depends on the value and expectanc y of the behavior. The HBM attempts to explain and predict behaviors by focusing on attitudes and beliefs of individuals that are represented by six distinct constructs. These constructs include, perceived susceptibility, perceived severity, perceived benefits, perceived barriers, cues to action, and self-efficacyRead MoreApplication Of The Health Belief Model. The Chosen Case1316 Words   |  6 PagesApplication of the Health Belief Model The Chosen Case Study and Applicable Theorist In the following paper, Marshall H. Becker’s theory of the â€Å"Health Belief Model† is going to be applied to a case study involving a burn patient. In the case study, the burn patient is a 2-year-old Native American girl that has a large second degree burn on her right foot. After being cared for in the Emergency Department, the mother was provided discharge instructions on how to care for wound. She was also notifiedRead MoreSubstance Abuse Disorder ( Samhsa )1597 Words   |  7 PagesAccording to the SAMHSA (2010) report on the national survey on drug use and health almost 22.5 million people are reported to be associated with substance abuse disorder (SAMHSA, 2010). This illness was found to be very common in all age groups, both sex, and seniors. There are several effects on these individuals and their families. Many people who suffer from substance abuse disorders fail to acknowledge these serious consequences. First of all, no response of pain relief can be se en with smallerRead MoreThe Health Belief Model ( Hbm )968 Words   |  4 PagesThere are six Constructs of the Health Belief Model (HBM), a psychological modal that assists on the prediction of health behaviors such as â€Å"why people will take action to prevent, to screen for, or to control illness conditions† (Glanz, Rimer, Viswanath, 2008). The first construct of the HBA is Perceived Susceptibility, which is the idea or belief that a person thinks that they can’t get a certain illness or have a problem, they often will not take account to prevent it. Second, Perceived SeverityRead MoreAfter reviewing the results and noting only one sufficient correlation, the discussion regarding1200 Words   |  5 Pagesdiscussion regarding intent and future behavior then arises. There are so many negative repercussions that alcohol is associated with so one cannot doubt the need for further research regarding this topic. Researchers have been further examining alcohol usage by utilizing the theory of planned behavior (TPB). The theory of planned behavior further examines behavioral cues and examines one’s perceived behavioral control, intentions, attitudes and subjective norms to try and predict future behavior. (Johnston

The Age Of Women s Rights - 1192 Words

The novel was written and is set in the decade following World War I, which ended in November 1918. The Jazz Age, a term coined by Fitzgerald, was a period of enormous social change in America, especially in the area of women’s rights. Before World War I, American women did not enjoy universal suffrage. In 1920, two years after the end of the war, they were finally given the vote. Before the war, standard dress for women included long skirts, tightly laced corsets, high-buttoned shoes, and long hair. A few years after the war, skirts became shorter, laced corsets began to disappear, modern footwear frequently replaced high-buttoned shoes, and â€Å"bobbed† hair became the fashion for young women. Perhaps most alarming for proponents of the old ways, was that women’s behavior began to change. During 1920s, great changes were taken places in American economy, society and cultures, which also impacted American women’ lives. At that time, new features occurred in women’s family, appearance and behavior. Thanks to great achievement of the technology, washing machines, vacuum cleaners and refrigerators became commonplace in every family. These things released women’s hands and freed them from endless housework. Thus they got more time to take care of themselves and their appearance. A author written that they used to wrap their hair in knobs fantastic, high, and queer, but now they cut it in bobs or curl it round their ears. The things they do and wear today, would make their fogyShow MoreRelatedWomen s Rights Within The Viking Age924 Words   |  4 Pagesof men over women had been accepted to such a degree that it appeared to be the natural order of th ings . Popular imagination was of male Viking warriors with their long beards, large axes, colorful shields, and bloodied swords. The presence of women was limited within the scope of early works. 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Health Care Delivery and Reform for NRHM- myassignmenthelp.com

Question: Discuss about theHealth Care Delivery and Reform for NRHM. Answer: Introduction: National Rural Health Mission (NRHM) was initiated in 2005 by Government of India. Main objective of the NRHM was to provide affordable and quality healthcare services to the people in rural India. Strategy of this healthcare delivery system is to involve different sectors and to achieve collaboration among these sectors and organisations to provide uniform health and family welfare services through single window. This system aimed at providing sustainable healthcare delivery to the rural Indians; however, this system didnt imagine potential hurdles and challenges in its implementation. However, foundation laid down by NRHM can be taken forward to improve healthcare delivery system in India to the next level. It can be considered as the road map to achieve varied goals of health and welfare in India. It is an appreciable effort by the Government of India to build the necessary infrastructure to provide uniform health services to all classes of people in the rural India. NRHM should b e given full credit for initiating efforts for empowering healthcare system in rural India specifically in the poor states. NRHM gave importance to the community participation and involvement of different sectors to achieve health indicators in most of the sates. NRHM can be taken forward by not only to give more attention for capacity building in terms of infrastructure and technical aspects but also to build skilled healthcare professionals which are one of the important components for providing sustained healthcare services. Body : NRHM was aimed to improve the accessibility of the people in the rural region like poor, children and women for quality healthcare services and utilization of these healthcare services in the sustained manner (Garg and Laskar, 2011). NRHM performs its functions through different important national healthcare delivery programmes like Reproductive and Child Health II project (RCH II), the National Disease Control Programs (NDCP) and the Integrated Disease Surveillance Project (IDSP). Aim of the NDCP is to provide preventive and curative efforts for control of diseases like filarisis, encephalitis, dengue, kalazar, leprosy, tuberculosis, blindness, iodine deficiency disorders, and polio. Healthcare delivery was planned through different centres like village health sub centres (VHSCs), recruitment and functioning of ASHAs, constitution of registered Rogi Kalyan Samities at district hospitals (DHs), Sub-Divisional Hospitals (SDHs), community health centres (CHCs) and primary health centre s (PHCs) (NRHM, 2011). NRHM put future picture of involvement of communities in providing quality healthcare services to the people of rural India. One of the most significant strategy of NRHM to improve capacity and capability of Panchayati Raj Institutions to participate and contribute in public health services. NRHM involves both Government professional bodies and nongovernmental organizations (NGOs) to monitor and evaluate implementation of the NRHM scheme. It also depends on the community stakeholders for monitoring delivery of healthcare services and provision of healthcare services (Doke et al., 2015). District level annual report preparation is the responsibility of Government departments and NGOs. State and national reports are being presented in the State Legislative Assemblies and the Parliament. At national level activities are being controlled by joint Mission Steering Group, headed by the Union Minister of Health and Family Welfare and at state level activities are being controlled by Health Mission headed by the Chief Minister. At district level activities are being controlled by Chairman of the Zilla Parishad, and District Head of the Health Department (NRHM, 2005). NRHM is also aimed at mainstreaming traditional system of medicine which is called AYUSH which comprises of different systems of medicine like Ayurvedic, Yoga, Unani, Siddha and Homeopathy systems of health. Main focus was given to the maternal and child health and family welfare by improving participation from the different community members and improving coordinated efforts by professional from different sectors like medicine, pharmacy, social, physiotherapy, nutrition and psychology. Healthcare services enabled by the NRHM can be availed at primary, secondary and tertiary health care levels. Though, objective of the NRHM is provide affordable and accountable healthcare services to the people across the country main attention was given to the 18 states with low socioeconomic status. These states include 8 North Eastern states, 8 empowered action group (EAG) states and 2 hilly states. Empowered action group (EAG) states include Bihar, Chhattisgarh, Jharkhand, Madhya Pradesh, Orissa, Rajasthan, Uttaranchal and Uttar Pradesh. Two hilly states include Himachal Pradesh and Jammu Kashmir. Public health expenditure in India reduced from 1.3 % of GDP in 1990 to 0.9 % in 1999. However, in NRHM it was aimed at improving public health expenditure from 0.9 % of GDP to 2-3 % of GDP. Aim of the improvement of the budget to improve health system and health status of the rural people (NHA, 2005). There was major implementation issue while implementing NRHM. It was not uniformly implemented in different states of India. Different states had their healthcare delivery strategy. Hence, it was difficult to implement NRHM uniformly throughout the India. For example, Tamil Nadu has Tamil Nadu health systems project (TNHSP) as a health delivery system. Though TNHSP and NRHM together brought improved results in improving health status and well being of the rural people; there were few basic variabilities in NRHM implementation owing to existence of schemes and strategies in the form of TNHSP. ASHA one of the components of the NRHM was not implemented in the Tamil Nadu because presence o f grass root workers namely village health nurses (VHN). Primary health centres (PHCs) are one of the major components of the design of NRHM for providing healthcare services. PHCs are the primary resource centre for the accessibility of healthcare services by rural people. In Tamil Nadu, it was evident that PHC load was augmented from 0.87 lakhs in 2005-2006 to 3.87 lakhs in 2008-2009. It indicates that NRHM played significant role in improving PHC load. From this it can be concluded that incorporation of PHC in the design and strategy of NRHM proved to be beneficial. Children being immunized gone down from 11.2 lakhs in 2007-08 to 10.1 lakhs in 2008-09. However, analysis of the data indicated that this decline in immunization was not due to implementation of NRHM; however, this decline was due to reduced fertility rate. Prior to implementation of NRHM also, there was improved quality of health services in Tamil Nadu. However, due to implementation of NRHM proved to be significantl y improved accessibility and quality of care. This improvement was observed mainly due to design and functioning of the NRHM. Functioning of NRHM was implemented at three different levels like primary, secondary and tertiary healthcare centres. It helped in improving accessibility of healthcare services by all classes of people. In NRHM multiple aspects were being incorporated; however, budget was not segregated effectively for different aspects. AYUSH system was incorporated in NRHM; however sufficient budget was not allocated for AYUSH. Hence, it was difficult to make proper plan for implementing AYUSH in rural areas. However, in lately in 2008-09 budget was allocate for improvement of infrastructure and manpower in AYUSH sector (Samal, 2015). Proper design and functioning of the NRHM helped in effective utilization of budget allocated under NRHM scheme for Tamil Nadu. Supply chain functioning of the NRHM system in Tamil Nadu seems to be worked efficiently. It has been observed th at drugs and other requirements were effectively supplied to PHCs after implementation of the NRHM (Gopalakrishnan and Immanuel, 2018; NRHM, 2011). NRHM proved to be effective in bringing face-lift in rural health in India. It enabled effective healthcare with uniform access to healthcare services to the rural population. Different aspects of the healthcare were assigned to the different healthcare schemes and missions. Hence, specific attention was given to each healthcare sector. For example, improvement in the indicators related to maternal and child health and fertility were achieved due to implementation of specific schemes and mission like ASHA and welfare scheme Janani Suraksha Yojana (JSY) (Nagarajan et al., 2015). Improvement in the health and wellbeing can be effectively achieved by improving accessibility to both health and social services. Structure of ASHA was designed in such a way that that there is provision for providing both health and social intervention for the people in the rural India. Social intervention can be effectively implemented by improving community participation. Community participation is one of the important components for the success of any programme. NRHM could not implement uniform functioning in all the schemes and healthcare centres. Successful implementation of the integrated health and social services in the ASHA was not effectively implemented in PHCs and panchayats. It indicates, there is scope for the improvement in the design of NRHM. All the centres which come under NRHM need to be provided with basis infrastructure, facilities and workforce to provide health and social services. Any mission and scheme can be effectively implemented and completed by giving authority and freedom (Shukla, 2005; Nandan, 2010). NRHM healthcare delivery system was designed in such a way that at each level of healthcare service decentralisation of the activities were implemented. This decentralised functioning of the NRHM proved to be successful because at each level task were performed with more responsibility and ownership. It helped to improve the accountability of panchayat raj a nd reduce the burden of State and Union Government. This decentralised functioning proved successful because workforce at the panchayat level knows the community well and healthcare services were provided in more effective manner due to intersectoral collaboration at the panchayat level. NRHM strengthened CHC as the first referral units (FRU). It helped in the improving capacity of the secondary healthcare systems and improving quality of care. However, it doesnt proved to be true for all the FRUs because in few of the districts due to long distance and less number of FRUs proved to be limiting factors for availing services at FRUs. Hence, number of FRUs need to be increased with availability of all resources and workforce (Shukla et al., 2012). In NRHM, PHC proved to be most widely healthcare centre for availing healthcare services under this scheme. However, in few of the rural areas PHCs proved to limiting factors for availing healthcare services. Main reason for availing insufficient healthcare services at the PHCs is scarcity of basic infrastructure and resources for availing healthcare services. Hence, PHCs need to be upgraded with all the modern facilities and resources. PHCs can be effectively improved through public private partnership based on the leasing model. It can be helpful in improving standards of PHCs without losing its identity. It is very important to reserve identity of the PHCs because in rural India, PHCs are the most accessible healthcare centres and rural people give more preferences to the PHCs in comparison to the private health centres. Healthcare services are workforce driven services. Hence, efficient workforce need to produce for the improving the functioning of the NRHM. It is evident that me dical professionals are not willing to work in the rural area. It can adversely affect outcome of NRHM. Hence, for these medical professionals compulsion need to be made for working at the PHCs. This practice is being already implemented; however increased duration of stay of medical professionals at PHCs can be helpful in improving outcome of the PHCs and NRHM (Sundararaman and Gupta, 2011). Increasing incentives of medical professionals and providing them with improved facilities can also be helpful in improving outcome of NRHM. This manpower need to be trained not only in medical services but also in administrative services; hence PHCs in the remote areas can be effectively managed by these people. In remote areas people seeking healthcare services can be less; hence posting people for each department can put burden on the national economy. Hence, these medical professionals with training in both medical and administrative departments can prove to be more cost-effective manner (N ayar, 2013). Hence, NRHM budget can be effectively shifted to the most desirable section. Alternative healthcare professionals need to be produced for occupying positions in the rural PHCs. Healthcare professionals from the alternative system of medicine need to be upgraded both in knowledge, skills and technological advances to the level of medical professionals. It can be achieved by implementing bridge course for these alternative medicine professionals. Hence, scarcity problem of healthcare professionals at the PHCs can be effectively resolved. After Alma Ata Declaration in 1978, India is competing at the global level for providing Health for All. It can be effectively achieved through Millennium Development Goals (MDG). Goals 4 and 5 of MDG are being already covered in the NRHM. One of the major discrepancy for achieving this goal is regional variations in India. Hence, to eliminate these regional discrepancies, NRHM gave special attention to the states which were lagging behind in implementing NRHM schemes. Beyond MDG, in current scenario India need to meet the goals of Sustainable Development Goals (SDG). According to goal 3 of the SDG, people of the age should live healthy life and with well-being. Hence, NRHM initiated efforts to achieve this goal. Policy makers and programme implementers of NRHM need to ensure credible, accountable and quality in health services through this health delivery service. Policy makers and programme implementers should amend the NRHM strategies and activities keeping in mind SDG and should work in with commitment and political will. In current scenario to meet the global standards with respect to MDG and SDG, NRHM should address the following recommendations : percentage GDP expenditure on the public health, increase in budget allocation to each state, increase in resource allocation at panchayat and district levels, resources need to be allocated based on public health studies and needs of the local people, improved utilization of the allocated funds obligation and insuring social protection of public health sector. NRHM should work towards availing health services in timely and easy manner which are nearer to each people. Hence, NRHM need to give attention to provide healthcare services at the village levels. Hence, healthcare sub-centre need to be set-up at each village. Access mapping need to be used to improve accessibility of the healthcare centres and outreach centres. Modification of the healthcare facilities infrastructure need to be modified based on the req uirements of the population and standards of access. It can be helpful in the availing healthcare services at the village level without moving to urban healthcare facilities to access emergency healthcare services. It can surely reduce mortality rate to the standards of MDG and SDG goals (Roy, 2015). Hence, India can compete effectively with the other countries in providing quality healthcare services to all the people. NRHM strategies and activities are designed for all the population of the rural India. However, in the current scenario, strategies and activities need to be amended based on the requirements and number of population. Primary and secondary care beds need to be increased based on the population in each district and epidemiological background of each district. Optimum utilization of the provided resources is very important in designing any type of scheme and mission for public health. Initially, 500 beds for every 10 lakh population can be fixed. Utilization of these b eds in each district can be evaluated by establishing occupancy rate of these beds. Based on the data obtained in the occupancy rate, number of beds for each district level hospital can be amended. Maximum size of district hospital also need to be fixed and those districts with overburdened district hospitals, another hospital need to be opened. 30 beds in CHC and 200 beds in the district hospitals need to be fixed per 10 lakh population to avail quality healthcare services (D'Silva, 2013). Poor coordination and the integration with other healthcare institutes is the major hurdle for implementing effective NRHM policies. Integration of different sectors like nutrition, water, sanitation and hygiene need to be achieved for implementing effective NRHM policies. NRHM was designed in such as way that there should be coordination among different related schemes like Total Sanitation Campaign, Integrated Child Development Services, Mid Day Meal, and National Disease Control Programmes for Malaria, TB, Kala Azar, Filaria, Blindness Iodine Deficiency and Integrated Disease Surveillance Programme. However, due to lack of coordination among different ministers and departments, effective implementation of NRHM scheme is questionable. Frame work of NRHM is designed to implement effective healthcare services at each level; however, there is no effective mechanism to assess or judge success of scheme at each level. Hence, evaluation and outcome strategies of the NRHM scheme need to be improved. Targets for each state need to be framed which can be helpful in the evaluation of each state in implementing NRHM scheme. Baseline surveys for health status of each state need to be carried out for evaluating outcome of NRHM. However, baselines surveys are not being completed for most of the states. Design and functioning of NRHM is being initiated as package of schemes. Hence, participatory activities need to be achieved from different stakeholders like Community, PRIs, government and non-governmental organizations. However, integration and collaboration of these different stakeholders is not evident in implementing NRHM scheme. Corruption in the utilization of the allocated budget can lead to the ineffective implementation of the scheme. Hence, authorities need to engage both civil societies and local people in the effective utilization of the allocated budget. However, it is evident that civil society engagement is not evident at the state level. Most of the times f unds are not being released at the proper time; hence not utilized in the proper way. Funds received after the completion of the priority tasks can result in the utilization of funds in the low priority tasks. Panchayat Raj Institutions are not adequately trained for the proper utilization of the funds (Dhingra and Dutta, 2011; Bahadur, 2010). Conclusion : NRHM contributed significantly for upgradation of the public health infrastructure of India. This scheme should be given its credit for empowering rural India to improve access to the required healthcare facilities and services. NRHM brings community participation and intersectoral collaboration in the healthcare services (Prasad et al., 2013). It helped in achieving healthcare indicators in most of the states. This foundation should be carried forward in capacity building not only in terms of infrastructure and technical improvement but also in training healthcare workforce. These improvements can be helpful in the providing sustainable healthcare services in rural India. Public private partnership need to be effectively implemented to improve quality of delivery of healthcare services. NRHM need to meet global standards of health through improved implementation of NRHM. References: Bahadur, A.S. (2010). National Rural Health Mission: a failing mission. Indian Journal of Medical Ethics, 7(3), 170-1. Dhingra, B., and Dutta, A.K. (2011). National rural health mission. Indian Journal of Pediatrics, 78(12), 1520-6. Doke, P.P., Kulkarni, A.P., Lokare, P.O., Tambe, M., Shinde, R.R., and Khamgaonkar, M.B. (2014). Community based monitoring under national rural health mission in Maharashtra: status at primary health centers. Indian Journal Public Health, 58(1), 65-8. D'Silva, J. (2013). Can India pull off its ambitious National Health Mission? British Medical Journal, 346:f2134. doi: 10.1136/bmj.f2134. Garg, S., Laskar, A.R. (2010). Community Based Monitoring; Key to success of National Health Programs, Department of community Medicine, MAMC, New Delhi, India. Indian Journal Community Medicine, 35(2), pp. 214-6. Gopalakrishnan, S., and Immanuel, A.B. (2018). Progress of health care in rural India: a critical review of National Rural Health Mission. International Journal Of Community Medicine And Public Health, 5, 4-11. Nandan, D. (2010). National Rural Health Mission: Turning into Reality. Indian Journal of Community Medicine, 35(4), 453-4. Nagarajan, S., Paul, V.K., Yadav, N., and Gupta, S. (2015). The National Rural Health Mission in India: its impact on maternal, neonatal, and infant mortality. Seminars in Fetal Neonatal Medicine, 20(5), 315-20. Nayar, K.R. (2013). Universalizing health services in India: the techno-managerial fix. Indian Journal Public Health, 57(4), 248-53. Evaluation Study of National Rural Health Mission (NRHM). (2011). In 7 States, Programme Evaluation Organisation, Planning Commission, New Delhi, 2011. Available at: https://planningcommission .nic.in/reports/peoreport/peoevalu/peo_2807.pdf Retrieved on 22April 2018. National Health Accounts India (NHA). (2005). National Health Accounts Cell, Ministry of Health and Family Welfare, (26-27) Nirman Bhawan, New Delhi. Available at: https://planningcommission.nic. in/reports/genrep/health/National_Health_Account_ 04_05.pdf. Retrieved on 22 April 2018. National Rural Health Mission (NRHM) (2005). Meeting people?s health needs in rural areas, Framework for Implementation. 2005-2012. 15-34. Available from: https://nhm.gov.in/images/pdf/about-nrhm/nrhmframework-implementation/nrhm-frameworklatest.pdf. Retrieved on 22 April 2018. Negandhi, P., Sharma, K., and Zodpey, S. (2012). An innovative National Rural Health Mission Capacity Development Initiative for improving Public Health Practice in India. Indian Journal Public Health, 56(2), 110-5. Prasad, A.M., Chakraborty, G., Yadav, S.S., Bhatia, S. (2013). Addressing the social determinants of health through health system strengthening and inter-sectoral convergence: the case of the Indian National Rural Health Mission. Global Health Action, 6, 1-11. Roy, P. (2015). Improvement in mortality indices in India, though National Rural Health Mission (NRHM) goal yet not achieved. National Medical Journal of India, 28(1), 51. Samal, J. (2015). Role of AYUSH workforce, therapeutics, and principles in health care delivery with special reference to National Rural Health Mission. Ayu, 36(1), 5-8. Shukla, A. (2005). The National Rural Health Mission- Hope or disappointment? Indian Journal Public Health, 49(3), 127-32. Sundararaman, T., and Gupta, G. (2011). 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The Farming of Bones the Symbolic Portrayal of Waters Relation to Death vs. Life Essay Example

The Farming of Bones: the Symbolic Portrayal of Waters Relation to Death vs. Life Paper The Farming of Bones: the Symbolic Portrayal of Waters Relation to Death vs. Life â€Å"Death is not the greatest loss in life. The greatest loss is what dies inside us while we live. † (Norman Cousins) Death comes to us all, for some it marks the end of a life, for others it reveals the road to a new path in which the soul travels. However it leaves behind a trail of darkness regardless for those who have experienced the loss. Through enduring the death and tragedies of those around us, we are tested by our emotions. The character Amabelle experiences the trauma of death and tragedy many times through water in her journey and Danticat shows us how it affects her in the novel. In a time where there was much death and tragedy, Danticat’s depictions gives us insight into just how horrific the events were that took place during the period of the novel. In Edwidge Danticat’s The Farming of Bones, water is viewed upon as a symbol of death vs. life and is a common theme in the novel especially in reference to the Massacre River. The Farming of Bones by Edwidge Danticat revolves around the true events that occurred in 1937 in the Dominican Republic. The dictator at the time was a man named Rafael Trujillo who ordered his troops to massacre as many as 15,000 Haitians living in the Dominican Republic. We will write a custom essay sample on The Farming of Bones: the Symbolic Portrayal of Waters Relation to Death vs. Life specifically for you for only $16.38 $13.9/page Order now We will write a custom essay sample on The Farming of Bones: the Symbolic Portrayal of Waters Relation to Death vs. Life specifically for you FOR ONLY $16.38 $13.9/page Hire Writer We will write a custom essay sample on The Farming of Bones: the Symbolic Portrayal of Waters Relation to Death vs. Life specifically for you FOR ONLY $16.38 $13.9/page Hire Writer The killings were brutal and left survivors with psychological trauma after experiencing the massacre. (Hewett 123) In The Farming of Bones, Danticat does an exceptional job with supplying the reader with details of just how horrific this massacre was, giving us an imagery of death by Trujillo’s soldiers and the brutal acts done upon Haitians living in the Dominican Republic. The character Amabelle shares her story and sorrow through her memories and present as she makes her way to the border in hopes of surviving the struggle. The loss of Amabelle’s parents in the Massacre River is the first hint Danticat gives us to support that water has a negative symbolism in the novel. As the narrator in the novel, we as the reader get a more personal in depth understanding of how the Massacre River has brought sorrow and death into her life. Amabelle dwells a great deal on the death of her parents. She has many memories and dreams that are thrown into the story and give us a greater insight to the development of her as a character. Her dreams are recollections of her mother and father drowning in the river that is on the order between Haiti and the Dominican Republic. She watches them drown but does not cross the river in which they are taken from her. â€Å"The ongoing trauma of her parents drowning manifests itself in recurring dreams about these events as well as Amabelle’s attitude towards water-rivers, waterfalls, and lakes, which can be understood not just as a symptomatic repetition of loss but also her own desire for a place of safety. † (Heather Hewett) We can see how water here plays a role in the book as a symbol of death through Amabelle’s experiences. Danticat repeats this theme of water being the bringer of death throughout the story. Danticat symbolizes water once again as a means of death when Trujillo’s soldiers have Haitian captures at the edge of a cliff, with jagged rocks and the sea beneath them. The bodies that lay motionless at the bottom of the cliff, scarred and torn with cuts, men and women cried in terror for their lives, for if they did not meet there end at the bottom of the sea, they surely would by the soldiers machetes. The choices that had to be made were far greater than anything most of us could understand, however Danticat gives us verbal imagery of just how horrific it must have been to make such a decision and knowing that one way or another, death was on the way. Dealing with the death of Odette, and taking her life to save her own, Amabelle’s character was forever changed. In some aspects, Amabelle never made it out of the river herself because she is forever changed after the trauma. She takes the life of Odette in order to save her own when crossing the river. There are guards standing with guns on top the river bridge, and this is where the life of Odette along with Tibon and Wilner are taken. Odette begins to choke under the water after Wilner is shot, which in turn is causing her cover to be blown, and in an attempt to save herself from being discovered, Amabelle shoves her head under the water so that the guards would not hear the noise. This scene marked a great change in Amabelle’s character. Taking a life for the first time, and the irony of it taking place in water, drowning the way her parents had drown support the idea of water being a symbol of death and tragedy in the novel. The event causes Amabelle to distance herself even more from the events that take place, and numbs her to the surroundings. When Sebastian does not return to the waterfalls, Amabelle becomes instilled with a sense of reality that her lover is truly gone and water once again is portrayed as a symbol of death and sorrow. Before the massacre takes place, Sebastian and Amabelle fall in love and help one another heal from the earlier tragedy. They become engaged and make love at the site of the falls. The water again here is present and can be symbolized as an element of two people coming together. However when Amabelle returns to the same falls in hopes of meeting Sebastian, she is sadly disappointed. Her hopes of Sebastian surviving the massacre are still embedded deep within her, but the truth is that he had passed and all that was left for Amabelle was the presence she felt when revisiting the memories they had made at the waterfall. â€Å"Water the destroyer, in the form of the river – ironically named Massacre – in which Amabelle’s parents drown, and in which, later, many of the escaping Haitians loser their lives. But there is also the waterfall on the Dominican side, behind which Amabelle and Sebastian make love for the first time. (Divakaruni 1) The waterfall cannot symbolize a happier time because it will be a constant reminder of Sebastian and only feed Amabelle’s pain of loss. The water constitutes as a symbol of death here again in Danticat’s The Farming of Bones. Amabelle has always been one to hold onto her dreams and past beca use she feels it is all she has to remember where she has come from. Amabelle comments â€Å"You may be surprised what we use our dreams to do, how we drape them over our sight and carry them like amulets to protect us from evil spells. (Danticat 265) Amabelle dreams symbolize her way of dealing with death and how she is able to hold onto the past. She continues to dream despite the sorrow and loss of her parent’s and Sebastian’s death. She feels she must do so because it is the only story she holds that is completely hers, and wants to hold onto that for as long as she can. Towards the end of the novel when Amabelle revisits the Massacre River where so many were killed along with her parents. The water here is very symbolic and can be looked upon as a symbol of death vs. ife because of the actions taken by Amabelle. She lays her body in the water as she slips herself into the current. â€Å"I looked to my dreams for softness, for a gentler embrace, for relief from the fear of mudslides and blood bubbling out of the riverbed, where it is said the dead add their tears to the river flow. † (Danticat 310) Amabelle at this point is ready to be reunited with her parents and Sebastian. She is allowing the water to o nce again play its role as a symbol of death and bring her peace after living a life of loss and struggle. She was â€Å"looking for the dawn† (Danticat 310), a new beginning, and would find it only in death. The irony of the novel is that water had taken the lives of so many in the story, and in the conclusion of it all, Danticat allows its heroine Amabelle to pass away in it. â€Å"Death is not the greatest loss in life. The greatest loss is what dies inside us while we live. † (Norman Cousins) Amabelle’s character was in constant change throughout the novel, and as the story progressed, we as the reader could make the depictions in her change and how after each loss, she died a little more inside. The death of her parents and Sebastian leaves Amabelle torn, and suggests that she is emotionally removed from everything that is occurring around her. At the end of the story, she gives her life to the Massacre River because she has nothing more to live for. In Edwidge Danticat’s The Farming of Bones, water is viewed upon as a symbol of death vs. life and is a common theme in the novel especially in reference to the Massacre River. Research Paper on The Farming of Bones: The Symbolic Portrayal of Water’s Relation to Death vs. Life By Habib Agha Literary Perspectives Professor Nevarez April 29th 2010