Notebook: PDHP 246

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PDHP 246:Sessions 1-33
A documentary on process and outputs
By May Haddad MD.MPH
Draft 21 1 15

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Acknowledgement
Special thanks to members from the Faculty of Health Sciences-University
of Balamand for their support. Included are: Dr Nadim Karam, Dr Laurie
AbiHabib, Roubina Karhily, Stephanie Rahi, Micheline Nseir, Catherine
Constantine, Rita Chaddad, and the librarians at Habib & Fouad Abi
Chahla-Medical Library.
Our guest speakers and visitor are also acknowledged included are Dr
Norbert Hirschhorn, pharmacist Nadia Dalloul, Dr Rania El-Masri, Houda
Abboud, Rana Karam, Yusra Scott, Josiane Badra and Sami Moussa.
Warm regards to dozens of the students (FHS and other), friends,
volunteers and community members who joined our classes and activities
included were the regular classes, the World Heart Day, the Geitawi Garden
Health Festival, the Dialogue survey and the Souk Al-Tayeb. We were also
very touched by the warmth and welcoming of children and their families
when we visited the Pediatric ward at St Georges hospital.

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Dedication
This compiled PDHP 246 work is dedicated to the students of the class:
Alissar Zaghlout,
Caroline Richani,
Cynthia Bakkalian,
Mia Hani Akra,
Ranya Younes,
Ribal Maatouk,
Rim Kalfayan,
Tarek Zeineddin
Ziad Younes
In recognition of their enthusiasm to learn, educate and influence other,
team work, active participation, dedication and commitment, creativity,
leadership, and assets that each one of them has brought to the class.
Best wishes for the most prosperous times at the university and most
productive and enjoyable career and life.
Note: This report includes a mix of class activities, results of home works
and assignments, related materials and images. This document does not
include all the results of the discussions, home works and assignments that
are tabulated in course archives.

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PDHP 246 students
Alissar Zaghlout Caroline Richani Cynthia Bakkalian
Ranya Younes Ribal Maatouk
Mia Hani Akra
Rim Kalfayan Tarek Zeineddin Ziad Younes

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Contents
Page/s
Acknowledgement
Dedication
About this document
About PDHP 246
Agenda outline
Session 1: Monday 22 9 14
Session 2: Friday 26 9 14
Sessions 5 & 6: Friday 10 10 14

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Sessions 14 -16: Friday 7 11 14
Session 22: Talk by
Dr Norbert Hirschhorn-Wed. 26 11 14
Session 25: Talk by pharmacist
Nadia Dalloul-Wed. 3 12 14
Take home final exam: 25 11 14- 5 12 15

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Students’ evaluation of the final exam
Session 33: With the dean Dr Nadim Karam-
Monday 12 1 15
Recommendations to the administration of
the FHS-the Balamand University
Typical Health Issues of University Students
PDHP 246 Evaluation
PDHP 246 Competencies
Students’ Appreciation Scheme
List of Attachments, PPP, face book page
links and reports
PDHP 246 face book group
Readings and references

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About this document
Students commented on draft of 25 12 14 of this document as follows:
 This document was a great idea. No other lecturer tried doing a similar
document in order to collect and evaluate all the things we did during the
course. I was surprised at the beginning when I saw the accumulation of tasks
that we performed all of us during this course and how much activities we have
done to develop ourselves to become better and more active health
professionals. We are still putting the baby steps or the primary blocks of our
career and knowledge and this document helps evaluate our progress and what
we can improve and how we developed from the beginning of the course till its
end by now.
 Very useful and interesting. Skimming through the document made me
remember every moment or event we have had throughout this course. It is a
diary of all the fun, educational and beneficial events we have been through.
 A good way to evaluate what we have learnt from this course/ and what new
information we have gathered/ and what we have worked through together.
 I find that this document is well developed; it is well divided, and shows the
details of our work in that course. This document shows our expectations,
goals, actions, and every activity that we have done together as a team.
 It is well organized and encompasses everything we tackled during this
semester.
 The document is the best way to document the work done in this non-ordinary
class that the program of Public Health and Health Promotion needs since it's a
link between the theoretical learning and the practice in the after graduation
life. The document can be a great source for the students to recall topics and

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issues discussed in the class. Moreover this document made every step made in
this course clear enough once we look backward to things done.
 I think it was well balanced and contained questions from activities we did and
things Dr. May taught us.
 It is well organized and tackles everything we took since the beginning of the
semester.
 In case the course is repeated it would be a great idea if students enrolled have
a look at this book to have an idea what the course is all about.
 It is a very interesting portfolio for us students of PDHP246, to see what we
have achieved in a very short period of time (+souvenirs, memories, beautiful
moments).
 To show the university and the program what we were also able to do and
accomplish, and that other people can benefit from it for learning objectives, key
findings or case studies.

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About PDHP 246
Quotes about this course:
 This course is from a total different level of others. It goes beyond my
expectations. I got beautifully surprised with the activities we had, those we
proposed in class were done. i couldn't imagine that we would have the chance to
make a festival, to be active and also have classes in different environment!-
Alissar
 This course has met all my expectations. There is only the part of the field
visit, but what was done and given by Dr May was way better from my
expectations. Starting from teamwork, to creativity, to public speaking, to
searching for articles, and the most important things done were the
activities-Caroline
 The course should be given more value and interest from the faculty. It
should be considered as a major course instead of an elective since it
constitutes knowledge, reading, and practical practices-Mia
 The various expectations that I have voiced at the beginning of this course are
met. Be it in terms of the topics covered and pathogenesis of diseases, or in
terms of the proximity between Dr May and the students (collaboration,
friendly-relationship, stress free atmosphere…) or in terms of field works and
visits-Cynthia
 The course met further my expectations. What I got to learn from the course
did not only reach what I was expecting but even made me achieve and
attain more knowledge and skills. It gave me the true essence of public
health, having a healthy lifestyle and promoting wellness and health in my
community, similarly, it taught me the importance of team work and group
work in addition to new creative methods, field work, project planning,
different ways of communication and delivering a health message without

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lecturing, met key individuals such as Dr Norbert Hirschhorn, Dr. Nadim
Karam, and pharmacist Nadia Dalloul. I learned about different topics such as
acupuncture, sexuality, tobacco, mental health and many other topics. To
sum up it was an extraordinary experience-Mia
 At the beginning of the course I had different expectations, some formed due
from previous courses, but standing here now, I realize that I have put the
wrong expectations to this course. It’s not about the studying or the
memorizing or the exams, it is about acquiring the needed information and
challenging yourself to do things you would not do under normal
circumstances. This course gave me the chance to work with all my
classmates, and with those shared activities I have learnt that working with
others is not that bad, and the people with me in class are not bad themselves.
I do not have any further expectations, but I am certainly satisfied with where
we have gotten and to the progress we have made, along with facing the
struggles that we came upon. I will finish this course with a better view
towards classes and lectures and learning-Ranya
 After going over my own expectations of this course, I can say now that all of
them were met. The topics I suggested were discussed in class (cancer, yoga
and stress). In addition to taking theory into practice and not just learn from
the book and write an exam the next day. I also enjoyed the friendly
relationship between each and every one of us, including Dr May, which
made the course smoother and more fun-Rim
 In the first session we were not sure what this course is really about and our
expectations were vague to a certain extent. Now looking backward I know
that we met the expectations we should have had in the beginning of the
course such as learning how implement theories into action, and moving the
course setting into the community to make a health action-Tarek
 I think this course really hit my expectations for the course. As all my
expectations and the topics I were interested in were covered in the course
and I have gained a deeper knowledge of them and have learned new
techniques and lifestyles to prevent the topics I was interested in and others

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as well-Ziad
 What I saw in this course was way beyond my expectations. Flexibility, peer
support, reading materials and field visits, all of the topics that I wanted to see
covered were done (drug addiction, smoking, substance abuse, psychological
disorders, STIs/STDs, and mostly it helped me improve my lifestyle towards a
healthy one. Integration of this style of learning in other courses is highly
recommended - Ribal
People:
 Nine students participated in the classes of PDHP 246. Students are: Alissar
Zaghlout, Caroline Richani, Cynthia Bakkalian, Mia Akra, Ranya Younes, Ribal
Maatouk, Rim Kalfayan, Tarek Zeineddin and Ziad Younes.
 Dozens of other students, friends and community members participated in
PDHP 246 through attending selected classes and talks; joining PDHP 246
activities of the World Heart Day, Geitawi garden health festival, students’
interviews and surveys, visiting children and families at St. Georges hospital,
PDHP 246 Celebrations and other.
 Guest speakers: Dr Norbert Hirschhorn (Tobacco, what’s new?); pharmacist
Nadia Dalloul (Are we abusing medicines?); Dr Rania Masri (skills in public
speech); Rana Karam (healthy cooking); Josiane Badra/Sami Moussa
(introducing Al-Sabil center and the Geitawi garden community); Houda
Abboud (CAP-HO); and Dr Nadim Karam (dialogue with the dean).
 May Haddad MD.MPH was in charge of course facilitation, design and contents,
and coordination.

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Duration of the course:
33 interactive sessions were implemented during the interval 22 Sep.
2014 to 14 Jan. 2015 (average duration of 80-90 minutes per session).
Venues of the sessions:
 Rooms 303, 204, 106 and 105 (computer lab);
 Students’ lounge,
 terrace in front of the FHS building,
 terrace in-front of the students’ cafeteria-FHS,
 lobby of the FHS,
 Tomates Cerises,
 Old hospital cafeteria,
 Assabil center,
 Geitawi garden,
 Pediatric ward-St Georges hospital.

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Teaching strategy and guidelines:

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Agenda outline
Session and venue Outline
Class 106
 Introductions, Stress balls,
 Concepts Healthy lifestyle-1,
 Expectations and class dynamics
 Communications
Class 303
 Heart healthy environment-1
 Comments to course syllabus
 Self appraisal
 Wider picture of healthy lifestyle
Session3: Monday 29 9 14
Old hospital cafeteria, Lobby
of FHS, Students’ lounge &
Class 303
 Heart healthy environment-2- Interviews, football game
 Class reflections and
 Welcoming new students
Room 303
 Team building- parachute games
 Three models of health: medical, environmental and holistic-
Debate game
 Concepts and definitions/Health, Wellness, Illness and Disease-
2 - Fishbowl
 Our lifestyle- Role play
 Celebrating Caroline’s B-day
Session 5 & 6:
Friday 10 10 14
Geitawi garden,
Assabil center
 Meditation and breathing exercise
 Introduction to Geitawi community and dialogue with children,
women and elders
 Introduction to Assabil center-Geitawi
 Global health days of October 2014
 Proper hand-washing techniques
 Breast self examination
 Concepts-3/ Risk factors and life style changes
 Results of Mapping the Geitawi area
 Results from Dialogue survey:
what does it mean to have a healthy lifestyle
Computer lab-Room 105
 Stretching exercises
 Computer lab-1 exercises:
Useful link, set yourself a challenge, PDHP 246 face book page

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Tomates Cerises
 Learning through entertainment: games about nutritional iron
deficiency anemia, more veggies and fruits, no junk foods, no
smoking, and healthy nutrition
 Healthy cooking-talk by Rana Karam
 Martial arts demonstration –by Tarek
 Geitawi garden health festival plan-1
 Breast cancer: handouts on facts, risks, myths, environment,
mammograms, what to do when someone we know has cancer
Room 303
 Students presentations-1 (topics of own choice):
Alzheimer (Ziad), Acupuncture (Rim), Facial expression (Ranya),
Lead poisoning (Caroline), Food allergies (Mia), Tobacco
(Cynthia) and Addiction (Tarek)
 Developing a students’ appraisal scheme
 Students responses to peers evaluation including what they
would like to see changed
 Martial arts-2 (with Tarek)
First Floor Terrace
 Sharing useful books in public health-1
 Introducing course main resource books: Health and Wellness;
Public Health in the Arab World; Hesperian Health Guides; Be
the Change Action Guide and other resources
 May’s feedback to students presentations
Class 303
 Students presentation-2: Hospital acquired infections (Alissar)
 Useful PH books-2
 Best practices: our topics
 Dance movement (with Caroline)
 Best practices draft-Geitawi garden health festival
 Geitawi garden health festival: Our roles
 Educating and influencing others
Class 303
 Team building exercises-Balloon games
 The stone soup: Our assets
 The river code: Self-reliance and dependency
 Our values-Human sculptures
 Students presentation-3: Drug abuse and addiction (Ribal)
 Celebrating Alissar’s B-day
Class 303
 Smarter snacking
 Chapters distribution: H & W and PHAW
 Geitawi garden health festival: Slogans and a parade
 Geitawi garden health festival: Guidelines

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 Geitawi garden health festival: Our roles
 Geitawi garden health festival: Modified best practices for
children, women and elders
 Geitawi garden health festival: Program
Session 14 -16: Friday 7 11 14
Geitawi garden
and Assabil center
Geitawi garden health festival
 Preparing the stands and decorating the garden
 Integrating 15 volunteers
 Implementation: mobile and fixed stands, parade, handouts and
gifts
 Wrap up
Class 303
 Geitawi garden health festival: Results of press activity (by
Ribal)
 Geitawi garden health festival: reflections
 Geitawi garden health festival: evaluation questions
 PDHP 246: Powerful moments to date
 PDHP 246: Our river- where do we stand, and how best to
continue
 PDHP 246: Venues
 PDHP 246: Resources
Old hospital cafeteria
 Diabetes Mellitus-Key messages of the World Diabetes Day
 Diabetes Mellitus-Blue circle
 Healthy breakfast
 Nutritional iron deficiency anemia (by Mia)
 Geitawi garden health festival: evaluation by Assabil
 Geitawi garden health festival: Certificates of appreciation
 Peer support-1: More veggies and fruits
 Our chapters H&W and PHAW: Images
Room 303
 Public speeches: Guest Dr Rania Masri
 Students public speeches: Stress management (Ziad), Cancer
(Alissar), Girls Scouts (Rim), Sexual Health (Tarek), Self image
(Ranya), Health inequalities (Caroline), Women’s health
(Cynthia), Mental health (Ribal)
 Healthy eating
 Reflections: what have we learnt about public speeches
 Heart choice not a hard choice-Speech by Mia
 Diabetes Mellitus-educational competitive game
 Diabetes Mellitus-Am I at risk?
 NCD statistics-Lebanon

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 My expectations by the end of the course
 Breathing exercise and Om with Houda
Room 303
 Peer support-2: towards best practices
 Our chapters H&W and PHAW: Mind mapping
 Our chapters H&W and PHAW: Our questions
 Our chapters H&W and PHAW: Schedule of presentations
 Our breakfasts: images
 Readings from international book resources HHG
Session 22:
Talk by Dr Norbert Hirschhorn:
Wed. 26 11 14
Room 204
 Tobacco, what’s New?
Computer lab 105
 Healthy declarations: Alma Ata, Health promotion, People’s
health Charter, Human rights, Nutrition, Code of marketing
breast milk substitutes, Rights of the child, CEDWA, World
Cancer declaration
 Applications World Cancer Day 2015
 Interactive links about cancer and smoking
 Quizzes: smoking, breast cancer, cancer risk, BMI, nutrition and
activity, calories count, target heart rate
 Waist circumference
Room 303
 Laughter yoga
 Our images and quotes about mind-body communication
 Mind-Body communication: By Rim
 Psychosomatic illnesses and somatization disorders
 Peer support-3: towards best practices
 World’s Aids day
Session 25:
Talk by pharmacist Nadia
Dalloul:- Wed. 3 12 14
Room 204
 Are We Abusing medicines?
 Introducing Zaka wa Dawa: the campaign and the flyers
Room 303
 Our images about anti-smoking advertisements
 Target heart rate
 Eliminating Tobacco: By Cynthia
 Physical activity for health and well-being: By Mia
 Exercises-led by Mia

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Room 303
 Cardiovascular diseases: Risks and prevention: By Caroline
 Peer support 4: Quitting smoking
Room 303
 Managing Stress: By Ziad
 Mental Health: By Ribal
Room 303
 Using drugs responsibly: By Ranya
 Sexuality and intimate relationships: By Tarek
 Competencies in Public Health and Health Promotion
 PDHP 246: Home works
 PDHP 246: Bibliography
 PDHP 246: Take home final exam
 PDHP 246: Meeting dean Nadim Karam
 PDHP 246: Competencies celebrations
 PDHP 246: general
 PDHP 246: people
 Healthy eating
 Visit to Pediatric ward and gifts to children
Take home final exam: 25 11 14- 5 12 15
Room 303
 Towards course completion
 Final exam and its evaluation
 PDHP 246 celebrations
Session 32: Monday 12 1 15  Cervical cancer: By Alissar
 Ribal: on smoking
 Happy Hormones
 Pot-luck lunch
Session 33
Dialogue with Dr Nadim Karam
Monday 12 1 15
 With the dean

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People: Alissar, Rim, Cynthia, Caroline, Ranya, Mia, Tarek and May.
Place: Room 106
Duration: 90 minutes
Images from the session:
https://www.facebook.com/media/set/?set=oa.960748570608847&type=1
7 students participated in this session that May facilitated (4 had already registered for the
course and the other 3 were exploring the possibility).
Contents: The session included:
(1) Brief introduction,
We introduced ourselves to each others in an open forum. Among the responses: I like most
nature and simplicity, I am interested in life and to me medicine is a way to help, I believe that
health is the most important, I like writing and reading, I am a pianist, a dancer and a reader, I
like to take things with a smile, I get mad very quickly, my family is central in my life…
May introduced herself as public health professional, social activist and an artist. Although she
has both MD and MPH, but she has learnt lots from people in marginalized and poor
communities. She has lived and worked in many countries ranging from arctic Quebec to the
Sudan and Yemen. Academically, she has spent time at AUB, Oxford University and University of
British Columbia. At this stage, she is happy to teach at Balamand. She defines useful when it
goes to our hearts and joyful when we learn with enthusiasm, fun and laughters. May has been
involved in the capacity building of thousands of people either directly, or working through
trainers or publishing books and materials. She hopes to share with the students some of her life
experiences particularly if they find it interesting and relevant.
(2) Exploring the title words of the course (healthy lifestyle and illness and disease),

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(3) Dialogue about: how we see the benefit of this course in our lives and/or future work;
features we liked in other courses that we like to see integrated in this course and aspects that
we would like not to see in PDHP 246, our expectations, specific topics/issues that we like to see
covered in the course, how can this course be most useful and joyful and how can we make it so,
our skills that we like to share, means of communications, grades and open comments.
Dynamics: We sat in a circle and practiced talking to the whole group; we worked in groups of 2-
3 and as the whole group. We also took photographs of how we felt during the class, and photos
of the working groups and the group.
May also introduced the concept of Parking Lot (Food for Thought) whereby we put aside topics
arising in discussions and refer to them at a different timing.
Stress balls (as tools for stress management) were distributed and used as a tool for pairing
people and as a ball to moderate the dialogue.
Communication among us: During this
session, we agreed upon the communication
tools among each other to include: e-mail,

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whatApp group, a facebook group and Moodle.
Reflections: Students comments at the end of the session were: Looks promising; Different -as
we are not used to situations where we talk; I felt that the class was unique, different and fun;
Creative and fun; Interactive; Forced to become committed ; meditative; I liked it (ana habeet).
Related happenings: Later in the evening, Mia established PDHP 246 whatApp group, and May
initiated the PDHP 246 facebook closed group and e-mail communications with all participants of
22 9 14.

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Results from mind-map-1 exercise as the students reported:
Healthy lifestyle: The shape of healthy lifestyle is circular or like heart and it has a good looking appearance, its
colors are green/blue/ white/, its smell is that of Spring/soil/flower/roses, its texture is rocky and rough/ soft, it
has the sounds of the birds/ wind and a good taste. We associate it with happiness/peace and serenity. The
following words have been associated with healthy lifestyle: creativity /influence /planning /continuous /art
/relationships /mood /stress /sanitation/ exercise /organization /responsibility
Illness/disease: is round, an echo, zigzag, rough, smells like spoilt eggs/disinfectants, sound like sirens, it is black/
red; it is about sadness, tears and pain, cancer, hospitals, morbidity, mortality and death. It is of public concern.
Genetic and unhealthy choices have been referred to. On the other hand, it is also about awareness, motivation
for change, help, faith, brightness, medicine, creativity, hope and an attachment to life.

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Food for thought
Based on a previous experience, one student talked about the irony of stress management that
has been stressful by itself!!!
As Mia pointed out, many of us have perceived illness and disease with negativity. We are all
challenged to take this concept further as we develop ourselves throughout this course and
other.

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STUDENTS’ EXPECTATIONS
How can this course be beneficial to me in my life and/or future work?
This course will teach me how to have the correct definitions of some common words such as illness, lifestyle,
and health … to be able to understand them and also to implement the theories for a better life (in general)
coping- What I mean by coping is for example to deal with any kind of stressor to be able live in a healthy
way./ Personal reflection, Life style changing, New methods/ aspects of course perception, Interaction and
peer support and communication, Directly related to public health since it deals with health, wellbeing of the
community and individuals, illnesses and diseases/ I believe this course will help me have a closer glance at
some forms of diseases/illnesses (as in their origin, transmission mode, sources…). It will teach me how to
handle situations more wisely through having healthier lifestyles and changing my behavior towards different
issues./ This course can help me cope with future issues dealing with illness and lifestyle and hopefully
influence it to the better, it would help me handle present situations and learn more about interaction and
communication since this course requires a lot of both./ Be creative, Get to know more about the science and
art of prevention./ It would help me thin outside the box when it comes to the relation between lifestyle and
disease./ It will help me develop certain lifestyle measures that can help me improve and keep my physical and
mental health at good terms. Furthermore prevent future illness from occurring. / In my opinion, I think this
course will make the idea of diseases and illnesses clearer in my head and it will help me maintain a healthy
lifestyle. I am talking about many years from now. / I guess this course would be beneficial for me because in
previous courses I mostly studied about diseases and illnesses without having any link with lifestyle. This
relationship will make it more interesting because it will give a clearer image of what I might see in my daily life.
What are the most successful features of other courses that I have liked
and would like to see integrated in PDHP 246? Poster presentations and fieldworks/
Integrate workshops and social activities; Take real life examples statistics, cases and be exposed to similar
examples (on the field experience) ; Outings on week-ends or during the vacation to be more exposed with the
community (visit the refugees or primary health care centers or a site depending on new events) / Closeness
between the Dr May and the students through interaction and integration; Feeling comfortable and engaged
during the class hours instead of being stressed out/ Field visits, classes outside university, creative thinking/
Introduction to Public Health; Real life examples and proves. I would like to see: something creative, real life
examples, having fun while learning/ Field visits/ the nutrition course were a great benefit. It helped me get a
better idea on types and variety of foods that are beneficial and harmful to the human bodies, thus helping
improve my lifestyle through better chose of foods./ Friendly relationship between the Dr May and the
students and Field visits/ The most successful features include: interaction between students and tutor and time
flexibility

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What are the aspects of other courses that I had taken and that I would
NOT like to see in PDHP 246? Quizzes and Limited time for many subjects / Stress, seriousness,
lack of communication and strict Dr May / Hardness of the exams, Being overloaded/ A very dense material
and having a lot of work to do, Being stressful throughout the entire semester/ Lengthy assignments, hard
exams, slide shows that put you to sleep/ Too much memorizing, Not seeing a real proof, Absence of
communication during the lecture and interaction./ Long reports/ The different types of microorganisms that
we have studied in the microbiology course. Such as the different viruses and bacteria and the illnesses they
cause. / Difficult exams, Stress, Too many projects and assignments / Well, personally, I don’t like the whole
attendance system, where students are graded based on their attendance, or receiving a penalty after missing a
session.
What are my expectations from this course? To learn about illnesses and severe diseases
coping, To learn how to implement “theories” about healthy lifestyles, To get good grades. : D/ I expect from
this course to have a clearer vision of what is public health practice, get familiar even more with the field and
how to deal with sickness illness and diseases. How to promote health and be an active individual in the
community. I know that the best school is the street that’s why I suggested previously having more classes in
the exterior world because lectures alone are just theory however through experience knowledge is gained. /
Knowing more about the pathogenesis of certain diseases. Knowing about how can an individual have a
healthier lifestyle and how to adapt to it. Discussing certain psychosomatic diseases, which are not taken into
consideration seriously/ To benefit in ways that people who have not taken the course will not benefit from,
To learn new aspects of illness and disease and lifestyle/ Get brief explanation of any point of case study, Get
to know more about the illness aspects and how it affect our lifestyle, Have more information concerning
public health policy./ To increase my knowledge, To know more about lifestyle’s effect of illnesses/ My
expectations are to learn the different diseases and certain lifestyle measures that can affect my health in a
direct and indirect way, and learn more about techniques or ways to prevent such diseases./ I actually don’t
have any specific expectation from this course, but I can say, I hope it would be helpful to me on a personal level,
so I can improve my lifestyle, and be able to share with people what I learnt in a simple way so they benefit as
well.
Are there specific topics/issues that I would like to see covered in the
course? Yes! The effects of severe diseases management. The topics I would like to see covered would be
for example “how to manage the stress of a cancer patient and his/her surrounding”/ Actually every topic
discussed will be useful. Throughout the course if any topic was “hot” we would add it in the parking spot to
be discussed between us. What I got encouraged to gain after this first lecture is how to be creative in

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spreading the awareness and the health message. This is a topic or an issue that numerous people face
because health professionals are not able to promote health efficiently since they do not focus on simplifying
their methods. After all, knowledge is important but if we were not able to deliver it then what is the purpose?
/ No specific topic/issue/ Mental illness and its effect on the body and on other people around you/ Causes of
illness and diseases. How do they affect our lifestyle? Prevention of such catastrophe. How to call for action in
case of illness of a whole community. / GMO’s, Manmade diseases/ Stress plays a major role in everyone’s life,
especially in today’s world. I think it is an interesting topic to be covered in class as it can greatly affect our
health without our knowledge of it. So gaining an idea of it can help us understand it more and prevent it. /
As I said in question 1, I hope that by the end of this course, I will be more aware of the threats on my health
and how to prevent them later on. / Although I covered these topics in different courses and fields but I would
like to take them again; maybe I could help in sharing some personal experiences: Drug addiction, Smoking,
Substance abuse, Psychological disorders, STDs/STIs
How can this course be most USEFUL for me? Most ENJOYABLE for me?
This course can be most useful and enjoyable if we get to participate more in social activities. In my opinion it
can be more useful and enjoyable if we can implement the theories learned in class but in real life with people
in need and thus feel productive. / Class interaction and discussions m Social media, Sharing of references and
articles among each other / It could be helpful by teaching me what behaviors to avoid in order to have a
healthier and a better lifestyle. / Field activities that require being introduced to new environments and new
things/ Increases my knowledge concerning health impacts. Non strengthened lectures can be considered
enjoyable and discussing new topics/ By being more of a practical course/ Class discussions and arguments can
be helpful and beneficial as it helps the information be better understood. / /Stress management, Cancer.
Yoga/ It would be more useful if there’s a balance between theory and practice (or being on the field); therefore
it would be more enjoyable and less boring, compared to any other course.
What can I do to make it most useful and enjoyable? Fieldworks, Campaigns
production / Share my talents with my classmates, Help them out in any topic I believe I can be useful or
provide them with an article I have previously read or used , Keep the smile on my face to make other
comfortable around me and encourage indirectly students to keep coming to class and attending since peer
pressure effects the outcome and the success of the course. / This course would be enjoyable if we relate it to
real life examples through case studies for examples. Also, by being involved in community activities./ Make
the best of it, work hard on the assignments and basically pass the course with very high grades and achieve a
sense of accomplishment and productivity/ Refer to true life examples and proofs., Communication skills/ Field
visits/ I believe that if we take theory into practice, the course will be more enjoyable and beneficial at the
same time./ Field visits, Practice sessions, Debates/ Share some personal knowledge and experience with others
and vice versa would make it more useful and enjoyable.

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Student Self Appraisal Healthy Lifestyle
(Q 1 of 8)
Is healthy lifestyle a concern of mine? Please explain why yes
or why not? I am really interested in a healthy lifestyle since it is the key to stay in good health and
to avoid, reduce, or delay disease and illness. A healthy life style can affect an individual positively in
numerous ways where it can reduce stress, promote a good mood and mental health, supports proper
functioning of the body and the brain. Adopting a healthy life style can facilitate the individual’s life through
making him a sociable individual, community active, teaches him time management and commitment. /
Healthy lifestyle is a big concern for me because it is the base of a healthy maturity of the body
and mind. To live without any disease or illness, the first thing to do is to adopt a healthy
lifestyle. / It is, because having a healthy lifestyle is the key to a fruitful life, and health is a main
factor of happiness, productivity, and continuity of life. / I believe that a healthy lifestyle should
be the concern of every individual, from children to elderly. We, humans, want to stay in a good
health to maintain our survival. Having a good health away from diseases/ illnesses/ or health
problems can only be achieved through having a healthy lifestyle. / Yes, it should be the
concern of everyone. It is important to achieve a healthy life style and everyone should try their
best to work on it. It is not as easy as it seems, and I don’t think anyone is able to achieve a total
healthy life style and should try their best to work on that because a healthy lifestyle can benefit
in every possible way. From going up a flight of stairs, to running 30 minutes a day, to even
have a goodnight sleep/ Of course a healthy lifestyle leads to a better life. Healthy habits help in growing
strongly, staying healthy and decreasing the risk of many diseases and illnesses. / Healthy lifestyle is a big
concern of mine since I am dealing constantly with high triglyceride levels in my blood. Come to think of it I do
believe even if I didn’t have this health issue I would always think of adapting such a healthy lifestyle, because
my family woks in the healthcare field, health is always an important aspect of our lives. / A moderate healthy
lifestyle, rather, is a concern of mine. Of course a healthy lifestyle is important, but I don’t like restrictions. A
healthy lifestyle will offer me a good state of health, as well as it will affect my surrounding so everyone can
benefit from it, whether by interchanging and exchanging healthy behaviors, or by reducing risk factors that
affect a person and his/her surrounding. / Yes, I'm not much into sports but I can already feel the
effects of the lack of exercise, so I want to have a healthier lifestyle.

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People: Alissar, Rim, Cynthia, Caroline, Ranya, Mia, Tarek and May
Place: Room 303
Images and video from the session:
Flipagram http://flipagram.com/f/JIfDTpehqK
We started the session with stretching exercises (source Health Promotion Programs at
University of British Columbia) to upper body, wrists, hands, back and legs.
Practicum:
As most of the participants have shown great enthusiasm for activities outside the classroom set-
up and fieldwork, we prepared ourselves for an outdoor activity that is in line with the World
Heart Federation recommendations for the year 2014: Heart-Healthy Environment: Heart choice
not a hard choice on the occasion of the International Heart Day on 29 9 14. Our preparation
included: learn the facts (competition game), introducing the 5 questions (why, who, what ,
when, where), class discussion of what we can actually do given the short time, and hands on
activities (play with the ball, use of face paint, making hand heart gestures, our medals etc.).
May explained that she sees this as an experimental activity for us to learn through practice.
Hopefully, we will use the lessons learnt as we organize other similar activities.
Our feedback to forms: Working in small groups of 2-3, we looked at course learning objectives,
teaching methodology and students’ work appreciation and commented on the “Self Appraisal”
questionnaire.

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Extracts from Our Comments on Course Syllabus
Our comments on learning objectives/methodology and grading:
https://www.facebook.com/groups/960731717277199/970360702980967/

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Looking at the wider picture of healthy lifestyle and health
The last activity of the day was an Image Gallery exercise. Each student picked up one image out
of 25, and wrote a paragraph about why she/he had chosen it. Students presented their work to
the group (as speakers). For the complete folder ################
“Hugs” were used as a means to reflect on the session in reference to the image “Hugging is
good medicine” http://www.encognitive.com/node/18608

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People: Alissar, Rim, Cynthia, Caroline, Ranya, Mia, Tarek, Ziad, Ribal and May
Visitors: Roubina- Engaging other students in World Heart day event
Places: Old Cafeteria, lobby, students lounge and Rm 303
Special thanks to Roubina for her support, Mia for the photocopies, Tarek for the
music and all for the contribution and enthusiasm 
Images and videos from the session:
https://www.facebook.com/groups/960731717277199/photos/
Flipagram http://flipagram.com/f/JZUJbRhJGJ
Videos See face book group
By now, nine students have registered to PDHP 246.
Day’s agenda included
12:00 -12:30: Planning for World Heart Day
 We reviewed: WHY are we doing this intervention, WHO are the people involved, WHAT
we are doing and HOW (interviews/Our questions/Inviting interviewee to the Football
Exercise/ playing football and other (face /body paint, slogans etc.), finalizing the WHEN
and WHERE…
12:30-1:30 Implementation:
 Interviews,
 Football game,
 Our recommendations to the administration,
 Group photo

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1:30-2:00 wrap up and appraisal
 Reflections: What worked well? What we need to improve for next time?
 Introducing the resource book: Health and Wellness
 Our letters to Ziad and Ribal/welcoming Ziad and Ribal (day’s evaluation)

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Preparing ourselves for World Heart Day 29 9 14
https://www.youtube.com/watch?v=HiMTwR8Dko0#t=120
http://www.who.int/nmh/events/2014/world-heart-day/en/
http://www.worldheartday2014.com/?fb_action_ids=10154662338940584&fb_action_types=og.shares

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Welcoming Ziad and Ribal:
As means of integrating and welcoming Ziad and Ribal, students wrote the following letters:

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Extracts from our reports Heart-Healthy Environment
For cumulative and complete reports
https://www.facebook.com/notes/pdhp-246/recs-to-fhsbalamand-heart-healthy-
environment/965014426848928
Mia and Cynthia:
Feedback:
 Fun event
 The number of people engaged was better than expected
 Very successful evaluation or assessment to what we can do with little effort,
limited time, and funding
 Developed a sense of belonging to the team
 The music was an important component during the football activity, which gave energy and grabbed
people’s attention
 Promoted health with a simple activity
 The key to health is not knowledge but knowing how to dissipate it
Ranya and Tarek:
ANALYSIS ON THE INTERVIEW OUTCOMES:
It is important to note how much our country plays a role in our environment and healthy lifestyles, it is
unfortunate to see that most of us are living in a non-healthy lifestyle, yet we seem too defeated to do
anything about it. “We don’t even have a park next to home I can walk in” claimed one of our participants.
ANALYSIS ON THE CLASS ACTIVITY:
We think the activity day today was very beneficial. We believe we had something new to teach the
students and they all took it in a good manner and they were all willing to absorb our information and
participate in our activities.
We believe today went better than expected and we are content of the level of interaction that occurred
on a class basis and on a university basis.

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We hope to get the chance to do more activities, and hopefully next time our crowd will be bigger!
Rim and Caroline:
Monday, September 29 was the day of the activity, during class hours. We first started by a meeting with the
Dr May of the course Dr May Haddad and Ms Roubina, where we prepared the questions we were going to ask
the people and ourselves (face painting and so). We then went back to our campus, divided into groups of 2,
and started asking everyone we met there. However, almost every person we asked had no idea about the
occasion, so we explained it to them before starting the questionnaire. We asked them if they know that CVDs
are the leading cause to death worldwide, especially in females, if they have an idea about some acts to
protect their heart and if they do some physical activities. Most of them didn’t know about the danger of CVDs
but they know that by not smoking, exercising and following a healthy diet they will prevent CVDs from
occurring. After that, we invited everyone we interviewed to the student lounge to play some football. The
purpose was to exercise a little bit, to have fun and to tell everyone about the importance of physical
activities.
I think this event was a hit. Students, including us, had fun and received some good information about our
health in a unique method.
However, if we took a little more time to prepare for it, it would have been even more successful. 
Alissar, Ziad and Ribal:
After interviewing several people, it was showed that cardiovascular diseases are not very well understood
and known. However, the risks factors leading to it and the measures of prevention are identified. Physical
activities have to be more encouraged. Knowledge and awareness are missing; they should be considered and
developed concerning important diseases, illnesses and lifestyle.
We believe the activity done was a great success, not only did it raise awareness to a group of people about
cardiovascular disease, but also showed them the importance of keeping the heart healthy and away of
harmful substances, furthermore the inclusion of an interactive beneficial activity of football brought together
students, in order to increase their heart rate, and show them that just a short time of exercise can greatly
help in improving your health.

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About World Heart Day
HEART-HEALTHY ENVIRONMENTS: heart choice not a hard choice
http://www.worldheartday2014.com/?fb_action_ids=10154662338940584&fb_action_types=og.
shares
CVD is the world's number one killer. It's already responsible for 17.3 million deaths per year, and
by 2030 this is expected to rise to 23 million. Too often, society 'blames' the individual for having
CVD - you smoke, you eat and drink too much, you don't exercise!
But the environments where we live, work and play can have a huge effect on our ability to make
the right choices for our heart health, especially in increasingly urban environments. A heart-
healthy environment is a space where people have the opportunity to make the right choices for
their health.
Not everybody has the choice; many adults and children across the world are ‘trapped’ In
environments where they face: Lack of access to green spaces, Unhealthy school meals,
Overwhelming displays of tobacco, alcohol and fast food, Exposure to second-hand tobacco
smoke in parks, cars, work places
Everyone should be able to make heart choices not hard choices wherever they live, work and
play. Join us on World Heart Day for better #heartchoices #worldheartday

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Appraisal of the Heart Friendly Environment Activity
Reported by PDHP 246 students
Practical implications of the Heart Friendly environment activity that we had implemented on 29
September 2014:
o A simple ball
o Student lounge
o Simple question
o Listening skills to others instead of imposing our opinions and knowledge
o Allowing free self expression of students through allowing them to write
down their requests to the Balamand FHS administration.
o Teamwork
o Active spirit
o Delivered the message without lecturing, only through a very simple game.
 The heart friendly environment was my first experience with the community. It was a
success. We could show the FHS community that we can save our hearts and protect
ourselves from cardiovascular diseases by simple actions, such as moving a little or playing
football. The students of the faculty were engaged in the activity and had fun. We, the
students of the PDHP246, enjoyed our time. Through this event, we could teach students an
important issue by combining it with fun.
 The activity done had several implications, first it helped raise awareness to the FHS
community about the heart and healthy choices, second implications is that it got the
students closer to each other and all participated in good healthy activity. It also showed
the students that even though we may not have a large space for activities we are still able
to do healthy activities in the space provided.
 We have increased the awareness of students about the importance of the health and
cardiovascular diseases and encouraged healthier behaviors such as healthy eating habits,
regular physical activity or tobacco avoidance.
 We implemented a simple exercise between students can increase the heart beats (playing
football in the lounge).

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 Students might become more aware of the health of their heart and start engaging in
healthier behaviors such as regular physical activity or quitting smoking.
 Students will be more aware of the need for physical activity to keep their hearts healthy.
o They will have a better idea on healthy foods and proper diets.
o They will know more about their health rights ( access to information, public spaces for
physical activity, other infra structure including healthy restaurants)
 Practical implications of the Heart Friendly environment activity that the class had
implemented:
o Information about CVD
o Informing people about the date: World Heart Day
o Engaging in physical activities
o Team work
o Happy hormone
o Lowering the risk of developing a CVD
o Reducing body fat
o Enhancing respiration
o First contact/experience with the community (interviews, activity engagement…)

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Visitors: 2-3 students
Places: Terrace of students’ cafeteria and Rm 303
Special thanks to Mia for the delicious cake 
Images and videos from the session: facebook group + Whats App
Flipagram http://flipagram.com/f/JiRsKdlqUo

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Day’s agenda included:
Parachute games: we played parachute games about cooperation and team building as we were
celebrating Caroline’s B-day
Open platform: dialogue circle of what we like to share/ Looking at events in October that maybe
of interest to us/ Classes and make ups in Oct 2014/ Too many home works?/ Calculating how
much time we spent on HW #3/ be able to let people interact with us more
Debate game: We formed three groups and debated the three models of health (medical,
environmental and holistic)

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Towards our definitions of health, disease and illness: A dialogue using fishbowl technique
Our lifestyles: two role plays about our lifestyles, showing issues in eating junk foods, smoking,
excessive use of mobile phones, drinking alcohol, being over protective about weight gain etc.
Risk factors: distributing the reading materials Risk Factors and Life Style Changes and discussion

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Health, Wellness, Illness and Disease
1. Develop a table contrasting the three models for health as mentioned in H & W book chapter
one, and present in a panel discussion
2. List key findings from what attracted your attention in the concept of health, disease and
illness as posted in PHAW's book chapter 9-
Readings from H & W: ch 1, p 4-10 and PHAW: ch 9, p 118-120

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Samples of students’ responses
Comparing the three models for Health
For cumulative results:
Medical model Environmental model Holistic model
 Relies on biological
explanation of diseases
and illness
 Deals with environment and its
effects on human health.
 Takes the health of the
person as a whole not
only certain parts of the
body.
 Can be interpreted in
terms of body, organ
malfunction
 Defines health in terms of
quality of a person’s adaptation
to environment conditions
 Includes physiological,
emotional, spiritual, and
environmental aspects of
the individual.
 Is measured in term of
vital statistics, such as
morbidity and mortality.
 Focuses on conditions outside
the control of humans that
affect his or her health such as
water, air and socioeconomic
conditions.
 Focuses on health,
prevention of diseases
and positive emotional
and mental states.
 Does not include social
problems that can affect
the health, and does not
integrate mental health
with biological health
 Being healthy means
having unity between
the mind, spirit, and
body.
 Health can be restored by
curing the diseases or
injured body part
The Medical Model The Environmental Model The Holistic/Wellness Model
Health is the absence of the one or
more of the “five Ds”- death,
disease, discomfort, disability, and
dissatisfaction.
Health is defined in terms of the
quality of a person’s adaptation to
the environment as conditions
change.
Health is defined in terms of the
whole person, not just in terms of
diseased parts of the body or the
environmental condition.

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Focuses almost on biological
explanation of disease and illness
and is interpreted in terms of
malfunction of organs, cells and
other biological systems.
Focuses on conditions outside the
individual that affect his/her health.
Conditions include: quality of air and
water, living conditions, access to
nutritious food, exposure to harmful
substances, socio economic
conditions, social relationships and
the health care system.
-Focuses on optimal health
prevention of diseases, and
positive mental and emotional
states.
-Moreover, it incorporates the idea
of spiritual health.
-Emphasizes the unity of the mind,
spirit and body.
Does not deal with social problems
that affect health and only with
difficulty integrates mental and
behavioral issues that do not derive
from diseased organs.
Associate health with harmonious
interactions with fellow creatures
and the environment.
As the environment changes, one’s
interactions with it must change to
remain in harmony
Illness is interpreted as disharmony
of human and environmental
interactions.
Symptoms of illness and disease
may be viewed as an imbalance in
a person’s state of being and not
simply as the malfunction of a
particular part of the body.
Three main ways to define health:
1. Medical Model
 Health is the absence of death, disease, discomfort, disability, dissatisfaction.
 Biological explanation of disease and illness
 Relate malfunction explanation to organs, cells, systems…
 Measurement: vital statistics (morbidity/mortality) and includes incidence (number of new cases) and
prevalence (total number of cases).
 No social problems
 Disease treatment only related to organs (biology)
 Successful in treating biological illness only without psychosocial.
 Limitations: promoting health- prevention- healthy lifestyle= avoiding unhealthy risky behavior etc…
2. Environmental Model
 Ecosystem
 Environmental health and impact on human health
 Quality of an individual’s adaptation to his environment

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 Focuses on external conditions affecting the person’s health (air quality- food- pollution- nutrition- life
conditions…)
 Effect of education- socioeconomic status- environmental factors on person
 Illness is defined as the inability to cope with environmental changes and with ecosystem.
3. Holistic (wellness) Model
 In terms of a person as a WHOLE
 Physiological- mental- emotional- social- spiritual- environmental aspects
 Optimal conditions (health- wellbeing- disease prevention- healthy mental status….)
 Illness is an imbalance between the mind spirit and body.
 Self- healing, health maintenance, disease prevention are included…. Not only symptoms medical
treatment.
 Works in parallel with medical treatment to cure a certain type of illness or disease since it encourages
each individual and patients to preserve their health and wellbeing and even be able to improve it
through healthy non risky behaviors

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Reading assignment and reports:
Risk Factors and Life style changes
Students read “Risk Factors and Life Style Changes” and the last two pages of WHO report on the
global health risks (key findings). For the reports posted as PDF documents on the face book:
The students wrote a commentary or conclusive paragraph.

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Students’ commentaries on risk factors and life style changes
Global wellness must be our concern, and we should all work hard to prevent chronic diseases that limit the
wellbeing of the population. So, doctors, nurses, employers, bankers, governments, and all nations should
have some regulations that eliminate the burden of chronic diseases before it's too late and share together
the spirit of awareness and lowering the risk. However, the first step that should be solved is by eliminating
the social, economical, financial, and health gap between rich and poor countries. We all share humanity and
we have the right to have a total state of wellbeing and a healthy lifestyle.
In the article “CDC: Lifestyle Changes Can Reduce Death from Top 5 Causes”, the author Stacy Simon
illustrated the fact that lifestyle change could help reduce deaths in the US. Moreover, the major five causes of
death are caused by poor lifestyles, all of which could be prevented and thus could easily help prolong lives.
These risks could be reduced by making healthy choices such as avoiding tobacco, eating a healthy diet,
maintaining healthy weight, engaging in physical activity, limiting UV exposure as well as alcohol consumption.
Kelly Young mentioned in her article that 37 million deaths could be delayed if we aim to improve the
risk factors that are causing mortality. All of which are related to poor lifestyles.
According to “Chronic Diseases in Rich and Poor Countries- the Causes Differ”, the author showed that the
leading cause of death are the chronic diseases, which besides death effect the quality of life. But the causes
of death differ from the developed to the underdeveloped countries. In the developed countries, the causes of
death are associated with five risk factors that are: tobacco use, cholesterol, overweight and alcohol
consumption, where as in that of the underdeveloped countries the risk factors are different and are related
to poor sanitation, unsafe sex and underweight. All of the previously mentioned risk factors are preventable
and individuals must be taught how to live more healthfully to avoid them
Conclusive paragraph/short summary:
Engaging in healthy life styles can increase the span of your life. In order to limit the top 5 causes of death
around the world, people should start focusing on their lifestyle, and focusing on how to make it better and
healthier.
The top 5 causes of death in the world vary from: cancer, to heart disease, to chronic lower respiratory

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diseases, to strokes and unintentional injuries.
In order to have a better lifestyle, people can start by avoiding tobacco use, they can focus on having a healthy
diet, maintaining a healthy weight, exercising and limiting their alcohol consumption.
They can focus on other things as well like minimizing the stress level in their life and controlling the
environment around them, however the things listed above are important factors, without them the risk on
your life would not be eradicated, but it would be less.
In order to help people get into a healthier lifestyle, we need to understand their environment and the factors
affecting their lives. We need to notice the policies and programs, and make the services accessible to them.
We can also notice that the “unhealthy lifestyle” led by the poor differs from the unhealthy lifestyle led by the
rich. The unhealthy lifestyle led by the rich involves tobacco use, high blood pressure, alcohol use, high
cholesterol and overweight.
However, the unhealthy lifestyle to the poor includes underweight, unsafe sex, bad sanitation and polluted air.
When a country develops a burden of a bad lifestyle, it wastes all its money on medical issues rather than
invest the money to build better schools, or to promote healthy education or better roads. Or any other issues
that might work on making the country more developed rather than more harmful.
Education is very important and must be given to all people in order for them to be able to lead better
lifestyles on their own. Support can be given by psychological standards or from educational standards. People
would start being aware of healthy lifestyles and would perhaps start choosing salads to sugars or fats.
Combined support from the people, the government, and the associations could make a better country with
more healthy citizens.
A way to measure the development of a country is by knowing the average life span of the population. In a
world full of diseases it was hard to extend the peoples average age, unless certain measures are taken to
reach the goals set by the World Health Organization to prevent mortality and extend lives.
According to the CDC simple measures such as avoiding tobacco, increasing physical activity and eating
healthier diet could significantly reduce the deaths rate. Up to 20% to 40% of the deaths can be prevented by
following the previous measures only.

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The measures are taken to avoid the top five causes of death in the United States: Cancer, Heart Diseases,
Chronic lower respiratory diseases, stroke and unintentional injuries.
In addition the people should be advocated on the turn their environment plays in increasing the risk of such
morbidities by increasing stress and other environmental factors that could be avoided easily if measures are
taken not only by the people but on a state level. Such interventions on a state level are so important for the
state since development and health are directly related to each other. Any weakness in the health sector puts
the government under a huge burden and a heavy health bill. So to implement strategies, the government has
to take health, environment and the people into consideration for the best development and health results.
Investing in a healthy lifestyle should not be the people's responsibility, but a governmental strategy which
starts by educating the children on the benefits of a proper lifestyle. In turn education will pay back the input
in the form of development, and money paid previously on the health bill by the government will now be paid
on education and research centers for further development.
The top reasons of death in the world are all related to lifestyles measures, and bad behaviors people pick up,
such causes of deaths include respiratory diseases, mainly caused by tobacco smoking, heart strokes, due to
high blood pressure and intake of foods with high level of fats, and cancer which can be caused by a variety of
reasons that include long exposures to UV radiation, all of which can be prevented and the relative risk of
getting them reduced by applying some simple changes to anyone’s lifestyle. Such changes include increase in
physical activity, cutting back on tobacco smoking, reducing alcohol drinking, lowering the amount of fats
ingested, and increasing the intake of vegetables in order to increase the intake of vitamins. Since the top
deaths of the world are controlled by our actions and behaviors, it is of crucial importance to raise awareness
of such facts to the public to help them take action and the first step in changing their behaviors, and lifestyle
in order to improve their life expectancy and life quality, so that they will live a healthier, and longer life.

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Events of Sep. and Oct. 2014

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Session 5 & 6: Friday 10 10 14
Helpers: Josiane and Sami (Sabil center)
Interaction with around 25 of community members (kids, women and elderly)
Places: Sabil library and its garden, Geitawi garden
Duration: around 120 minutes
Images from the session: posted at Whats-App and Face book page
Special thanks to Cynthia for saving documents on her I-Pad and bringing it to class

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We were welcomed by Josiane who introduced us to the Sabil library at Geitawi and its clients.
We started with an open platform about our concerns at this stage, and May explained a general
framework for our course. Rania was concerned about introducing I-pads at the Sabil center, and
some students reflected that the course is speedy and required more feedback from May when it
comes to their performances.
Then we experienced an exercise in meditation after we shared our previous experiences
including the meaning of mindfulness.
Groups of students presented the results of their mapping of the area and their posters and 3D
installations (based on HW assignment to explore an area of choice and report about enabling

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factors for a healthy lifestyle) Caroline and Mia’s presentation consisted of a 3 D installation
whereby they showed enabling components in Geitawi area. Here are few images:

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We shared the significance of 4 international days/events in October included were breast
cancer awareness month, hand-washing global day, international day for ending poverty and
mental health day in reference to a handout prepared by May and that was distributed to all. We
also reviewed together the proper technique of hand washing (see handout
https://www.facebook.com/groups/960731717277199/970364959647208/ )
Sharing the results of the dialogue survey:
The students presented their findings from stage 1 of the Dialogue Survey and informed us about
the people they selected as follows:
Cynthia: 2 housewives in their 50’s,
Tarek: 2 domestic Syrian workers
Rim: two ladies in their 40’s (one is a teacher)
Alissar: 2 ladies in their 50’s with cancer
Ziad: 2 Syrian guards
Caroline: 3 nurses
Mia: 3 housewives and friends.
In preparation to the dialogue survey, the students had selected a homogenous group of 2-3
people that they encounter regularly in their life and who would be willing to talk to you (porters,
waiters, guards, shopkeeper, elderly, housewife etc.) and asked their permission to talk to them
from time to time to listen to their views about specific issues in healthy life style. The students
told them that this is a university project that aims at widening their scope of thinking by listening
and understanding the perspective of people around us so that they become better public health
people. The first question: what comes to their mind when we say healthy lifestyle…?
‫صحيه‬ ‫بطريقه‬ ‫منعيش‬ ‫نقول‬ ‫لما‬ ‫بالك‬ ‫ع‬ ‫بيخطر‬ ‫شو‬
The following are extracts from students’ reports about their first dialogue:
Caroline:
After asking the nurses in Saint George hospital, I started with nurse number 1, who is the right hand of a
therapist. His response was that health is a job for him, lack of problem, and the absence of disease. He added
that it is an absent case in Lebanon.
A second nurse replied with his mate that it is a psychological and physical state of a person, where the
individual can prevent some risks to reach it. These risks were no tobacco smocking, exercise, a good and a

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healthy diet, knowledge in managing stress.
Their answers were logical, but it lacked the idea that health isn't only related to disease. Where in fact, as
cited in WHO, health is the physical, mental, and emotional wellbeing and not merely the absence of the
disease!
Mia:
For my study I decided to interrogate three women in my building. In fact they are friends and neighbors living
in the same building same region and have close ages. They come from a similar economic status and they all
raised kids. Two of them work and the third one doesn’t. None of them is in the medical field. They are all
from the same religion however different nationalities. One is Armenian Lebanese, another is Syrian Lebanese
and the third is Lebanese.
Methodology:
 I waited till the afternoon until they are home
 I introduced myself (in fact they know me from the building)
 I told them about the study and that it is among the requirements for a course at the University of
Balamand which gave me more credibility
 I asked their permission if can ask them from time to time some questions during this semester.
The question:
What comes to your mind when we say healthy lifestyle?
‫صحية؟‬ ‫بطريقة‬ ‫منعيش‬ ‫نقول‬ ‫لما‬ ‫عبالك‬ ‫بيخطر‬ ‫شو‬
Responses:
First Housewife’s response:
 Exercise
 Eat healthy
 Avoid alcohol smoking and addiction
 Do regular tests and consult family doctor from time to time.
Second Housewife’s response:
 Eat healthy food
 Exercise regularly
 Eat organic
 Do regular tests (mammography, blood tests etc…)
 Proper hygiene and cleaning
 Being in good health… no diseases or at least managing sickness ( taking proper medication)
Third Housewife’s response:
 Healthy cooking
 Avoid eating outside home
 Active lifestyle and exercising
 Sickness illness free (in good shape)
 Proper weight
 Avoid smoking cigarettes and arghileh

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 Reduced pollution environment (mountains, greenery etc…)
 Limit alcohol (do not get drunk and addicted)
 Avoid drug abuse
Ranya:
For the second part of the home work, I chose 2 people, both Quantity Surveyors to interview in regards of the
“healthy life style” awareness. I chose those 2 people because they are as far from the “medical field” as could
be. They work as part of an engineering company and that means their information is based on numbers and
facts about construction. I had hopes to help them “strengthen their building” regarding their health, and
make their body the “strong pillar” they try their best to achieve in buildings.
I questioned both people separately and managed to understand their idea of a healthy life style, and after
that, I managed to explain the functions of a healthy lifestyle, how to achieve it, and how you know you have
it. I believe the brief interview widened their knowledge and motivated them to want to change to the better
and try and achieve a healthy lifestyle.
In this report, I will post the questions I asked and the answers I got, and then I will portray a small conclusion
on each person. I will call them “Person A” and “Person B”.
Person A:
When I asked Person A what he thinks of a healthy life style, he claimed: “In order to achieve a healthy life
style, you need to be financially comfortable, and have the time to invest in it, otherwise, you can’t do it,
especially in a country like ours where a salad is for 10$, and a burger is for 5$”. “It’s very easy to lead an
unhealthy lifestyle, the challenge lies in whether you can control what you eat and how you behave, and not
fall for the easy, but compete with the hard.”
Person A went along and explained that he believed that having or leading a healthy lifestyle is really worth it,
however he doesn’t believe he has the strength or the time to go through with it himself.
When I asked him if he believes he leads a healthy life style, his answer was filled with guilt as he said
“unfortunately, I don’t lead a healthy life style. I did diet for a couple of months and I have to say, I felt great,
but as soon as I reached my targeted weight, I lost my motivation completely. I stopped exercising and I went
back to eating junk food and fast food.”
Here I had to explain to Person A that “dieting” is different from leading a “healthy lifestyle”. I explained that
as soon as he made his weight the targeted goal, he was limiting his lifestyle. As the word portrays, it is a
lifestyle, not a phase.
He thought that was a very interesting point because he never realized that dieting was different from a
lifestyle, and he thought as long as he had to cut down on the chocolates or the burgers, then he could go
back to consuming them as soon as he reached the desired weight.
After that, I asked Person A if he believes his environment and surrounding permit him to lead a healthy
lifestyle, he said no. “I work in an office” he claimed. “My lunch break is a good 15 minutes; I eat what’s there
and what’s fast and I go back to my desk and resume my work. I do get food from home, they’re healthy and
home-made, however, I sit on a chair from 8 AM till 5 PM, and that doesn’t really allow me much movement.”
I then resumed asking person A what he thinks of when I say “Healthy Lifestyle”, he claimed that it is having
the “right eating habits”.

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Person A thinks he could have a better lifestyle if he had the right motivations; my friends don’t go to gym and
I find that affecting me because I have no motivation to drag myself to the gym and work out, I’m also always
outside the house so whenever I want to eat, it’s always the fast food and the junks that I find fulfilling, cheap,
and mouthwatering” he goes on to say “I have the needed finances to lead a healthy lifestyle in terms of
healthy food, however I do not have the time to do so. I don’t have time to make salads or to cook my dinner,
and I live alone, so there is no one to do it for me. So laziness takes over and I end up dialing Pizza Hut’s
number for a good greasy pizza”.
Finally when I asked person A how he imagines the physical appearance of a healthy lifestyle is, his answers
were:
- Color: Light Blue
- Smell: pine trees
- Texture: silky
- Shape: circle
- Taste: sweet
Person A and I went along and had a small chat where I explained a little bit about a healthy lifestyle, and
how it is not a punishment but a reward. I went on and asked person A how he felt about this small
interview he said that he feels guilty about the lifestyle he leads and he thinks he wants to change to the
better.
After that he sent me a picture of a cucumber and said “look Ranya, I’m having a vegetable!”
I felt pleased with the outcome and I felt like I made a difference, hopefully Person A will go on with the
change of lifestyle and sees the rewards it promises.
Person B:
With person B, the talk was different; he knew everything there is about leading a healthy lifestyle; however
his main concern is “Fighting so hard not to go back to my old habits”. Person B has lost around 25 kilos in the
previous year and a half; he now has a body he is pleased with and an appearance that satisfies him. “I went
from eating 2 burgers at dinner, to having a grilled chicken breast with a side salad. I’m content with my
progress, and I’m still working as hard to maintain my weight. I go to the gym nearly every day and I still
manage not to have those 2 burgers at the end of each work out.”
“I think it’s very easy to go back to your old lifestyle and your old habits, especially when leading a healthy
lifestyle takes up so much of your time, and requires a good amount of financing. To order a chicken breast for
dinner, that is for about 15$, rather than a burger knowing that the chicken breast will barely satisfy your
hunger is still challenging for me, sometimes when we go out I go for what’s convenient rather than what’s
healthy because it all depends on your financial situation.”
“What I try to do now”, claimed Person B “is to balance my lifestyle in a way where I can eat some unhealthy
meals, but at the same time make up for it in the next meal. I don’t think anyone can go on with a lifestyle
without having a juicy burger or a cold ice cream once in a while, and I think what’s keeping me going with the
healthy lifestyle, is knowing that I can reward myself with the “bad stuff” when I want to.”
“I do think that your state of mind affects your food. Before I started my diet, I was going through a rough
phase and although I had the opportunity to eat healthy food, I chose not to. I would have homemade dishes
in the fridge yet I would still order that pizza or the fries. But when I escaped that phase, when I figured that I
cannot go on like that anymore, I threw away the menus –so to speak- and I put all my energy on maintaining

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a good lifestyle; exercising helped me a lot as well.
When I asked about his environment, if it permits him to lead a healthy lifestyle, his answer was a definite
“no”. “I live in a place where everything around me is made up of fat. Their ingredients are 90% butter and
10% water; it’s very hard to find something healthy on the menu or in the restaurant for that matter.” “We
also don’t have the food dieting services where they deliver food to your house, 3 meals a day and you
wouldn’t worry about cooking or eating right. I live in a very small area where the facilities are limited and the
options are minimal.” “However, I do find the time to hit the gym at least every day. My friends go to the gym
too, so it’s easy for us to commit, we go together and encourage each other I guess. It would be hard not to go
when they do because the guilt would be too much. I also find the gym a huge motivation because then I
could have 2 sandwiches for breakfast and know that I will have to go burn away the calories later on that
day.”
When asked to imagine the physical appearances of a healthy lifestyle, Person B gave me the following
answers:
- Color: green
- Smell: flowers
- Texture: smooth
- Shape: triangle
- Taste: it’s like water, it tastes good, but it’s not strong enough to identify. You can’t explain what water
tastes like, so I can’t explain what a healthy lifestyle tastes like; but I know it’s good.
-
I left person B feeling accomplished in only 1 way, I knew I had no new information to give him regarding a
healthy lifestyle, and I knew that he has tried to do whatever it is to maintain that lifestyle, but I did succeed in
one thing: I made him realize the importance of what he has done, and I think I reduced his hesitation towards
giving up or going on. I have no doubt that this person will resume a healthy lifestyle, not because he has to,
but because he doesn’t see himself as he was before.
Tarek:
Case 1:
Domestic worker lives with other Workers in a construction site where dust and pollution is everywhere, he's
poor and doesn't have enough money to eat complete meals every day. He doesn't eat every day and when
he does it's a lot of bread and cheap stuff. He tries to save money for rent (after the building is done) and a
shower once every 2 days. He lives with 2 other guys for cheaper rent and they live in a very small room with
low hygiene. He doesn't believe he is un-healthy and claims he can work hard every day and he still has strong
muscular body. If he could get anything, he would ask for food because that's how much he's hungry. He does
not believe that stress could affect his health or future, and he consumes some alcohol if available when he
feels extremely stressed. He smokes more than 40 cigarettes a day while working (according to the
construction site, if the HSE office (if present) is not so strict).
Case 2:
A Domestic worker living with his family a wife and four children, he works hard to feed them and try to send
the old son to school, so he almost forget himself. His wife cooks some stuff when they can such as potatoes
and Mediterranean foods and although they're healthy food, he doesn't believe he is healthy because of the
lack of meat and fat in the food. They live in one room with a toilet which is not isolated from cold nights or

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warm summer sun. He doesn't smoke cigarettes but a hookah or a Hubble bubble ( shisha ) and he thinks it's
much healthier then cigarettes.
The government is not providing the domestic workers with any means to have a healthy life; all they can
afford is bread and processed meats, tuna and cheese. And most of their diets consist of dairy foods such as
cheese spreads and dry milk with toasted bread. They are not receiving their basic rights to have a healthy
lifestyle not even the information. And none of the Lebanese population who are in the same
socioeconomically status can afford a healthy lifestyle or even provide their new generations with education
to overcome this degradation in the idea of a healthy life.
Be the Change Model
May briefly introduced the Be the Change model:
 The basics (current practices and choices)
 I can do more: seeking best practices/choices
 Educating and influencing others (people around us)
 Community projects

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The best practice: ________________________________________________
The basics: The actions that I am doing now
(please add as many items as needed)
What actions I can do more
Educating and influencing others
Community Projects

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Then, we prepared ourselves to conduct FGDs with three groups of people who are the
community at the garden. Included were kids, women and elderly.
We divided ourselves into three groups and built on the questions that May had proposed and
proceeded with the discussions.
Elderly: about social pensions for elderly, what do elderly advise the younger so that they
maintain their health, what are the elder doing to maintain their health, in case we organize a
health festivity in the garden, what do they like to see? How can they contribute?
Women: Do they do self breast exam? What makes them strong and healthy? In case we
organize a health festivity in the garden, what do they like to see? How can they contribute?

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Kids: show us how you wash your hands with soap and water, what makes strong and healthy
(drawings)? In case we organize a health festivity in the garden, what do they like to see? How
can they contribute…?
Groups of students roamed in the place and interacted with people
We ended the session with brief presentation about the findings.

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Extracts from our reports:
Interactions with the community

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Interacting with children- By Cynthia, Mia and Ziad
Cynthia, Mia and Ziad were asked to walk around the Geitawi garden on the 10th
of October and to target children and ask
them several questions to see how they view different matters regarding healthy lifestyles. We did not pressure kids to talk
we simply gave them their space and freedom. Dr. Haddad told us that children in groups are more cooperative and
responsive so we started talking to children sitting in a group.
The questions were divided as follows:
1. Draw/ Sketch a picture that shows what does being strong or healthy look like
2. Ask them to show how they wash their hands
3. Suggestions from children for a small festival in the garden.
Cynthia was responsible for the first part. I moved around the area and asked children to move into the library holding
colorful pens and papers. The children were responsive and most wanted to get into the library and draw. These children
were intelligent, clever and were able to critically think and analyze. Different children had different perspectives of a
healthy life and each showed that through his/her drawing.
According to these two girls, Sahed - Bahir and Sybelle, we should protect our body and should eat healthy food in order
to survive.
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Ziad moved around the area and asked children if they knew how to wash their hands effectively. He tested their
knowledge through asking them to wash their hands in front of him. None of the interviewed children knew how to wash
their hands.
Mia walked around and asked random children about ideas to imply for a festival in this particular garden. The
results were as follows:
Games Football Handball Animation Puppets Pop corn Ice cream Cotton Candy Clown
Balloons Exposition on plants specifically sun flowers Chips Fireworks Face Painting Artisanal Work
Drawing Coupons and rewards
 Findings:
All what kids listed was directly related to unhealthy lifestyle and diets. What is interesting is that none of these
kids suggested having fruits as a treat or something healthy. The activities that they asked for are doable and
attainable only if we collaborate among each other. The activity was really interesting, I personally loved it. I loved
talking to children, listening to their conversations, their suggestions and discover what a wide imagination they
have and how creative they could be. It made me think of my childhood again in order to understand what they
were asking for or wanted to have. I compared their responses to mine if I were their age. I figured out that this was
impossible. With the knowledge I had I was judging if their choices are healthy or not but I understood that after all
when I was a kid I had similar choices too! It made me enjoy my time and motivated me to try and implement all
Last, Eva viewed things differently.
She believes that we can have
healthier lives if each one of us
becomes a princess and lives in a
castle.

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what they asked for which is fun but also teach them indirectly how they could be healthy and have fun at the same
time.
 Suggestions:
 Print fliers and post them around the park gates and ask the library there in the garden to send e mails to
neighboring people. Try to get confirmation of who might be able to come or not.
 Someone to dress like a clown. Make the kids dance and do animation for them. Give them balloons and do
face painting for them
 Another person could bring nice music for them to dance and gain activities.
 Girls can teach little girls to dance
 Boys will play football handball etc… whatever ball games the boys want to play
 Prepare popcorn bags at home
 Skip the cotton candy ice. Too much sugar is not good for their teeth and health
 Ice cream could be doable.
 Fruit is a better choice than chips.
 If anyone has puppets at home maybe they can do a puppet show for the kinds.
 Another individual could lecture kids about plants or handmade stuff in our country for example.
 We can let them draw their own drawings and maybe let them do some art and craft work with empty bottles
plastic cups glue and maybe threads. Let them learn that anything old can be reused (old bottles) which will
develop their environment friendly skills especially that many kids in Cynthia’s activity emphasized on the
importance of a clean environment for being healthy.
 Can contact an organization to do the activity and help up (non-profit organization) similar to the one I saw in
“spinneys” GMI maybe they are interested to help for free specially that they are doing this activity for free to
young children.

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Interacting with women- By Ranya, Rim and Tarek
In the occasion of Pink October, which is the month dedicated to breast cancer, we discussed this sensitive topic with four
random groups of young females at the “Geitawi garden” on October 10th
. We started our discussion by asking the
following questions:
1. What do you believe a healthy lifestyle is?
2. Do you think you are healthy? Does the environment around you allow you to be healthy?
3. Do you have any idea about Pink October?
4. Do you have any idea about how to do the self examination o breasts to detect any sort of abnormalities?
5. Do you do mammography on daily basis?
Our findings were the following:
Group 1: Two Lebanese mothers gossiping while their kids were in the playground
They were a bit hostile and not very welcoming regarding the subject and our approach. One of them was updated about it
while the other one did not share her inputs on this topic. Although they seemed a bit taken aback, we felt that they had a
general background on the subject at hands.
Group 2: Two Russian mothers
We believe that our approach was more welcomed. We should note that one of the women has a breast cancer background
(she lost her mother due to that). Although the woman was interested more about the subject, she seemed a bit reluctant
to actually go do the exam (fear of finding out if she has the tumor). The woman with her stood ideally by and listened.
Group 3: A Lebanese mother pushing her baby on the swing
She gave more of her time and seemed interested about the subject. She was aware of the self breast examination and
motivated in starting a healthier lifestyle (cooking, eating, physical activity…).
Note: she is living with her husband and his parents; she went on saying that she used to have a healthier lifestyle when she
was still in her parents’ house, however, that changed to the bad when she moved out.
Group 4: Two Syrian mothers
This group was totally unaware of the subject. They did not know about breast cancer, about the campaign, the self
examination and the required yearly examinations.
It is important to note, that although we targeted four different groups, of which three have different backgrounds
and cultures, none of them had the sufficient information about the subject.
It was unfortunate to realize that there are still some people unaware of the issues around; especially ones crucial to our
health. However, it was satisfying to know that our questions played an important factor in the awareness, and we would
love to think that we made a change and that the women will go home and invest in promoting their health and doing the
required tests.

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Interacting with elders- By Alissar, Caroline and Ribal

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Last week, on Friday October 10th
, 2014, the class was held at the Jesuit Garden and students were divided into groups of
three. Each group had to pick one category of people: Elderly, mid-aged women and children. Alissar, Caroline and Ribal
picked the elderly group. They walked around the corners at the garden and met many people that were sitting in groups of
3. All of the interviews were based on different questions such as:
1- What is a healthy lifestyle for you?
2- When we say illness or sickness in front of you, what is the first to pop up your mind?
3- How do you advice the youth to maintain a healthy lifestyle and avoid illness or disease?
4- Do you make any physical activity?
5- What about your eating habits?
6- If a health related festival was to be held in this Garden, how can you help with ideas or support to make it
successful?
They talked to 3 groups:
1- Two ladies and one man.
The conversation started by asking first if it’s possible to have 5 minutes of their time. One woman was smiling and she was
very appreciative, whereas the other one wasn’t really interactive. As for the healthy lifestyle, the woman said that she is
basically sick “ aamaliyit alb maftouh ”, and she lives in an environment where her son (the man sitting next to her) is sick as
well. She had to take care of him as he’s not being able to work anymore, due to epilepsy, which involves her in physical
activity. As for eating habits, she said that it would depend on their financial abilities. But, she mentioned that she cooks
healthy with “OIL / LESIEUR” and not “ samneh “ and they eat everything “biftek w batata, riz 3a djej, w foul”. Concerning
the festivities, the first idea to cross her mind was that she was asked for money. After being explained that the support is
humanist and not materialistic, she asked the group to ask the second lady “hiye bta’arif aktar menneh”. The other woman
didn’t understand the question and barely answered, saying that she had hearing problems.
2- Three men:
The men seemed to be indifferent and neglectful at first, and weren’t taking the approach seriously. When provided with
more explanation, the oldest man (89 years old) among three was leading the conversation, talking about some old
experiences and events concerning physical activity “ emcheh mnel cheyyah aal hekmeh” which would take 4hours “rawha
rajaa”. When asked about his lifestyle, he said that eats on time 3 meals per day, and drinks “ Arak mich Whisky”. The
second man then got interested and his advice for younger generation was based on avoiding drugs and smoking “ma
tetaato ya chabab, hayda al tari’ al bechi’”. Then, when they were all asked about the first disease that pops up their mind,
all of them agreed on cancer, then came up the suggestion for helping in participating in the health related festival, which
was based on promoting cancer campaigns.

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3- Two men and one woman:
When the group arrived to talk to those people, the first man didn’t show any interest, without even knowing what the
topic is about “ma eleh khele’ “. Then, the approach turned out on the others who really got into it. The oldest man said
that youth should avoid smoking because it’s a very bad habit, although he was holding a cigarette in his hand. He said he
smokes up to 7-8 cigarettes per day. When asked about his lifestyle and eating habits, he said that he doesn’t have dinner
and sleep at 10, and when he wakes up, he drinks a cup of milk. That was the healthy way for him to have a good quality of
life. As for the physical activity, only one of them said that he walks from his house to the park. When the students asked
them about the first disease that pops up their mind, they all answered “cancer”.
Conclusion:
After discussion, the students concluded that the people questioned had little knowledge about healthy lifestyle, and their
information is strictly based on their own experiences/cases. It was obvious that they were mainly talking about their
disease/pain/suffering – a clear sign of depression, according to their facial expression, body language and responses.
As long as the garden is a space of recreation for elderly, it would be a very interesting idea to hold a health related festival
there. It would be helpful to promote physical activity by offering/doing stretching exercises and making them participate.
Moreover, older people need to have a better vision/perception of life and thus accept their general state without being
ashamed or feeling weak. Therefore, the festival should focus on promoting positivity, and seeing life from a brighter
perspective.

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Place: Computer lab
Special thanks to Cynthia for leading the stretching exercise
Images from the session: posted on Face book page
We started with an open forum followed by stretching exercises that were lead by Cynthia
(handouts of the exercises were distributed to all)

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Students worked individually and as small groups and followed the exercises that had been sent
to them as an e-mail and PPP attachment. We introduced a fun game during the session and
ended the class with an open dialogue about the session.

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Exercises Computer lab-1
1. Useful links
Step one
Kindly familiarize yourself with the following sites
World Health Organization: Health topics
http://www.who.int/topics/en/
Healthy Lifestyle- Mayo Clinic
http://www.mayoclinic.org/healthy-lifestyle
http://www.mayoclinic.org/search/search-results?q=healthy%20lifestyle
NHS
http://www.nhs.uk/Livewell/Pages/Topics.aspx
Health Tips for Healthy Living
http://www.medicinenet.com/healthy_living/article.htm
Step two
Be an advocate to one site and tell us why it is great
What other sites do you find useful
When do we say that a site is Credible?
What are your impression if someone quoted just one site in his/her paper or presentation?
2. Set yourself a challenge
http://www.cutyourcancerrisk.org.au/quiz/default.asp#.U8au6PmSzG-
3. Video: Watch the video- pick up one finding and validate it after consulting professor
Google - Add your comment to the file https://www.facebook.com/notes/pdhp-
246/comments-on-the-video/973338369349867
Video's link: http://www.npr.org/blogs/goatsandsoda/2014/07/31/336369873/how-will-
youdie?utm_source=facebook.com&utm_medium=social&utm_campaign=npr&utm_term
=nprnews&utm_content=20140731
4. DPHP 246 Face Book page
Students skimmed through the page: images, photo albums, files/documents and
responded to the following tasks:

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1. Pick up one image that you like: write down why did you pick up that image
2. What do you like about the page?
3. How can it be better?
4. Is it time that we open up to others? If yes, what do you propose (make it an open
group? Add our friends after we talk to them about their interest? )
Comments on the picture chosen
Mia, Ranya and Cynthia: Collaboration and team work made our day at the Geitawi garden fun
and successful. I believe that the key to the useful and active learning is the creativity in location
choices and peer interaction. We can notice in this picture how attentive we are while listening
to each others' experiences without getting bored. Mia Cynthia and Rania May Haddad
Alissar: I picked this image because first of all, i really enjoyed the activity and learned a lot.
Secondly, i liked the fact of being all together and working as a team. It was an amazing
experience and hope for more to come. Thank you Dr May Haddad
Caroline: I consider that this image shows the real image of our teamwork, we share education,
good times, and friendship. So, i chose this picture because it reminds me in the interesting
activity we have done last week, where we communicated in a perfect way, exchanged different
point of views, and the most important thing is that we enjoyed our time together.

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Ribal chose a different image of the students with May and other friends. He commented as
follows:
Ribal: Besides the first image I picked, I guess this picture is a very nice picture. It shows a
moment of joy. We were celebrating Caroline Richani birthday. It's a colorful picture. It involved
all of us, especially Dr. May Haddad, because rare are the pictures where we all appear in.
Comment about the facebook page
Ribal, Alissar and Caroline:
We do like this page, because it's a sort of album that collect all our memories and experiences
that we had throughout this course. It's a link between all of us, students and tutor, to
strengthen the relationship among us. Moreover, besides pictures, we can find a lot of
interesting web pages (links) related to healthy lifestyles and health issues.
Mia: The group is not yet ready to be open to public since it contains material such as homework
and information related to the class community. It might be useful to make it public when we
start doing events and posting health information that interests the community we live in.
Having the homework through e mail is a better idea.
It is cook to have all our pictures posted, share nice links and YouTube videos and other types of
media in order to make education easier and more fun.
The facebook page makes us more active and reinforces peer communication and builds stronger
bonds.

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Our results: Set Yourself a Challenge
http://www.cutyourcancerrisk.org.au/quiz/default.asp#.U8au6PmSzG-
The challenges that I was given where:
1. Using more of the 5 sun protection measures when there is high UV radiation
2. Checking the sun protection times before leaving the house
3. Eat more than 1 first per day
4. Eat more veggies per day
5. Check out sun smart and BOM websites
I have decided to take on more than one 1 challenge as they are not hard ones and require a little change in my
habits. The more important ones I will be taking are the fruits and vegetables ones, my consumptions of them is
very low and thus I will try to add as much as possible both of them to my daily meals. As for the sun protection it
is not very much needed during winter due to the weather however when the summer comes it will be important
to apply protection especially outings during the peak hours.
***
Challenges
* Call the Quit line on 13 7848 (13 QUIT) and have a chat with an advisor.
* Give up energy-dense snacks or soft drinks.
* Make a conscious effort to adopt the 5 sun protection measures when the UV is 3 or above.
* Get into the habit of checking the sun protection times whenever you're going to be out and about.
* Eat one more piece of fruit each day.
* Add one more serve of veggies to your daily diet.

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Results of our life-style choices and practices
This report compiles students’ current choices and practices and what they like to see improved
in the themes of Eating, Exercise, Stress, Smoking, Alcohol, Sleep, and more.
#####

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EATING
OUR CURRENT CHOICES AND PRACTICES:
 healthy food ( avoid junk food and nibbling) eat more organic food vegetables fruits whole grains meats (lean) poultry
fish and dairy products (low fat). Avoid trans fats and saturated fats. Consume more of natural fats and unsaturated
fats such as avocadoes raw nuts and olive/plant oil
 I try to eat healthy ( balance and complete my meals)
 I eat healthy food mostly based on fruits and vegetables
 Eating nutritious food, by trying to avoid fats and sugars and focusing more on a protein-vitamin based diet plan
 A good diet
 Healthy eating habits
 The fact that I take homemade lunch already prepared on weekend to have during the week when I am away from
home. This food normally is based on vegetables and less on any kind of meat
 When I go grocery shopping I always grab some greens that I sometimes make salads of them to which I add no
dressing at all which makes it even healthier
 Eat- if not always healthy- at least a good quality food. (I mean by not healthy, fatty or sweet). Varied diet, rich in
proteins, carbohydrates, lipids, vitamins and minerals.
 Healthy food, I cook my own food and most of the time I get my products from my village where I'm sure it's not a
GMO products, and at the same time I eat it in its natural maturity season.
WHAT WE LIKE TO IMPROVE:
 I would like to improve more my eating habits to have a better lifestyle because lately I have been nibbling and eating
unhealthy snacks
 I want to reduce consumption of fast food
 To know how to cook healthy food (to have a healthy diet plan)
 Maybe a healthier diet
 I would like to improve my eating habits
 To be able to organize my diet
 Changing my eating habits
 The one challenge I would like to achieve is to have a constant healthy three meals a day because I am used to skip
breakfast or have a minor one when it is the most important meal of the day and sometimes I skip my lunch which
causes me to have a heavy dinner which sometimes is junk food

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PHYSICAL ACTIVITY
 exercise a minimum of 30 min daily
 Continuous exercise to boost energy and be active enough
 Every time I drive to university or take a taxi to it, I stop the car away couple of meters from the university which adds
some exercise and movement
 I go to the gym almost every day
 I exercise through dancing
 I go hiking on weekends around my village and spend time in nature and I feel it's the best stress relief method
 Some good exercise!
 Physical exercises
 I want to get back on track with my physical activity
 Exercising from time to time
 I should do more cardio sports
 Maybe some more exercise
 To have more energy to exercise more
 I would like to improve the physical exercise aspect of my lifestyle
 I have been having some trouble exercising on regular bases and I guess that is to be blamed on my lifestyle now,
which includes university and studying. University in the morning and studying in the evening, it gives me little time to
go exercise, furthermore laziness plays also a role in the list of reasons, as I come tired from university and usually
have no motivation to go exercise
 I guess some physical exercise will be very helpful, especially for me to burn fat and be in shape
 Go back to my martial arts classes, or at least do any sort of Exercises

STRESS
 try to reduce stress in some ways
 Having a positive attitude to avoid stress and nervous behaviors
 As for my mental health, I do not tend to get angry easily, and try to avoid or ignore things that might annoy me

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 Escaping from the city and having a road trip to the mountains where I can breathe clean air
 I go hiking on weekends around my village and spend time in nature and I feel it's the best stress relief method
 Have an efficient way in stress management
 Reduce my tendency to stress for, for example exams
 Stress management, because I get stressed quickly and it affects my health immediately by lowering my blood
pressure
 to get rid of stress and external pressure to have a healthy mind
Stress management
SMOKING/ALCOHOL
 I avoid alcohol and smoking
 I done smoke, non-alcoholic
 no smoking, no alcohol
 I don’t smoke at all, I drink alcohol occasionally, and I know my limits
 Moderate smoking and consumption of alcohol
 I think stopping smoking could help me achieve a better lifestyle
 I would like to lessen the amount of cigarettes that I smoke per day until I reach a stage where I can turn to be a non-
smoker again
 I should decrease or cut down the consumption of alcohol.
SLEEP
 Sleep early… get enough sleeping hours for healthy functioning of the brain and energy for physical activity
 Allowing my body to rest through “healthy” sleeping

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 I have a very precise sleeping schedule, a minimum of 8 hours of sleep every day, and don’t tend to stay up late if not
necessary
 I would like to add more sleeping hours/ I should have more sleep.
MORE
 Going out
 Love/family/friends
 Being loved my everyone
Hygiene: 1- Showering at least once per day
2- Brushing teeth at least twice per day
3- Wearing clean clothes and underwear
4- Live in a clean house, drive a clean car
 Practice Healthy Sexuality
Every year I get medical checkups/ make checkups at the doctor
 I’m the kind of person who tends to postpone everything to the last minute; although I took the stress management
course, that emphasizes on time management, that I also already have, but I still have the problem
 University in the morning and studying in the evening, it gives me little time to go exercise, furthermore laziness plays
also a role in the list of reasons, as I come tired from university and usually have no motivation to go exercise
 I would like to focus on a different point in my lifestyle; staying up late. This is affecting my whole lifestyle, mood,
behavior and emotional balance

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Our Case Studies
The following narrations are developed based on students’ weekly agendas. They have been
used in practices analysis using the following framework:
The practice/s or
intention/s
How do you assess the practice/s? What can be improved
Narration one (by Karim):
Elements that I consider it makes my lifestyle healthy are:
1) the fact that I take homemade lunch already prepared on weekend to have during the
week when I am away from home. This food normally is based on vegetables and less on any
kind of meat.
2) When I go grocery shopping I always grab some greens that I sometimes make salads of
them to which I add no dressing at all which makes it even healthier.
3) Every time I drive to university or take a taxi to it, I stop the car away couple of meters from
the university which adds some exercise and movement.
4) I don’t smoke at all, I drink alcohol occasionally, and I know my limits.
5) I have a very precise sleeping schedule, a minimum of 8 hours of sleep every day, and don’t
tend to stay up late if not necessary.
6) As for my mental health, I do not tend to get angry easily, and try to avoid or ignore things
that might annoy me.

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Narration two (Samia):
I am proud of myself because I attended all classes and did not fall asleep in either one. I was
able to make it out of bed in the morning even though every cell in my body was demanding rest
and more sleep.
Important elements that make my lifestyle healthy include: Eating nutritious food, by trying to
avoid fats and sugars and focusing more on a protein-vitamin based diet plan. Today, I am happy
I did not exceed calorie intake, meals were healthy and chosen wisely.
I have been observing my smoking habits as follows: i have been trying to cut down my smoking,
today I smoked 3 cigarettes which is still more than I had hoped, but still less than what I usually
go for.
Narration three (Farah):
I am proud of myself because i ate turkey and goat cheese with veggies and dark coffee for
breakfast. I had carrots as a snack and for lunch i had quinoa salad with lean steak and peppers.
As for dinner i had a grilled fish fillet with grilled vegetables and grilled potatoes.
I studied my lectures for the day, I spent the day with a close friend of mine. We had a movie
night together. I slept at 3 am because my friend was annoyed and i was really glad to be by her
side. I woke up by 7 am. I did not sleep well. Total hours of sleep: 4 hours.
Generally, I would like to add some hours of sleep. One thing that I also like to develop is to
reduce my tendency to stress, for example exams.
Narration four (Hani):
What elements make my lifestyle healthy?
1/ Hygiene: 1- Showering at least once per day
2- Brushing teeth at least twice per day
3- Wearing clean clothes and underwear
4- Live in a clean house, drive a clean car

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2/ 1-Eat- if not always healthy- at least a good quality food. (I mean by not healthy, fatty or
sweet)
2- Varied diet, rich in proteins, carbohydrates, lipids, vitamins and minerals.
3/ Moderate consumption of alcohol
4/ Moderate smoking
5/ Escaping from the city and having a road trip to the mountains where I can breathe clean air
I would like to lessen the amount of cigarettes that I smoke per day until I reach a stage where I
can turn to be a non-smoker again. In addition to that, I would like to focus on a different point in
my lifestyle; staying up late. This is affecting my whole lifestyle, mood, behavior and emotional
balance. Moreover, I guess some physical exercise will be very helpful, especially for me to burn
fat and be in shape. To be honest, there’s a point that I didn’t mention in the previous question
that I would like to mention here. I’m the kind of person who tends to postpone everything to
the last minute; although I took the stress management course, that emphasizes on time
management, that I also already have, but I still have the problem.
.
Narration five (Mira):
My week in a paragraph
I don’t put myself in the category of people having a healthy lifestyle but I think I am halfway
there. If I look again at what I did or ate this week, I will find the following.
On Monday and Tuesday I ate home cooked meals for lunch and I didn’t go around nibbling
snacks the whole day as I normally do. I just had fruits on Monday during a class activity. I didn’t
do much physical exercises. I was studying for my exam on Tuesday.
As for Wednesday, I went out with my friends and had half of a club sandwich for lunch, with
side fries. At 7 o’clock, I went to the gym as usual and trained for an hour. My trainer noticed my
improvement and was impressed by it and proud of me. I am proud of myself as well.
This is in general, what happened during this week so far. This is surprisingly the healthiest one I
have had for a while. In addition, I spent money on my lunch, the training session and coffee in
the morning at the university. I think I am starting to cut down my expanses a bit. I am doing so
to encourage myself to have more real food and to go shopping with the money I have saved.

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Narration six (Jamal):
My week in a paragraph
In the last week I managed and made sure to have 5 meals per day: (Breakfast, Lunch,
Dinner, and two snacks in between). I only had one serving of fried food. I did my best to
have smart snacks instead of snacking on chocolate, cake or chips. I only had one can of
soda drinks. I only had two glasses of alcohol.
I took a shower twice a day and brushed my teeth 3 times/day. I also tried my best not
exceed 15 cigarettes per day and I was successful in doing so for 3 days out of 7. The
reason behind that is that I didn’t sleep well. And when I usually don’t’ sleep well; I tend to
smoke more than the usual.
I only slept 3 nights out of 7 and this was overwhelming and exhausting. I tried my best to
manage my stress and deal with it in the best way I could, but the tasks that I had to do
were as just too much. For future plans I will do my best to working on managing my stress
in better ways and devote more time for sleeping and focus on that because it might be a
solution for other issues.

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People: Rim, Cynthia, Caroline, Ranya, Mia, Tarek, Ziad, and May
Visitors: Rana, Susan and George
Place: Tomates Cerises
Images: Face book page
Learning through entertainment was practiced in this session where we were introduced to
games and healthy practices in nutrition and anti-smoking through board, card and dice games.
Included were: (1) Bye Bye Anemia board game, (2) nutrition snakes and ladder board game, (3)
Powerful World board game, (4) No Junk cards games and (5) the dice game.
The session was also a time for us to sketch the tentative plan for the upcoming Geitawi garden
festival on Oct 31.
Rana- the owner of Tomates Cerises introduced her place and shared principles in healthy
cooking.
Tarek demonstrated movements in martial arts that he practices.
Songs from the CD “Health and Happiness” were played during the session included were health
songs by Rim Banna, Paul Abi Rashed, Sami Hawat and Paul Mattar (May Haddad’s collection)
The session was evaluated positively as follows:
 Very entertaining, beneficial and useful
 Very interesting information
 Very entertaining, we loved it, Kids will find the games most exciting!
 Fun
 All were nice

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 We liked the information about veggies and fruits, not to have tea with foul, chips not
good for us etc.
Parking lot: An interesting debate between Caroline and Tarek
Caroline: such games enhance communication between kids instead of I-Pads
Tarek: Such games should be integrated into I-Pads that kids use so often
Note: Copies of the 4 games were given to all (Powerful World, No Junk, Bye Bye Anemia and
Snakes and Ladders).

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Tarek teaching Mia and the class martial arts

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Our questions about breast cancer
Readings from Breast Cancer Action
 Breast Cancer Risks: Facts & Myths
 What You Should Know About Breast Cancer & the Environment
 The Facts and Nothing But the Facts
 What to Do When Someone You Know Has Been Diagnosed with Breast Cancer
 Should I have a mammogram

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 Where do chemical exposures that might lead to breast cancer come from?
 How did marketing affect the pink October breast cancer campaign?
 Give four things to do when someone you know has been diagnosed with breast cancer.
 What are the true risk factors that increase the probability of having breast cancer?
 What are the things that you SHOULD DO when someone you know is diagnosed with
breast cancer?
 Which chemicals found in our environment can cause breast cancer?
 What factors contributed in increasing the incidence of breast cancer?
 What are, in summary, the steps one should make when someone he/she knows has
breast cancer?
 What is the main concern of Christie Allen regarding the breast cancer awareness
campaign?
 Where do chemical exposures that might lead to breast cancer come from?
 How did marketing affect the pink October breast cancer campaign?
 Give four things to do when someone you know has been diagnosed with breast cancer.
 What are some chemical exposures we face that lead to breast cancer?
 What are some factors we stumble upon in our everyday life that could cause -breast
cancer?
 How can you reduce the probability of having breast cancer?
 In your opinion what is important in relation to breast cancer, prevention or early
detection? Clarify?
 Can socioeconomic status of a person affect the risk of him/her getting breast cancer? If so
how?
 Does social interactions help improve the environment of the cancer patient? How?

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 Does the exposure to chemicals increase the burden of breast cancer?
 Name two factors that studies have shown to contribute to breast cancer. Explain briefly.
 Is there any scientific evidence that alcohol consumption and the continuous wearing of
bras actually contribute to breast cancer?
 Breast cancer questions for the exam:
 Why do you think that the percentage of women having breast cancer is increasing in the
U.S?
 List some supporting steps that a person should do when he/she has a close women
diagnosed with breast cancer.
 Why is alcohol one of the main risk factors causing breast cancer? List some other risks.
 Can physical activity reduce the risk of breast cancer?
 Can a healthy diet help to prevent breast cancer?
 Does smoking cause breast cancer?
 Is self-examination the best way to detect breast cancer?
Breast Cancer matrix (students’ responses)
Pathogenesis
 It is a series of molecular alterations at the
cell level forming alterations in breast
epithelial cells with immortal features and
uncontrolled growth
 The disease subtypes is aligned with the
presence or absence of estrogen receptors,
progesterone receptors, and human
epidermal growth factor receptor 2 (HER2).
Risk factors
 Family History (first degree female
relative)
 Genetics
 Personal History of breast cancer
 Radiation to chest or face before the age
of 30
 Certain Breast Changes (benign tumors)
increase your risk to developing breast
cancer
 Race/Ethnicity: white females are at a
higher risk than blacks Hispanic or Asians.
However, if a black woman develops
breast cancer she will get the aggressive
version.

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 Being overweight
 Pregnancy history
 Menstrual history
 Using HRT (hormone replacement
therapy)
 Drinking alcohol
 Lack of Exercise
 Having dense breasts
 Smoking
Best practices to protect ourselves
 Self breast examination
 Limit alcohol
 Do not smoke
 Control your weight
 Physically active
 Breast feed
 Limit does and duration of hormone
therapy
 Avoid exposure to radiation and
environmental pollution
 Healthy diet
 Mammography
Best practices in case the
person has breast cancer
 Follow up and check up
 Healthy diet
 Keep track of medication
 Conserve energy
 Avoid smoking
 Avoid alcohol
 Get exercise
 Manage stress
 Know when to seek medical support

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People: Rim, Cynthia, Caroline, Ranya, Mia, Tarek, Ziad, Alissar and May
Place: Class 303
Images and videos: Face book page
We started with as short mindfulness meditation. The students took turn in 8-10 minutes
presentations. Other students graded the presentation by: Extra ordinary, Excellent, Very Good,
Good, Satisfactory, and explained why the grade.
Towards the end of the session, each student reviewed what peers have graded her/him and
commented as follows: (1) My response, (2) What would I have changed based on the feedback
that I got and what I have observed in this session?
The presentations were:
Student Presentation
Ziad Alzheimer (PPP)
Rim Acupuncture (PPP)
Ranya Facial expression (talk and facial expressions)
Caroline Lead poisoning (PPP with reference to campaigns)
Cynthia Tobacco (PPP: integrated personal stories)
Mia Food Allergies (PPP included table of contents
and quiz +answers)
Tarek Addiction (Dialogue)
Among the responses:
Ziad: My response regarding the presentation is that i could have included a few more
information regarding my topic, to fill out the time remaining. The feedback i have received
where mostly excellent with one very good and one extraordinary, however most of my

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classmates seem to have forgotten to write down the why part of the evaluation, except for 2
comments that where positive regarding my presentation and did not include negative
comments, thus it is difficult for me to write down comments regarding my presentation and
what i will change next time.
Among our responses:
Tarek and Rim ended the class with a demonstration of Martial arts.
Ziad sent an e-mail evaluating the session as follows: it was generally good since it gave us a
chance to present what we have prepared, and share what we have learned with the rest of the
class. Thanks to all.

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PPP by students
As homework, the students picked up a relevant topic of interest to them, did a web research
and developed a PPP that included: the topic, links reviewed, and most interesting findings.
Several of these PPP were presented during the classes. The PPP were as follows:

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People: Rim, Cynthia, Caroline, Ribal, Mia, Tarek, Ziad, Alissar and May
Place: First floor terrace
We started the session looking at the resource books that some of us have selected and
presented the books to the group.

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We started the session looking at the resource books that some of us have selected and
presented the books to the group. Tarek shared ### and Alissar #####
Mia shared with us her book and an article #### as follows:
Book title that Mia shared with us
Mia additionally shared an article as follows:
We reviewed the course two main textbooks:
Health and Wellness”, Public Health in the Arab World”, The Hesperian Health Guide resource
books of Helping Health Workers Learn, Where There Is No Doctor, Where Women Have No
Doctor, Environmental Health and Women with Disabilities. May also introduced 3 other useful
books for us in this course.

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The two main textbooks of the course:
Ranking the chapters of the two main textbooks:

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Announcement:
To help friends stop smoking, please check out Allen Carr’s book
Copy at Habib & Fouad Abi Chahla-Medical Library.

138
May’s feedback to students’ presentations of session nine
May praised the group as diverse and talented. She shared what worked very well in the
presentations as follows:
 The way Tarek sat with us on a chair in a circle. He led a discussion and talked to the
group. To emphasize his topic, he wore a related T-shirt
 The effort that both Mia and Ziad did to engage the audience through quizzes
 Mia beginning her presentation with a slide that showed an outline of what to come
 Starting with a personal story as Cynthia has done was very powerful in gaining attention
 Referring to the Lebanese law as in Cynthia’s presentation
 Success in creating a hot issue for discussion after the PPP as was the case with Cynthia’s
presentation
 Rim and Cynthia, presenting themselves and the reason of their choices of topics
 The passion that both Ziad and Caroline showed when they were presenting their topics
and the way they (and Mia) interacted with their slides
 Caroline’s referral to campaigns and actions
 Rim’s interest in alternative medicines and her willingness to accept the comments given
to her saying that she will improve for next time
 The power of good performance and using body language as was the case with Ranya
What to improve
 We need to always check the accuracy of what we say and not make conclusive
judgment
 Need to improve PPP techniques (font, using the space, using images, references)
 Need to re-examine our objectives. If helping others think and learn is high on our list,
then we need to re-examine well our approaches and means of engagement
 Be aware of our body movement and gestures
 Not to take it personal and to look at the feedback as learning opportunities to develop

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People: Rim, Cynthia, Caroline, Ribal, Mia, Tarek, Ranya, Alissar and May
Place: Class 303
Hospital
Acquired
Infections
Starting with a
personal experience,
Alissar presented her
topic of Hospital
Acquired Infections. A
hot discussion was
generated about the
use of medicines,
antibiotics abuse,
issues with the medical
system, poverty etc.

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Useful books
Cynthia, Caroline, Rim and Ribal presented the books that they had found useful.
Ziad shared with us this book and he commented:
“I have chosen this book as it talks about public health but in an
anthropological perspective. It is important because it helps a
person realize and understand that it is important to understand
the culture of a certain community before implementing a public
health intervention. By understand the culture it will help the
intervention be more successful and beneficial to the people.”

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Ranya Favorite PH book:
Ranya reported: I stumbled upon a book at the library which I read only out of curiosity, it was
called “stuttering”. It talked about why people stutter, how it’s done, and what brings stuttering
upon people. It lists ways of dealing with it, along with some medication that might help out the
stress in a person (since stress increases the rate of stuttering in a person that stutters). I thought
this book was very interesting, and I believe that everyone should read it. It’s a small book, but it
is full of information no one ever knew about stuttering (like how the parents play a huge role in
the whole issue). I took a personal interest in that book because I subjected to it in my life (my
cousin suffers from stuttering) and after reading that book I realized that now it is easier for me
to try to help out, and it is easier for me to try to understand. People don’t really give stuttering
an importance, and some might see it as a horrifying disorder. Sometimes I see how people treat
my cousin or look at her as if she is a freak coming out of a circus. So I guess if more people were
to read this book, things could be easier, for us and for the stutterers.
Best Practices/Topics of our presentations
We shared the best practices (What I should do/know) with respects to the topics of our
presentations as follows:
Caroline: The tasks that I do in order to prevent lead to emit to my body:
1. We prevent using food containing lemon juice in traditional Lebanese clay mediums.
2. We know what water we drink (soha or nestle) in order to avoid exposure of contaminated water.
3. At my house, we do not get in direct contact with household wastes, where we have large barrels to throw
directly thing by thing and to be taken by Sukleen workers.
Rim: After listening to all the presentations in class, I did the following:
 Told my mom to stop using potteries as containers of hot and acidic food since they might have Lead in
their composition (Caroline’s presentation);
 Be more aware of the food that might decrease my energy… (Mia’s Presentation)
Ziad: I have learned that Alzheimer diseases preventions starts at a young age and not when a person grows
old should he start to worry about it. So I have decided that there are some practices that I must take into
consideration and start to practice them in order to protect myself from Alzheimer later on in life.
1. I should do regular exercise. Exercise can greatly reduce the risk of getting the disease, and thus I must
start a daily exercise plan and apply in without excuses.
2. Healthy eating, and avoiding harmful fats found in fast food, the practice I must do is increases my
intake of health fats such as omega 3, 6, 9.
3. The practice I must do is mental stimulation and exercise. Since I am at university, I am under plenty of
mental exercise as I grow older that tends to decrease and thus I must continue to challenge my brain

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at times where mental exercise will decrease.
Cynthia:
 I would never smoke a tobacco cigarette because of the associated health consequences.
 I would stay away from smokers to avoid being a passive smoker and thus avoid inhaling all the toxic
substances.
 As a public health student, I will try to convince smokers to stop this.
Mia: After my project about food allergies I became more aware of the possible allergens
I did an intolerance test just to know what are the potential foods that might cause me discomfort.
I now understand why my friends who have allergies why they avoid certain types of food or restaurants of
why they don’t share me my lunch box
Started following a diet where I reduced the intake of the food that I am intolerant to.
Read labels and ingredients on the products before I buy them.
Alissar: What do i practice after experience:
After a personal event and my internship at St Georges Hospital in the Infection control
department i had a passion for this domain and i believe that it is a key to reduce the human
cases mortality and morbidity worldwide. I learned a lot. To be able to make a change, you
must start with small steps and personal steps at home.
I do it myself. I make small steps to satisfy my person and to indirectly show people the right
way of infection prevention and control. I wash my hands for 30 seconds as the WHO hand
hygiene steps describe it. If i cook, I make sure to have tied hair, clean hands.
I learned how to sneeze and cough in the right way. If i go to a hospital, i wash my hand
before and after entering a patient room, I try not to be touching the patient objects (cups,
water bottle...). And the funny part is that now that i had an experience and knowledge of the
domain, i have a tendency to make remarks to healthcare practitioners when they do wrong.
Ranya: Practices for my presentation as I mentioned in class, are limited. I can’t really have
practices with strangers or apply facial expressions with everyone or on everyday basis.
However, now I challenge myself in finding out the secrets and hints that I learnt and I try
applying them, and sometimes I share them with friends and try to get them to see what I see.

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Dance Movements: Caroline led us into dance movement and Cynthia presented key points
for the breast awareness stand to be implemented during the Geitawi festival.
BEST PRACTICES-GEITAWI GARDEN HEALTH FESTIVAL
Groups looked at the best practices that they hoped to be advocating during the Geitawi festival.
One group focused on children, second on women and the third on elderly.
We looked at the activities of the Geitawi festival day and discussed roles.

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How we see our roles in the festival
Alissar: For the festival, i truly see myself having some fun activities with elderly and i am sure that i and they will enjoy
the time. However, i have some doubts concerning « playing football » because maybe some of them wouldn’t be able to
play because some health problems. And maybe that would be a bit unfair and annoying for the person. Maybe, if
possible, we could find an alternative in case we don’t get a good number of people playing. No?
Caroline: For the Geitawi festival, I would like to take some tasks in order to help in making this event meets
success. First, because I attend dancing sessions in my daily life. So, giving some moves to the women in order
to let them exercise in a simple way will be a good idea. Where these moves will be simple and practical, where
women can exercise it at home without the need of a personal coach. Second, I would like to be the one sharing
with Cynthia (maybe) the activity that will be done for breast cancer awareness. I like that topic and it means a
lot to me to help and give useful information about an interesting topic like that. At last, I would be the one
making the breast cancer awareness ribbons. Maybe a small ribbon can be a great message for awareness or
even taking action.
Rim: I would love to be in charge of the face painting corner if possible. And since I have no problem in dealing
with children, I can be in charge of children drawings and help Mia or the person responsible of the games
corners.
Cynthia: First, there would be a lecture about breast cancer awareness to the women of the garden. I will be
presenting some facts about breast cancer in Lebanon and globally. Then, I want to highlight the symptoms
associated with breast cancer and who are those who are more prone to developing breast cancer. Last, I will
end up my session with detection methods be it detection or mammography. Second, when I finish the
previously mentioned part, I would like to join the children and proceed with the games or drawings. Note: For
the first part, 4 to 5 pictures need to be enlarged that are related to the self-assessment test. I contacted Maliks
and they mentioned that this might cost 2000 to 4000 each
Mia: I was assigned to be in charge of the overall activities for the children and the games corner. I believe I can
perform this task and it wouldn’t be difficult to deal with it. However I am ready also to help in dancing with
Caroline or making the breast cancer ribbons or even provide some copies of the breast cancer brochures I got
with me from the awareness conference done at the Ministry. I will also try to find volunteers to help around in
the children activities and games.
Ziad: My task as talking to the elderly regarding Alzheimer and informing them is something I am pleased with, I
can inform them of all the important stuff regarding it. I can also help out my classmates with their duties if
anyone needs help during the festival.
Ribal: Be the link among different stands, stations and colleagues. Inform people about the festivity. Collect
their comments. Explain to them anything they would like to know related to what we’re raising awareness
about. Give the team some energy and positive vibes to make it for active.

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Educating and influencing others
The following are the students’ comments on the reading from “Be the Change Action Guide”
Alissar: Communication skills are a subject that is very important for me because i think it is the best way to
listen and to get knowledge or information and, to be understood and transmit a message. To find the right
words with the right intonation according to the situation and the people you are talking should be meticulous.
Some people do not pay attention to the words and related behaviors ( body language, seriousness, respect,…)
which result in a misunderstanding both ways. To communicate/transmit a message, you need to be respectful,
not judgmental, appropriate to the situation you are exposed to, focused and aware of what you are talking
about and with whom. Words can change the mood, feelings and emotions of a person. I will take a small
example, but said from personal experience. Nowadays, healthcare practitioners must have a course of
communication skills to be able to know how to deliver information to the patients and their families according
to particular situations. Death, severe diseases or even remission phases are words that must be said with huge
understanding, humanism and attention- depending on the people and their cases.
Caroline: “Body language"- I find that body language is one of the most important skills that a speaker should
have because it is a way of attracting people and connecting better with them.
Rim: I personally found that all the communication skills present in the document at hand interested me.
However, the one that attracted my attention the most is: “Speak from personal experience”. If I put myself in
the shoe of a listener, I would be more interested in listening to the speaker if he/she shared with us his/her
personal experiences regarding the topic discussed.
Ziad: All the points in the guide are important and most of them should be used when talking a person, because
they will help the speaker reach their point in a much better way to the listener, however the point that has
attracted me the most, is the point “Be Curious-listen for understanding”. I think listening is an important part of
any conversation. People like to talk about themselves or experiences they had, thus it is important to listen to
them and then reply back in a way that relates to them, that way they will listen more effectively to what you
have to say, and furthermore you can adjust what you have to say in a way that can be effective to them. When
you listen to someone first they tend to listen to you when you have something to say.
Ranya: I see that all the communication skills mentioned in the pages are very important; however one that I find
very convenient is the one where you share your personal experience. I think it’s important to communicate with
people on all basis; however the personal grounds give more effect. When you give out a story and you back it up
with a life experience, not only do you establish credibility, but you also form a sort of personal connection with
the person or people you are addressing.
Cynthia: Be Curious – Listen for Understanding: During a conversation there are two parties; one that is being
heard and one that is hearing. It is very important that both parties listen to one another to be able to have an
engaging conversation. Always seek to reflect back what you heard, so that people could know that you were
actually listening. This gives you the chance to alter the message to suit what they are passionate about. Be

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curious about their views!
Mia: I believe this is the communication skill that I might be good at since I am always curious to hear the other
side’s point of view without judging or disrespecting the individual since every person is special in his own way
and have their own believes and way of thinking. In the end, everything is true depending on the side or the
perspective you tackle the issue from. I love sharing personal experiences sometimes in order to motivate or
influence or have an optimistic impact on someone. Experience sharing is an effective way to help prevent error
or to spread awareness (campaign against drug abuse might be successful if an old drug addict shared his own
experience). Such individual has knowledge and probably experience the same things that drug abusers or
potential drug abusers might be experiencing. During education the person should be persistent and should not
be interested in the outcome more than offering the best he can. Transparency and being clear builds trust and a
kind of comfort zone which facilitates the procedure. Body language and the use of the right tools to deliver the
message to the target population is a key role for success. I believe I would be successful in fulfilling the task of
education and influence.
Ribal: In order to have a good conversation, dialogue, speech… etc. all of the communication skills mentioned in
“BE THE CHANGE ACTION GUIDE” should be present, as they complete each other in order to grab’s someone
attention, let them be interested and deliver the message properly. For instance, “speak from personal
experience” this skill will help gaining the listeners’ trust and confidence and learn from your experience, make
them get more interested in your topic, and receive the message.

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Extract from Geitawi Garden Health Festival plan (p 1):
The reports includes: Organizers, Community, Time, Themes, Learning objectives (students),
Learning objectives (community), Preparation, Tentative program, The Students, The Press, The
Volunteers, The Stands (children, women, elders), The Parade, Estimated Budget
##

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People: Rim, Ziad, Caroline, Ribal, Mia, Tarek, Ranya, Alissar and May
Place: Class 303
Images: Face book page and Whats App group
Because of rainy weather, we had delayed the festival to Friday Nov 7 where it is projected to be
a sunny day (decision made with ASSABIL center). We started the day with balloon games on
team work and cooperation.

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We focused the day on exploring our values using many techniques included were: Story-telling,
mime performance, reviewing what we said about best photos and human sculpture.
The Stone Soup:
Alissar narrated the story of the Stone soup:

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After
concluding
the meaning
of the story,
we shared
what each
one of us
brings to the
class.

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Our responses were as follows:
Tarek:
Team spirit
Ziad:
Atmosphere
of happiness
Ranya:
Humor
Mia:
Smiles
Rim:
The fun part in me
Alissar:
Positive
energy
Caroline:
Friendship
Ribal:
Dedication
Cynthia:
The best of
me + hearts

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The River Code:
Mia narrated the river code and Tarek, Alissar and Rim acted the mime play:

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Discussion followed with Tarek as facilitator:
(1) What did we see in the play?
(2) How many ways did you notice for crossing the river?
(3) What can the river present?
(4) Who can those people present?
(5) What do we conclude from the story?
Self reliance and dependency were key concepts coming from the story. We talked of how to
foster self- reliance.

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Our Values
We extracted key concepts and values from what Mia, Cynthia, Ranya, Alissar, Caroline and Ribal
had said before as they described favorite photos (P. ###). They included: collaboration, team
work, creativity, peer interaction, all together, friendship, good communication, joy etc.
As two teams students expressed two key values:
Love and Trust

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Drug Abuse and Addiction
Ribal presented his PPP on Drug Abuse and Addiction, and the students graded him using.
We ended the class celebrating Alissar B-day.

164
People: Rim, Ziad, Caroline, Ribal, Mia, Tarek, Ranya, Alissar,
Cynthia and May
Place: Class 303
Students shared their perspective about what are Smart Snacks. The talk was followed by a
reading of ### by Dr Andrew Weil, that in turn was followed by a discussion.
Secrets to Smarter Snacking:
To snack smarter, consider both the quality
and quantity of your selections- and follow
these six tips:
1. SIDESTEP THE PITFALLS
2. MAKE BETTER CHOICES
3. KEEP IT SIMPLE
4. THINK OUTSIDE THE BAG
5. BRING YOUR OWN
6. ALLOW YOURSELF A GUILTY
PLEASURE

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We then presented the snacks that we had brought to the class and talked about the benefits of
walnuts, dark chocolate, organic apples and cucumber, avocado, fruits and veggies etc.

166
We also celebrated May’s B-day and enjoyed the smart healthy snacks…

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Chapters’ distribution:
May distributed the Chapters selections from the two resource books Health and Wellness and
Public Health in the Arab World to the students. The selection was based on a compilation and
analysis of students’ preferences and interests.
Book: Health and Wellness
Chapter Student
Ch 2 Mind-Body Communications: Maintain Wellness Rim
Ch 3 Managing Stress: Restoring Mind-Body Harmony Ziad
Ch 4 Mental Health and Mental Illness Ribal
Ch 7 Physical Activity for Health Mia
Ch 8 Sexuality and Intimate Relationships Tarek
Ch 13 Cancer: Understanding Risks and means of prevention Alissar
Ch 14 Cardiovascular Diseases: Understanding Risks and Measures
of Prevention
Caroline
Ch 16 Using Drugs Responsibly Ranya
Ch 17 Eliminating Tobacco Use Cynthia
Public Health in the Arab World
Chapter student
Ch 2 The Political, Economic and Social Context Ziad
Ch 5 Health Inequities Caroline
Ch 12 Non-Communicable Diseases Mia
Ch 14 Mental Disorders Ranya
Ch 17 Child Health Rim
Ch 18 The Health of Young People Ribal
Ch 19 Women’s Health Cynthia
Ch 20 The Older Persons Alissar
Ch 23 Conflict and Health Tarek

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Geitawi garden health festival: Slogans
The last part of the class was devoted to preparing ourselves to the Geitawi festival. We started
by developing slogans and rehearsing for a parade

170
We shared our guidelines to ourselves as we implement the festival:
Geitawi garden health festival: Our Guidelines
 Team work
 Be active
 Help each other in the tasks
 Be involved in the activity
 Be enthusiastic
 Enjoy
 Commit
 Think of goals
 Think from your head, not from your
heart
 Invest in logic not emotions
 Do the maximum we can, and make
children happy, women and elderly
satisfied
 Team leader is needed
 Don’t let shyness limit our abilities
 Reach as much people as possible

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 Be natural with people, don’t show
any differences
 Final organization and planning for
Friday’s noon session
 To be organized
 End the activities on time
 If someone is making an activity and
has a big number of people, the ones
who can help should do so
 Seek one helper ahead of time
 Ask people from the community to
give a hand when needed
 Improvise, don’t be rigid
 Don’t give any information that you
are not sure of
 Don’t lecture
 Respect
 Make specific activities for children
and protect the activities with elders
and women
Geitawi garden health festival: BEST PRACTICES
May distributed the handouts about the best practices that are being promoted as well as
festival activities:

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‫فيا‬ ‫استثمري‬ ،‫غالية‬ ‫صحتك‬
‫كبار‬ ‫و‬ ‫صغار‬ ‫بتفيدنا‬ ،‫خضار‬ ‫و‬ ‫فواكة‬
‫تمكين‬ ‫و‬ ‫قوة‬ ،‫تدخين‬ ‫بال‬
‫عزيمة‬ ‫و‬ ‫قوة‬ ،‫أرغيلة‬ ‫بال‬
‫كثير‬ ‫رواق‬ ، ‫الروايا‬ ‫كيف‬
‫حقنا‬ ‫من‬ ،‫الشيخوخة‬ ‫ضمان‬
‫بركة‬ ‫و‬ ‫صحة‬ ،‫حركه‬ ‫و‬ ‫رياضة‬
‫مناح‬ ‫نحنا‬ ،‫مناح‬ ‫إنتو‬

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Sessions 14 -16: Friday 7 11 14
People: Rim, Ziad, Caroline, Ribal, Mia, Tarek, Ranya, Alissar, Cynthia and May +
14 volunteers (students, ASSABIL and friends)
Interaction with an estimate of 100 community members throughout the day
Place: Assabil center and Geitawi garden
Duration: 12:30-5:00 pm
The students succeeded in working as a team as they prepared for and implemented the
festival. We also succeeded in recruiting 15 volunteers as helpers.
Preparation included: decoration in the garden, making banners, and preparing the stands.

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Activities: Geitawi Garden Health Festivity- Friday 7 11 14
The activity Addressed to
Mobile activities
1. Q & A (Ziad) Elderly
2. Distributing Breast Cancer Awareness
ribbon (Ranya, Cynthia)
All adults
3. The PRESS (Ribal) All
4. The Parade, banners and slogans (All) All
The Stands
5. Healthy foods (Rana) All
6. Stretching exercises (Alissar and Tarek) Elderly
7. Breast Cancer Awareness to women
(Cynthia)
Women
8. Dance movements (Caroline) Children
9. Yoga (Yusra) Children
10. Free drawing and coloring (Mia+) Children
11. The 5 differences, coloring and maze
game (anti-smoking). (Mia +)
12. Health crown (nutrition) (Mia) Children
13. Bye Bye Anemia (nutrition) (Mia+) Children
14. Snakes and ladders (nutrition) (Mia+) Children
15. Gifts (Sami) Children
16. Face paint (Rim+) Children
17. Animal care (Tarek) All
18. Hand-washing (the bathrooms) All
Handouts and gifts
19. No smoking stickers Children
20. Banners All
21. Powerful World (No smoking) and
Bye Bye Anemia card games
Children
22. Breast Cancer awareness ribbons All adults
23. Self examination-breasts Women

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People: Rim, Ziad, Caroline, Ribal, Mia, Tarek, Ranya, Alissar, Cynthia and May
Place: Class 303
May distributed marbles that we used for self massage of hands and face.
Dialogue: Geitawi garden health festival
Students discussed the festival and shared their stories and moments. Ribal shared with us the
results of interviewing people during the festival and their opinion about the activities and
recommendations. Cynthia, Caroline, Alissar and Ziad talked about their roles. The students
also talked of few difficult moments such as discrimination (when one child put down another
because he is Syrian), not proper manners/attitudes expressed by few community members.
Several students felt that the elderly were depressed and thought that we should have
focused more on mental health issues.
Students developed a list of questions that they would ask themselves and that would help
them reflect on the event- review p ####
Our evaluation questions regarding the Geitawi festival
Caroline: Did we meet our goals? Were our expectations met?
Rim: How do you evaluate yourself after this event? (Am I satisfied in regards to my
contributions? / What is the level of my personal satisfaction? )
Cynthia: Were we prepared enough? How could we have reached more people?
Ribal: Do you think the message behind each campaign or activity was properly delivered?
Ziad: Do you feel you have accomplished something good towards the community, or not?
Tarek: What can we say to the Geitawi community about the results of the festival?

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Ranya: If we know that the country is corrupt, and everyone in the country knows that it is
corrupt; will we ever be able to make a change or get our people motivated to make a change or
accept the change?
Alissar: What can we do to be better accepted and more integrated in the community?
May added: What did we (the students) learn? What are our recommendations to the
administration of the University of Balamand- Faculty of health sciences? What do we want to tell
Assabil?

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PDHP 246: Powerful moments to date
Students reflected on moments that they remember with emotions or have been powerful
to them. Among the responses:
To many the day of the World Heart Day was very powerful as they remembered it with
passion. “We did not expect that we can succeed that day”, Tarek said as he was referring
to the empowering result of that activity.
Meeting and talking to community members was also of high impact. Alissar, Ribal, Rim
shared specific stories of their interactions with elderly, women and children at Geitawi
garden. “It was the first time that I talk with community women”, Rim reported. Alissar was
happy about her dialogue with elderly and her surprise she discovered her abilities to work
with children.
“Every moment in this course has been different” Rim said, “Every session had high
moments”, she continued.
Students also talked about the impact of the first session where they enjoyed speaking to
each other.
Cynthia spoke of one moment where she had an insect bite when we were at the Geitawi
garden and that necessitated medical attention...
OUR RIVER of PDHP 246
Reminding of the river code, May displayed several elements from the previous 15 classes on a

185
stretch of cloth. “We are now in the Middle of the River,” she said, “Let us review together,
what we have learnt and how we want to continue?”
Groups of students picked up all the materials and looked at them with the intention of
describing what they were and what they recommend for the next half of the course.
We shared the following:
Venues:
The students appreciated the variety of venues that we have used so far, included were the
Geitawi garden, Assabil center, the classrooms, the front terrace, the old hospital cafeteria,
the Computer lab, Tomates Cerises, the student lounge etc.
We would like to continue using variant venues for our classes, the students recommended.
We also brainstormed about other areas we could visit: Sabra/Chatila, and our villages/towns
(Te’nayel, Shouf, Akkar, and Qaroun).
Resources:
To date we have used selected books and articles and key web sites. Students cited such
resources that have been used to date. “We need to continue using resources”, students
voiced themselves. New resources that we can use were videos, people (Dr Berj was
mentioned), and Focus groups particularly people with a selected condition, such as children
with cancer. One student mentioned the possibility of visiting centers as resources included
were medical centers.
***
In preparation to this session, the students were encouraged to skim through the notes from
the first 15 sessions (circulated as an e-mail). The following message was e-mailed to all:
Please review your expectations and the comments that you have written about the course
syllabus and your response to Life Style Self Appraisal
For Cumulative results on expectations
https://www.facebook.com/groups/960731717277199/970364212980616/ and for
Cumulative comments on Syllabus

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Cumulative responses on Life Style Self Appraisal
Think of these questions and come prepared to dialogue for a "REFLECT IMPROVE" session
that is scheduled for Monday 10 11 14
1. What have been the high moments for you in this course so far?
2. Are you learning new things? Topics? Skills?
3. Are we on track in reference to course outline and our expectations?
4. What aspects do we need to enhance in the next half of the course?
5. What are modifications and new changes that we like to introduce?
6. What are our key responsibilities to complete this course?
7. Open comments
***

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Our evaluation questions regarding the Geitawi festival

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Q by Caroline: Did we meet our goals? Were our expectations met?
Tarek: Our expectations can be divided into three parts, and meeting the expectations was different up to the
expectation. Starting with the number of people attending the event, our goal was higher than the number of
people who attended the festival. When it comes to our benefit from the experience, and on a personal level
we met our goals perfectly by getting exposed to the people from the community, and the experience of
advocating them about healthier lifestyles. The last goal was the benefit of the local community, which I don’t
think was 100% met. The people hoped we can be there one more time to have time to build a trusted link
with us since we are still students and unfortunately people only trust medical doctors and no one else when
it comes to health topics.
Ranya: I think our goals were met, I think we reached out to as many people as we could. It would have been
better to get more people to join the festival but I believe that we did what we had to do to the people that
were there, and the people that we could reach. Some people found it difficult to accept our approach, and
some even mocked our optimism (seeing the corruption of this country) but towards the end, the people
found it within them to set aside their cynical attitude and listen to what we had to say.
As to our expectations, I personally had low expectations for this festival due to the lack of organization and
time management. However I was surprised that the festival turned out to be better than what I thought it
would, and I believe that we truly did what we could consider the time we had and the access we were
permitted. We could have done better, yes, but I don’t think we didn’t do better because we couldn’t; it was
only because we didn’t have the upper hand and the complete power in our hands.

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Q by Rim: How do you evaluate yourself after this event?
(Am I satisfied in regards to my contributions?
What is the level of my personal satisfaction? )
Alissar: After this event, for me a new experience, I noticed that I made small efforts concerning my ability to
communicate with different people and transmit a message according to their characteristics (age, gender,
sex, race...) and also to make people, and especially elderly- who are not very easy to convince- participate in
our activity.
It is really important to know how to deliver a message.
I am quite satisfied because I learned how to deal with a community in a particular event for the purpose of
transmitting a critical message according to their opinion/moods/attitudes...
However, I had to handle two activities but, I missed one because of tiny lack of time management. I should
work on timeliness and management.
Caroline: The level of my personal satisfaction is good. Although, it needed some improvements for sure, but I
think we were able to meet our goals especially for the elderly and children. In general, the work that was
done for this festival was satisfying. But, as I believe that I could have been more effective , since women
weren't interested enough to join the dancing activity, so I worked with children, which are the sector that I'm
neither responsible for nor the most preferable choice for me.
Ribal: As a first experience of mine in such a thing, I feel honestly satisfied in regards to my contributions
especially that I was sick and feverish. I am looking forward to improving my performance in future events and
that would be a challenge for me.
Ranya: evaluating myself in regards to the Geitawi festival, I am going to have to say that my presence wasn’t
very beneficial. I did not have a role in the festival and although I was happy to be a part of it and attend the
whole thing, I still felt like I didn’t make a change and I didn’t affect anyone with my presence. I would have
hoped to have been more productive but I only blame myself because I chose not be fully active because none

190
of the aspects of the festival gave me a sense of will to be passionately a part of. When I participate in
something I usually like to give everything that I have, so a part of me did not what to take up a big part in the
festival because I knew that I will not give my best (due to many reasons). I think my fellow classmates worked
beautifully but I don’t think I can take place in any part of Friday’s accomplishment. I was very glad to be a part
of it nonetheless.
Rim: During this event, I was in charge of the face painting in the kids’ zone. I think I did a good job, the kids
were very responding and they started having talking to me and joking. But I could have done better by taking
more roles in different age groups.

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Q by Cynthia: Were we prepared enough?
How could we have reached more people?
Ziad: I believe we were prepared enough given the time limit we had to present what we have prepared, and
almost all of us were able to perform the task we were given to do. However perhaps a little more preparation
could have been better to reach more people, and to perform our tasks in a better way.
We could have reached more people if we have hanged posters around the garden area, perhaps between the
neighborhoods of Achrafiyeh, so that people who do not usually come to the garden, can come on this time.

192
Rim: In my opinion, I think we were prepared fairly enough. Everyone fulfilled his or her role until the very
end. We could have reached more people I think by posting flyers around the Garden, or by regularly visiting
the garden and informing people about our event.
Mia: We were prepared for the event however since we lack experience we had to face unexpected situations
since we lacked the necessary training. With time it will all come smoothly.
We could have reached more people and more efficiently if we planned several festivities to separate age
groups and topics separately. We would have done 1 task at a time with more teamwork and cumulative
effort on one thing/topic/issue.
Ranya: I don’t think we were prepared enough, no. I have taken part of many events before, none related to
campaigns, but they were ‘people based’ and ‘crowd targeted’. As a previous scout chief, whenever we had an
event to work on, we would meet every day until we were satisfied with all the plans included. We would sit,
we would talk, we would share ideas, and then after the whole plan was laid, we would practice over and over
until we got as close to perfect as possible. However, for the Geitawi festival, none of those were applied, I
don’t blame anyone for this because we didn’t have much time on our hands, nor did we have time to meet
and plan things out every day because of classes and exams. But I do believe we could have prepared more
and done a better job; but then again, I’m only satisfied with perfection, and that is impossible, so I will take
what I can get.
Speaking of reaching more people, I think that is related to my point in the paragraph above when I
mentioned that we did not have much time on our hands. However, if we did, we could have reached out to
people by distributing flyers on the streets to the people who we think might be interested, we could have
also told more friends and had more family members participate. We could have had banners hung at
university and encouraged students to participate (we would have had to use incentives and bribes, but we
could have gotten there).
Alissar: I think we were not well prepared because of the lack of time and the "novelty".
It was the first time that a class engaged in this kind of experience that’s why we needed more preparation
and a bit more of seriousness and commitment.
b- We could have reached more people if we posted fliers all over the street, the university … and if we had
spread more oral messages.
Caroline: I think that we weren't prepared that well. Our progress would have been better if we worked on
our roles and activities more. b) We could have given students in the university some brochures and flyers, We
could have put flyers in the garden since a week or two before the event, We could have given the Sagesse
school flyers too, where its students from all ages would have learned more about the healthy lifestyle, and
talked to an organization to reach more people.

193
Cynthia: During the preparations and while we were decorating the garden, the majority of people in the
garden did not know what was going around. Thus, they were asking what will be following this decoration.
When we responded to their questions, most said the following, “Why didn’t you post flyers around the area
to inform a wider proportion of people?”
However, we cannot exclude the factor that the weather was somewhat cold and the timing was close
to sunset, thus the majority of people prefer staying home rather than roaming around the garden.
Therefore, I believe that the area surrounding the Geitawi garden had to be full of posters or flyers so
that residents of that area knew about the festival one or two weeks prior to the event. Or we could’ve asked
shops (and in particular markets...) surrounding the garden to inform residents about the event.

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Q by Ribal: Do you think the message behind each
Campaign or activity was properly delivered?
Caroline: Yes. I believe that we worked well on delivering the message behind each and every activity done.
Ziad: I think the message at first was a little mixed up in the minds of the people, as some thought it is about
something or about elderly insurance only, however I think they later on understood what the event was
about and some asked us what we were doing. So whether they asked us and we told them or they got it on
their own I believe most of the people present understood the meaning behind the event.
Ribal: The majority of people that I interviewed enjoyed what they saw and what they participated in. Some
people praised our activity and approach, and benefited from the information we were delivering, whether
implicitly or explicitly. We could have done better of course with some support and help, yet I guess we did a
good job.

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Q by Ziad: Do you feel you have accomplished
Something good towards the community, or not?
Alissar: In my opinion, we have accomplished something good towards the community that doesn’t not
encounter such events. After this experience, I noticed that the community of the park has the same routine

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and the importance of a healthy lifestyle is missing ( These words are familiar at the park: smoking,
cardiovascular diseases, cancer, depression, fatigue…).
It was a small and short event; we didn’t have many activities and choices; the people were few; we were not
taken seriously by the whole community, but we did make people participate and smile. We transmitted thin
layers of knowledge, health and life values. I am certain that our action did affect, in a positive way, the
community of Geitawi Park. :)
Cynthia: While answering to this question, I will focus on my own task, since, because of lack of time, I
wasn’t exposed to other tasks.
As for my task, which was basically breast cancer awareness, I believe I have achieved a lot.
The moment I walked around the area to inform women about the festival and the breast cancer
awareness, most were responsive and wanted to join. Literally, no one refused joining the stand to know more
about this matter.
Before starting the dialogue, I asked women if they had knowledge about this issue. Some women
knew little about it. As I proceeded, I realized that they started asking and they were grasping every concept I
was mentioning. Most of them, not to say all, mentioned that they will do the self-examination on a monthly
basis. Moreover, none of them knew about The Ministry of Public Health’s campaign for this year, so I
informed them about it.
Therefore, women were exposed to information regarding their health which is their right. I realized
that these women in particular are really interested in knowing more about their health, but the tools and
means are just not there.
Tarek: On a personal level I think I have made small accomplishment when the group of elderly promised me,
without me asking for it even, to practice the stretching exercises daily after they group together.

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Q by Tarek: What can we say to the Geitawi
Community about the results of the festival?

198
Q by Ranya: If we know that the country is corrupt, and everyone in the
country knows that it is corrupt; will we ever be able to make a change
or get our people motivated to make a change or accept the change?
Cynthia: George Bernard Shaw once mentioned, “Progress is impossible without change, and those who
cannot change their minds cannot change anything”.
Therefore, if we want to grow, improve or advance we need to make a change. If we always stick to the
idea that we are living in a corrupt system and we can do nothing about it, we will never make efforts. Our
efforts may either be successful or not, but that’s not the matter. The thing is to try and never give up. Before
changing systems or societies, I believe, the mentality of individuals should be altered.
Mia: To make a change we should start by the man in the mirror. If every individual is really motivated to get
rid from corruption he can start with himself before even judging or criticizing others. If every individual starts
with small actions to take care of his safety and health in parallel with NGO’s and organizations implementing
campaigns and reinforcing healthy behavior and attitude.
Ranya: That was a question I put down; it was something I could not stop thinking about all through the
campaign and after it was done too. It is a question I never fail to stop thinking about. When we were

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practicing the parade and chanting “daman l shaykhoukha min ha2na” a man sitting on the bench across
looked at us, laughed a mocking lack and said “I think you mean daman l shakhoukha”. When I heard that I
stopped chanting and I just stared at him and kept thinking: “is he right?” is all what we are given in this
country bullshit? (Forgive my language). The old man got me thinking about the lives people are living here,
and how horrible the situation is.
Each and every single person I know, including myself, says “when I finish university I’m out of here”. The thing
is, we know that the country is corrupt, and we know that there is no future for us here and so we are going to
grow and have a future outside the country so we could live in houses rather than the streets. But do we have
the right to come up to those tormented souls that are stuck in this damned country and tell them to have
hope? If we know there is no hope, and they know there is no hope, is there a reason to believe that change is
upon us, or better yet, to sell words to the people saying that what we want is change, when we are only
waiting for a silly certificate to get the hell out of this country? I think at the end of it all, we should ask
ourselves this: “and then what?” and I don’t think any of us will find the answer we are looking for in Lebanon.
It’s a shame, but it’s the truth, I don’t think I’m being pessimistic, I think I’m being realistic. But the elderly we
met at the festival have no shred of hope in them; all they can do is live each day as if it were the last, because
in Lebanon, you never know when it really is your last day.

200
Q by Alissar: What can we do
to be better accepted and more
integrated in the community?
Tarek: The people are looking more to see us again in a similar
event. The first meeting was a first step to build a link of trust
between the community and a group of health promoters, the
thing they might have certain doubts about. So a continuation of
the festival should be made, in order to give them the time they
need to accept and trust us more.

201
What did we (the students) learn?
Ziad: We learned a wide array of skill. Practice skills more than theoretical. Such as we have learned how to
communicate with strangers from different age groups and mentalities, and that was very beneficial to us. We
also learned how to implement health campaigns. We have learned a lot on how to set them up and what to
do, but never had the chance to apply what we have learned in real life, and thus it was a great learning
experience to us.

202
Rim: Personally, I learned that we sometimes might not be welcomed by the people we are intending to talk
to and that should not stop us from reaching our target. In addition, I now know how to approach people
coming from different backgrounds, age groups and cultures
Mia: I learned through this festivity how to be active in the community, be able to help and respond quickly to
urgent situations such as being able to manage the sudden overcrowding. I learned how to interact with
different age groups and among people of different backgrounds and nationality.
Ribal: I personally learned that working on field is not an easy task to do, especially that we didn't previously
know the people we were in contact with to expect their reaction or approach.
GEITAWI GARDEN HEALTH FESTIVAL-
OUR RECOMMENDATIONS TO FHS-UNIVERSITY OF BALAMAND
Some recommendations to the university of Balamand FHS, is first to have more application of
what we learn in class to real life, as it helps us understand more.
Second to have students not necessary in a class, set up such events in public locations to help
the community and raise awareness to certain subjects.
To the administration of the University of Balamand- FHS, I propose the following
recommendations:
 To give the chance to students and especially public health and health promotion
students to be more involved in community work to be able to learn from experience.
 To organize more "good cause/action events" and health fairs at the faculty with its
name.
 To push and motivate students to be more engaged in health promotion and active
 Make more activities concerning campaigns and health festivals.
 Work more with students to be integrated with real cases in life to conduct what they
learned concerning health facts.
 Support students in every activity they do concerning improving the health of the
surrounding.
 Add a community service as an activity done for students.

203
As a Public Health student, I highly encourage the University to increase the community
involvement, since we will actually be able to put all the theories we have studied into
action. We will be exposed to different types of groups within the population that each
requires a specific approach. We need to be more integrated into the community and know
more about the community health before graduating.
The university has to provide the students all the tools and the materials to encourage
community involvement.
Last, more courses should be integrated into the curriculum in form of electives that
encourage community participation and involvement.
Our recommendation to the FHSC would be a never-ending list, however a couple of things I
would mention on the top of my head would be:
-include students in activities, especially health promoting activities
-help us learn how to make campaigns, not only by punishing us with slides and exams, but by
helping us work on the field to understand more the basis of the issue
-teach us how to communicate with people, especially uneducated people and elderly (most
vulnerable population)
-help us get subjected to cases and teach us the appropriate approach and a way of dealing. I
was personally mad at myself for getting affected in the case of the woman we talked to in the
Geitawi garden. She was depressed and she had lost her mother to breast cancer and there we
were foolishly trying to explain to her about breast cancer awareness. I was never put under a
situation like this and I don’t think I managed it properly. So the university needs to explain to
us how to manage on the field, especially as health promotion and public health students
where our jobs require nothing but communication and dealing with unhappy people.
-the last point I want to mention to FHSC is: stop seeing us as dollar bills roaming the
university and start seeing us as people; treat us like students, or better yet, treat us like
humans.
One of the most important recommendations that I could provide the faculty of health and
sciences in the University of Balamand is to encourage and support and incorporate more
community work, field experiences, and most importantly project residency. The medical field
needs more experience and application than just lectures. The best learning is through
experience. Another recommendation to the University will be promoting health facilities to
the students and staff through more on campus activities and facilities.

204
We need more field work since this is what we will be doing in the future.
The university's administration knew about the health festivity we were going to do. I guess it
would have been better if they've shown some support (e.g. inviting students and staff from
the faculty to attend or help in the preparations, helping in promoting the event, sending a
crew to cover the event in terms of media...).

205
RECOMMENDATIONS TO ASSABIL
Ziad: I think Al-Sabil can help promote health by placing more public health posters around the garden, placing
brochures so that people of all ages in the garden can have a look at and read, and perhaps set up a similar
events to what we have done (nothing to fancy giving the limited budget) with the help of volunteers to
consistently raise and remind people of healthy lifestyle choices they can do to improve their health.
Mia: Al Sabil is trying to be active members in the Geitawi community through very limited resources. They
are introducing education and awareness in a very responsible and responsive way. They were welcoming and
supporting to our health festival and they supplied us with what they had in order to have a successful event.
Ribal: Thanks for Al-Sabil for their contributions in whatever help they offered, but personally, as I took the
press task, I noticed that all people I interviewed didn't know about the event, and some people don't even
know that Al-Sabil exists. Besides, we knew that some elder people visit the library at specific hours to read
newspapers or use the computers, thus they could have simply invited those people to attend or contribute-
and I guess that would have been an easy task to do.
***
Report of the festival- By Ribal
10 Nov, 2014
On Friday, November 10, 2014, Dr. May Haddad, students of PDHP246 and some
volunteers went to the Jesuit Garden at noon to prepare for afternoon’s health festival. They
rehearsed on the parade and worked on the decoration of the garden (e.g. balloons) and did
the banners. At the afternoon, they gathered again around 3:00 pm and finalized everything
before they start with the festivity. At 3:30 they held the banners and started with the parade,
walked around all the gardens twice, calling for some acts (e.g. against smoking, preventing
breast cancer…) as they invited people from all corners of the garden, ranging from kids to
older people to join them.
After two rounds around the garden, every person had a specific task to do at different
stations. In the kids’ zone, Mia was wearing a clown costume and basically took care of games
with the kids. Rim did the face painting with the help of Alissar and Caroline in the beginning.
Yusra was doing some meditation exercises for children outdoor, whereas inside of the Al Sabil
Library, Caroline was doing some physical activities based on oriental dancing. As for the mid-

206
aged women, there was a station of breast cancer awareness held by Cynthia, where they
benefitted from information about self-examination and mammography.
On the other side, Alissar joined Tarek in the stretching and physical activity station for
elderly. They taught them some stretching moves to do on a regular basis, to enhance their
lifestyle and stay healthy. Ziad’s main intended audience was elderly, so he held the Q&A
board and walked around them asking to pick a number from 1 to 6 to ask them questions and
get answers. Ranya was wandering around the garden to coordinate between different
stations and provided help when needed. May was holding her camera and taking pictures of
the whole event, from stations, to people, to decoration and also inviting people to join and
participate in a certain activity. Ribal played the role of the journalist/press. He interviewed
many people and collected information from them about their opinions towards the event and
if they engaged in any activity.
The event as a whole was a success. People, from different age categories benefitted
from many stuff, ranging from engaging in physical activity to learning new information. The
message behind each campaign was delivered to the intended audience.
***
Festival Summary
http://www.balamand.edu.lb/Academics/Faculties/FHS/QuickLinks/Pages/HealthFestival.aspx
An estimate of 100 people participated in the Geitawi Garden Health festival organized by The
Health Promotion Program at the Faculty of Health Sciences-University of Balamand and the
Municipal Public Library of Geitawi- Assabil on Friday 7 November 2014. Students of PDHP 246
and volunteers implemented the festival that aimed at enhancing healthy practices for elderly,
women and children in the themes of exercise, healthy foods, hand-washing, and breast
cancer.
The festival included a parade and slogans, mobile and fixed stands throughout the garden
(Stretching, Yoga, Breast Cancer awareness, Interviews, Face paint, Board games, Arts, Healthy
Foods stand etc.)
Info about the festival was posted on line on the first page of the University of Balamand:

208
Results of interviewing people during the festival-
Press activity (By Ribal)
1- Name: Caroline Topalian
Age: 60s
She was holding two banners, trying to quit smoking, could not participate in the parade
because she is paralyzed.
About the parade: Interesting, she enjoyed it, and the messages were important and direct.
She comes to the garden daily.
“Behlam bi daman al chaykhoukha”
Message to us: Yaa’tikoun al Aafyeh
2- Name: Jacqueline Sayegh
Age: 70s
She did not talk much because she finds difficulty in speaking. She was not present when we
did the parade. Main discussion was about her health status (partial paralysis).
Her helper was quite reserved but she has shown interest when I mentioned the breast cancer
awareness station, in front of her, so I led them to Cynthia.
3- Name: Gladys Abdel Kardim
Age: 50s
She is originally from Ashrafieh, but does not live in Ashrafieh currently. She was visiting a
friend and on her way back, she heard some voices coming from the garden and saw the
decoration. She had the curiosity to come and see. She was very happy to see there is a
festivity held. She participated in the stretching session and learnt some moves although she
finds difficulty in exercising. She was mostly interested in the breast cancer campaign. She said
she had certain knowledge about it – she used to work in the radiology department in Hotel
Dieu de France – but learned more interesting and helpful facts.
Message to us: Ana beftekhir bi talamiz metelkoun nachitin w mest’eeddin yse’edou el gheir.
4- No name/ No age
Approximately in his late 70s
“ Rouhou ‘imilou chi yenfaa’koun w dresso bi jemaa’tkoun ahssan min hal ta’ al hanak kello “
I asked him why he finds what we were doing useless so he said that in 1965 he was in Paris
and heard saying about Lebanon third world. Back in that time, he got upset but now he
understands why. “ Nehna balad ma kharjna chi, kharjna yehekmouna w ysakroulna temna” he
added, claiming that he is very convinced with that statement. “ Ana ektanaa’et bi hal chi,
bedfaa’ darayeb w aaref rah yakhdouwoun aalam m’aayanin w ma rah yetlaa’le chi, bas ana
radakhet lal amr al wakee’ “. Then he said that he is not going to wait for the government to
cover him so I interfered “bas bi ra’yak iza sakatna aal mawdouu’ ma mnkoun aam nfarji al
dawli ennou nehna akher hamna? Ennou eza nehna ma talabna, henni ma rah yoa’ordou

209
aalayna fa min wajbatna ntalib w n’aalli sawtna w nsarrekh aala amal nouwsal lachi mahall”.
Here he said that he lost hope and he does not care about these useless stuff and advises us to
stop trying because we will reach a dead end. He worries a lot about his monthly bills
(electricity, water, dish cable…) because it is very expensive, and he is not going to wait for the
government to cover him. Then I asked him, if thinks that those bills and payments are more
important than health when he had shown that he does not feel like talking anymore so I
apologized, thanked him and I left.
5- Name: Jacques and Arthur
Age: 50s
Jack was the one who held the conversation. He is a member in the committee for the
protection of the Jesuit Garden and a member of Al-Sabil library, among many other stuff. He
congratulates us for what we did, claiming that it is a great idea, and we are very active people,
where we can act as good models for others. The weak point in his opinion was the advertising
of this event: “ ken lezim tkatro di’aayeh ta yejeh aalam aktar”. I told him that we coordinated
with Al-Sabil and asked them to invite people, in addition to the posters we made. He said that
it is not enough and sometimes they can gather 300, 400 even 500 people in this garden and
you should have done the same to deliver the message to the maximum amount of people.
Arthur interfered: “I prefer what we saw today on what I see on T.V or hear on the radio. Every
day I see stuff related to health, but it does not really grab my attention”. Jacques: “The fact
that there is a direct contact between you and people, interactions and face to face discussions
is very productive and positive. People would enjoy it, and would definitely be interested to
hear more and receive the message”. After he finished giving his opinion, he mentioned
something about psychology, tackling our approach and praising it. And then he said that he
has a master degree in psychology and that it why he was emphasizing on the psychological
level about it.
Incidents:
Alissar was doing some face painting and asked a Syrian kid if he wants her to draw him so a
Lebanese kid came telling her “Chou baddik fi, hayda soure ma byefham bi chi”.
Tarek was working with people on stretching and physical activity. He interviewed a smoker,
stating some facts about smoking and asking him to quit it, so the other man interfered saying:
“baa’tik benteh, bas ma t’achetne el cigara”.

210
CERTIFICATES FOR STUDENTS & VOLUNTEERS
A total of 24 certificates were issued to PDHP 246 students (9 people)
and the volunteers (15 people).
The volunteers were: Samer Diab, Patricia El-Masri, George Kerdah,
Rebecca Ibrahim, Samantha Sukkar, Hanan Al-Masri, Rashad Al-Bitar,
Rana I Karam, Chebl Saade, Paul Sehnawi, Samar Chkaiban, Josiane
Badra, Sami Moussa, Yusra Scott and Tarek Rabbah.

211
Appraisal of the Geitawi Garden Health Festival
Reported by PDHP 246 students
Several students expressed that the Geitawi Garden Health Festival was the
most useful and enjoyable experience to them during PDHP 246 sessions. They
said (Section VII, final exam):
 The most enjoyable and useful session for me was the Geitawi Festival because it
was first of all, it was enjoyable because it is always fun to participate in
community work and be around people who need to know and adopt healthy
behaviors. We helped them! Secondly, it was useful because, it was new, it was
practical (we put what we know into practice and somehow got prepared to the real
life) and we learned a lot from it, such as how to work as a team, how to take a
responsibility with human beings, how to communicate and deliver messages
through activities.
 The most enjoyable session for me was the Geitawi festival. The overall idea of the
festival aimed at enhancing healthy practices for the elderly, women and children,
using the themes of exercise, hand washing, healthy eating and breast cancer. I was
in charge of the “breast cancer” stand. I felt all the women who were present in the
area benefited from what was offered. They asked several questions regarding the
issue and were very curious in discovering new matters. I believe, through this
festival, I could achieve something. Which is reaching the community members,
understanding their needs and make them more aware of their health.
 The Geitawi Festival was a special day. I was exposed to something New
something Concrete. It was a very beautiful and productive experience. It was my
first experience in direct contact to people. It was a challenge for me as well, to be
able to coordinate among all stations and people, examining the person first, pick
the best approach, and using communication skills to be persuasive or credible. I
also loved the team spirit, and I had very positive vibes by the end of the day.
 The most enjoyable are the field work and activities we did like the Geitawi
Garden Health Festival.

212
 I really enjoyed the Geitawi session, it was new experience for me with the
community directly, and made me feel I have accomplished something good to
the community, and more importantly learned lots of new things.
Students’ conclusions and recommendations based on their organization
of the Geitawi Garden Health Festival on 7 November 2014:
 The Geitawi festival was a very successful event. We could reach the Ashrafieh
neighborhood people by enhancing healthy practices for the elderly, women and
children, using the themes of exercise, hand washing, healthy eating and breast
cancer. Different students were responsible for different activities planned for
various age groups. The elderly enjoyed their time through stretching and certain
quizzes. Women developed their knowledge further regarding breast cancer.
Children had the chance to participate in a dance class, they played with the clown
and with certain games and they received gifts. All the different age groups were
satisfied, enjoyed the festival and learnt new matters regarding their health.
 My recommendations for the FHS administration is have teachers have the
students apply more practical work and projects, because I believe it’s a much
better and effective way to apply what we learn in class. Furthermore is an
interactive activity that helps bring the community and the students together all
working for a good cause.
 The Geitawi festival, I would say, was a success. It included integration and
awareness, along with activities and healthy snacks. I would recommend it would
be done again but o a bigger scale and with more preparations and more activities. I
would say the geitawi festival is one of the important implementations people
should follow to get a message through to the people in a smooth and indirect way.
 The Geitawi garden health festival I believe was an exciting and new experience
that introduced me to a new aspect of health promotion and public health, the
practical side of it. It was successful as we targeted groups of all ages, and did
activities for them.
 One of the implementations that we sought in class and one that was very important
was the Geitawi activity. We managed to tackle a lot of issues, from the

213
environmental side, to the health based issues; breast cancer, smoking, and healthy
food.
 In my opinion the festival was amazing and beautiful experience. It was something
new for the class and for the public. It is important to deliver messages to people in
constant need to know the importance of living healthy in good way. As
recommendations, for next time, the class should be better prepared and really work
as a team. Everyone must attend, participate and help. Nevertheless, i think only
one topic should be taken to transmit the messages to the whole public and
integrate it at any age.
 The Geitawi Festival was a very good step we have made in this course. Thus, it
encouraged us and helped us to explore more in the field that we will work in
after we graduate. We talked to people, promoted healthy activities, Helped them
prevent risky behaviors, and drew a smile on their faces.
 I think the festival was to a certain extent successful since it met most of our
expectations except for the number of attendees. I recommend a project on
mental health as we met a lot of the people who claimed that other attendees are
not mentally healthy.
 The people of the area need such activities since they lack awareness on many of
the basic information, and this can be the role of the St. George hospital as a part
of its corporate social responsibility in collaboration with the Faculty of Health
Sciences department of Public Health and Development Sciences.
 Such festivals should be done regularly and in collaboration with MOPH and other
NGO’s since from very limited resources we were able to deliver a message
through fun and games. Reached a limited group of people, however it was a good
start. Would have been better if the festival was only for kids or only for adults
since most of the adults did not benefit enough because they had to take care of
their kids. Some issues need more time and more collaboration from the adults
and elderly.
 I think the festival was a success. People needed these kinds of activities and
awareness sessions because of their lack of information and knowledge.

214
As recommendations, they should have cleaner bathrooms and Al-Sabil library
should organize other awareness sessions for women on many other health related
issues such as nutrition, cervical cancer, diabetes, cholesterol…
Conclusions and recommendations as a result of the Geitawi Garden Health Festivity
that the class has implemented:
o Dedication, communication, knowledge and teamwork are keys for success
o People lack information about health
o A lot of misconceptions about healthy lifestyle
o People like to learn and get to know new stuff
o Different people require different approaches (you cannot use the same approach
with everybody)
o Women were very glad when they learnt new tips for detecting/preventing breast
cancer
o Elders are not lazy, they just need a catalyst that can engage them in physical
activities
o Children are very creative
o Health messages could be delivered through games to children
o Once the ice is broken, everything runs smoothly (We broke the ice by starting the
event with the parade, holding banners)
o The university program could have supported us in so different ways (by giving it
more attention and care, providing us with more resources(e.g. human resources),
professionals and activists that could have helped in order to make this event more
successful) especially that it was our first experience on the field.

216
People: Rim, Ziad, Caroline, Ribal, Mia, Tarek, Ranya, Cynthia and May
Place: Old hospital cafeteria
Duration: around 90 minutes (the class as a group) + 40 minutes (individual
meetings)
Individual meetings with Ribal, Cynthia and Rim before and after the class
On the occasion of World Diabetes Day, we shared a healthy breakfast (foul with veggies) and
took this opportunity to distribute handouts on World Diabetes Day and the blue circle. We
also drew the blue circle on our hands and arms

217
Nutritional Iron Deficiency Anemia- By Mia
Mia presented to the class what she has learnt from the booklet Bye Bye Anemia ##### . Mia
presented in Arabic:
‫الدم‬ ‫فقر‬=‫نقص‬
‫الجسم‬ ‫في‬ ‫الحديد‬
(Anemia)
‫الدم‬ ‫فقر‬ ‫ْج‬‫ى‬‫:نتا‬
‫الضعف‬
‫الشحوب‬
‫االصفرار‬
‫التعب‬
‫االنزعاج‬
‫الشهية‬ ‫قلة‬
‫بالدوار‬ ‫االحساس‬
‫التركيز‬ ‫في‬ ‫مشاكل‬
‫االداء‬ ‫في‬ ‫انخفاض‬
‫المناعة‬ ‫ضعف‬
‫القلب‬ ‫ضربات‬ ‫في‬ ‫سرعة‬
‫النفس‬ ‫قصر‬
‫الفتيات‬:-‫الفتيان‬-‫األطفال‬
‫الحركي‬ ‫و‬ ‫الفكري‬ ‫النمو‬ ‫تأخر‬
‫التأخر‬‫و‬ ‫التركيز‬ ‫على‬ ‫القدرة‬ ‫و‬ ‫الدراسة‬ ‫في‬
‫العلم‬
‫:النساء‬
‫المبكرة‬ ‫الوالدة‬
‫الوالدة‬ ‫اثناء‬ ‫النزف‬
‫ذلك‬ ‫عن‬ ‫ينتج‬ ‫و‬ ‫الحجم‬ ‫صغير‬ ‫طفل‬ ‫والدة‬
‫مشاكل‬
- ‫ضرورة‬ ‫لذلك‬ ‫العالمات‬ ‫بهذه‬ ‫نحس‬ ‫ال‬ ‫قد‬
‫الدم‬ ‫فحص‬
: ‫بالحديد‬ ‫الغنية‬ ‫المأكوالت‬
‫اللحوم‬-‫الدجاج‬-‫السمك‬
- ‫من‬ ‫يعزز‬ ‫الطبخات‬ ‫في‬ ‫منها‬ ‫القليل‬ ‫وجود‬
‫الحديد‬ ‫امتصاص‬
:‫بالحديد‬ ‫الغنية‬ ‫المأكوالت‬ ‫نباتية‬ ‫مصادر‬ ‫من‬
‫عدس‬-‫حمص‬-‫برغل‬-‫الكامل‬ ‫الرز‬-‫القمحة‬ ‫خبز‬
‫الكاملة‬-‫بامية‬-‫فاصوليا‬-‫الفول‬-‫البقدونس‬-
‫الملوخية‬-‫السبانغ‬-‫حلوة‬ ‫بطاطا‬-‫الحلبا‬-‫النعنع‬-
‫عنب‬ ‫ورق‬-‫سلق‬-‫خبيزة‬-‫كزبرة‬-‫طحينة‬-
‫السمسم‬-‫كربوزة‬-‫البروكلي‬-‫بقلة‬-‫الجرجير‬-
‫البزال‬‫ء‬-‫الدبس‬ .
: ‫الغنية‬ ‫الحديدالمأكوالت‬ ‫امتصاص‬ ‫على‬
"‫س‬ ‫بالفيتامين‬"‫الجسم‬ ‫تساعد‬
‫حامض‬-‫برتقال‬-‫الجوافة‬-‫الشمام‬-‫البندورة‬-
‫الكليمنتين‬-‫الحر‬ ‫الفلفل‬-‫الحلوة‬ ‫الفليفلة‬-‫البصل‬
‫األخضر‬-‫البروكلي‬-‫األخضر‬ ‫الزعتر‬-
‫المانجة‬-‫أرنبيط‬-‫ملفوف‬-‫اللفت‬-‫الكركديه‬-
‫الغريفون‬ ‫.عصير‬
‫م‬ ‫او‬‫العشاء‬ ‫او‬ ‫الغداء‬ ‫ع‬:‫كوجبة‬ ‫تناولها‬ ‫يجب‬ ‫و‬
‫الغنية‬ ‫السلطات‬ ‫خفيفة‬"‫س‬ ‫بالفيتامين‬ "
‫تبولة‬-‫فتوش‬-‫سبانغ‬ ‫سلطة‬-‫بطاطا‬ ‫سلطت‬
‫نعنع‬ ‫و‬ ‫اخضر‬ ‫بصل‬ ‫و‬ ‫قشرها‬ ‫مع‬ ‫مسلوقة‬-
‫كليمنتين‬ ‫و‬ ‫خضار‬ ‫سلطة‬-‫عدس‬ ‫سلطة‬-‫سلطة‬
‫روكا‬-‫و‬ ‫الدجاج‬ ‫و‬ ‫اللحوم‬ ‫اليها‬ ‫يضاف‬ ‫سلطات‬
‫.السمك‬
- ‫المدعمة‬ ‫المعلبات‬ ‫اشتري‬‫الى‬ ‫انتبه‬ ‫بالحديدو‬
‫الصالحية‬ ‫تاريخ‬
- ‫مع‬ ‫بالكلسيوم‬ ‫الغنية‬ ‫المأكوالت‬ ‫تناول‬ ‫عدم‬
‫أفضل‬ ‫الحديدز‬ ‫امتصاص‬ ‫يضعف‬ ‫النه‬ ‫الحديد‬
‫التب‬ ‫الوجبة‬ ‫من‬ ‫ساعتين‬ ‫بعد‬ ‫الكلسيوم‬ ‫تناول‬
‫الحديد‬ ‫على‬ ‫.تحتوي‬
-‫الحديد‬ ‫امتصاص‬ ‫يعزز‬ ‫س‬ ‫.الفيتامين‬
- ‫و‬ ‫الطبخات‬ ‫الى‬ ‫يضاف‬ ‫الدم‬ ‫فقر‬ ‫من‬ ‫للوقاية‬
‫ل‬ْ‫المو‬ ‫االكل‬‫من‬ ‫بالحديد‬ ‫الغنية‬ ‫االطعمة‬ ‫من‬ ‫فة‬
‫الفيتامين‬ ‫او‬ ‫االحوم‬ ‫من‬ ‫القليل‬ ‫نبتية‬ ‫مصادر‬
‫.س‬
- ‫يجب‬ ‫لذلك‬ ‫الحديد‬ ‫امتصاص‬ ‫يمنع‬ ‫الشاي‬
‫بساعتين‬ ‫االكل‬ ‫بعد‬ ‫او‬ ‫الوجبات‬ ‫بين‬ ‫تناوله‬
- ‫مع‬ ‫باالخص‬ ‫الحديد‬ ‫امتصاص‬ ‫تمنع‬ ‫القهوة‬
‫بعد‬ ‫او‬ ‫الوجبات‬ ‫بين‬ ‫تناولها‬ ‫يجب‬ ‫لذلك‬ ‫الحليب‬
‫.االكل‬
- ‫الغازي‬ ‫المشروبات‬‫من‬ ‫تقلل‬ ‫الكوال‬ ‫و‬ ‫ة‬
‫الحديد‬ ‫.امتصاص‬
- ‫المياه‬ ‫االكل‬ ‫مع‬ ‫تناول‬ ‫استطيع‬-‫الكركديه‬-
‫الليموناضة‬-‫البرتقال‬ ‫عصير‬-‫الجوافة‬ ‫عصير‬
‫الطازج‬-‫ينسون‬-‫بابونج‬ .
-‫بالحديد‬ ‫غنية‬ ‫ليست‬ ‫العدس‬ ‫.ماء‬
‫بالحديد‬ ‫الغنية‬ ‫:التسالي‬
‫التمر‬-‫المخفف‬ ‫المشمش‬-‫الزبيب‬-‫عباد‬ ‫بزر‬
‫الشمس‬-‫الترمس‬-‫المج‬ ‫التين‬‫فف‬-‫الفستق‬-
‫اللوز‬-‫قرع‬ ‫بزر‬-‫المدمس‬ ‫الفول‬

218
Geitawi festival appraisal-continued
May shared with the group what Josiane and Sami (ASSABIL) reported about the festival as
follows:
Both were very happy about the festival and thought that it was ran very well given the limited
resources and that it was the first activity of its kind. They said that the children enjoyed the
diverse activities and knew what they were about. The elderly also reported that they like the
activities but hoped that they were longer in duration. They reported that we could have
attracted more people, had we organized on Saturday, and did more advocacy (the e-mail list
was insufficient). They both hoped that there will be follow up and that similar events be
organized. They appreciated this cooperation with the Balamand University and thanked us.
May lead a game on team building as she was hoping that the students reflect on the relations
among each other and how much did we succeed in working as a team.

219
Certificate of appreciation – Geitawi festival

220
Peer support: More veggies and fruits
Working groups discussed among themselves what are they currently doing and what more
can they do. All were encouraged to increase their intake of veggies and fruits for the week
and report back to the group next Friday.
Among the results:
Cynthia + Ribal:
For Now:
Happens or not to be consuming a fruit per day.
Consuming vegetables as long as they are present in lunch.
Ideal:
Always prefer a salad alongside your lunch
Increase the intake of fruits (depending on the season and the availability of the fruits)
Make veggies part of your breakfast (specifically tomatoes and cucumber) along with dairy
products
Replace or substitute snacks such as chocolates and chips with fruits

221
Consume a wider variety of fruits and vegetables
Make the fruits and vegetables visible and in front of your eyes
Tarek + Rim:
For now, Tarek doesn’t consume a lot of fruits and veggies. He lives on his own and finds it
time consuming and somehow difficult to go, get the fruits or vegetables, wash them very well
and then eat them. However, Rim eats 4 to 6 portions per day (tomatoes, cucumbers, apples,
oranges…), whatever is available.
To improve this situation, Tarek suggests the following:
- Whenever I go shopping, I will try to buy fruits and veggies instead of other snacks
(chocolate, potato chips…);
- Always have a basket of fruits on the table;
Rim suggests the following:
- Always have a side salad with the lunch or dinner;
- Replace the high fat high sugar snacks during the day with fruits or veggies (carrots,
cucumbers, apples, bananas…)
Ziad + Ranya:
Ziad claims that right now he only consumes around 3 to 5 servings of vegetables per day, and
around 2 servings of fruits. He hopes to change that by increasing the servings of each (by at
least 2 portions). He will go on to buying fresh fruits and vegetables for the house, and
increasing his snacks to healthy snacks rather than unhealthy ones.
Ranya: right now I have at least 3 servings of fruits per day, and 2 salad plates with 2 meals
along with having cucumbers with my sandwiches and when I’m bored (sometimes I eat when
I’m bored).
I don’t think there is anything to change, I could add some more vegetables but I’m afraid I
would grow a tail and start mooing with that. I think my progress is fine considering I didn’t eat
fruits and vegetables 6 months ago, but I took a decision back then and I have not yet failed in
eating healthy.
I still crave the unhealthy food, but I try my best not to have them close by because then I’m
pretty sure my mind would unconsciously choose not to see the fruits and vegetables lying
next to the chocolate.

222
Caroline + Mia:
*What we are doing:
1. Eating junk food.
2. Eating small portions of fruits etc.
* What should we do to improve:
3. Make fruits our first choice as snacks.
4. Eat salads.
5. Introduce more and different kinds of vegetables to our plates.

223
Images about our chapters
We shared the images that we have chosen with the group. To note that many of us brought
more than image to share.

224
Note: May met with Ribal, Cynthia, Rim and Mia on individual and group levels and discussed
their performance and grades to date etc.
Preparing ourselves for the class of Monday 17 11 14
Dr Rania Masri will be with us. Rania is
the associate director of Asfari
Institute for Civil Society and
Citizenship at the American University
of Beirut.
Rania will be commenting on our
speeches/talks and respond to our
questions about how to deliver
effective speeches and talks.
Come prepared to the class as follows:
Task #1 – Watch the two videos with Rania’s talks:
https://www.youtube.com/watch?v=V4H5PFGr03Q&index=37&list=FLwxXvHbY9WnlCGnzbKB
KVIA —
The Protest talk
https://www.youtube.com/watch?v=hHAmAULY23U&index=33&list=FLwxXvHbY9WnlCGnzbK
BKVIA —
The longer talk, at a panel presentation
And visit: http://greenresistance.wordpress.com/my-writings/
Write down key points about what makes these talks effective- to discuss during the class
Task #2 - Be ready to present a 2-3 minutes talk/speech - specify who your audience is.
I encourage you to choose your contents from materials inspired by your chapters from the
two books “Health and Wellness” and “Public Health in the Arab World” and/or related
materials

225
People: Rim, Ziad, Caroline, Ribal, Tarek, Ranya, Cynthia, Alissar and May
Guest: Dr Rania Masri
Place: Rm 303
Dr Rania Masri was our guest today. Rania introduced herself and d her background. We

226
started the session with what the students wanted to ask her. Few questions were asked: Do
you stress out before a speech? How do you get your self confidence? Rania asked the
students to comment on the speeches of each other using the following four questions: Q.1
what did the speech make me feel? Q.2 what did the speech make me think? Q. 3 what are
they asking me to do? Q. 4 what is the take home message?
Each student presented her/his 2-5 minutes speech. Other students commented and Rania
shared her tips. The topics were:
Ziad: Stress management Alissar: Cancer
Rim: Girls Scouts Tarek: Sexual health

227
Ranya: Self image Caroline: Health inequities
Cynthia: Women’s health Ribal: Mental health

228
Speech writing- By Dr Rania Masri
So, you’ve been given a certain time period to write a speech on a particular topic. What to
do?
(1) Develop your schedule; time management is key.
Based on the time that you’re given for your assignment, the breakdown in your time
management should follow these three activities:
1. Research (audience and the material)
2. Write the speech
3. Edit the speech
(2) Identify the audience, and your objectives. Keep in mind that you will likely wish to
return to this point during and after your research.
1. Who is the audience?
2. What do you want them to think, to feel, and to do with regards to this topic?
3. What information and appeals are necessary for those objectives?
(3) Conduct the research. Transform the information into a narrative, with a take home
message focused on and for the audience.
Identify your goals clearly: Do you have a short-term goal and a long-term goal, or only one
goal? A short-term goal is one that would be achieved in this speech, and a long-term goal is

229
one that requires more than one messenger and message before it resonates fully with the
audience.
(4) Write the speech as a narrative. What is your story?
(5) Edit - for the length of the requested speech. Keep in mind that a powerful speech needs
time to be processed by the audience, so edit it to be shorter than the time slot so that the
speaker has time to give emphasis to the words and is not rushed.
(6) Edit again. Keep your speech focused on the take home message, and keep only the “salt
and pepper” issues that are focused on your long-term goal, if you have one.
(7) Perform the speech yourself. Keep in mind the take home message, the audience, and
the spoken style of the one who will make the speech. Perform it again.
(8) Edit again - for the performance of the speech. Insert assistance in your speech for the
speech-maker so that you guide the performance of the speech.
Rania Masrihttp://www.greenresistance.wordpress.com

230
People: Rim, Ziad, Caroline, Ribal, Tarek, Ranya, Cynthia, Alissar, Mia and May
Place: Old hospital Cafeteria
Visitors: Houda Abboud and Sami Achkar
Duration: around 90 minutes- Followed by short meetings with Caroline, Alissar
and Tarek (around 30-40 minutes)
A delicious
Veggie meal
We started the day
by sharing a
vegetarian meal
prepared at the old
hospital cafeteria
(thanks to Hoda
Abboud).
The meal consisted of
quinoa salad, kebbet
batata and loubieh
khadra bizeit. We
exchanged proverbs
and practices about
healthy eating.

231
Reflections: what have we learnt from Rania?
We reflected on Dr Masri’s sessions and shared our learnings as we were informing Mia about
key points as follows: don’t tell everything, keep some findings for further questions; relate to
own situation; turn fear into excitement; be confident; be aware of your posture; public
speeches are skills we can develop.
Mia presented her public speech whereby she summarized the students’ recommendations
after the World Heart Day activity. Students appreciated Mia’s tone and facial expressions.
One person commented that she should not have read from the paper. Mia’s speech:
Students and teachers,
“Heart Choice is not a hard choice”
By Mia Akra
As part of the illness, disease, and healthy
lifestyle course, we organized a small event to
touch people’s life by raising awareness about
different ways to maintain a healthy heart
through daily personal minor interventions. With
limited resources such as a ball, fliers, cardboard,
but enriched with strong will and determination,
my classmates and I successfully spread the
knowledge of better lifestyle in our small
community, the FHS campus, University of
Balamand, Ashrafieh.
We defied all odds and proved to our colleagues
that, if they have a will to exercise even the
students’ lounge could be the best playground to
have fun and exercise. A significant number of
students that participated in the activity got
touched and shared with us obstacles at the
university that prohibits them from exercising

232
regularly.
We carried these concerns and suggested recommendations to the university administration to
promote the well being of the students and employees on this campus.
Some of the collected suggestions were to offer an elective course about the importance of
physical activity and healthy eating habits, have elective classes for physical activity, gym and
dancing classes, outdoor sports and activities on regular basis, encourage sports activities,
accommodate spaces for exercise near the university, establish basketball/football courts,
establish university gym, organize sports activities by FHS students, provide more free hours for
activities, and stress management instead of work overload and long hours of lectures, give
free salads with food and meals, and be more strict with implementing a non smoking policy or
a smoke free campus.
Friends, you are the future health specialists. It is up to you to be the change, influence people’s
behaviors and have a positive impact on the society. Start by the man in the mirror. The
journey is tough, long, and challenging. I invite each one of you, to put our hands together,
turn words to action, advice to reality.
Thank you doctor for giving us the opportunity to be part of this project and for bring the best
out of us. Thank you for exposing us to field work at early stages since the most efficient school
is the school of the streets and knowledge through experience. Thank you classmates for being
such supporting team members. You are all one of a kind.
Good luck
Diabetes Mellitus Competition
We reviewed key finding about Diabetes through playing a competition game (pathogenesis,
risk factors, best practices). We also learnt how to measure our BMI and measure our waist
circumference. The questions were based on our home work readings from International
Diabetes Federation, materials posted in the book Health and Wellness and PHAW together
with other resources that May has used (WHO data on NCD-Lebanon profile 2014
http://www.who.int/nmh/countries/en/ and other).

234
When Do I say I am satisfied?
My expectations by the end of the course?
We shared what will make this course experience most satisfying to us (written
task at an individual level. Reponses ranged from one to 5 responses per student):
 When we learn while enjoying the class
 When the class time passes fast and we need more time
 More classes like today’s lectures: competitive learning and
questions about health topics
 When we get exposed to different learning materials
 When I receive the message properly and I learn something new
 When we believe that we have learnt more things than what we
already knew before taking this course
 Around this time, we noticed that we have learnt lots of things
during the first half of the course and our efforts were shown by
getting good grades
 I would say I am satisfied with the course when we present our
presentations and findings
 Present the final campaign (field activity)
 When people ask us something about illness and healthy life style
and we can tell them all we have learnt and they would benefit
 With continuous sharing of our meals and habits to be evaluated and
improved
 Best practices
 When I start having healthier habits (diet, sports…)
 When we see personal improvements
 When we feel confident enough to share our ideas

235
 When I will become able to convince others in having a healthier
lifestyle
 When we find ourselves more comfortable, ready, and confident
during the field work
 I get easily engaged in any community
 When we see that the teamwork and festivals that we are doing
concerning health impacts in addition to the daily activities are all
reflected on everyone we tried to give him/her a message to improve
and he/she will be doing so
 When I get appreciated for something that I have done
 When I receive good feedback
 When we get rewards or feedbacks (negative-positive)
 When we make a voice
 Having met Dr May Haddad
Five people mentioned grades as follows: When we get good grades
(2 responses), When we get the grades (one response), When we get
high grades (one response)
Our Chapters from “Health and Wellness” and “PHAW”
We commented on the proposed plan for studying our chapters from Health and
Wellness and PHAW book.
Class closure Houda led us with an Om and a breathing exercise and then we took
a group photo with the blue circle (World’s Diabetes Day).

237
AM I AT RISK TO DEVELOP DIABETES TYPE 1 or 2?
As a homework, the students calculated their risks if they are at RISK for developing Diabetes
Type 2
http://riskscore.diabetes.org.uk/2013
http://www.diabetes.org/are-you-at-risk/diabetes-risk-test/
Additionally they explored the Interactive circle: The BLUE CIRCLE TEST
.http://www.idf.org/worlddiabetesday/bluecircletest

238
Risk profile: Overweight, lack of physical activity, impaired glucose tolerance (sometimes
referred to as pre-diabetes), unhealthy diet, ethnicity, history of gestational diabetes, family
history, age, high blood pressure, high cholesterol
Students expressed their opinions about the tools as follows:
Ziad: I think these interactive tools are great, they can greatly help a person analyze their current conditions regarding
their health and more specifically the risk of diabetes, and thus when a person takes them they can give him/her a rough
estimate on the risk they have of developing diabetes now or in the future so that the individual can take action
regarding his/her situation and act accordingly. Furthermore the test tells gives you small tips you can apply to health
decrease your risk of acquiring diabetes and improving your health. I would definitely advise my friends and family to
take the exam to see where it puts them in the risk meter.
a) The first test from diabetes UK my score was a 1in 20 chance of developing type 2 diabetes in the next 10
years. Which is considered excellent, however I must continue to watch my diet weight and waist size, and
make sure I maintain a healthy lifestyle.
b) The second test is the American diabetes association, which I scored a 2 in it. The risk factors are 1. Being a
male increases the risk and 2. My lack of enough exercise can increase the risk as well. The blue circle test I
believe is not as simple as the other ones, perhaps the way it is taken, although it is just as beneficial.

239
Ranya: After doing the diabetes test, the results showed that I am not at risk of developing either type of diabetes. I am
not at risk to develop type 2 for at least 10 years (depending on what they wrote).
-The interactive tools prove to be very beneficial and informatory. They are important to help the individual understand
about diabetes and also test if they are at any risk of having it. Early detection is still better than late. The blue circle test
is also one of the best approaches for this subject.
Cynthia: The three of the tests are effective and they help people to have a general idea about whether or not they have
developed or have chances of developing diabetes.
The three assessment test take into consideration the gender, family history, high blood pressure, ethnicity, age, level of
physical activity, gestational diabetes in women, height and weight.
Rim: I found the test very interesting. They don’t replace physiological testing and so but at least, they make us more
aware of our health. In addition, if there was something wrong in our results, we will be more motivated to refer to our
physician.
Alissar: I just did the tests and they all gave me the same answers- i have a low risk of developing Diabetes, however
there is a parental link which could be a way of having the disease.
The tests are easy and quick to get an idea about Diabetes and can be a small insight for people at high risk to get a
medical checkup and also a people at low risk to continue to take preventive measures.
Caroline: The tests done are very clear and helpful. When every person makes the test if he/she is in risk will make them
indirectly get more information about diabetes.
In addition, I mostly liked the blue circle because the message from it is shown in a clever way, in which the person will
have the curiosity to open the question marks which will reveal an answer (a factor) which sticks in their mind, and I am
one of them!
Key points from the theme of Healthy Breakfast
by International Diabetes Federation
Students read handouts about Smart Breakfast and wrote key points from the 5 documents
of the International Diabetes Federation on its theme of the year Healthy Breakfast:
http://www.idf.org/wdd-off-to-the-right-start?language=en

240
Ziad: Key points of the document regarding diabetes given:
1) Eating healthy can help reduce and prevent diabetes, such as eating several servings of fruits and vegetables per
day, having nuts or fat free yogurt as a healthy snack, eating lean cuts of meat, replacing bad oils with good ones
such as canola oil, and eating whole grain bread.
2) Having a health breakfast is very important and helps reduce weight gain. Health breakfasts include
unsweetened tea, coffee or water, Wholegrain bread, Low fat milk, and Low sugar, high fiber cereal.
3) Diabetes worldwide has a great economic burden, as it costs 550 billion us dollars every year, and causes 5
million deaths every year.
4) Having a healthy diet is only 1.50$ more expensive than an unhealthy one.
5) Almost 385 million people are living with diabetes and it is expected to increase to 600 million in the coming

241
years
6) Early diagnosis is important as it can target the issue in a better, safer way.
Ranya: Key points from the documents of the International Diabetes Federation:
• Eating a healthy breakfast decreases the risk of developing type 2 diabetes
• Skipping breakfast is associated with weight gain
• Reducing the prevalence of type 2 diabetes will result in an increased participation and productivity in the workforce,
given that the greatest number of people with diabetes is between 40 and 59 years of age.
• Delayed diagnosis means that many people already have at least one complication by the time they are diagnosed
with diabetes.
Cynthia: Task #1
Write key points from the 5 documents of the International Diabetes Federation on its theme of the year Healthy
Breakfast:
 Every individual has to seek to consume a healthy breakfast to achieve overall good health status.
 Healthy breakfast means you are consuming the following: Vegetables, coffee- unsweetened tea or water,
whole grain bread, low fat milk, eggs (boiled), low sugar-high fiber cereal, cheese, 1 piece of fresh fruit…
 Unhealthy breakfast includes: sweetened beverages, fried foods, white breads-pastries-croissants, sugar
sweetened yoghurt, fruit juices, jams …
 The wide availability of cheap energy dense low-nutrient food is contributing to the global epidemic of type 2
diabetes
 Healthy breakfast is important in order to decrease the risk for developing type 2 diabetes, control appetite
and maintain blood glucose levels.
 Healthy breakfast can help decrease the burden of type 2 diabetes: Eating 3 servings of vegetable, drinking
water or unsweetened tea, eating up to three serving of fruits each day, limiting alcohol intake, choosing
peanut butter instead of jams and chocolate, choosing whole grain breads, and choosing saturated fats instead
of the unsaturated.
 Almost 400 million people worldwide live with diabetes, 5 million die and USD 550 billion is the annual
healthcare cost.
 70% of the type two diabetes can be reduced by: Healthy eating and physical activity and would lead to
reduction of 150 million cases by 2035

242
 If people shift to healthy breakfast choices, this would reduce the global burden of diabetes, and at the same time
will save billions in lost productivity and healthcare costs: Most of the healthcare costs are being spent on treating
complications, this should not be the case. The complications should be prevented through early diagnosis and the
management of diabetes.
 Reducing the prevalence of type 2 diabetes will result in an increased participation and productivity in the
workforce, given that the greatest number of people with diabetes is between 40 and 59 years of age.
Tarek: -A healthy eating and proper food choices can reduce the risk of type two diabetes. So rather than treating
diabetes we can prevent it in an easy efficient way, which is insuring people have a breakfast.
A Healthy breakfast will decrease the risk of obesity which is another factor that increases risk of having diabetes. It’s
highly important to eat a breakfast rich in vegetables mostly green leafy ones, in addition to cut down fats and added
sugars. A simple act to improve the people’s view to the importance of the breakfast will decrease the global burden of
diabetes and insure a healthier…
Rim: Individuals can reduce their risk of type 2 diabetes through easy steps
1- Skipping breakfast is associated with weight gain.
Fish and grilled chicken are healthy breakfast options.
2- Complications affect the heart, eyes, kidneys and feet.
Diabetes might be a burden on the human as well as on the economy.
70% of type 2 diabetes cases can be prevented or delayed by adopting healthier lifestyles.
Skipping breakfast is one of the main risk factors for type 2 diabetes.
Reducing the prevalence of type 2 diabetes will result in an increased participation and productivity in the
work field.
382 million people were living with diabetes in 2013.
Alissar: Key points from the theme of Healthy Breakfast by International Diabetes Federation :
Nowadays, the world faces a high number of people having Diabetes type2 which results in over 5 millions of death
every year.
It is not only a human burden but a heavy economic one; Almost 550 billions of dollars is spent on mostly treating
complications of Diabetes type2.
However, these burdens are preventable. It is possible to prevent diabetes type2, reduce mortality and prolong the lives
of Diabetes cases in a better quality of life by :
 Early diagnosis
 Healthy lifestyle (proper eating habits, physical activity…)
70% of type2 Diabetes cases can be prevented which count about 130 millions of people in 2035!
Up to 11% of the total health expenditures across the globe could be saved by touching the preventable risk factors of
Diabetes type2.
So studies of the International Diabetes Federation have shown that now of the key solution is to have a healthy
breakfast which would be composed of
 Leafy vegetables
 Fresh fruits
 Whole grain bread
 Nuts
 Eggs
And avoid excess sugar, processed food, white bread, fatty aliments…
It is easy to cite and propose the beneficial aliments, but the problem is to provide them to the public. They should be

243
less costly and easily and widely accessible.
Caroline
Eating a healthy breakfast is a main factor that decreases the risk of having diabetes type2.
The message should be transferred to people more widely.
Know more about the IDF materials, and learn the way of usage.
Get more people to be engaged with the federation.
Mia
Diabetes Mellitus Key Points:
To reduce risk of type 2 diabetes or to help people with diabetes to achieve stable control:
o Chose water, unsweetened coffee or tea
o Eat at least three servings of vegetables every day including green leafy vegetables.
o Eat up to three servings of fruits every day
o Snack on nuts or sugar free yogurt
o Limit alcohol consumption to no more than 2 drinks per day
o Leans cuts of white meat, poultry, seafood
o Choose peanut butter instead of chocolate spread and jam
o Choose whole grains
o Chose unsaturated fats
Imporatnce of a healthy breakfast:
o Controls appetite
o Controls glycemia in adults and children
o Skipping breakfast is associated with weight gain
o A healthy breakfast decreases the risk of type 2 diabetes.
Healthy Breakfast options:
o Unsweetened tea, coffee, water
o Whole grain bread, rice, etc…
o Peanut butter
o Eggs
o Unsweetened yogurt with nuts seeds and fruits
o 1 piece of fresh fruit
o Low sugar high fiber cereal
o Vegetables
o Low fat milk
o Small portions of cheese or cold cut ham
o Sih
o Grilled chicken, turkey
Key message 1:
o 400 million affected
o 5 million deaths annually
o Costs related to diabetes are spent on treating complications
o Delayed diagnosis means that the individual can suffer from at least 1 complication

244
o 70% of tye 2 diabetes cases could be prevented or delayed
o Leafy vegetables, fresh fruits, whole grains, lean meat, fish and nuts can prevent from type 2 diabetes or can
help people with the desease avoid complications
o Skipping breakfast leads to weight gain. Obesity account to 80% cases of type 2 diabetes
o Reducing type 2 diabetes prevalence will increase workforce participation since it affects people between 40
and 59
o Diabetes accounts to 10-15% of total healthcare budget in high income countries
o Up to 11% of health care expenditure could be saved by dealing with preventable risk factors
Key Message 2:
o A healthy breakfast decrease type 2 diabetes risk
o Cheap energy dense low nutrient food is contributing to epidemic
o Healthy food need to be more affordable than unhealthy food
o Diabetes is a huge and growing burden
DIABETES MELLITUS: RISK FACTORS
Additionally, the students researched risk factors for developing DM type 2 and 1 as follows:
Risk factors Diabetes Mellitus type 2 Risk factors Diabetes Mellitus type 1
Ziad: There are several risk factors that can increase the
risk of acquiring diabetes type 2, first being overweight or
obese is major risk factor, second is impaired glucose
tolerance or impaired fasting glucose, meaning being pre
diabetic, and thus it is important to be tested to see if a
person is in this category. Third is insulin resistance, it is
usually on the cellular level where cells are unable to
absorb insulin and glucose moves from the blood to the
cells that can cause diabetes. Fourth is ethnic background,
Hispanic, African/American, Asian/American, pacific
islanders are in an increased risk. Fifth is hypertension and
it plays a major risk factor in type 2 diabetes. Sixth is
gestational diabetes, if a pregnant woman develops
diabetes during pregnancy then she is in an increased risk
of developing it later on in life. Seventh is lifestyle, lack of
exercise and proper diet increases risk. Finally age, after
the age of 45 the risk of diabetes 2 increases.
Risk factors for developing diabetes type 1 are first
genetics and family history. Having family members and
more specifically first degree relatives (father, mother,
brother, sister) are factors that might put you in risk of
type 1 and thus must be tested on the regular bases. The
second risk factor is disease of the pancreas or infection of
it inhibits the pancreas from producing insulin and thus
causes type 1 diabetes.
Reference:
WebMD. Retrieved from:
http://www.webmd.com/diabetes/risk-factors-for-
diabetes
Ranya:
SOME FACTORS THAT CONTRIBUTE TO DEVELOPING
DIABETES TYPE 2:
 Weight. Being overweight is a primary risk
factor for type 2 diabetes. The more fatty tissue
you have, the more resistant your cells become to
insulin. However, you don't have to be overweight
to develop type 2 diabetes.
 Fat distribution. If your body stores fat
SOME FACTORS THAT CONTRIBUTE TO DEVELOPING
DIABETES TYPE 1:
 Family history. Anyone with a parent or
sibling with type 1 diabetes has a slightly
increased risk of developing the condition.
 Genetics. The presence of certain genes
indicates an increased risk of developing type 1
diabetes.

245
primarily in your abdomen, your risk of type 2
diabetes is greater than if your body stores fat
elsewhere
 Inactivity. The less active you are, the greater
your risk of type 2 diabetes. Physical activity helps
you control your weight, uses up glucose as
energy and makes your cells more sensitive to
insulin.
 Family history. The risk of type 2 diabetes
increases if your parent or sibling has type 2
diabetes.
 Race. Although it's unclear why, people of
certain races — including blacks, Hispanics,
American Indians and Asian-Americans — are
more likely to develop type 2 diabetes than whites
are.
 Age. The risk of type 2 diabetes increases as
you get older, especially after age 45. That's
probably because people tend to exercise less,
lose muscle mass and gain weight as they age.
But type 2 diabetes is also increasing dramatically
among children, adolescents and younger adults.
 Pre-diabetes. Pre-diabetes is a condition in
which your blood sugar level is higher than
normal, but not high enough to be classified as
diabetes. Left untreated, pre-diabetes can
progress to type 2 diabetes.
 Gestational diabetes. If you developed
gestational diabetes when you were pregnant,
your risk of developing type 2 diabetes increases.
If you gave birth to a baby weighing more than 9
pounds (4 kilograms), you're also at risk of type 2
diabetes.
 Polycystic ovary syndrome. For women,
having polycystic ovary syndrome — a common
condition characterized by irregular menstrual
periods, excess hair growth and obesity —
increases the risk of diabetes.
http://www.mayoclinic.org/diseases-conditions/type-2-
diabetes/basics/risk-factors/con-20031902
 Geography. The incidence of type 1 diabetes
tends to increase as you travel away from the
equator. People living in Finland and Sardinia
have the highest incidence of type 1 diabetes —
about two to three times higher than rates in the
United States and 400 times the incidence among
people living in Venezuela.
 Age. Although type 1 diabetes can appear at
any age, it appears at two noticeable peaks. The
first peak occurs in children between 4 and 7
years old, and the second is in children between
10 and 14 years old.
Many other possible risk factors for type 1 diabetes
have been investigated, though none have been
proved. Some other possible risk factors include:
 Exposure to certain viruses, such as the
Epstein-Barr virus, Coxsackie virus, mumps virus
and cytomegalovirus
 Early exposure to cow's milk
 Low vitamin D levels
 Drinking water that contains nitrates
 Early (before 4 months) or late (after 7
months) introduction of cereal and gluten into a
baby's diet
 Having a mother who had preeclampsia during
pregnancy
 Being born with jaundice
http://www.mayoclinic.org/diseases-
conditions/type-1-diabetes/basics/risk-factors/con-
20019573
Cynthia:
Diabetes Mellitus type 2 occurs when the body does not
produce enough insulin to maintain a normal glucose
level or the insulin is not working efficiently enough.
Known as the adult-onset or noninsulin-dependent
diabetes.
Risk factors include:
 Age: people who are over 40 years old are
more exposed to developing it.
 Having a family history i.e. any member of the
Diabetes Mellitus type 1 results from the
autoimmune destruction of the insulin-producing
beta cells in the pancreas
Risk factors include:
 Family history: anyone having a family
member with type 1 diabetes in prone to
developing it.
 Genetics: the presence of certain genes in
the body indicates the risk of developing

246
family has developed it earlier.
 Being overweight or obese and having a waist
size over 80cm for women and 94 for men.
 South Asians, Chinese, African-Caribbean or
black African origin are more vulnerable.
 Having a cardiovascular disease, such as stroke
or heart attack.
 Being a woman and having either Polycystic
Ovary Syndrome (POS) or gestational diabetes.
 Having severe mental health conditions (being
depressed, schizophrenic, bipolar …).
 Having impaired glucose tolerance or impaired
fasting glycaemia.
 Lack of physical activity and having a
sedentary lifestyle.
 Distribution of fat: If the body stores fat in the
abdominal area  high risk of developing
diabetes type 2.
Reference:
-National Health Service (NHS)
-Mayo clinic
type 1 diabetes
 Age: type 1 diabetes is known as juvenile
diabetes which hits children between the
ages of 4 to 7 and children between 10 to
14 years old.
 Geography: the incidence of diabetes tends
to increase as you travel away from the
equator.
 Exposure to certain viruses, such as the EB
virus, Coxsackie virus, mumps virus...
 Being born with jaundice
 Drinking water that contains nitrates
 Low vitamin D levels
 Having a mother who had preeclampsia
during pregnancy
References:
-Mayo clinic
-University of Maryland Medical Center
Tarek:
From WWW.NHS.UK
Type 2 Diabetes
Causes of type 2 diabetes
Type 2 diabetes occurs when the pancreas doesn't
produce enough insulin to maintain a normal blood
glucose level, or the body is unable to use the insulin
that is produced – known as insulin resistance.
.
Risk factors for type 2 diabetes
Four of the main risk factors for developing type 2 diabetes
are:
 age – being over the age of 40 (over 25 for
South Asian people)
 genetics – having a close relative with the
condition (parent, brother or sister)
 weight – being overweight or obese
 ethnicity – being of South Asian, Chinese,
African-Caribbean or black African origin
(even if you were born in the UK)
Symptoms of type 2 diabetes
The symptoms of diabetes include feeling very thirsty,
passing more urine than usual and feeling tired all the
time.
 urinating more often than usual,
From WWW.NHS.UK
Type 1 Diabetes
Causes
Type 1 diabetes occurs when the body is unable to produce
insulin. Insulin is a hormone that's needed to control the
amount of sugar (glucose) in your blood.
When you eat, your digestive system breaks down food and
passes its nutrients – including glucose – into your
bloodstream.
The pancreas (a small gland behind your stomach) usually
produces insulin, which transfers any glucose out of your
blood and into your cells, where it's converted to energy.
However, if you have type 1 diabetes, your pancreas is
unable to produce any insulin (see below). This means that
glucose can't be moved out of your bloodstream and into
your cells.
Autoimmune condition
Type 1 diabetes is an autoimmune condition. Your immune
system (the body's natural defense against infection and
illness) mistakes the cells in your pancreas as harmful and
attacks them, destroying them completely or damaging
them enough to stop them producing insulin.

247
particularly at night
 feeling very thirsty
 feeling very tired
 unexplained weight loss
 itching around the penis or vagina, or
frequent episodes of thrush
 cuts or wounds that heal slowly
It's not known exactly what triggers the immune system to
do this, but some researchers have suggested that it may be
due to a viral infection.
Type 1 diabetes is often inherited (runs in families), so the
autoimmune reaction may also be genetic.
If you have a close relative – such as a parent, brother or
sister – with type 1 diabetes, you have about a 6% chance
of also developing the condition. The risk for people who
don't have a close relative with type 1 diabetes is just
under 0.5%
Symptoms of type 1 diabetes
The symptoms of type 1 diabetes can develop very
quickly (over a few days or weeks), particularly in
children.
The main symptoms of diabetes are:
 feeling very thirsty
 urinating more frequently than usual,
particularly at night
 feeling very tired
 weight loss and loss of muscle bulk
 itchiness around the genital area, or regular
bouts of thrush (a yeast infection)
 blurred vision caused by the lens of your
eye changing shape
 slow healing of cuts and grazes
Vomiting or heavy, deep breathing can also occur at a later
stage. This is a dangerous sign and requires immediate
admission to hospital for treatment.
You should visit your GP immediately if you think you
may have diabetes.
Hypoglycaemia (low blood glucose)
Symptoms of a "hypo" include:
 feeling shaky and irritable
 sweating
 tingling lips
 feeling weak
 feeling confused
 hunger
 nausea (feeling sick)
Hyperglycaemia (high blood glucose)
The symptoms of hyperglycaemia are similar to the main
symptoms of diabetes, but they may come on suddenly
and be more severe. They include:
 extreme thirst
 a dry mouth
 blurred vision

248
 drowsiness
 a need to pass urine frequently
Rim: A person is more likely to develop type 2 diabetes of
he/she:
- Had heart diseases
- Is a woman who has polycystic ovary syndrome
- Has cases of diabetes in the family (parent, brother,
sister)
- Is not physically active
- Has a low level of “good cholesterol”
- Is overweight, especially around the waist
- Has high blood pressure
Reference:
12 Things That Make Type 2 Diabetes More
Likely,
http://www.webmd.com/diabetes/guide/risk-
diabetes
Type 1 diabetes, is also known as juvenile diabetes of
insulin dependent diabetes. However, it can begin in adults
in their late 30s.
The various risk factors that might contribute to type 1
diabetes are:
- Being ill in early infancy
- Having a parent with type 1 diabetes (greater risk if
a father has the condition)
- Having an older mother
- Having autoimmune disorders such as multiple
sclerosis.
Reference: Type 1 Diabetes-Risk factors,
http://www.healthcentral.com/diabetes/type-I-
diabetes- 000009_3-145.html
Alissar:
The risk factors for developing Diabetes Mellitus type2
(DM2) are commonly know to: overweight or to have a
high body mass index (BMI) , to have a large waist (more
than 80cm/31.5 inches in women, 94 cm/37 inches in men
or 90cm/35 inches in South Asian men), to be over 40
years old, lack of exercise, to have a relative diagnosed
with DM2, to have ever had high blood pressure, a heart
attack or a stroke, to have a history of polycystic ovaries,
gestational diabetes or have given birth to a baby over 10
pounds/4.5kg, to take anti-psychotic medication or the
most important, to have an unhealthy diet and impaired
glucose regulation.
The risk factors for type 1 diabetes are still being
researched. However, having a family member with type 1
diabetes slightly increases the risk of developing the
disease. Environmental factors and exposure to some viral
infections have also been linked to the risk of developing
type 1 diabetes. Moreover, an unhealthy diet, lack of
physical activity and impaired glucose regulation are of
high risk exposure.
References:
Diabetes UK, 2014, guide for diabetes , retrieved
from: http://www.diabetes.org.uk/Guide-to-
diabetes/Managing-your-diabetes/Healthy-eating/
International Diabetes Federation, 2014, risk factors,
retrieved from: http://www.idf.org/about-diabetes/risk-
factors
Caroline:
Diabetes type2:
Obesity or being overweight. Diabetes has long been linked
to obesity and being overweight. Research at the Harvard
School of Public Health showed that the single best
predictor of type 2 diabetes is being obese or overweight.
Diabetes type 1:
With type 1 diabetes, which starts in childhood, the
pancreas stops producing insulin. Insulin is a hormone your
body needs to be able to use the energy -- glucose -- found
in food. The primary risk factor for type 1 diabetes is a
family history of this lifelong, chronic disease. Genetics and
family history. Having family members with diabetes is a
major risk factor. The American Diabetes Association
recommends that anyone with a first-degree relative with

249
Reference:www.webmd.com type 1 diabetes -- a mother, father, sister, or brother --
should get screened for diabetes. A simple blood test can
diagnose type 1 diabetes. Diseases of the pancreas. Injury
or diseases of the pancreas can inhibit its ability to
produce insulin and lead to type 1 diabetes. Infection or
illness. A range of relatively rare infections and illnesses
can damage the pancreas and cause type 1 diabetes
Mia
Mia Akra
Risk Factors for diabetes type 2:
o Over weight
o Fat Distribution in the abdomen region
o Inactivity and sedentary lifestyle
o Family History
o Race
o Age
o Prediabetes
o Gestational diabetes
o Polycystic ovary syndrome
o You've had heart disease.
o You have high blood pressure.
o Your "good" cholesterol level is low. It's too low if
it's less than 35 mg/dL
o Your triglyceride level is high. It's too high if it's
over 250 mg/dL
References:
http://www.webmd.com/diabetes/risk-factors-for-
diabetes
Risk factors for diabetes type 1:
o Family History
o Genetics
o Geography
o Age
o Exposure to certain viruses, such as the Epstein-
Barr virus, Coxsackie virus, mumps virus and
cytomegalovirus
o Early exposure to cow's milk
o Low vitamin D levels
o Drinking water that contains nitrates
o Early (before 4 months) or late (after 7 months)
introduction of cereal and gluten into a baby's diet
o Having a mother who had preeclampsia during
pregnancy
o Being born with jaundice
o Diseases of the pancreas. Injury or diseases of the
pancreas can inhibit its ability to produce insulin
and lead to type 1 diabetes.
o Infection or illness. A range of relatively rare
infections and illnesses can damage the pancreas
and cause type 1 diabetes.

250
People: Mia, Rim, Ziad, Ribal, Tarek, Cynthia, and May
Place: Rm 303
A brief meeting between Ziad and May preceded the class
We started the class with a relaxation exercise listening to meditative flute music “A Touch of
Grace Bamboo Flute Meditation” by Jonathan Foust.
We reflected on our last session and voiced priorities for this session. The following were the
activities of this session:
Peer support: Best practices
May reflected on what we have been doing so far, the theory and the tools that we have used
to understand our current practices (included were life style survey, role plays, weekly agenda,
web quiz).
In pairs, the students discussed their successes in the following: more veggies and fruits; smart
snacks and; not skipping breakfast and having a smart one and decided upon new challenges
to take by Friday. Generally, they have notes an improvement in their eating habits.
As to the challenges to be addressed by Friday:
Ziad and Cynthia: Use an eco bottle
(in order to reduce plastic bottles)
Rim and Ribal: Not to skip breakfast (Ribal)
and more smart snacks (Rim)
Mia and Tarek: More exercise.

251
Mind-maps
We wrote associated words, concepts and scribbles. Among our results:
EXERCISE. Happy hormone. The first step is the hardest,
so take it without thinking. Feel the burn
Do it more often. Discipline.
STRESS: Stop. Management. Gaining weight.
Daily payment for life. Exams. Chocolate.
TOBACCO: Addictive. Trap. Stopping it. Stupidity.
Will power. Killing me softly with his song (song)
MENTAL HEALTH: No stigma. Present in every mind.
Mind. Stress-free – happiness and love.
No one can run away from this illness.
TRUST: Essential. The Base. Disappointment.
‫فيك‬ ‫ثقه‬ ‫عندي‬
Basis for every relationship:
Person-person interaction, Work, Education, Friendship
.
MIND-BODY: Harmony. Spirituality. Peace.
Connection. Balance. Stress management. Wellness.
SEXUALITY: Protection. Life continuity. Personal decision.
Affection. Sex. Intimate. Love. Not something to be ashamed of.
LOVE: Best medication therapy. You.
Friends. Joy. Family. Relationship.

252
Preparing ourselves to our presentations
We wrote our ideas of what we like to see covered during the presentations of the 6 chapters
that have been assigned to us and gave it to the person in charge of the chapter. Our results
included:
Addressed to Rim
Ch 2 Mind-Body Communications-
Maintain Wellness
 Please tell us how we can find the perfect balance
 What are things that can be done to improve
mind-body connections
 How to reach inner peace? How to make the
balance to achieve this task?
 Waw! Very interesting. Just tell us the most
information that you have! Different methods,
therapies, benefits etc.
Addressed to Ziad
Managing Stress:
Restoring mind-body harmony
 Introduce us to easy steps in managing stress
 Any easy steps to avoid daily stresses
 How can we get rid of stress (excluding eating?)
 I suffer from overeating and eating addiction
when I stress or my mood changes. What should
be done?
 Is it not only a theory? Can someone apply easily
into the daily life?
Addressed to Ribal
Ch 4 Mental Health
and Mental Illness
 Clear definition and classification
 Basic knowledge of how to deal with such cases
 Symptoms of the very common illnesses (OCD,
anxiety, depression)

253
 Why mental health is not considered a major
concern?
 What is the best way to deal with a person with a
mental disability
 What can be done to make this topic something
normal and open in our society
Addressed to Mia
Ch 7 Physical Activity
for Health and Well-being
 Introduce us to easy exercises that we can do on
daily basis
 Give us some tips to engage in physical activity for
those who have never done so
 How can we help ourselves to start and continue
 Living in a world like this where time is always an
issue, what can be done in a fast and effective
way?
 Does lack of exercise and sedentary lifestyle
actually lead to dangerous illness
 Exercise in class
Addressed to Tarek
Ch 8 Sexuality
and intimate relationships
 Why are people always afraid to talk about this
issue? What are the best ways to spread
awareness about this matter?
 Make sure to tackle this topic carefully because it
is a controversial topic
 Sexuality? When is it a taboo and when is it
normal? Where are the limits drawn?
 How can we help change this subject from being a
taboo?
Addressed to Cynthia
Ch 17 Eliminating Tobacco Use
 How people can quit and their responsibilities
towards themselves and others
 How can we reduce smoking in a large scale
 Beneficial: 8 ways to quit smoking
 Avoid typical smoking discussion
 Creative interventions
 Awareness ideas
 Use the interview with our quest speaker
 It will be useful to take Dr Bert as a reference for
your presentation i.e. ask him questions that may
support you=

254
Addressed to Caroline
Ch 14 Cardiovascular Diseases:
Understanding Risks and Measures
of Prevention
1) what is more effective when it comes to CVD
prevention dieting or exercise?
2) What should our behaviors be and what are the
causes of CVDs?
3) Protecting ourselves from CVDs/Who are the
ones that are most prone to developing it?
4) How to react when a person gets a heart attack
next to us?
5) Different heart diseases/prevention ways/Is
there a reversible stage in CVD?
6) Are medications more beneficial than
prevention?
7) What are some good foods to eat that are
beneficial for the heart and reduce CVD?
Addressed to Ranya
Ch 16 Using Drugs Responsibly
 Why are drugs illegal
 Why are drug abusers stigmatized in society
 What are some ways to integrate addicts in
society
 If we know the consequences of drugs, why aren't
there rules to limit their use
 What is the most efficient way to help a person
stop taking drugs
 What's the most reason of drug abuse specifically
in adolescence
 How much time does it take a person to get
hooked on drugs

255
May also shared a list of questions that she had for every student and that she had prepared
ahead of time.

256
We then started a discussion about the plan for chapters sharing during this course. The
following was agreed upon (updated 22 12 14):
Dec. 1
Rim: Mind-Body
Dec 5
Mia: Exercise
Cynthia: Tobacco
Dec. 8
Caroline: Cardiovascular disease
Dec. 12
Ribal: Mental health
Ziad: Mental Health
Dec. 15
Tarek: Sexuality
Ranya: Drugs
Jan. 12
Alissar: Cancer

257
Images of our breakfasts:
Students posted on a special photo album (facebook group PDHP 246) their images of
breakfasts:
Other meals: Mia posted an image
of delicious soup that she had prepared

258
International Health Books Resources
In order to introduce the students to these valuable book resources, students picked out one
chapter and developed a question and an answer. The chapters:
Where There Is No Doctor WTIND
Ch 1 Home cures and popular beliefs
Chapter 2 Sicknesses that are often confused
Helping Health Workers Learn HHWL
Ch 1 Looking at learning and teaching
Ch 7 Helping people look at their customs or beliefs
Where Women Have No Doctor WWHND
Ch 1 Women’s Health is a Community Issue
Environmental Health
Ch 2 Understanding and Mobilizing for Community Health
The books: To download the books free of charge
 Where Women Have No Doctor
http://en.hesperian.org/hhg/Where_Women_Have_No_Doctor
 Where There is No Doctor
http://hesperian.org/books-and-resources
 Helping Health Workers Learn
A Community Guide to Environmental Health
http://en.hesperian.org/hhg/A_Community_Guide_to_Environmental_Health

260
Students’ responses (Q & A): international health books
Ranya: WHAT MIGHT CAUSE POOR HEALTH IN WOMEN?
Answer: Women are one of the “vulnerable” groups in society. They are more subjected to poverty (2 out of 3 women), and they are
discriminated most of the time in most societies, so they are left with no education or a stable job. That would result in low income,
leading to poverty.
Because women are raised with no well educational background, they grow to depend on their husbands to live. They turn out to be
‘stay in wives’ that wait for the husband to give them money for basic shopping of clothes and food. That would put women in a
mental state of not being able to say no to her husband’s commands and needs, thus being subjected to probable violence and
abuse.
Discrimination would take part as well, although discrimination may target the mental health more, it would still cause “poor health”
from both the mental and he physical state. Since in a world like ours (now less than before) families require men in the family as
children to “hold out the name”, so when a girl is born instead of a boy, she is directly, consciously or unconsciously, mistreated. It
could vary from lack of education to lack of attention both mentally and physically. It’s safe to say that a woman’s needs would not
be met as sufficiently.
A woman also suffers when it comes to legal issues, from something as small as not being able to legally have a child on her own, to
owning very little rights when it comes to divorce.
Being a woman, it is biologically written for us to bare children, however, when a woman gets pregnant a lot, either by having a lot
of children, or by giving birth on small time intervals between each one, that is definitely going to affect her health, her body and her
mind.
It is thought that taking care of a woman’s health requires a lot of money, so most poor countries don’t have the required health
services to meet woman’s need and that would lead to a decrease in the woman’s health because there is no care.
Caroline:
CH1: Women's Health is a community issue
Book: Where Women Have No Doctor;
Question:
What are the common health problems that affect women mostly?
By Cynthia:
After reading chapter 1 “Home Cures and Popular Beliefs” from the book “Where there is No Doctor”, state 10 folk beliefs and
home remedies that you find interesting and would imply if you lived in an area where there was actually NO DOCTOR.
Then, mention whether or not these beliefs contradict with current medical approaches.
 For coughs and common diarrhea, herbal tea is often better, cheaper and safer than modern medicine.
Herbal teas and medicines have showed to cure coughs and diarrhea according to modern medicine.
 When a person has a high fever, he should be wrapped up so that the air will not harm him.
This is not true. When a person has high fever, take off all covers and clothing. Let the air reach his body. This will help the
fever go down.
 According to Mexican villagers, to get rid of poisonous snakebites, use guaco leaves, apply tobacco, apply the skin of a
poisonous lizard, bite the snake or smear the snake’s bile on the bite.
None of these remedies has any direct effect against snake poison. For snakebites it is usually better to use modern
treatment. Simply obtain “antivenoms” or “serums” for poisonous bites.
 Breast milk is considered the best food for an infant.
This is true. Even modern medicine encourage breastfeeding. In addition to containing all the vitamins and nutrients your
baby needs in the first six months of life, breast milk is packed with disease-fighting substances that protect your baby from
illness.
 When the top spot of a baby’s head sinks inward, the baby will probably die of diarrhea, unless he gets special treatment.
This is true, since the baby will be dehydrated. Although Sunken Fontanelles may seem scary, its treatment is so simple;
providing the baby with a rehydration drink, breast milk or boiled water can solve the issue.
 The stump of the cord should be kept dry until it falls off.
Modern child care advices that after the umbilical cord stump dries up, falls off, and the area heals, you can start giving
your newborn tub baths. Meanwhile, the baby can be gently cleaned with a clean, soft and a damp cloth.

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 In rural Mexico, it is believed that goiter could be solved by: tying a crab on the goiter, rubbing the goiter with the hand of a
dead child, smearing human feces on the goiter. None of the previously mentioned is actually beneficial. The treatment of
goiter is simply iodized salt.
 For a nosebleed, use a yesca (a bright red mushroom).
The solution for nosebleed is simple. FIRST AID.
Sit up straight and tip your head slightly forward.
Use your thumb and forefinger to firmly pinch the soft part of your nose shut.
Apply an ice pack to your nose and cheeks. Cold will constrict the blood vessels and help stop the bleeding.
Keep pinching for a full 10 minutes
 For dog’s bite, drink tea that is made from the dog’s tail.
The wound can be properly assessed and cleaned. If part of the wound has dead or damaged skin then it may need to be
trimmed or removed. This is because infection is more likely to develop in dead skin. Moreover, tetanus and rabies
vaccination can do the job!
 Aloe Vera can be used to treat minor burns and wounds. The thick slimy juice inside the plant calms the pain and itching,
aids healing, and prevents this infection. It can also help treat stomach ulcers and gastritis.
A cream with aloe has been used to treat skin lesions and has shown some evidence of benefit. Also, Aloe may alter
immune function and reduce inflammation.
Aloe Vera juice has been found to be one of the substances that help loosen and flush undigested, toxic build-up from the
stomach walls.
Ziad
Home cures and popular beliefs chapter 1
Question: Are home remedies just as effective as medical medications? And can the mind play a role in the effectiveness of either
way?
Answer: Home remedies in some cases can be just as effective as medical drugs; however the mind plays a role in its effectiveness,
if a person believes strongly of the remedy given then the probability of him healing from the illness is high, and vice versa, however
there are some cases where home remedies are not effective, and medical treatment should be applied, such illnesses can include
poisonous snake bites, and strong infections that cause high fever and other serious symptoms. In some cases modern medicine can
be of less effective than old beliefs, such as breast feeding, recent studies have shown that breast milk is best for newborn, but with
big companies interference in the medical field with relation to powder milk, people can tend to believe that powder milk is better
as it is fortified with essentials, however this is wrong and “breast is best”. On the other hand the power of belief can harm a person
rather than help him, if a person tends to believe that a certain food or drink is related to pain after a certain accident, and then
whenever a person drinks or eats that certain food than he or she will think that it will result in pain. A person must be wise when it
comes to treatment and know when it is safe to use home remedies or refer to medical treatment.
Rim
The chapter I decided to read was the following "Sicknesses that are often confused".
The question about this chapter is:
- What are the important acute illnesses in which fever is an outstanding sign? Give 4 examples.
Answer:
1-Malaria: fever may come and go for few days, with shivering as the temperature rises and sweating as it falls. The it may come
for few hours every second or third day.
2-Typhoid: temperature goes up a little more each day. Pulse relatively slow. Diarrhea and dehydration. Trembling or delirium.
Person very ill.
3-Pneumonia: fast, shallow breathing. Temperature rises quickly. Cough with green, yellow or bloody mucus. Pain in chest. Person
very ill.
4-Childbirth fever: begins a day or more after giving birth. Starts with a slight fever, which often rises later. Foul-smelling vaginal
discharge. Pain and sometimes bleeding
Alissar
Question about « HELPING PEOPLE RECOGNIZE THE STRENGTHS IN THEIR TRADITIONS » first paragraph, retrieved from « Helping

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Healthcare Workers Learn», chapter 7:
How can healthcare workers can reach the goal of healing human beings when by ethical issues such as cultural values are not
taken into consideration? Wouldn't lead to a rejection of medical care by villagers?
Tarek
Chapter 2: sickness that are often confused
What are the different types of non-infectious diseases?
Ans. 1-Problems caused by something that wears out or goes wrong within the body.
2-Problems caused by something from outside that harms or troubles the body.
3-Problems caused by a lack of something the body needs.
4-Problems people are born with.
5-Problems that begin in the mind (mental illnesses).
Mia
Where Women Has No Doctor:
Chapter 7.
Breast feeding.
Question:
o Give 4 adavantages for breastfeeding and 4 consequences if breastfeeding was avoided.
Answer:
o Advantages:
o Helps the womb stop bleeding after delivery
o Builds emotional bonds between the baby and the mother, a feeling of security.
o Breastfeeding is free
o Contraceptive method for women.
o Drawbacks for not breastfeeding:
o Formula milk does not give the baby and immunity or protect it from any diseases
o Bottles and water used need sterilization
o Formula milk is expensive
o The baby may suffer from malnourishment.
Ribal:
Where There Is No Doctor: Chapter 1: Home cures and popular beliefs
Question: Can viral infections be treated with antibiotics? What about non-infectious diseases? Why?
Answer: No. Antibiotics are used to treat only infectious-disease and specifically bacterial infection because they fight bacterial
germs (bacteria) that infect the body. As for viral infections, antiviral drugs should be used.

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Session 22:
Talk by Bert: Wed. 26 11 14
People: Rim, Ziad, Ribal, Tarek, Cynthia, Alissar, Mia, May, Bert, Roubina, + 3
other students
Place: Rm 204
Dr Hirschhorn responded to PDHP 246 students’ questions that Cynthia collated. Bert shared
with us his e-mail contacts in case people had further questions. The following are synopsis
from the talk as reported by Cynthia (special thanks to Rim as well for sharing her notes):
University of Balamand
Faculty of Health Sciences
PDHP 246
A talk with Dr Norbert Hirschhorn
Tobacco: What’s New?

265
Name: Cynthia Bakkalian
Date: 29th
of November 2014
Special thanks to Dr Bert for reviewing the contents of this report
On the 26th
of November 2014, Dr Norbert Hirschhorn visited the PDHP246 class and their friends. The
class started by welcoming Dr Norbert and by mentioning a brief biography of his own work.
Norbert Hirschhorn is an American public health physician born in Austria, currently residing in
Lebanon. He is the developer of the “oral rehydration therapy”, which saved the lives of infinite infants,
children and adults. Thus, for this work, he is recognized as the American Health Hero by President W. Clinton.
Moreover, he is the conductor of research on tobacco control. Nowadays, Dr Hirschhorn is involved in writing
as well as publishing poetry and literacy book reviews.
Some of the issues raised during the talk:
 We got introduced to the e-cigarettes. Dr Norbert mentioned that e-cigarettes are not considered suitable
alternatives, although it is free of tobacco but its basic focus is the nicotine. Around 500 companies are
working on e-cigarettes in the current days.
 In the West lung cancer is has a higher mortality among
women rather than breast cancer, and that is
because of the decades of increased consumption of

266
cigarettes by women, and the better treatment available
for breast cancer. Moreover, it is the MORTALITY from
lung cancer that has increased.
. Note that there is a twenty-year lag period between increasing consumption and occurrence of lung cancer.
 Why isn’t tobacco smoking banned till nowadays?! The answer is simple, because the tobacco industry
is a legal industry and no government (except Bhutan) has the political will or legal right to ban a whole
industry. In fact, in US banning tobacco is forbidden: The Congress gives the right to regulate tobacco
but does not allow to eliminate nicotine or ban manufacture and sale of tobacco
 Nicotine is addictive to the brain; it stimulates the smoker both to relieve a down-mood as well as to
calm an excitable mood... It affects pleasure centers and stimulates the need to have more of the drug.
Therefore, if the addicted brain does not receive a regular supply of nicotine it will send urgent signals,
called craving, for another smoke.
Morning smoking is a serious sign of addiction, for instance if you have your tobacco pack near your
bed to light up as soon as you are awake.
 Italy, Spain and France, many US states, and now China have banned smoking inside public spaces.
This has decreased the number of patients being admitted to the hospitals for heart attacks. Banning
tobacco smoking was also good strategy to protect the health of workers in restaurants, who are
continuously exposed to the smoke. Bans are also occurring voluntarily in offices and apartment
buildings, since smoke is like water, it goes through cracks, lighting fixtures, etc.
 Third hand smoker: When the smoke is stuck on the walls, furniture, cloths, rugs…
As a result, when babies crawl on the rugs, for instance, they will be exposed to all the toxic material.
 In-utero exposure of the fetus to the smoke of cigarette has shown to cause physiological and behavioral
illnesses as they grow old.
 Two billionaires who have invested a lot of their money to control tobacco use are former New York
Mayor Michael Bloomberg and Bill Gates of Microsoft.
 70% of the smokers begin during their teenage years.
 The majority of smokers are now the poor and under-educated, as well as persons with mental health
illnesses (nicotine a kind of self-medication).
 The majority of smokers are in developing countries, and that is where the tobacco industry is focusing
its greatest efforts at marketing and advertising.
 Tobacco control is as much based on politics and striving for social justice.
 You can make your 40-year career in tobacco control: it will take this long to remove the scourge of
smoking.
During the session, Dr Norbert answered all the questions that were prepared by PDHP246 students

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Our Questions to Dr Norbert:
1. Why is tobacco still legal, at the time certain illicit drugs are less destructive to human
health and are illegal?
2. Nowadays the excess consumption of soft drinks, chocolate and much other confectionery
are the reason for numerous health problems. Would you think it is the time to implement
laws and regulations that are similar to that of tobacco industry for those types of goods
(Health warning message, higher taxation)
3. In Lebanon, the government has issued a new law banning tobacco consumption in public
places as well as has set certain guidelines that banned above the line marketing activities.
However, this law is not being implemented. Tell us what we can do to have a positive
impact on the society.
4. Each adult has the right to choose the way he/she is willing to live his life. Would you think
that the role of governmental agencies should be just limited to raising awareness on the
risk of some products such as tobacco or they should intervene?
5. Do you believe that the restricted smoking indoors legislation that was issued few years
ago, improved the general public health of the Lebanese population with regards to
respiratory illnesses?
6. Lebanon is one of the top consumers of American cigarettes in the world, what do you
think is the best, most effective way that can be done to help reduce this?
***
In preparing ourselves for the session, the students were encouraged
to skim through the following sites:
http://en.wikipedia.org/wiki/Norbert_Hirschhorn
Selected articles by Dr Hirschhorn
Shameful Science four decades of the German tobacco industry’s hidden research on smoking
and health: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1748350/pdf/v009p00242.pdf
Corporate Social Responsibility and the tobacco industry: hope or hype?
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1747956/pdf/v013p00447.pdf
The Philip Morris External Research Program: results from the first round of projects
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2564674/

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Session 23: Friday 28 11 14 pm
People: Rim, Ziad, Caroline, Tarek, Cynthia and May
Place: Computer lab Rm 105
The following were the computer lab exercises. Responses of few students are listed as
samples.
Exercises for the Computer lab-2 session 28 11 14
A-USING PDHP 246 MOODLE
Plz access and let us discuss NOW our plans to DOWNLOAD all documents that we will need
for the FINAL TAKE HOME EXAM
Feedback: Students did not find it very friendly and preferred that we continue using the
facebook group and e-mails for sharing documents.
B-COME PREPARED FOR MONDAY’S SESSION WITH RIM
(1) QUOTES: MIND-BODY (IN COORDIANTION WITH RIM)
CHOOSE 1-3 RELEVANT POSTER- QUOTE BY (1) DEEPACK CHOPRA OR (2) TARA BRACH OR (3) DALAI
LAMA OR (4) OTHER FAVOURITE OF YOURS
(Plz add the poster-quote to the special Face Book photo album and also, kindly print for MONDAY’s
CLASS for a potential activity)
(2) SKIM through these two articles:
(a) Psychosomatic Disorders http://www.patient.co.uk/pdf/4664.pdf
(b) Somatization /Somatoform Disorders http://www.patient.co.uk/pdf/4665.pdf#

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C- HEALTHY DECLARATIONS
http://www.healthydocuments.org/index.html
Acquaint yourself with the following important documents, declarations, charters and instruments that impact
people’s health. Note that the Lebanese government has ratified several of these declarations.
Quote 1-3 items from each that you value + Samples of students responses
 Healthy Document Items
 The Declaration of Alma Ata
http://www.healthydocument
s.org/public/doc9.html
“Governments have a responsibility for the
health of their people which can be fulfilled only
by the provision of adequate health and social
measures”.
“The existing gross inequality in the health
status of the people particularly between
developed and developing countries as well as
within countries is politically, socially and
economically unacceptable and is, therefore, of
common concern to all countries”.
All governments should formulate national
policies, strategies and plans of action to
launch and sustain primary health care as part
of a comprehensive national health system and
in coordination with other sectors.
 Ottawa Charter on Health
Promotion
s.org/public/doc10.html
“Good health is a major resource for social,
economic and personal development and an
important dimension of quality of life. Political,
economic, social, cultural, environmental,
behavioural and biological factors can all favour
health or be harmful to it. Health promotion
action aims at making these conditions
favourable through advocacy for health”.
Health promotion policy requires the
identification of obstacles to the adoption of
healthy public policies in non-health sectors,
and ways of removing them. The aim must be
to make the healthier choice the easier choice
for policy-makers as well.
 People’s Health Charter
s.org/rights/doc6.html
“Public services are not fulfilling people's needs,
not least because they have deteriorated as a
result of cuts in governments' social budgets.
Health services have become less accessible,
more unevenly distributed and more
inappropriate”.
Demand measures to prevent accidents and
injuries in the workplace, the community and
in homes.
 Universal Declaration of
Human Rights
s.org/rights/doc7.html
“Member States have pledged themselves to
achieve, in co-operation with the United
Nations, the promotion of universal respect for
and observance
of human rights and fundamental freedoms”.
Motherhood and childhood are entitled to
special care and assistance. All children,
whether born in or out of wedlock, shall enjoy
the same social protection.
 World Declaration on
Nutrition
s.org/nutrition/doc31.html
“We recognize that poverty and the lack of
education, which are often the effects of
underdevelopment, are the primary causes of
hunger and undernutrition. There are poor
people in most societies who do not have
adequate access to food, safe water and
sanitation, health services and education, which
are the basic requirements for nutritional well-
being”.
Wars, occupations, civil disturbances and
natural disasters, as well as human rights
violations and inappropriate socio-economic
policies, have resulted in tens of millions of
refugees, displaced persons, war-affected
noncombatant civilian populations and
migrants, who are among the most
nutritionally vulnerable groups. Resources for
rehabilitating and caring for these groups are
often extremely inadequate and nutritional

270
deficiencies are common. All responsible
parties should cooperate to ensure the safe and
timely passage and distribution of appropriate
food and medical supplies to those in need, in
accordance with the Charter of the United
Nations.
 The International Code of
Marketing of Breast milk
Substitutes,
s.org/children/doc35.html
“Recognising that governments should
undertake a variety of health, nutrition and other
social measures to promote healthy growth and
development of infants and young children, and
that this Code concerns only one aspect of these
measures”.
“Affirming the right of every child and every
pregnant and lactating woman to be adequately
nourished as a means of attaining and
maintaining health”.
Affirming the right of every child and every
pregnant and lactating woman to be
adequately nourished as a means of attaining
and maintaining health
 The United Nations
Convention on the Rights of
the Child
s.org/children/doc36.html
“Recognizing that the child, for the full and
harmonious development of his or her
personality, should grow up in a family
environment, in an atmosphere of happiness,
love and understanding”.
Recognizing that the child, for the full and
harmonious development of his or her
personality, should grow up in a family
environment, in an atmosphere of happiness,
love and understanding
 Convention on the
Elimination of All Forms of
Discrimination Against
Womenhttp://www.healthyd
ocuments.org/women/doc41.
html
“Recalling that discrimination against women
violates the principles of equality of rights and
respect for human dignity, is an obstacle to the
participation of women, on equal terms with
men, in the political, social, economic and
cultural life of their countries, hampers the
growth of the prosperity of society and the
family and makes more difficult the full
development of the potentialities of women in
the service of their countries and of humanity”.
The right to social security, particularly in
cases of retirement, unemployment, sickness,
invalidity and old age and other incapacity to
work, as well as the right to paid leave
World Cancer Declaration
http://www.uicc.org/world-
cancer-declaration
 Reduce stigma and dispel myths about
cancer
 Universal access to screening and early
detection for cancer
 Reduce exposure to cancer risk factors.
Improve access to services across the cancer
care continuum
 Items
http://www.healthydocuments.org/public/doc9.html
 Governments have a responsibility for the health of
their people which can be fulfilled only by the
provision of adequate health and social measures.
 An acceptable level of health for all the people of the
world by the year 2000 can be attained through a fuller
and better use of the world's resources, a considerable
part of which is now spent on armaments and military
conflicts
 Ottawa Charter on Health Promotion
 Health promotion supports personal and social
development through providing information, education
for health and enhancing life skills.

271
http://www.healthydocuments.org/rights/doc6.html
 The participation of people and people's organisations
is essential to the formulation, implementation and
evaluation of all health and social policies and
programmes.
 Health is primarily determined by the political,
economic, social and physical environment and should,
along with equity and sustainable development, be a
top priority in local, national and international policy-
making.
 Universal Declaration of Human Rights
 it is essential to promote the development of friendly
relations between nations
 World Declaration on Nutrition
http://www.healthydocuments.org/nutrition/doc31.html
 We recognize that poverty and the lack of education,
which are often the effects of underdevelopment, are
the primary causes of hunger and undernutrition.
 nutritional well-being is hindered by the continuation
of social, economic and gender disparities; of
discriminatory practices and laws; of floods, cyclones,
drought, desertification and other natural calamities;
and of many countries' inadequate budgetary
allocations for agriculture, health, education and other
social services.
 The International Code of Marketing of Breast milk
Substitutes,
http://www.healthydocuments.org/children/doc35.html
 Recognising that infant malnutrition is part of the
wider problems of lack of education, poverty, and
social injustice.
 Recognising that the health of infants and young
children cannot be isolated from the health and
nutrition of women, their socioeconomic status and
their roles as mothers.
 The United Nations Convention on the Rights of the Child
 Recognizing that, in all countries in the world, there
are children living in exceptionally difficult conditions,
and that such children need special consideration.
 Convention on the Elimination of All Forms of Discrimination
Against Women
http://www.healthydocuments.org/women/doc41.html
 Aware that a change in the traditional role of men as
well as the role of women in society and in the family
is needed to achieve full equality between men and
women.
 concerned that in situations of poverty women have
the least access to food, health, education
 http://www.uicc.org/world-cancer-declaration

 Develop and implement culturally sensitive policies
that will create health-promoting environments to
reduce population-level risk factors, and enable and
encourage people to make informed choices

272
Another student responded:
1. Alma Ata Declaration
a. All countries should cooperate since the attainment of health in one country directly concerns and benefits health
in any other country.
b. Governments have full responsibility for the health of the citizens.
c. Health is a human right and it is not the absence of disease but the overall physical, mental, social wellbeing.
2. Conference of Health Promotion, at Ottawa, Canada
a. Health is a resource for everyday
b. Health promotion is not the responsibility of the health sector but goes beyond healthy lifestyles to well-being
3. People’s health charter
a. Health is a reflection of a society’s commitment to equity and justice.
4. Universal Declaration on human rights
a. The people of the United Nations have in the Charter reaffirmed their faith in fundamental human rights, in the
dignity and worth of the human person and in the equal rights of men and women and have determined to
promote social progress and better standards of life in larger freedom.
5. World declaration on nutrition
a. People still do not have access to enough food to meet basic daily needs for nutritional well-being
b. Chronic non communicable diseases related to excessive or unbalanced dietary intakes often lead to premature
deaths in both developed and developing countries
c. Poverty and lack of education are the primary causes of undernutrition and hunger.
6. The international code of marketing of breastmilk substitutes
a. The encouragement and protection of breastfeeding is an important part of the health, nutrition and other social
measures required to promote healthy growth of infants
b. Inappropriate feeding practices lead to infant malnutrition, morbidity and mortality and improper practices in the
marketing of breastmilk substitues and related products.
7. The united nations convention on the rights of the child
a. The child should grow up in a family environment, in an atmosphere of happiness, love and understanding for full
and harmonious development.
b. Childhood is entitled to special care and assistance.
8. Convention on the elimination of all forms of discrimination against women.
a. Charter of the united nations reaffirms faith in fundamental human rights, in the dignity and worth of the human
person and in the equal rights of man and woman
b. All human beings are born free and equal in dignity and rights and that everyone is entitled to all the rights and
freedoms set forth therein, without distinction of any kind, including distinction based on sex.
D-Application- World Cancer Declaration (in coordination with Alissar)
REVIEW how the World Cancer Declaration has been used in the upcoming World Cancer Day 2015
World Cancer Day 2015 http://www.worldcancerday.org/
World Cancer Day Fact Sheets http://www.worldcancerday.org/fact-sheets
Write a paragraph introducing the four fact sheets:

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The FACT SHEETS: WORLD CANCER DAY 2015 (+ samples of students’ responses)
Healthy Life Choices:
 Health systems will be strengthened to ensure sustained delivery of effective and comprehensive, patient-centred cancer
control programmes across the life-course.
 Global tobacco consumption, overweight and obesity, unhealthy diet, alcohol intake, and levels of physical inactivity, as well
as exposure to other known risk factors will have fallen significantly.
 Cancer causing infections human papillomavirus (HPV) and hepatitis B virus (HBV) will be covered by universal
vaccination programmes.
Early Detection:
 Population-based screening and early detection programmes will be universally implemented, and levels of public and
professional awareness about important cancer warning signs and symptoms will have improved.
 Innovative education and training opportunities for healthcare professionals in all disciplines of cancer control will have
improved significantly, particularly in low- and middle-income countries.
Treatment for All:
 Health systems will be strengthened to ensure sustained delivery of effective and comprehensive, people-centred cancer
control programmes across the life-course.
 Access to accurate cancer diagnosis, quality multimodal treatment, rehabilitation, supportive and palliative care services,
including the availability of affordable essential medicines and technologies, will have improved.
 Effective pain control and distress management services will be universally available.
Quality of Life:
 Stigma associated with cancer will be reduced, and damaging myths and misconceptions about the disease will be dispelled.
 Access to accurate cancer diagnosis, quality multimodal treatment, rehabilitation, supportive and palliative care services,
including the availability of affordable essential medicines and technologies, will have improved.
 Effective pain control and distress management services will be universally available.
The 4 areas of focus are: healthy life choices: Empowering people to make healthy choices and reducing the social and environmental
risk factors for cancer are key to achieving the global goal of reducing premature deaths from non-communicable diseases (NCDs) by
25% by 2025 and reaching the targets of the World Cancer Declaration
Early detection: Ensuring the availability of, and access to, early detection programmes for cancer can significantly reduce the cancer
burden in all countries.
Treatment for all: All people have the right to access quality, effective cancer treatment and services on equal terms, regardless of
geography and without suffering economic hardship as a consequence.
Quality of life: Understanding and responding to the full impact of cancer on emotional, mental and physical wellbeing will
maximize the quality of life for patients, their families and careers.
The fact sheet prepared for World cancer day 2015, highlighted 4 key areas of focus in order to decrease the prevalence of the NCD,
cancer. These fact sheets were based on the World cancer declaration targets.
o First key area was “healthy life choices” where targets 1, 3, 4 of the declaration were tackled. The main target behind it is to
reduce global premature deaths, and reducing social and environmental risk factors of cancer. In addition, the main
purpose is to deliver sustainable and effective patient centered cancer control program, reduce global tobacco
consumption, overweight and obesity, unhealthy diet, alcohol intake, and levels of physical inactivity, as well as exposure to

274
other known risk factors, and finally universal coverage of the vaccines that prevent HPV and HBV.
o The second key area was “early detection” which reinforces the availability and access to early detection programs
o The second area was “early detection” where targets 6 and 9 of the declaration were discussed. The main target behind it is
to ensure availability and access to early detection programs for cancer. Spreading the necessary awareness and education
among the population and health professionals that build above the existing material and equipment , in addition to
screening programs integration, and adequate investment in health personnel in all settings but particularly in low-
resource settings, where education of frontline health staff is critical for a successful early detection strategy.
o The third area of interest is “treatment for all” claims that all people have the right to access quality, effective cancer
treatment and services on equal terms, regardless of geography and without suffering economic hardship as a
consequence. The world cancer declaration targets to be achieved are:
o Target 1 - Health systems will be strengthened to ensure sustained delivery of effective and comprehensive,
people-centred cancer control programmes across the life-course.
o Target 7 - Access to accurate cancer diagnosis, quality multimodal treatment, rehabilitation, supportive and
palliative care services, including the availability of affordable essential medicines and technologies, will have
improved
o Target 8 - Effective pain control and distress management services will be universally available.
For the above to be achieved, through strengthening health systems that deliver cancer prevention and care services,
achieving equity in access to essential cancer medicines and technologies, and reducing the financial toll of cancer on
individuals, families and economies.
o The fourth key area is “quality of life” which gives high significance to understanding and responding to the full impact of
cancer on emotional, mental and physical wellbeing will maximize the quality of life for patients, their families and care
givers. The World Cancer Declaration Targets to be achieved by 2025 are:
o Target 5 - Stigma associated with cancer will be reduced and damaging myths and misconceptions about the
disease will be dispelled
o Target 7 – mention previously.
o Target 8 – mentioned previously.
There are numerous challenges to achieve the mention key are and targets, therefore, The emotional and mental impacts
of cancer are taken as seriously as the physical impacts.Cancer patients are made aware of treatment-related symptoms
and side effects so that they can be more informed in their
choices. A holistic, person-centred, multidisciplinary approaches to cancer
care are accessible, which will improve cancer outcomes and maximize quality of life for people of all ages living with
cancer, their families and carers. Individuals feel empowered to talk about cancer and reach out for support. Governments
implement global commitments to ensure that palliative care is included in all national health policies and budgets, and in
the curricula for health professionals. Finally, healthcare providers are equipped with the skills and knowledge
to ensure that all cancer patients have access to adequate pain
relief and quality palliative care.
The FACT SHEETS: WORLD CANCER DAY 2015
The fact sheets talk about simple solutions that can be made to help people of all socioeconomic status to fight cancer.
The first fact sheets or solution is to empower people. To help raise awareness of healthy choices that can make to help reduce the
chances of getting cancer whether it is social or environmental factors.
The second is to help offer detection equipment’s to the general population to help detect cancer early.
The third is to target society. Provide equity of resources to all people without geographical or economic factors standing in the way.

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The fourth to help improve the quality of life. Cancer can strongly effect the emotional, physical and mental wellbeing’s of a person,
so helping with people from this perspective will help them live happier.
The FACT SHEETS: WORLD CANCER DAY 2015
The four World Cancer Day 2015 factsheets are covering four different areas that have been
mostly reviewed for better awareness on cancer prevention and management.
Lifestyle: the fact sheet is primarily encouraging society and its people to develop healthy
life style habits which would in turn decrease the risk of other illnesses: like premature
deaths caused by non-communicable diseases. The fact sheets highlights on the goal of the
World Cancer Declaration claims that there will be a 25% decrease by the end of 2015.
Early Detection is the preventive measure for cancer and it is very important to have early
detection procedures available and affordable for all people
Treatment is a human right. The factsheet discusses this issue by stating that Effective
treatment is a right for all cancer patients regardless of any demographic or socioeconomic
situation.
The final issue claimed would be the understanding of society when it comes to the
psychological issues that affect the cancer patients because as soon as a patient feels
understood, welcome, and accepted, it will definitely help him achieve a better quality of
life for them and their families.
A-INTERACTIVE – LINKS
TO MAKE SURE THAT WE REVIEW SPECIALLY BEFORE ALISSAR AND CYNTHIA’S SESSIONS
Enjoy the learning as you explore the following interactive links:
CANCER (needs sound): Watch BBC-Science Video about what cancer is and how it can be treated
http://www.bbc.co.uk/science/0/22028516
SMOKING
(1) Graphic anti-smoking ad (needs sound)

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http://www.bbc.com/news/health-20805059
(2) SMOKER’s BODY
http://tobaccobody.fi/n_en.php
http://tobaccobody.fi/
(3) Interactive: the Smoker’s Body
http://gulfnews.com/multimedia/graphics/interactive-the-smoker-s-body-1.109854
(4) 18 ways smoking affects your health
http://smokefree.gov/health-effects
MY COMMENTS ABOUT THESE INTERACTIVE TOOLS-
Do I recommend other interactive tools?
 Cancer (BBC): Very beneficial video and explanation of what cancer is. The explanation is through
nonscientific and simple words, therefore anyone can understand the content.
 Smoking (BBC): Touching advertisement. It directly tells smoker if you SMOKE, you will certainly suffer
from MUTATIONS and RISKS.
 Tobacco Body: Most effective interactive tool I have ever seen through the internet. It tells the individual
about all the health risks associated with smoking in different sites of the body. Very brilliant idea!!!
 Gulfnews.com: Similar to the previous idea. But is less effective than the tobacco body illustrations.
 18 ways smoking/quitting affect your body: It is a very important comparison for smokers who have
already quitted smoking. It gives all the necessary information about the topic.
These tools suggested are very useful and informative.
These interactive tools help people understand the issue from different views, they are
even capable in affecting the people in the field and help them find ways to support
their explanation of smoking effects on the health, and they can do it better and show it
right.
B-QUIZES
What is your score in at least FIVE of the following quizzes (+ samples of students
responses)

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THE QUIZ MY SCORE (Cynthia)
Do I need help quitting
http://www.cancer.org/healthy/toolsandcalculators/
quizzes/app/smoking-habits-quiz
Test Your Breast Cancer IQ
http://www.cancer.org/healthy/toolsandcalculator
s/quizzes/breast-cancer-quiz/index
You answered 6 out of 6 questions correctly.
Nutrition and activity quiz
quizzes/nutrition-activity-quiz/index.htm
9-12 "Yes" answers:
Good for you! You’re living smart!
Cancer Risk Quiz
http://www.cutyourcancerrisk.org.au/quiz/default.a
sp#.VHb4PjGUf4X
Smoking
Well done, keep up the good work. This has
significantly decreased your risk of cancer!
Alcohol frequency
Alcohol is a risk factor for cancer so it's great you're
not drinking very often. Just remember that when
you do drink, try to limit yourself to one or two
standard drinks, or better still, to further decrease
your risk, avoid alcohol altogether.
Fruit
Great but one more would be even better! We
recommend adults eat at least two serves of fruit
each day.
Vegetables
Having some vegies is great, but a few more would
likely further reduce your risk of cancer of the
mouth, oesophagus, stomach and bowel.
Processed meat
Excellent! Processed meat has been linked to an
increased risk of bowel cancer so limiting or
avoiding it altogether is a good idea.
Waistline

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Great! Maintain your healthy weight by eating
plenty of fruit and vegies and exercising regularly.
UV exposure
Good stuff, but it is important to use a combination
of all five sun protection measures in order to
seriously reduce your risk of skin cancer and eye
damage.
Vitamin D
In Victoria from May to August, when the UV is
below 3, sun protection isn't needed unless near high
altitudes or highly reflective surfaces like snow.
UV alert
Checking the sun protection times each day is the
best way to work out if you need sun protection.
Find the sun protection times in the weather section
of the daily newspapers, on the free SunSmart app
for smartphones and on the SunSmart website. Try
to check it every day so you know when you need to
be protected from the sun's UV.
Breast awareness
Great! Don't forget to check your breasts regularly
and report any unusual changes to your doctor
immediately. If you're over 40, you're also able to
attend a free screening mammogram with
BreastScreen Australia every two years.
Pap tests
Don't put it off any longer! Make an appointment
today to have a Pap test and dramatically reduce
your risk of cervical cancer.
HPV vaccine
Males and females may benefit from the protection
the HPV vaccine offers against some HPV-related
cancers and genital warts.

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Body Mass Index Calculator
calculators/app/body-mass-calculator
Your BMI is 24.0
Nutrition and activity score
quizzes/nutrition-activity-quiz/index.htm
You answered 6 out of 6 questions correctly.
Calories Count
calculators/app/calorie-counter-calculator
9-12 "Yes" answers:
Good for you! You’re living smart!
Target heart rate
calculators/app/target-heart-rate-calculator
Your target heart rate is 100-150 beats per minute.
OTHER THAT YOU CHOOSE….
o Test your breast cancer IQ: 6/6

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o Nutrition and Activity Quiz: 5/8 yes answers
o Calculate my body mass index:

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o Calories counter
o Target Heart Rate Calculation

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C- WAIST CIRCUMFERENCE
Learn more about waist circumference, VISIT THE FOLLOWING SITES:
http://www.heartfoundation.org.au/healthy-eating/Pages/waist-measurement.aspx
http://www.webmd.com/diet/calculating-your-waist-circumference__
http://www.cdc.gov/healthyweight/assessing/Index.html
http://www.nhlbi.nih.gov/health/educational/lose_wt/risk.htm
What should I know about waist circumference (+ samples of students responses)
 You should measure your waist circumference to know if you’re at risk of type 2 diabetes, heart disease,
high cholesterol and high blood pressure.
 It is measured by a tape.
 Your waist circumference is measured by standing and placing a tape measure around your middle, just
above your hipbones. Measure your waist just after you breathe out.
 The waist should not measure more than 40 inches for men and 35 inches for women.

how to measure it
-how to calculate it
-what are the normal range for the different sexes and ages
-risk factors associated with not being within the normal range
o Used to measure risk of developing chronic disease
Waist size At risk At high risk
men Over 94 cm Over 102 cm
women Over 80 cm 0ver 88 cm
o High waist size puts you in greater risk for developing obesity-related conditions
o High waist size increases the risk of developing type 2 diabetes
o How to measure your waist size?
o
1. Find the top of your hip bone and the bottom of your ribs.
2. Breathe out normally.
3. Place the tape measure midway between these points and wrap it around your waist.
4. Check your measurement.
It's very important to know how and right place of measurement in order to get it right and it
is important to know the different circumferences of the different genders.
Reducing waist circumference will help in preventing diabetes.

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Home work- By Rim
Ch. 2 Mind-Body Communication: Maintaining Wellness
In preparation for the session on Monday December 1st and to be more involved in the
subject I will be presenting, which is "Mind body communication, maintaining wellness ", I
would like to ask you to post any picture or quote related to this topic in the album "Mind,
body and wellness" on our Facebook group and to bring it with you to class as a soft copy or
on your tablets.
In response to Rim’s request, students shared images about MIND-BODY as follows:
Alissar posted on facebook a talk by Deborah Kern on Mind-Body interaction
https://www.youtube.com/watch?v=GuMMqlKiHbE

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People: Rim, Ziad, Ribal, Tarek, Cynthia, Ranya, Alissar, Caroline and May
Place: Rm 303
Duration: around 90 minutes, meeting Ranya after class
Laughter Yoga
After a brief introduction about Laughter Yoga, May led the class with 10-15 minutes exercises
to experience laughter yoga.
Mind-Body Communication
Rim presented Ch 2 using different techniques included were exercises, PPP, dialogue, quotes
and images. Her learning objectives were:
- Mind and body communication
- Psychosomatic illnesses
- Placebo effect
- Meditation
- Power of Suggestion
The students evaluated Rim’s presentation as follows: Interactive, interesting and beneficial;
Fantastic work and exercises, good voice, loved it! Well presented and designed; Bravo; So
Confident, highly knowledgeable, good performance and examples.
Grading:
Extra-ordinary Excellent Very good
Rim 2 5 1

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Responses about key learnings and new questions arising:
Key learnings from Rim’s session:
 The mind is a major player in our wellbeing and can help us positively
 The strong relation between MIND and BODY
 We can reduce stress and clear our minds
 Meditation is beneficial
 The value of meditation and other mind-body activities that we could do to help us relax
 Imaginary and suggestions techniques were new to me
 Power right
 The 5 questions of the exercise made me think…
 I learnt how to clear my mind from useless stresses
New questions arising:
 What are the best techniques to apply?
 If all stressful situations can be resolved, why do we live our lives constantly stressed?
 Is it beneficial to do such techniques before exams?
 How to clear my mind from thoughts?
 How to improve my physical state through our mind?
Rim ended her session sharing with us useful quotes that she identified (Deepak Chopra, Tara
Brach and Dalai Lama)

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Extracts from Rim’s reading materials:

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PEER SUPPORT- Towards improved practices-2
Groups of 2-3 met together and reflected on their practices of the topics under consideration
(Ziad, Alissar and Cynthia; Rim, Caroline and Ribal; Ranya and Tarek).
World’s Aid Day: Dec 1
We ended the class with a group photo wearing the World’s Aids Day ribbons

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Talk by Pharmacist Nadia Dalloul
Preparing ourselves:
Skim through the flyers of Smart Use of Medicine: Zaka wa Dawa- Link to English translations:
http://www.anera.org/wp-content/uploads/2014/01/RUMBoxesEnglishTranslation.pdf
These educational materials were the basis for a national campaign that aimed at using
medicines responsibly- the campaign was about smart, simple and cost-effective practices that
people can do by themselves in the rational use of medicines and entailed capacity building,
development of best practices, partnerships-action and wide distribution of user friendly well
tested materials.
To be introduced to the Zaka wa Dawa
campaign in Lebanon:
Watch the launching of a national campaign in Lebanon
In April 2011, more than 120 activists met to launch the
campaign and exchange experiences
https://www.youtube.com/watch?v=Rd9pijhGmIY&list=UUVapzto3EgB8YIFaXYlV1jA
And watch how a similar event was organized in Borj Shmali camp
https://www.youtube.com/watch?v=8kupIwik048&list=UUVapzto3EgB8YIFaXYlV1jA
***
Students’ questions- Special thanks to Rim for collating the questions
1-What are the risks of overuse
2- Does every drug have a specific limit different than the others?
3- In case of a person overusing a kind of drugs, what is the solution? How can we reduce the
risk of this chemical in his/her body?

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4- Why isn't the Lebanese government implementing laws on pharmacies, similar to those in
the US or Canada, in terms of requiring a drug prescription before purchasing any form of
drugs
5- Is the consumption of paracetamol, panadol or Advil in case of pain without prior medical
advice considered an abuse?
6- What sets of boundaries for a pharmacist in Lebanon to sell a drug to a customer, when no
prescription is present?
7- How can pharmacists help to reduce the issue of drug abuse in Lebanon?
8- Could you tell us if you believe that the laws and regulations that are set by the Lebanese
pharmacist syndicate are up to date and aligned with international law?
What is the legal state of drug abuse in Lebanon9-?
10- What kind of alternative measure could stop drug abuse among students?
11- What kind of measures could be taken in order to protect the new generation of people
from drug abuse
12- We have recently seen on TV pharmacists giving an abortion medicament without doctors’
prescription, how frequent in Lebanon to see pharmacist not abiding by the law and how this
is affecting the Lebanese public health
13) What's the role anti-addiction playing in our modern life? Is it beneficial? Or is it more
addictive than the drugs themselves

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Session 25
Talk by Nadia: Wed. 3 12 14
People: Rim, Ziad, Tarek, Cynthia, Alissar, Mia, Mounir, Assil, Caroline, Peter,
May and Nadia
Place: Rm 204
Nadia shared with us her 50 slides PPP and integrated the students’ questions into her
discussion:

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Notes extracted from Nadia’s PPP (by Ranya)
Medication is a drug taken to cure and or ameliorate any symptoms of an illness / medical
condition
or may be used as prevention
Adverse Drug Reaction (ADR): is a response to a drug which is:
“ noxious and unintended
“ occurs at doses normally used for the:
ØProphylaxis
ØDiagnosis
Øor therapy of disease
Legal Drugs:
Easy available medicines in the market either by doctor’s prescription or over the counter;
alcohol and tobacco are also an example of legal drugs.
Illegal drugs:
Are drugs that are outlawed and that carry penalties upon possession and dealing
People often think that prescription and OTC drugs are safer than illicit drugs, but that’s most
of the time true when they are taken exactly as prescribed and for the purpose intended.

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Smart Use of Medicine:
Zaka wa Dawa: Copies of
“Zaka wa Dawa flyers/box”
were distributed to all.
May and Nadia briefly
introduced the campaign.
To note that May had posted info about the Zaka wa Dawa Campaign in Lebanon in the
facebook PDHP 246 group.

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Home work- By Cynthia
Ch. 17 - Eliminating Tobacco Use
For the preparations of Friday's class (05.12.2015) and for my presentation "Eliminating
tobacco smoke", I kindly ask you to choose an anti smoking advertisement/picture that you
find interesting and impressive. Post the picture on the Facebook group and during the
presentation you will be requested to tell the reason for choosing this picture.

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Home work- By Mia
Ch. 7- Physical Activity for Health and Wellness

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A sample of responses to Mia’s HW (by Cynthia)
For many busy women, exercise slips to the bottom of the to-do list. But 2 1/2 hours of moderate physical activity each week
-- or about half an hour 5 days a week -- can help keep your heart healthy. Sure, you can join a gym or go for brisk walks.
But even chores around the house can get you moving, such as cleaning windows or floors, washing and waxing a car,
gardening and raking leaves, and shoveling snow.
Make exercise a fun family affair. Turn off the TV and video games and go play tennis or toss a Frisbee around. Take bike
rides together. Your entire household gets health benefits, plus your motivation stays stronger if you exercise with others. If
you or spouse struggle to find individual exercise time, consider eating dinner later so that you can take turns hitting the gym
after work.
For most people, exercise is safe. But before starting physical activity, check with a doctor if you or a family member has
diabetes; asthma or lung disease; heart, liver or kidney disease; or arthritis or osteoporosis. Once your doctor gives you or
your loved one the green light, get going. Exercise can help control weight, strengthen muscles and bones, ease arthritis pain,
and lower heart disease risk.
Before exercise, fitness experts recommend that you do movements to get your heart rate and circulation up, for example,
jumping jacks. It's best to stretch muscles after they are warmed up, or after exercise, to prevent muscle strain and injury,
experts say. It also improves your flexibility and range of motion. Beware of stretching muscles when they are cold.
If you do these vigorous-intensity exercises, you're boosting your health in a quicker burst of time. In general, one minute of
vigorous exercise like singles tennis or basketball equals two minutes of moderate exercise like doubles tennis or canoeing.
How can you tell the difference? With moderate exercise, you'll sweat and your heart rate rises, but you can still carry on a
conversation. With vigorous exercise, your heart rate and breathing get much faster, and you can't say more than a few words
at a time without pausing for breath.
Besides getting your heart rate up with aerobic exercise, try muscle strengthening exercises at least two times a week. These
include weight lifting, working with rubber resistance bands, and push-ups or sit-ups. Shoot for working all of your major
muscle groups (chest, shoulders, arms, back, abdomen, hips, and legs). If you're a heart patient, check with your doctor first
before you start any weight or strength training.
Exercise doesn't have to be drudgery. If you love music, take a dance class. If you're always the first to splash into the pool,
sign up for water aerobics. If you adore nature, get your family out for a long weekend hike. Try a variety of physical
activities that suit your interests and lifestyle -- and you may just succeed in making exercise a regular part of your life.
Responses by Ranya
Physical Activity Quiz: How Well Do You Move?
Find out if you are getting enough activity for good health as you age.
1. How often do you get at least 30 minutes of physical activity or exercise a day?
You answered: 2 or 3 times a week
For many busy women, exercise slips to the bottom of the to-do list. But 2 1/2 hours of moderate physical activity each week
-- or about half an hour 5 days a week -- can help keep your heart healthy. Sure, you can join a gym or go for brisk walks.
But even chores around the house can get you moving, such as cleaning windows or floors, washing and waxing a car,
gardening and raking leaves, and shoveling snow.

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2. How often do you play outdoor games with your children, spouse, or friends?
You answered: Never
Make exercise a fun family affair. Turn off the TV and video games and go play tennis or toss a Frisbee around. Take bike
rides together. Your entire household gets health benefits, plus your motivation stays stronger if you exercise with others. If
you or spouse struggle to find individual exercise time, consider eating dinner later so that you can take turns hitting the gym
after work.
3. Does anyone in your household have a medical problem that might limit activity?
You answered: No
For most people, exercise is safe. But before starting physical activity, check with a doctor if you or a family member has
diabetes; asthma or lung disease; heart, liver or kidney disease; or arthritis or osteoporosis. Once your doctor gives you or
your loved one the green light, get going. Exercise can help control weight, strengthen muscles and bones, ease arthritis pain,
and lower heart disease risk.
4. Do you stretch your arms and legs before or after exercising?
You answered: Both
Before exercise, fitness experts recommend that you do movements to get your heart rate and circulation up, for example,
jumping jacks. It's best to stretch muscles after they are warmed up, or after exercise, to prevent muscle strain and injury,
experts say. It also improves your flexibility and range of motion. Beware of stretching muscles when they are cold.
5. Do you jog, swim laps, hike uphill, or do sports that require lots of running?
You answered: Yes, at least once a week
If you do these vigorous-intensity exercises, you're boosting your health in a quicker burst of time. In general, one minute of
vigorous exercise like singles tennis or basketball equals two minutes of moderate exercise like doubles tennis or canoeing.
How can you tell the difference? With moderate exercise, you'll sweat and your heart rate rises, but you can still carry on a
conversation. With vigorous exercise, your heart rate and breathing get much faster, and you can't say more than a few words
at a time without pausing for breath.
6. Do you do muscle-strengthening exercises, such as lifting weights?
You answered: Not often
Besides getting your heart rate up with aerobic exercise, try muscle strengthening exercises at least two times a week. These
include weight lifting, working with rubber resistance bands, and push-ups or sit-ups. Shoot for working all of your major
muscle groups (chest, shoulders, arms, back, abdomen, hips, and legs). If you're a heart patient, check with your doctor first
before you start any weight or strength training.
7. Do you choose physical activities/exercise that you enjoy and that fit into your lifestyle?
You answered: Yes, most of the time
Exercise doesn't have to be drudgery. If you love music, take a dance class. If you're always the first to splash into the pool,
sign up for water aerobics. If you adore nature, get your family out for a long weekend hike. Try a variety of physical
activities that suit your interests and lifestyle -- and you may just succeed in making exercise a regular part of your life.

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People: Ribal, Tarek, Cynthia, Alissar, Caroline, Mia and May
Place: Rm 303

303
Cynthia presented her topic of eliminating tobacco use through a PPP (29 slides) that she had
prepared. The slides included those from previous national campaigns in Lebanon. Cynthia

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also prepared a video whereby she interviewed a smoker peer. Contents of Cynthia’s PPP
were:
 Reasons of smoking
 Beneficial ways of quitting
 Setting a Quit Date
 Nicotine Replacement Therapy
 Hypnotherapy
 Stages of the quitting process
 Health tips to quitting
 Anti-Smoking Campaigns in Lebanon
Mia’s presentation about Physical Activity for Health and Wellbeing included a handout, PPP
(53 slides) and questions. She also led a ten minutes stretching exercises. Mia’s outline
included:
1. Define sedentary lifestyle and identify reasons for its current prevalence
2. Physical Activity
3. The 4 categories of physical activity:
a. Household tasks
b. Work related movement
c. Leisure-time activities
d. Performance-based activities
4. Three different measurements of physical activities:
a. Calories/min
b. MET
c. PAL
5. Levels of physical activity for health
6. The 6 components of physical activity
7. Motivation
8. Cardiovascular Fitness
9. Body Strength
10.Endurance
11.Flexibility
12.Body composition
13. 6. Guidelines for integrating physical activity
14. 7. Types of performance-enhancing substances

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15. 8. Overuse injuries
16. 9. Exercise
The students appreciated both presentations.
The comments about Cynthia’s presentation included: Well prepared. One student mentioned
that the information per one slide were too many making them overloaded. Well done! The
presentation was interactive, interesting and beneficial. Not boring at all. Good job! Well
organized. One student appreciated the campaigns, the stages and the non-traditional talks.
One person said that Cynthia made her/him interested in the topic.
The comments about Mia’s presentation included: Very interesting topic. I liked the questions.
Well done! Great cover of the topic and great presentation skills. One student commented
that the slides were long and overloaded.
Students’ Grading:
Cynthia 1 3 2
Mia 2 2 2
Key learnings from Cynthia’s session:
 Stages of quitting process
 Use of gum
 The quit date
 Ways to stop smoking
 Handling cravings, habits etc.
 What do you think we can do as public health, to help the new generation run away
from smoking?
 How can we use hypnosis in other health issues?
 Do you think that nicotine replacement gum is effective? So why don’t some anti-
smoking campaigns distribute them for free to promote the quitting process?
 Is there a treatment for the consequences of smoking on our body?

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Key learnings from Mia’s session:
 Learnt lots! It was a full presentation- very fruitful
 Figures such as calculated calories/step
 Counts for different kinds of metabolism
 The components
 How can we get addicted to working out 
 Would like to search for more examples of the types of exercises

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v
10 Ways to Boost Your Exercise Motivation
By Virginia Anderson- WebMD Feature
Reviewed by Brunilda Nazario, MD
http://www.webmd.com/fitness-exercise/features/exercise-motivation
You know exercise is good for you. Doing it, though, is another thing.
To stick with an exercise routine, you need to get out there when that little voice inside you says, "I'll do that
tomorrow. Or the day after -- maybe."
Motivation does that, and it's not about just powering through.
1. Lighten Up Your Goals
Your fitness goal may be too big for you right now, especially if you're new to exercise.
Beginners "want to go for maximal goals, but they tend to get overwhelmed," says Gerald Endress, exercise
physiologist at Duke Center for Living in North Carolina.
So don’t start off trying to work out an hour every day. Instead, set more reasonable, achievable goals, like
exercising 20 to 30 minutes two or three times a week.
2. Track Your Progress
Chart your workouts, whether you do it online or in an old-school fitness journal. Seeing improvements,
whether running faster, doing more reps, or working out more often, makes you want to keep going.
3. Delete Guilt
Get real. You're going to miss a day or two. If you accept that there will be some side steps on your fitness
journey, you’ll be better prepared mentally to deal with setbacks, Endress says.

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Don’t let a misstep be an excuse for giving up.
4. Focus Only On Yourself
There will always be someone fitter, faster, or more flexible than you.
Don’t compare yourself to them, Endress says. Forget about them. Do not let them deter you from your goal.
Your workout time is for you, and about you.
5. Get a Cheering Squad
Find people -- friends, family, co-workers, neighbors -- who will encourage you to stay on track. Ask them to
do exactly that.
"The person should be in support, but not say, 'Why can’t you? It’s so easy,'" says Carla Sottovia of Cooper
Aerobics in Dallas. If helpful reassurance turns into criticism, gently remind your pal that you don’t need
nagging.
6. Find the Fun in It
If you can't get motivated, maybe you're doing the wrong activity. Or you used to like it, and now it's gotten
stale. Pick activities you like the most, and they become something to look forward to. Remember, exercise
does not have to happen in a gym. Maybe you'd rather go hiking or horseback riding, do a charity run or walk,
or dance.
7. Break It Up
Talk yourself into exercising for a few minutes. You may want to keep going. If not, you can do a couple more
mini-sessions during the day, instead of one long workout.
8. Make It Convenient
When you're busy, don't spend 30 minutes driving to a gym. Use online exercise videos instead. If you're too
tired to work out at the end of the day, set your alarm a little earlier and exercise in the morning.
9. Forget the Past
So maybe you weren’t the most athletic kid in high school and were the last chosen for class games. That was
years ago. Your goal now is not to win a letter jacket or make the cheerleading squad. You want to exercise to
stay healthy and enjoy your life.
10. Reward Yourself
Treat yourself for working out.
Choose rewards like a new outfit, a massage, new tunes, a ball game -- whatever you enjoy.

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POWERFUL WORLD campaign – Lebanon 2009-2011

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Selections from Students’responses on physical activity
(1) Benefits of physical activity (2) Optimal behaviour/best practices
 Control your weight.
 Reduce your risk of cardiovascular disease.
 Reduce your risk for type 2 diabetes and
metabolic syndrome.
 Reduce your risk of some cancers.
 Strengthen your bones and muscles.
 Improve your mental health and mood.
 If you are not used to physical activity, it is best
gradually to build up the level of activity. Start with
10 minutes and over time build this up to 30 minutes.
Brisk walking is a great activity to start with.
 One big obstacle is the uphill battle to become fit.
Many people feel that the first few attempts at
physical activity are quite a struggle. Do not get
disheartened. You are likely to find that each time it
becomes easier and more enjoyable.
 Try to keep physical activity high on your list of
priorities. If one kind of activity becomes boring, try
switching to another type. A variety of different
activities may be better. Physical activity needs to be
something that you enjoy or it will not be something
that you will keep up.
 Some people set their goals too high. For example,
aiming to run a marathon. This may take too much
time, you may lose enthusiasm, and physical activity
may become a drudge. Be aware of this pitfall.
 Use everyday activities as part of your physical
activity programme. Consider a brisk walk to work or
to the shops instead of using a car or bus; take the
stairs in the office or shopping centre and not the lift,
etc. Reduce the amount of time that you spend being
inactive (watching TV, sitting in front of a computer
screen, etc).
 Mental health and functioning
 Stress management
 Weight management
 Disease Prevention
 Useful leisure-time engagement to relax
reflex and indulge your imagination.
 Enhance your performance at work
 Moderate physical activity
 Active lifestyle ex: take the stairs instead of an
elevator
 A minimum of 30 min of physical activity daily
 Do not over exercise to avoid any kind on injury
 Set achievable goals …. Take it easy in order not to
give up
 Go for group sports or get a friend to join you for a
walk.
https://www.google.com.lb/?gws_rd=ssl#q=benifits+of+physical+activity
http://www.patient.co.uk/health/Physical-Activity-For-Health.htm

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ELIMINATING TOBACCO USE
Damage to the body Reversible body changes and their timing:
when we stop smoking
 Brain: The nicotine present in the cigarette
develops extra nicotine receptors.
 Ears: Hearing loss.
 Eyes: Blindness and night vision.
 Mouth: Oral health problems.
 Skin: Dryness, wrinkles and stretch marks.
 Heart: Smoking increases the blood pressure and
stresses the heart. Over time, stress on the heart can
weaken it, making it less able to pump blood to
other parts of the body.
 Lungs: Smoking causes emphysema, which
destroys the alveoli that are responsible for the
exchange of oxygen. Eventually, emphysema
causes severe shortness of breath and can lead to
death. Moreover, smoking is associated with lung
cancer.
 DNA: Smoking contains certain dangerous
chemicals that can access the body and cause
mutations in the genetic material.
 Blood and the Immune System: Smoking
enhances the increase in the number of white blood
cells. If WBCs stay at elevated levels for a long
period of time, this often causes heart attacks,
strokes and cancer. Also, Nicotine causes blood
vessels to tighten, which decreases levels of
nutrients supplied to wounds. As a result, wounds
take longer to heal. Slow wound healing increases
the risk of infections. Cigarette smoke contains
high levels of tar and other chemicals, which can
make the immune system less effective at fighting
off infections. Thus, smokers are more vulnerable
to autoimmune diseases.
 Brain: The large number of nicotine receptors in the
brain will return to normal levels after about a month
of quitting.
 Ears: Quitting smoking will keep hearing sharp.
 Eyes: Quitting smoking will improve night vision
and helps preserve the overall vision by stopping the
damage smoking causes.
 Skin: Quitting smoking is better than anti-aging
lotions. Quitting can help clear up blemishes and
protects the skin from premature aging and
wrinkling.
 Heart: Quitting can lower the blood pressure and
heart rates almost immediately. The risk of a heart
attack declines within 24 hours.
 Lungs: Scarring of the lungs is not reversible. That is
why it is important to quit smoking before permanent
damage happens to the lungs. Within two weeks of
quitting, the individual might notice it is easier to
walk up the stairs because he/she may be less short of
breath.
 DNA: Quitting smoking prevents further DNA
damage and can even help repair already damaged
genetic material.
 Blood and Immune System: Quitting smoking helps
maintain the normal WBCs level. Moreover, the
immune system becomes stronger and will no longer
be defensive and cause a wide range of autoimmune
diseases.

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Lung Cancer
-Impotence (erectile dysfunction)
-Dental Caries
-Low test scores (for children exposed to environmental
tobacco smoke)
-Atherosclerosis
-COPD (Chronic obstructive pulmonary disease)
-Oxidants-antioxidants imbalance
-Oxidative stress
20 minutes after quitting: Heart rates drop
-12 hours after quitting: CO levels in bloods drops to normal.
-2 weeks to 3 months after quitting: Lung function improves,
risks of heart attack drop.
-1 year after quitting: Risk of heart attack is half compared to
a smoker.
-5 years after quitting: Risk of a stroke is same as that of a
non-smoker.
-10 years after quitting: Risk of lung cancer is half that of a
smoker’s.
-15 years after quitting: Risk of heart disease is same as a
non-smoker
Reference:
Smokefree. (n.d.). 18 ways smoking affects your health. Retrieved from http://smokefree.gov/health-effects
http://journal.publications.chestnet.org/article.aspx?articleid=1085097

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Home work- By Caroline
Ch. 14 – Cardiovascular Disease
Please everyone choose one component/part of the heart, search for its function,
and bring it as a hard copy with you to class (let this role be brief and simple).

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People: Ribal, Tarek, Cynthia, Alissar, Caroline, Ziad, Rim and May
Place: Rm 303
Caroline led a remarkable presentation, where she used
several techniques, materials and media and engaged
the class fully. Included were handouts, PPP, results of
interviews (people, cardiologist), healthy snacks,
presenting to the students a real cow’s heart.
Caroline 4 2 1
One student mentioned that Caroline “tried to give every single detail about the heart and
CVDs”, another student commented that “the details at the beginning were not necessary”
and one person said that she “focused more on biology and less on public health implications”.

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Key learnings from Caroline’s session:
 Beneficial facts
 I learnt lots about the heart functions
 Difference of each CVD as in Arabic they are all put under the tag “Jalta”
 She answered everything
 How many symptoms must appear to know it is a heart attack?
 How can we make the Lebanese population work on prevention rather than cure and
using medicines?
 To Caroline: did you believe in the doctor’s information? I mean from where his info
was?
 How long is the period between a heart attack and possible death?

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We then discussed the Projects needed for class completion, the meeting with Dr Karam and
planning next Friday session.

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Extracts from Caroline’s reading materials:

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Peer support: Quitting smoking
Special thanks to Ribal for his willingness to discuss the topic of quitting smoking with his
peers. Students’ questions and comments were:

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Home Works
By Ziad- Ch 3: Managing Stress: Restoring Mind-Body harmony
Please answer the following, and prepare to share your answers with the class:
What is one illness (psychological, mental, or physical), that can happen to a person when
under constant stress.
Among the responses to Ziad’s question
What is one illness (psychological, mental, or physical), that can happen to a person when
under constant stress.
Cynthia: Physical illnesses: heart diseases, diabetes and gastrointestinal problems.
Psychological and mental illnesses: Alzheimer’s disease, depression and anxiety
Ranya: depression is one of the disorders that would hit you if you remain under stress for a
long time. When you are stressed you are always trying to work on something, always trying to
think and to fix some problems, but at one one, when you can’t take it anymore your mind
shuts down and you go into surrender. That is depression, and that is what you will get if you
could not manage stress well.
Rim: GI tract upset, migraines, ulcers, anxiety, over eating or under eating, heart attacks,
tachycardia
Caroline: illnesses that might occur to a person under stress are: heart disease, Alzheimer
disease, Asthma, and more.
Mia: under constant stress anxiety disorder can develop

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By Ribal - Ch. 4 Mental Health and Mental Illness
Dear colleagues, in order to cover as much as possible from any material related to this topic,
and in order to help me and you better understand this topic, I would like to ask you to do the
following few task before Friday’s session (without using the internet or doing any research):
1- In few words, define what is a mental illness or a mentally ill person?
2- Ask two random people, who are not into the medical, public health or any field related
to health the same question: What does it mean a mentally ill person? Or what is mental
illness in general? Who are those people? (I.e. Chou ya3ne marid nafsiyan/3a2liyan?)
3- What are the psychological disorders that pop up automatically on your mind?
4- Pick one of those psychological disorders and define it in your own words/ how do you
perceive it? What information you know about it? (you can simply give an example)
5- Do you know any psychiatric hospital/mental hospital in Lebanon? (If Yes please name
it)
6- Do you know any NGO that takes care of mental health in Lebanon? (If Yes name it)
7- Please read the following article as we might not be able to do it together in class due to
time limit, and we will discuss it on Friday:
https://now.mmedia.me/lb/en/reportsfeatures/552885-an-incomplete-draft
8- Find me some links and websites that… no I’m just kidding that’s it for the HomeWork :D
9- Please don’t kick me or punch my face when you see me
Hope to see you all on Friday !!
Among the responses to Ribal’s questions
By Ranya
1) A “mentally ill” person is a person that is a bit mentally unstable in some aspects, either coping or behaving or
reacting. They require some external help and a “push” every now and then. I’d like to believe that they are the people
that know more about life and have seen a lot of its troubles.
2) Depression: when a person sees nothing but darkness, they find it hard to get out of bed in the morning, and pretty
much lacks motivation in everything and anything. It is a disorder that makes a person helpless and puts him in a
constant struggle to understand what the purpose of living is all about.
3) St. George has a floor that helps people deal with mental disorders (9th floor). And I know of AUH. We have some
centers but all I know of is “deir l salib”.

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4) I don’t know of NGO’s no
5) Upon asking people what they believe mental illness is they said:
Person A stated: a person who is not stable. They suffer ups and downs and behave outside the norms of the society he
lives in.
Person B said: a person that has severe problems and those problems led him to suffer mental disorders. They are like
everyone else, but more troubled and may need psychological help and treatment to help them deal with the issue at
hand
By Ziad
1- In few words, define what is a mental illness or a mentally ill person? A: it is a condition which causes problems or
disorders in a person’s cognitive ability and/or behaviour.
2- Ask two random people, who are not into the medical, public health or any field related to
health the same question: What does it mean a mentally ill person? Or what is mental illness in general? Who are those
people? (I.e. Chou ya3ne marid nafsiyan/3a2liyan?). A: 1st person ( My neighbour): a person who cannot think straight.
2nd person (neighbour): a person who cannot communicate properly with other people, and sometimes has trouble
socializing.
3- What are the psychological disorders that pop up automatically on your mind? A: bipolar disorder, schizophrenia, and
anorexia
4- Pick one of those psychological disorders and define it in your own words/ how do you perceive it? What information
you know about it? (you can simply give an example). A: bipolar disorder is illness where a person encounters
sudden change of mood(mood disorder). For example a person can go from being happy to depressed quickly and each
period of those 2 moods can last a while.
5- Do you know any psychiatric hospital/mental hospital in Lebanon? (If Yes please name it) A: I am not aware of any,
other then those found in large hospitals such as Saint George and AUH.
6- Do you know any NGO that takes care of mental health in Lebanon? (If Yes name it) A:I am sure there is, however i do
not know any of them by name.
By Rim
1- In few words, define what is a mental illness or a mentally ill person? A mental ill person is someone who lacks inner
peace, is always over thinking and lives in constant stress and imbalance.
2- Ask two random people, who are not into the medical, public health or any field related to health the same question:
What does it mean a mentally ill person? Or what is mental illness in general? Who are those people? (I.e. Chou ya3ne
marid nafsiyan/3a2liyan?) Mira (18, engineering student, UL): A person who is not comfortable and always worry.
Marilyn (18, engineering student, UL): A person who is not him/herself “byofsoul aw2at”.

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3- What are the psychological disorders that pop up automatically on your mind? Stress, anxiety, depression and OCD.
4- Pick one of those psychological disorders and define it in your own words/ how do you perceive it? What information
you know about
it? (you can simply give an example) Anxiety; extreme case of stress. Can cause serious physical disorders such as
migraine and GI tract problems
5- Do you know any psychiatric hospital/mental hospital in Lebanon? (If Yes please name it) Deir l salib
6- Do you know any NGO that takes care of mental health in Lebanon? (If Yes name it) No
By Mia
Ribal’s homework on Mental Illness
1. mental illness is a mental health condition or disorder that effects the way a person thinks and behaves. An
example is depression, anxiety, schizophrenia etc…
2. I asked a business student in AUB about mental illness and he answered the following: “a mentally ill person is a
person who is suffering from abnormal thinking behaviors and emotions.” Another student I asked was an
architecture student in LAU and his response was:” a mentally ill person is a mentally disrupted person, a crazy
person.”
3. psychological disorders that pop up to my mind:
a. schizophrenia
b. border line personality
c. OCD
d. Anxiety disorder
e. Eating disorders Neurocognitive disorders
4. Anxiety disorder: excessive fear, anxiety, fear, insecurity, panic attacks, inability to sleep, over thinking and
exaggerating ideas till an extent to feel fearful.
5. Yes. Deir el Salib
6. No

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People: Ribal, Tarek, Alissar, Caroline, Ziad, Rim, Ranya and May
Place: Rm 303
After an open platform, both Ziad and Ribal presented their chapters.
The students appreciated both presentations: Ziad’s presentation included a PPP (16 slides),
questions, breathing exercise and quotes; Ribal’s included a PPP, case presentation, dialogue,
questions and referral to NGOs/centers working in mental health in Lebanon. It is to note that
Ziad also shared with us his interest in fish keeping.
The comments about Ziad’s presentation included: Good presentation. Ziad applied what he
was preaching. Well done! It was brief, interesting and informative. Bravo Ziad! Great
presentation skills!
The comments about Ribal’s presentation included: I never thought that I will enjoy this
presentation. Although some of the terms used were briefly explained, the examples that Ribal
gave made the interaction increase. Well done! Pulled me right in!
Extra-ordinary Excellent Very good Good
Ziad 1 4 1 1
Ribal 2 3 2 -

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Key learnings from Ziad’s session:
 Ways of stress management
 Diseases caused by stress
 Effects of stress
 The mechanism of stress and the response
 Great quotes by Deepak Chopra
 Don’t you think that finding solutions for stress is stressful itself?
Key learnings from Ribal’s session:
 Kinds of mental illnesses
 Dangers of stigma
 Learnt lots in details
 Exercises were very useful and showed the difference
 Would it be possible for anyone to get a check up from time to time?
 Can we present psychological disorders through public health prevention measures?
Quotes by Deepak Chopra
Ziad shared with us the following quotes:
“Meditation is not a way of making your mind quiet. It is a way of entering into the quiet
that is already there - buried under the 50,000 thoughts the average person thinks every day”
Inner silence promotes clarity of mind; it makes us value the inner world; it trains us
To go inside to the source of peace and inspiration when we are faced with problems
and challenges”
“Relaxation is the prerequisite for that inner expansion that allows
a person to express the source of inspiration and joy within”

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Students’ responses (selections): MANAGING STRESS
The changes that happen in our bodies as a result of stress
Stress can have many different effects on the human body and include, emotional, mental, and
physiological. Emotional changes include the rush of emotions such as anxiety and fear. Second
mentally the mind and the thinking capacity can be changed when a person is put under stress, thus
can alter his conscious thinking preventing him from taking good or important decisions. The third
aspect stress can affect is the physiological aspect includes the release of hormones for several glands.
Increase in heart rate and blood pressure causes constriction in the nerves and contracts the muscles,
The hypothalamus-pituitary-adrenal gland release cortisol that circulates the body causes all the cells
to respond to the stressor.
Tensions in the body, and the muscular system is the direct response to stress.
Stress causes an increase in blood sugar and increases the risk of bad behaviors, such high alcohol
consumption and drugs. It's also linked to obesity, since it encourages food craving. It is also linked to
heart diseases and mental disorders.
Other health disorders include asthma, headaches, Alzheimer's disease, anxiety and depression and
finally premature death.
Respiratory system: asthma attacks, hyperventilation, panic attacks, difficulties breathing
Cardiovascular: Acute stress: increased heart rate, strong contraction of the heart muscle, release of
stress hormones (adrenalin and cortisol), dilation of blood vessels, increased amount of blood pumped to
body, increased blood pressure. Chronic stress: long-term problems for heart and blood vessels, high
risk of hypertension, heart attacks and strokes.
Endocrine: increased risk of diabetes.
Gastrointestinal: heartburn, acid reflux, heartburn pain, nausea, stomach pain, vomiting, ulcers,
indigestion, diarrhea or constipation.
Reproductive system: Females: irregular menstrual cycle, painful periods, cramps, bloating, negative
moods, mood swings, decreased sexual desire. Males: effect on testosterone production, sperm
production and maturation, erectile dysfunction or impotence, body becomes vulnerable to infections (of
testes, prostate gland and urethra).
Stress management/relaxation techniques that we have encountered in this course
Technique Definition
Exercise
Applying regular exercise or when a person is under stress can greatly help
reduce the amount of stress mentally and emotional and further help reduce
the muscle tension in the muscles from the stress.
Meditation/ Deep Meditating or taking your mind of the stressor or situation can help your

336
Breathing body relax from all the reactions occurring, furthermore it can greatly help
you take better, more wiser decisions
Yoga Yoga is an ancient art based on a harmonizing system of development for the
body, mind, and spirit.
Laughter yoga Forced laughter that changes to an uncontrollable laugh, this fake laugh tech
will make the brain deal with the laugh as real. This release tension and give
a feeling of happiness.
Unconditional laughter combined with yogic breathing.
Social activity Participating in a social event or having a conversation with a person you
trust, can be a great way to help the person, it can help first release all the
stress in one’s self and furthermore can help take your mind of the subject or
get good advice from that person to help you overcome the situation.
Stress ball When you squeeze, the muscles not only contract in your hand, but up your
arm as well. Hold the squeeze for a second or two and then release. As your
muscles relax, the tension will leave your arms and hands, thereby relieving
stress. It’s a great way to take out your frustration.
Marble massage
Rub a marble on stress points and pass it on your hands, thumbs, toes, and
other.
Visualization Forming mental images to take a visual journey to a peaceful, calming place
or situation.

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Exploring Souk Al-Tayeb
Saturday 13 12 14
Pamela’s (one of Souk al-Tayeb organizers) message to public health students was that the
souk is PUBLIC HEALTH! She explained that it is about yummy foods and artisan’s foods. She
hoped that more public health students would visit and promote such markets.
Sheikh Hussein Abi Mansour sent us a recorded message saying:” our products are healthy and
from our land. It is organic and natural. The modern foods are destroying our health.”

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Healthy eating –A review
Review of selected healthy eating messages/practices encountered during PDHP 246 and their
related activities-Responses by students
Healthy Eating
message/practices
Related activity/activities
Healthy breakfast  The foul Breakfast in the old hospital cafeteria
 Diabetes prevention discussion on World Diabetes
Day + related handouts
 Photos of our breakfasts posted on face book
 Peer support
Smart snack  Sharing the smart snacks at class n Nov 2
 Readings from Dr Weil’s article
 Small working groups discussion and support groups
More veggies and fruits  Eating together+ discussions
 Talk by Rana Karam
 Nutrition games (cardboard/cards)
 Peer support
 Quizzes
Healthy eating  Geitawi garden health festivity
 World Heart Day
 Students’ presentations
 Class discussions on NCDs (Cancer, CVD, DM etc.)
 Quizzes

339
Tarek’s HW to peers:
1-State three misconceptions you know about sexual relationships.
2-what are the dimensions of sexuality?

340
Among the responses
State three misconceptions you know about sexual relationships.
Cynthia  It is often thought that young people will be more engaged in sexual
activities if they are taught and made aware about condoms and their
application.
 Teaching sexual education in schools is unethical, since it undermines the
roles of the parents and encourages students to be engaged in sexual
relationships.
 Sexual relationship is not an important factor in a couple’s “healthy”
relationship.
Ranya Misconceptions: 1- kids growing up with gay parents will turn out to be gay.
2- Kids don’t need to be given any sexual education
3- Putting on 2 condoms will make the chance of getting pregnant less
Rim Sex education is a taboo and should not be taught to young students;
Sex is just a biological function;
Pornography is useful to enhance the sex life of a person/couple.
Caroline Sexual relationships transmit many diseases, sometimes are illegal, it can
affect people and women basically.
Mia three misconceptions about sexual relationships:
1. Considered as a taboo
2. Sexuality is innate therefore there is no need to talk about it or teach
developing generations about it
3. Distributing condoms on HIV/AIDS day is considered as encouraging
people to have sex.
Ziad 1. The sex in porn is the same as in real life.
2. Condoms tend to lessen the pleasure during intercourse, and thus
should be avoided.
3. the misconception of the duration of sexual relationship.

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What are the dimensions of sexuality?
Cynthia  Biological or physiological aspect (Gender, genetics, reproduction,
fertility control…)
 Psychological aspect (Emotions, experience, motivation, body image …)
 Sociocultural aspect (Religious, multicultural, political, media and ethical
influences)
 Sexual behavior (Sexual attractions and attitudes…)
Ranya Dimensions of sexuality:
*Biological (physiology of sex)
*Psychological
*Sociocultural factors
Rim Physical, psychological and behavioral
Caroline biological. Psychological, social, economic, political, cultural, ethical,
legal, historical, religious, spiritual
Mia sexuality dimensions:
1. biological
2. relationship
3. behavioral
4. Believes
5. Psychological
Ziad The dimensions are biological, psychological, and socio-cultural

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Ranya’s home work to peers:
My presentation is about drugs, your homework is simple:
1) Show up for class
2) Get a water bottle to class (0.5L OR 1L as you wish)
3) Think of just one reason to why you personally don’t use drugs/ or if you do, why?
4) Come to class with an open mind
See you guys tomorrow!

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Among the responses Ranya’s HW
Think of just one reason to why
you personally don’t use drugs/ or if you do, why?
Cynthia: I personally do not use any forms of drugs, whether for medical purposes or illicit
drugs, since I am aware of the health complications associated with the abuse of drugs as well
as the consequences of the resistance the body can make.
Rim: Dangerous effects on the health (physical, psychological and social)
Ziad: One reason I do not use drugs is that they are addictive furthermore damage our body
and on the long run hurts my wallet as well. There is no benefit from drugs and thus I find
them useless.
Mia: The reason why I avoid using drugs and medication is due to the fact that if not necessary
why take it? Some people take panadol for a simple head ache instead of resting or trying to
tolerate the pain till a reach a point where they start abusing panadol and taking it in the
wrong dosage or for the wrong symptoms ending up with health complications. As for illegal
drugs, people who tend to abuse drugs need support. The main reason why they tend to take
such drugs is due to social exclusion for example. I think we should treat the community and
society before treating these victims. The topic of illegal drugs is very vast and complicated. It
should be tackled on different levels.
Ranya: Drugs as perceived in our society- and our country in general- is something ‘bad’ and
illegal. As some people like to reform and rebel and walk on the opposite road of what society
demands and requires, I personally do not seek that sort of path. I believe if something will
cause more negative consequences such as jail, or ‘a black dot’ on my record, than it would
make my life better, I chose to not seek it. In conclusion I would say that I do not use drugs
because it would harm me more than benefit me. This does not mean that the influence of
drugs on our body is not horrifying and deathly, but in my belief, I do not seek it because it is
illegal and I would not like to go down that road in fear that it would end my life before I start
living it; I believe it not worth it.

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People: Ribal, Tarek, Cynthia, Caroline, Ziad, Rim, Mia, Ranya and May
Place: Rm 303
Ranya’s presentation consisted of a competition
game (Q & A), discussions and a video.
Tarek presentation consisted of a PPP (33 slides), a
video and an interactive exercise-condoms.
The students appreciated both presentations.

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The comments about Tarek’s presentation included: An interesting topic, well presented, well
done! I felt satisfied with the information we learnt during the activity. Bravo! Loved it! Tarek
was really courageous while presenting a sensitive topic. Loved the video, funny and straight
to the point! The game was educational and creative  Great presentation and great visual
aids. Wonderful presentation and class demonstration! The issue is more important than what
people know, so it was very important to talk about it, Good job!
The comments about Ranya’s presentation
included: Different approach! The quiz activity
was perfect and interactive. Interesting and new
information! High level of interactions, but not
everything was totally clear. Some definitions on
a PPP would have helped more.
TAREK 3 4 1
RANYA 4 2 2
Key learnings from Tarek’s session:
 Proper condom use
 Leant about the condom thing
 Dimensions of sexuality (physical, psychological, orientation, behavioral)
 Sexual response cycle
 Us-ness
 Why is this topic a taboo?
 Why are people ashamed to discuss sexuality?

347
CDC Center of Disease Control
Retrieved from: http://www.cdc.gov/condomeffectiveness/brief.html
Condom Fact Sheet In Brief
Consistent and correct use of the male latex condom reduces the risk of sexually transmitted disease (STD) and human
immunodeficiency virus (HIV) transmission. However, condom use cannot provide absolute protection against any STD. The most
reliable ways to avoid transmission of STDs are to abstain from sexual activity, or to be in a long-term mutually monogamous
relationship with an uninfected partner. However, many infected persons may be unaware of their infection because STDs often
are asymptomatic and unrecognized.
Condom effectiveness for STD and HIV prevention has been demonstrated by both laboratory and epidemiologic studies. Evidence
of condom effectiveness is also based on theoretical and empirical data regarding the transmission of different STDs, the physical
properties of condoms, and the anatomic coverage or protection provided by condoms.
Laboratory studies have shown that latex condoms provide an effective barrier against even the smallest STD pathogens.
Epidemiologic studies that COMPARE RATES of HIV infection between condom users and nonusers who have HIV-infected sex
partners demonstrate that consistent condom use is highly effective in preventing transmission of HIV. Similarly, epidemiologic
studies have shown that condom use reduces the risk of many other STDs. However, the exact magnitude of protection has been
difficult to quantify because of numerous methodological challenges inherent in studying private behaviors that cannot be directly
observed or measured.
Theoretical and empirical basis for protection: Condoms can be expected to provide different levels of protection for various STDs,
depending on differences in how the diseases or infections are transmitted. Male condoms may not cover all infected areas or areas
that could become infected. Thus, they are likely to provide greater protection against STDs that are transmitted only by genital
fluids (STDs such as gonorrhea, chlamydia, trichomoniasis, and HIV infection) than against infections that are transmitted primarily
by skin-to-skin contact, which may or may not infect areas covered by a condom (STDs such as GENITAL HERPES , human
papillomavirus [HPV] infection, syphilis, and chancroid).
STDs, including HIV
HIV Infection
 Consistent and correct use of latex condoms is highly effective in preventing sexual transmission of HIV, the virus that
causes AIDS.
Other STDs and Associated Conditions
 Consistent and correct use of latex condoms reduces the risk for many STDs that are transmitted by genital fluids (STDs
such as chlamydia, gonorrhea, and trichomoniasis).
 Consistent and correct use of latex condoms reduces the risk for genital ulcer diseases, such as GENITAL HERPES , syphilis,
and chancroid, only when the infected area or site of potential exposure is protected.
 Consistent and correct use of latex condoms may reduce the risk for genital human papillomavirus (HPV) infection and HPV-
associated diseases (e.g., genital WARTS and cervical cancer).

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To achieve maximum protection by using condoms, they must be used consistently and correctly.
The failure of condoms to protect against STD/HIV transmission usually results from inconsistent or incorrect use, rather than
product failure.
 Inconsistent or nonuse can lead to STD acquisition because transmission can occur with a single sex act with an infected
partner.
 Incorrect use diminishes the protective effect of condoms by leading to condom breakage, slippage, or leakage. Incorrect
use more commonly entails a failure to use condoms throughout the entire sex act, from start (of sexual contact) to finish (after
ejaculation).
How to Use a Condom Consistently and Correctly:
 Use a new condom for every act of vaginal, anal and oral sex throughout the entire sex act (from start to finish). Before any
genital contact, put the condom on the tip of the ERECT penis with the rolled side out.
 If the condom does not have a reservoir tip, pinch the tip enough to leave a half-inch space for semen to collect. Holding
the tip, UNROLL the condom all the way to the base of the erect penis.
 After ejaculation and before the penis gets soft, grip the rim of the condom and carefully WITHDRAW . Then gently pull
the condom off the penis, making sure that semen doesn't spill out.
 Wrap the condom in a tissue and throw it in the trash where others won't handle it.
 If you feel the condom break at any point during sexual activity, stop immediately, WITHDRAW , remove the broken
condom, and put on a new condom.
 Ensure that adequate lubrication is used during vaginal and anal sex, which might require water-based lubricants. Oil-based
lubricants (e.g., petroleum jelly, shortening, mineral oil, massage oils, body lotions, and cooking oil) should not be used because
they can weaken latex, causing breakage.
Sources
Carey, Lytle, & Cyr (1999). Implications of laboratory tests of condom integrity. Sex Transm Dis, 26(4): 216-20.
Lytle, Routson, Seaborn, Dixon, Bushar, & Cyr (1997). An in vitro evaluation of condoms as barriers to a small virus. Sex Transm Dis,
24(3):161-164
CDC (2006). Sexually Transmitted Diseases Treatment Guidelines, 2006. Morbidity and Mortality Weekly Report, 55(RR-11).
Steiner, Cates, & Warner (1999). The real problem with male condoms is non-use. Sex Transm Dis, 26(8): 459-62.
Warner, Stone, Macaluso, Buehler, & Austin (2006). Condom use and risk of gonorrhea and Chlamydia: A systematic review of
design and measurement factors assessed in epidemiologic studies.Sex Transm Dis, 33(1): 36-51.
Weller & Davis (2001). Condom effectiveness in reducing heterosexual HIV transmission. Cochrane Database Syst Rev; 3:CD003255.

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People: Caroline, Cynthia, Ranya, Rim, Ribal, Tarek, May
Visitors: Houda and Lamis
Visiting 10 children at the Pediatric ward of the hospital
Place: Old Hospital Cafeteria + Pediatrics Ward- St Georges Hospital

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During this session we brainstormed about several aspect of the course and discussed plans
towards course completion as follows:
Competencies in
Public Health and
Health Promotion
 Three students found it difficult to explain.
 Among the responses: depends on workforce? Depends on
student’s character? To advise people and spread knowledge
and raise awareness
 Competencies are about behaviors and not only knowledge;
they refer to the ability to act and link theory and research into
work and action…
PDHP 246
Home works
 Mixed responses.
 They are about study!
 Tooooo long! Some were interesting 
PDHP 246
Bibliography
 Knowledge?
 Challenging!
 Very important.
 Takes time to complete.
PDHP 246
Take Home Exam
 Don’t make it long.
 Let it be fun, interesting, informative and easy!
 I hope that it is going to be fine 
 Interesting and not too much.
 Too many questions to answer.
 Mmmmmmm. Good grades!
Meeting dean Dr
Nadim Karam-Jan 12
At 5:10 pm
 This is a very nice opportunity; something new and unusual.
 As a previous public health graduate, let us benefit from his own
experience.
 Let us ask him about the plans for the university.
 Talk about interesting topics so that he can see what we have
done so far/ so he can see that we are competent and capable
on opening topics and discussions.
 Inform him of our results and what the students wanted to tell
the administration about heart friendly environment (the World
Heart Day) and the value of community work (the Geitawi
Garden Health festival).
 Include food in the meeting.
PDHP Celebrations:
Jan 13 (1:00-2:00 pm)
 Has to be well organized and planned.
 What are the competencies that we want to show other people
 Looking forward.

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 Should be interesting.
 I want cake. Celebrate!
PDHP 246  Spread the word. As unique as ever.
 Healthy lifestyle. No stigma.
 Lots of love among us. Love you Dr May. You made it better <3
PDHP 246 people  One family. Love.
 We are the best! Interesting combination of people in this class.
 It was an honor to be a part of it.
 Cool stuff . Be active. Love you.
 We reached many students and community members.
 I love you FRIENDS. 1 world. Zee Best.
Additionally, we
celebrated Tarek’s B-
day, enjoyed a
vegetarian soup and
salad, and wrote our
wishes and
comments to each
student.
We distributed the gifts to ten children at the Pediatric ward at St Georges Hospital- with
special thanks to the help from Mrs. Houda Abboud (CAP-HO).

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GUIDELINES FOR THE EXAM
 Delivery time: By 5 January 2015 (or earlier).
 This take home final exam is composed of 7 parts and 20 key questions.
 Make sure that you read the questions well. Often you can choose from selected
options, and you don’t have to answer all the questions.
 Kindly use this form as a template for your responses.
 Please start NOW and don’t delay till the last moment.
 EDIT your work and preferably RE-EDIT before submission.
 Make sure to list the references that you use.
 You are encouraged to refer to our class discussions and use the course readings in
your responses (review the attached document PDHP 246 Classes 1-30/ Draft of 25
12 14)
 Whenever appropriate, feel free to insert graphs, visuals or quotes.
 Feel your breathing and let it be a learning and enjoyable exercise.
 All the best 

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CONTENTS OF THE EXAM
Parts
PART I: HEALTHY LIFESTYLE
About concepts, people with a health condition, people living in poor and
marginalized communities, farmers’ market and human and health rights
PART II: HEALTHY CHOICES
About Physical Activity (benefits and optimal behavior/best practice),
Eliminating tobacco (damage to the body and reversible changes and their
timing: when we quit smoking), Healthy eating (practices during the course, our
breakfasts), Managing stress (changes that happen in our bodies, techniques
encountered in the course)
PART III: HEALTH CONDITIONS
About Pathogenesis/Risk factors/Best practices to protect ourselves/Best
practices to deal with the condition in case a person has it: Diabetes Mellitus-
type 2, Breast cancer, Cardiovascular disease, Mental health and mental illness,
Sexually transmitted diseases/infections, HIV/AIDS
PART IV: BEST PRACTICES & PEER SUPPORT
About best practices listing, using the Be the Change framework, Narrations by
university students (Karim, Samia, Farah, Hani and Mira), Typical Health Issues of
University students, Whatsapp support groups
PART V: OUR CHAPTERS
About our pictures/quotes, peer’s questions about our chapters from “Health
and Wellness”, my article from the chapter “Public Health in the Arab World”
PART VI:

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RECOMMENDATIONS TO THE FHS-BALAMAND
Recommendations regarding healthy lifestyle practices/guidelines, practical
implications of the Heart Friendly environment activity, Conclusions and
recommendations from the Geitawi garden health festival
PART VII: COURSE EVALUATION
This document, Most useful and enjoyable session, River code, Meeting my
expectations, Course syllabus, Competencies, Re-start, Open comments
STUDENTS EVALUATION OF THE FINAL EXAM
The following are responses of the students in evaluating the final take home
exam. Special thanks to all for.
I. What did you like most in the exam?
 The exam took into consideration all the material that we have covered so
far. Be it concepts of healthy lifestyle, healthy choices, peer education,
events within the course, pathogenesis and many more.
 What I liked most about the exam is the multidisciplinary topics and
questions that tackled health issues in addition to our field experiences and
class discussion moving forward to the rich articles and reading and
presentations we passed through the course.
 I liked the most that it included almost everything we took in the course,
and gave us the chance to choose the options we felt good answering.
 Questions are based on understanding and research and not on
memorization.

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 The most thing that I liked from the exam is that we learned a lot through
research.
 The questions were straight forward, easy and enjoyable
 I liked the variety in the exam and that it covered everything we tackled
throughout the course.
II. What was most useful to you in the exam?
 The most useful part in this exam was the part where certain diseases were
mentioned, their risk factors, and prevention (Diabetes and breast cancer).
Since I believe that this part is both a general knowledge and things we
need for our profession.
 The most useful part of the exam was answering the questions about the
topics our classmates presented in class.
 The health conditions part of the exam. It was useful because it required
me to open references and read about the topic and deepened my
knowledge on that topic. It focused on the medical side on the course
which also an important aspect.
 The research that I had to do in order to find credible references for the
information I was providing so I could complete all the questions.
 The thing that we have to search for the information and read articles,
which widened our knowledge in the field.
 Having to read different articles to answer the questions.
 Part 3: Health conditions
III. How many hours you needed to complete the
exam?

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 I worked on the exam for 4 consecutive days, each day took me half an
hour but the last day about two and a half hours, since I edited the
information, corrected some questions and so on.
 In total about 6 hours
 6 hours
 Around 6-7 hours
 I did not track my time as I did it over several days, however I believe
cumulative it took me around 4 hours.
 App. 2 hours
 2-3 hours non stop
IV. What are the objectives of the different sections
of the exam:
Part Objective/s
I. HEALTHY
LIFESTYLE
 To introduce us to what healthy lifestyle is in details
as well as its key enabling factors (Healthy eating,
physical activity, avoiding smoking and drugs…)
 Knowing what the beneficial activities we do are in
our daily life and our risky behaviors and working on
reinforcing the good ones and stopping the bad.
 Understanding the reason for a healthy life style in
order to make it a habit
 To focus on the lifestyle part of the course and how
changes in it can either harm or benefit our health.
And that a change in lifestyle can occur even in
certain bad conditions.
 Understanding more the concept of a healthy lifestyle
 Different factors (e.g. environmental, social…) that

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affect a person’s lifestyle and influence it; factors
that help in having a healthy lifestyle OR factors that
obstruct from having a healthy lifestyle
 To know till what extent students have learned from
this course about the meaning of healthy lifestyle
and its determinants.
II. HEALTHY
CHOICES
 To know the benefits and the importance of the
factors that enable healthy lifestyles.
 Healthy choices were an interesting section since we
learned how to go for better and healthier
alternatives in our daily life.
 Better choices for better health
 Focuses on the choices we make in our life and
when it comes to our health, and how it’s important
to make healthy choices to improve our body and
maintain it with age.
 Being more aware of the healthy behaviors that needs
to be done in order to stay healthy
 Healthy choices learnt that should be applied in the
course of a healthy lifestyle
 Let students choose some activities done to
promote a healthy lifestyle and talk about it.
III.HEALTH
CONDITIONS
 To know the certain diseases, pathogenesis, risk
factors as well as prevention tools.
 Health conditions familiarized us, as public health
students, about the different health conditions and
diseases and familiarized ourselves with ways to
prevent them and promote a healthy lifestyle.
 No matter what is the health condition people can
be healthy
 This part focused on the medical side of the course.

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To show us that medicine is a part of public health
and we must know these conditions and not always
depend or leave it for the doctors to do it.
 Understanding more the common chronic diseases
and ways to prevent or lessen their symptoms
 Health conditions (e.g. CVD, breast cancer, DM 2…)
that could be prevented when living in healthy
conditions/healthy lifestyle
 Students choose a health condition or disease that
negatively affects a healthy body. Students should
list how it affects the body, risks factors, best
practices for protection, and best practices in case
the person is infected.
IV. BEST
PRACTICES &
PEER
SUPPORT
 Different approach. Learning and knowing new
matters through the help of our colleagues
 Best practices and peer support reinforced and
strengthened the peer to peer collaboration and the
sense of teamwork which is the basics of a public
health career which is an interdisciplinary field
 Support each others to meet our goals and use the
friendship to support healthy life style
 To see if we have learned from the practice part of
the course, and if we are able to help others by
improving their lifestyle and choices.
 Being aware of the unhealthy behaviors that each one
does and the ways to correct them
 Best practices that every person should take into
account towards achieving healthy lifestyle, and the
support we should create to help peers and
surroundings to help everyone live in healthy
lifestyle, thus reaching a healthy society.

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 Test if students know the best practices to be done
that are the factors of a healthy lifestyle. In addition,
check if students recognize some bad habits done by
others/ surrounding and how well he/she can
correct it and promote healthy activities to others
V. OUR
CHAPTERS
 Important elements from both books were
answered, which increased our knowledge about
certain topics other than ours.
 They covered several interesting topics that could
come in handy in our life later on. The encounters
with different guest speakers, the topics and issues
tackled such as tobacco, medicine abuse, student
presentations, peer group support and finally the on
field activities were all extremely beneficial.
 Dividing the topics is a better way to manage time
and divide work.
 This part focuses on the material of the course and
what we have learned from the chapters that we
have presented or others have and we listened and
to read the phaw chapters and present what we
learned.
 Recapitulation
 Chapters that students of PDHP246 explained.
Questions were raised before explaining the
chapters. The objective of this section is to see if the
material that was explained in each chapter
answered their questions and concerns about each
topic
 To check if students are familiar with the chapters
discussed by with colleagues.
VI
Recommenda-
 To improve the university as a whole. In addition, to
apply the elements of healthy lifestyle within the

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tion to the
University
borders of the university
 It was a great idea because it is the first time in the
university where the voice of students was carried
forward to the faculty administration and the
students collaboration and response was so
interactive.
 To share ideas for a better faculty.
 To help Balamand improve the system and what we
see that needs improvement, to help the future
generation of public health students.
 Suggesting ways to keep the campus healthy
 Students’ major stressor is the university and the
faculty where they’re studying and they
continuously seek more facilities and supportive
environment by their faculty so they can perform
best. This section was a free area for the students to
express their opinions about what they think should
be improved or added.
 The student has the right to recommend some
improvements to be done in their university.
VI. COURSE
EVALUATION
 To know what has been done so far. How did we, as
students, benefit from this course and how did we
improve our learnings regarding certain matters.
 The objectives of the course evaluation were a nice
idea since the syllabus is the contract between the
students and the Dr May. Having the chance to
modify it and design it according to our needs and
points of interest, made it a better and more
interesting and beneficial experience.
 To improve the course and its materials.
 To conclude if the course met our expectations and
if we enjoyed and learned throughout the course.

367
 Assessing the course and whether or not it met our
expectations
 Students’ evaluation of the course; were their
expectations met? What did they learn? What was
new for them? What did they achieve? New
questions arising? New practices? New goals and
aims.
 To see if students have any comment concerning the
course, if they have met their expectations or not,
and tell what improvements should be done in their
opinion.
V. Titles of sections that could have been deleted
 As I mentioned during the class, the last part (the course evaluation thing)
was repeated in several parts.
 I believe that all where important sections that targeted different sectors,
so no section could have been deleted.
 recommendations to FHS Balamand
 Health conditions
 None
VI. Titles of sections that could have been added
 I believe everything we have covered was already present in the exam.
 I believe no needed sections could have been added
 GMO's Genetically Modified Organisms
 Why is it more important to count chemicals in processed food than
calories?

368
 Field activity report ( questions about the state of people at the Geitawi
festival)
 Toxic chemicals in the environment that are the underlying causes of chronic
diseases.
 Poverty and war, the new burden on our society’s health and wellbeing.
 None
VII.Additional comments
 The whole exam was great, however it does seem long at first, but once a
person starts and reviews it, it is not long, taking into consideration it is a
take home exam and a long duration of time was given.
 Thank you Dr. May. It was a pleasure having met you. LOVE

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People: Caroline, Cynthia, Ranya, Ribal, Rim, Tarek, Ziad and May
Place: Rm 303
We discussed course completion and made decisions about PDHP 246 celebrations as
follows:
 Final exam: Students commented about what they liked and disliked about the
exam, the time to complete its sections etc. They also reviewed the questions for
evaluating the exam.
 Yoga and Meditation with Dr Hisham Nasr: Students hoped that the session be
given next semester and that the students/friends who are not at the university
anymore will be allowed to join in.
 PDHP 246 Celebrations: As 4 students can’t make it on the planned open activity
of Tuesday Jan 13, we decided to include the “HAPPY HORMONE” activities in our
upcoming class on Monday Jan. 12
 Meeting the dean: We developed questions and findings that we like to share with
the dean
 Special thanks to Cynthia for taking charge in helping the class classify the
different options in order to make their consensus of what decision to make.

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HOME WORK by Alissar
HOLA Everyone!!!
Tomorrow, i will have my presentation on Cervical Cancer!
January is Cervical Cancer Awareness Month, i would like you, as a homework, to
bring something teal/white! Whatever you want: a blue paper, ribbon, t-shirt,
scarf, bracelet, anything but teal/white! Get ready
See you all tomorrow

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People: Alissar, Caroline, Cynthia, Mia, Ranya, Ribal, Rim, Tarek, Ziad and May
Alissar’s talk was about cervical cancer. She had few interactive questions and quizzes. The
students appreciated her talk and said: “it was so touching and really she knew how to deliver

373
the message without letting our attention get distracted”; “it is very interesting. She expressed
it very well, and touched my feelings”; “loved: the quiz and knowledge testing, the
presentation, the sharing of personal experience, the positivity and optism”. The students
graded Alissar as follows: Extra-ordinary (4 responses), Excellent (4 responses), Very good (one
response).
Groups of three discussed among each other what they wanted to share with the dean and
what their questions were.
Ribal responded to the group’s comments about smoking.
Then, each one of us took leadership in “happy hormone” activity.

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Session 33
Dialogue with Dr Nadim Karam
People: Alissar, Caroline, Cynthia, Ranya, Ribal, Rim, Tarek, Ziad, May and Dr
Karam

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The dean challenged the students with several concepts including why change.

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DR. KARAM’S LETTER TO PDHP 246 STUDENTS
To Alissar, Caroline, Cynthia, Mia, Ranya, Ribal, Rim, Tarek and Ziad
Dear Colleagues,
I am writing in follow up to our meeting and valuable and interesting
discussion on Monday January 12, 2015.
I start by thanking Dr. May Haddad for her initiative in calling for the
meeting and for the opportunity to meet with you that she made possible.
And, I thank Dr. Abi Habib and all concerned faculty and staff with your
Program.
I found the meeting valuable and interesting. I hope you feel the same.
Following are some impressions:
1- I value your interest in making recommendations based on your experience
within the course and based on your experiences in the Faculty.
2- I admire your passion; you seem to have advanced into being “converts”
into Public Health.
3- I hope our discussion strengthened your understanding of the importance
of engaging processes that ensure engagement and understanding among all
concerned; and the importance of this in ensuring appropriate
decision-making in favor of what you could recommend.
4- I had a solid impression about your appreciation of the importance and
value of Team work; and about the importance of investing in Team dynamics.

377
5- I am still counting on your ability to nurture your interest in
translating your recommendations into effective change. Short of this you
could be compromising your role as “agents / elements” of change; and you
would be falling in the trap of “taking no for an answer”.
6- And, as you nurture your role as public health ‘workers” / “activists” /
“practitioners” / “professionals” / “advocates”, remember to consider your
priorities and understandings in light of the priorities and understandings
of all concerned others. Respecting all concerned is a necessary (but of
course not sufficient) determinant of success. And analyzing priorities of
all concerned allows avoidance of missing the forest for the tree or the
tree for the forest.
I encourage you to keep me updated about your professional growth and
development, and about your human achievements as effective members of
your social and professional networks.
I look forward to expanding my pride in your achievements!
I wish you all the Best.
Nadim
16 1 15

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RECOMMENDATIONS TO THE FHS-BALAMAND
BY PDHP 246 CLASS- FALL 2014
The healthy lifestyle practices/changes that the PDHP 246 students recommended
as priorities to be addressed:
Physical activity
 Physical activity is essential. Educate youth about the importance and benefits of
physical activities. Provide free access to a gym, sports facilities and league games.
Encourage students to do sports through getting scholarships, reduced prices to
competition trips etc… and helping students manage their stress and weight and
preserve their health.
 Keep promoting physical activity benefits
 Encourage all to do more physical activities
 Give the students the opportunity to benefit from small discounts at gyms in Ashrafieh
and around it, to encourage their engagement in physical activity
 A physical activity facility or a gym should be designed within the University’s borders
to encourage students to be more engaged in physical activities
 Provide students with a gym to increase their exercise and/or contract gym places and
reduce gyms prices
 Advise students about physical activities they can do, and the benefits on the body and
the mind
 Choose an area close by, that students get free access to do activities and sports, or
get free rides to the main campus in north to use the facilities they have.
 Make different weekly sessions where the university brings an athlete, tic wan do
player, a dancer, Zumba dancers, and others to entertain and provide exercise to
students.
Healthy eating: No junk, More veggies
and fruits, Smart snacks, Healthy options
 Eating well is a key for better health and performance. University should provide
students with healthy alternatives to junk food. In addition, increasing the prices of

379
chocolates and junk snacks and reducing the prices of health snacks such as fruits and
vegetables, this will increase the consumption and alteration of students’ lifestyle to a
healthier and better food choice.
 Promote healthy diets
 Providing students with healthy foods (in the cafeteria)
 Add bigger healthy options in the cafeteria.
 The cafeteria should encourage students on eating healthy snacks such as vegetables
and fruits. Whereas chocolates and chips should be offered in minimal quantities.
 Add to the snacks present in the cafeteria packs of fruits, like chopped oranges,
apples, bananas, and oatmeal
 Reduce the costs of healthy foods present to encourage students to buy
 Reduce the price of veggies and fruits in the to allow consumption for everyone
 Allow the students to store their home cooked meals at the cafeteria and to use the
microwave at the students cafeteria
 Advice: increasing fruits and vegetables and decreasing fat and carbohydrates as well
as greasy and fatty food and chocolates. Explaining about healthy lifestyles also
requires educating people on the risk factors of eating unhealthy food. We would
explain about cardiovascular disease and diabetes mellitus, the risks of both and how it
affects the body and how they lead to other risk factors like cholesterol and
hypertension. It’s important to explain to the people how they can replace the bad
behaviors with good ones, how to eat the good fats instead of the bad ones, how to seek
almonds and walnuts instead of chocolates and cucumber instead of chips and fried
snacks.
 Food safety measures should be taught to cafeteria staff and fliers should be hung
for students to know how to handle their food.
Stop Smoking
 Make a smoking area and ban smoking on the terrace, in the cafeteria, lounge, and
other.
 Ban smoking in any public spaces and keep promoting tobacco threats
 Students who smoke within the University’s borders should be subject to penalty (such as
paying a particular amount of money or grade reduction…)
 Tobacco is a major concern! It is harmful to the smokers and to the innocent people
inhaling the smoke! Green spaces should be done to absorb the toxic chemicals and
provide clean oxygen. The university campus, even the open regions should be smoke
free.

380
 The recommendations given for healthy lifestyle would be the smoking campaigns we
held, telling people not to smoke, and telling people that smoke ways to stop smoking,
explaining the psychological and physiological effects of smoking and what they can do
to replace those addictions and bad habits.
 Increasing green spaces on campus, or just adding more plants and lowering the
areas allocated for smoking
 Cut down tobacco consumption
 Educate about the dangers of hookah smoking and teaching students to invest their free
time through reading, exercising, communicating with other students or joining clubs
instead of hanging out at a hookah café near the university.
 Educate about hookah: Hookah is not a better alternative to tobacco smoking, in fact it is
worse, therefore students should have awareness campaigns in collaboration with the
office of students’ affairs and health department. Hookah and tobacco can expose non
smoking people to second hand and third hand smoke where there life put at risk.
Sexual health
 Sexual health is essential specially in collage since students tend to get more exposed,
more active and at a higher risk. In order to protect these students while exploring
themselves, special seminars and awareness campaigns should be done. A psychologist
should always be accessible for students in order to discuss their relationship issues,
avoid mental challenges and be oriented properly to preserve their health and avoid
STD.
 Give lectures concerning awareness against bullying and sexual health
Drugs and alcohol
 Be aware of the drugs and medications abuse
 Marijuana, weed, alcohol consumption are really common drugs consumed by youth.
Many individuals smoke weed and get drunk just to be able to party with the rest of
their friends or in order to fit in. Others do it for fun, to rebel or just through curiosity.
Youth are exposed to these risky daily specially in collage, therefore it is up to the
university to provide awareness to these students through health promotion campaigns,
access to reliable databases about these issues, and inviting parents and students to
participate in seminars and workshops. When drinking alcohol youth should stay at their
friend’s place and sleep over instead of driving back, biking, or walking back home.
Parents could pick up their kids. Youth could carpool and make sure that the driver will

381
be fully capable of driving back safely and take care of the rest. Calling a cab could be an
alternative. As for marijuana smoking, it is essential that youth should know about
their tolerance and should have proper education about health risks and safety
measures in order to avoid any problems or undesirable effects.
OTHER
 Accidents prevention
 Students usually play games on campus and compete with other universities.
Consequently, they are more susceptible to injuries such as concussion. Concussion is a
serious issue since the brain bounces in the skull that can be dangerous and life
threatening. It is up to the university to provide to the students and athletes the
necessary health care, medical team and follow up and educate the students on how to
deal with cases of concussion, the symptoms and if they can proceed with the sports.
 Give sessions for time and stress management
 Provide sunscreen always to get protection from UV radiation and prevent skin cancer
at the office of students’ affairs
 Having more greeneries on campus
 Engaging students in healthy lifestyle activities where students themselves can benefit, or
students can pass the word on a broader spectrum to the community from practices and
keys they’ve learnt in different courses, to achieve a healthy society.
 Pay more attention to hygiene (Toilets, classes, terraces, balconies, stairs…)
 Be aware of cancer risk factors
 diabetes prevention

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Typical Health Issues of University Students-
By PDHP 246 students-Fall 2014
PDHP 246 Students compared the issues that students at the Faculty of Health Sciences-University of
Balamand face compared to those findings from the US (Source: “Health and Wellness”, Ch. 1 p. 16-17). The
issues are posted at: https://www.facebook.com/groups/960731717277199/965332603483777/
The issue chosen PDHP 246 student/s response/s
Sexual and relationship health:
Students of the faculty of health sciences are not very exposed
to any subject concerning sexual activity and prevention. It is a taboo
subject hardly spoken with peers. Sex is not seen as a good thing
before marriage and is not very accepted. Sexual active students do lie
about it and sometimes do not go to any healthcare specialist to
get a regular check up and be safe. It is true that the main cause if the
cultural context in Lebanon, but as the world is being developed and
sexual transmitted infections are increasing; it is a must to adopt a one
lecture class about the several methods of prevention or even the
attitudes to adopt facing a particular situation. It has been four years
that i attend FHS and i never took a lecture talking about it. I also know
people not knowing what are the modes of HIV transmission, which
is bit weird for university students. Nevertheless, the modes of
getting any sexual infections are also misunderstood. It is important to
integrate this hidden behavior and explain the benefits and disadvantages
to students to remove closed minded thoughts for the healthy growing
of Balamand students.

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Mental health:
Mental health affects the majority of people of all ages; it is an issue
that causes other diseases through the body. Lebanese students I believe
face a similar problem as those of America. University students in Balamand
at times can be under lots of stress and overload, thus many students at time
feel anxious and fear of not completing the assignments on time or not
doing well on the exams. Such a thing can greatly affect the students as
they go, because as a person faces stress in an early age, as they grow they
can develop chronic illness from constant stress. Furthermore many students
in the university of Balamand tend to sleep late and for short periods
when have homework’s to complete on a deadline thus put their body
under more stress. I believe organization and time management are
important aspects to help reduce the amount of stress in a student’s life
At FHS, students are facing the same problems. They are being exposed
to noise pollution on daily basis since the campus in the middle of the most
crowded city in the country. Adding to it the different working sites around
it releasing loud noises, which increase tension and lowers the students’
concentration. Students are also overloaded with exams and projects all due
at the same time, which disrupts their time management and schedule and
increases their stress level leading to health problems such as migraines,
anxiety or just crying for no reasons (been there, done that!!!). In addition
to the everlasting competition between students on things such as who gets
on the dean’s honors list or who’s the first one to submit the homework, etc… e
increases the level of stress in students. What if they are all combined
together? Students will develop first of all chronic stress, leading to anxiety
or depression and of course other health disorders, let alone the feeling of
insecurity and the fear of trusting people, even the closest friends (also been
there, done that!!!).
Substance use and abuse:
In the Faculty of health substance abuse is present. Mostly tobacco and
alcohol, tobacco is the first substance new students are getting in contact
with, and it’s the typical fit in the groups around campus. Alcohol is the
second substance that usually students abuse outside the faculty campus in
parties and events, sadly the culture we live in still consider high alcohol
consumption as a power. In most of the faculty parties alcohol is a major
substance present and at the same time it encourages new student to pass
some cigarettes with the drinks although they are none smokers. Other drugs
also present in the faculty and due to my personal knowledge of most of
the students I heard lots of stories that mostly include medicine students
and free medicals samples of controlled medications.
Health Care:
Students in the U.S have limited access to health care because
of lack of health insurance and comprehensive services. This is not the
case in the Faculty of Health Sciences- University of Balamand (and most
of the Universities in Lebanon) where all university students are registered
by the university in the NSSF (National Social Security Fund) which gives
them access to health care.

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Food and weight:
As students, we are always under constant stress and pressure because of the
exams, papers and the deadlines that we have to meet. As a result, to try to
cope with this stress we tend to consume chocolates (since it is believed to be
a source of energy) or unhealthy snacks. Moreover, at the Faculty of the Health
Sciences, the cafeteria contains mostly chocolates, chips, biscuits and high
caloric foods. Therefore, during breaks or at times of hunger, students grab a piece
of chocolate and nobody cares about healthy food which is a serious concern.
This is one of the most important factors people face; from students to adults
to children. There’s always a struggle between what you want to eat, what
you should eat, and what is available to eat. This is one of the problems we face
in the University Of Balamand; we do not have something to encourage us
to eat healthy food. The food served in our university is either junk (varying
from chocolates to chips to salty nuts) or sandwiches made up of just
bread and a slice of cheese with a hint of cucumber. For snacks, we don’t
have food we can snack on other than the chocolates and the chips; we
don’t have fruits or veggies. I for one would love to buy fruits in the afternoon
and have it as a snack after my lunch. Sometimes I can’t get food from home
so I suffer all day with utter starvation because I won’t allow myself to eat
chocolates or chips. Sometimes I go to the cantin, however the place closes
at 2 and we stay at university till at least 8pm, that’s 6 hours of no healthy
food, so you find yourself resorting to sugars and oils and garbage food. In the
US people face the eating problem due to stress management, although we
may find that very common here in Lebanon and in UOB too of course, I would
say the main issue is not having the healthy food. I for one get a guilty
conscience when I eat bad things, but if I have the option of munching
on apples or kiwis, I know that it would be easier to deal with and know
that you won’t deal with more stress later on when you realize that you
acquired god knows how many calories from a kitkat bar.
As students of Balamand University FHS, we have less problems with consuming
junk food. Since we have healthy food prepared daily in the Canteen of Saint
George Hospital, where homemade food and fresh salads are served and
also we buy fruit portions in plates. In addition, we have better services concerning
size and shape, since we have special dietitians who take very low payments to
make diet plans for students and to keep them in shape. As for weight issues,
we have much lower percentages of students who are overweight or obese.
Food and weight is a significant issue that students suffer from in the
states and still in Balamand FHS campus. Students are always under stress
and face time management issues. They tend to snack on chocolates from
vending machines and eat fast food meals to grab class on time. They stay long
hours outside home or they live alone in dorms. So basically fast food is their
easy way out in order not to lose time from studying. Similarly, emotions and
stress push students to eat food high in sugars and fats such as ice cream
and chocolates which are dangerously harmful. Eating addiction is a severe
issue students are facing in our days. Weight control became an issue to
students and the prevalence of obesity and overweight is increasing sharply.
Excess weight can also develop eating disorders and can lead to weight loss
pill abuse. Improper nutrition is also a harbor for chronic diseases such as
hypertension, diabetes, and cardiovascular and cancer.

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PDHP 246 Evaluations
by PDHP 246 students
The following are the cumulative results from a written questionnaire that
PDHP 246 students filled out towards the completion of the course. Dr May
Haddad developed the questionnaire and tabulated the results.
CONTENTS
Meeting our expectations
Course Syllabus
The most useful session
The River Code: Where do I see myself
Competencies in course tracks
Rating our competencies
RESTART?
OPEN COMMENTS

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Meeting our expectations
Students responded as to the extent this course met the Expectations that you had
voiced during the first session of the course as follows:
 This course is from a total different level of others. It goes beyond my expectations. I
got beautifully surprised with the activities we had, those we proposed in class were
done. i couldn't imagine that we would have the chance to make a festival, to be
active and also have classes in different environment!- Alissar
 This course has met all my expectations. There is only the part of the field visit, but
what was done and given by the Dr May was way more better from my expectations.
Starting from teamwork, to creativity, to public speaking, to searching for articles,
and the most important thing s done were the activities-Caroline
 The various expectations that I have voiced at the beginning of this course are met. Be
it in terms of the topics covered and pathogenesis of diseases, or in terms of the
proximity between the Dr May and the students (collaboration, friendly-relationship,
stress free atmosphere…) or in terms of field works and visits-Cynthia
 The course met further my expectations. What I got to learn from the course did not
only reach what I was expecting but even made me achieve and attain more
knowledge and skills. It gave me the true essence of public health, having a healthy
lifestyle and promoting wellness and health in my community, similarly, it taught me
the importance of team work and group work in addition to new creative methods,
field work, project planning, different ways of communication and delivering a
health message without lecturing, met key individuals such as Dr Norbert
Hirschhorn, Dr. Nadim Karam, and pharmacist Nadia Dalloul. I learned about
different topics such as acupuncture, sexuality, tobacco, mental health and many
other topics. To sum up it was an extraordinary experience-Mia
 At the beginning of the course I had different expectations, some formed due from
previous courses, but standing here now, I realize that I have put the wrong
expectations to this course. It’s not about the studying or the memorizing or the
exams, it is about acquiring the needed information and challenging yourself to do
things you would not do under normal circumstances. This course gave me the chance
to work with all my classmates, and with those shared activities I have learnt that

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working with others is not that bad, and the people with me in class are not bad
themselves. I do not have any further expectations, but I am certainly satisfied with
where we have gotten and to the progress we have made, along with facing the
struggles that we came upon. I will finish this course with a better view towards
classes and lectures and learning-Ranya
 After going over my own expectations of this course, I can say now that all of them
were met. The topics I suggested were discussed in class (cancer, yoga and stress). In
addition to taking theory into practice and not just learn from the book and write an
exam the next day. I also enjoyed the friendly relationship between each and every
one of us, including our Dr May, which made the course smoother and more fun-Rim
 In the first session we were not sure what this course is really about and our
expectations were vague to a certain extent. Now looking backward I know that we
met the expectations we should have had in the beginning of the course such as
learning how implement theories into action, and moving the course setting into the
community to make a health action-Tarek
 I think this course really hit my expectations for the course. As all my expectations
and the topics I were interested in were covered in the course and I have gained a
deeper knowledge of them and have learned new techniques and lifestyles to
prevent the topics I was interested in and others as well-Ziad
 Well to be honest, what I saw in this course was way beyond my expectations.
Flexibility (and I would like to thank you for that), peer support, reading materials
and field visits, all of the topics that I wanted to see covered were done (drug
addiction, smoking, substance abuse, psychological disorders, STIs/STDs, and mostly
it helped me improve my lifestyle towards a healthy one-Ribal
Course Syllabus
Students re-assessed their comments on the course syllabus that you had voiced
early in the course and they voiced themselves as follows:

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Syllabus: What do we want to confirm, add or change?
(Cumulative results)
Course learning outcomes
I was very confident about the course learning outcomes, and i was right! i knew things right in a different way!
I had experience to anchor the knowledge i got and apply it in the future. I wouldn't change anything!!!
Know the bad habits we make, know what are the elements of a healthy lifestyle, learn about different
diseases(causes, effects, and ways of prevention), present our topics, and make academic activities.
This is what I have mentioned at the beginning, “The course learning outcomes are perfect as they are.
Nothing to add or remove. Major illnesses or disease are discussed such as cancer and cardiovascular
diseases. Moreover, what seems so interesting is the part where we, students, challenge ourselves to
improve our own lifestyle practices to reach out to better and healthier ones”.
In fact, all the matters that I was expecting at the beginning of the course are met!! We learnt about major illness
and discovered further matters about them including cancer (breast cancer in particular), cardiovascular diseases,
diabetes mellitus, mental health and sexually transmitted diseases.
My peers and I, by the help of Dr Haddad and the course, decided to employ healthier living habits in terms of
choosing healthier snacks, making healthy breakfasts, exercising, avoiding tobacco and alcohol…
Course learning outcomes:
o Have a healthy lifestyle
o What is a healthy lifestyle
o CVD
o Cancer
o Mental illness
o Physical activity
o Interactive learning
o Key terms
o Preparing health activities for each other and the community.
o Peer support
o Essence of public health: the ability to save an entire community not just to treat a patient.
o Do more reading
o Self education
o Learn to say “I do not know” instead of giving wrong information to people.
The outcomes of this course were very positive; we acquired the information in a very well challenged way,
with as little stress as possible. I would say we have reached the learning outcomes of this course in the
healthiest most student suitable way.

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“This course sounds very promising. And by the end of it we will be more aware of everything threatening
our health and the different ways to stay healthy”
We are almost done, and I believe that by far, I am more aware of many health relate issues such as infectious
and chronic diseases, stress management, balanced and healthy nutrition. In addition to becoming capable of
addressing health concerns to strangers coming from different backgrounds and familiar with community work.
This course is about understanding the public health issues and the ability to apply it in a community setting,
which is in parallel with the outcome of Public Health and Development Sciences major. The course is an
opportunity for the students to experience the application of the theory into practice as a base for future
careers in the public health field.
Nothing has changes in my comments I still believe they are precise and clear.
Course learning outcomes: All what was mentioned was covered. I would also like to add: communication skills,
teamwork, peer support.
Learning methodology
It was the best way to learn! We put the knowledge we got into practice and applied with fun and simplicity!!! I
would suggest other courses to adopt this methodology!!!
Teamwork, better public speaking, improved way of communications with patients and people, creativity,
and interesting lectures!
“This course seems unique and has a different approach than all the others, which comforts students and
makes them more motivated and engaged. It is interactive and students, throughout this course, will be
able to discover themselves.
In addition, what seems interesting is that this course is rich in events. I cannot wait to be part of each and
every event ”
This course is unique. I enter to the classes with excitement and enjoyment, trying to guess what is waiting for
us in this particular session. This course was not based on getting a lot of lectures and going back home and
memorizing them. We learnt a lot, but the way we learnt was different. We could experience different matters
ourselves, and that is how we learnt. All the information provided in this course is stuck on my head, since the
way the information was provided was one of a kind.
o Learning Methodology:
o Take our lifestyle as an example to change. Start by the man in the mirror.
o The river code was amazing for self evaluation
o Peer support and interaction
o Developing IT skills

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o Using reliable databases for information
o Applying what we learn or read about
o Interactive quizzes and learning through games and prizes.
o Reaching out to others in our small community as a small training to be able to reach the wider
and bigger community.
o Respecting others opinions and point of views and learning from them
The learning methodology for this course were so different from the other courses we have taken at UOB,
however I would certainly say that the way we have taken to learn in this course is better than what we are
usually given in other courses. The idea of sitting down to lectures and presentations, memorizing and
undergoing stressful exams really discourages the student and wills them to do badly. I believe we will all
pass with course with beautiful results and we will look at our grade and realize that we are capable of much
more than we think we are.
Combining fun and learning is very beneficial”
I have nothing more to add, this sentence says it all.
Excellent peer education techniques used.
Highly interactive classes and information passed in an easy way, at the time most of the education is through
proper research, and further ideas are shared in class.
None of my comments of the methodology have changed, I liked the way they sounded in the beginning, and I
liked when we applied them in class. They were clear and precise.
Learning methodology: I confirm on that, and the most important learning tool for me was the case studies.
Student work evaluation/Grading
The grading system is fair enough and well divided. I wouldn't change anything at all!!!
The grading system is fair enough, but maybe a slight increase in the percentage of the presentations and
topics done from the Health and Wellness book.
“I guess the grading system if fairly distributed”
The grading system changed a couple of times and it is still fair. (Although I believe that the homeworks should
still rank the highest, since they demanded the most of our times).
Student Work evaluation/ Grading:
o Very lenient
o Flexible
o Allows the student to work harder since the bonus work is graded
o Interactive and influential homework.

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o The homework gave leadership yet interdependence to us. We were able to lead and give homework,
send posts and do our own presentation; yet fix it to the needs of our colleagues and our success is
dependent on our peer support and collaboration.
I think the evaluation and grading are well put, they are distributed in a good way giving importance to
every aspect of the class and every piece of our work.
“The grading system is very fair and well divided”
As I said in my previous homework, the grading system is fair and square. And the updated grading system is
even better.
The grading system the course used is fare enough, and dealt with each individual on a separate base
according to personal achievements and progress.
Student work evaluation/Grading: I think after we have discussed in class, the modifications we have done to
the grading is much better the initial grading’s. As they better balanced and help us more.
Student work evaluation/Grading: This section was modified to the best. In the beginning of the course, I
remember we were expecting to have a mid-term exam, besides the final exam. As we proceeded in the course,
adjustments and modifications took place, according to the flow, the learning material and methodology, and
what students also agreed on.
Other
The doctor's high experience and high skills added to the course outcome. The students benefit from this
experience each on his/her own way.
The most Enjoyable and Useful session to us:
 Each session had its different aspects. For me, they were all useful and during each
session I learned something new, especially during our presentations on the Health and
Wellness chapters. The different class activities done in each session were very beneficial
and entertaining at the same time-Rim
 The most enjoyable and useful session for me was the Geitawi Festival because it was
first of all, it was enjoyable because it is always fun to participate in community work
and be around people who need to know and adopt healthy behaviors. We helped them!
Secondly, it was useful because, it was new, it was practical (we put what we know into
practice and somehow got prepared to the real life) and we learned a lot from it, such as

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how to work as a team, how to take a responsibility with human beings, how to
communicate and deliver messages through activities-Alissar
 The most enjoyable session for me was the Geitawi festival. The overall idea of the
festival aimed at enhancing healthy practices for the elderly, women and children, using
the themes of exercise, hand washing, healthy eating and breast cancer. I was in charge
of the “breast cancer” stand. I felt all the women who were present in the area benefited
from what was offered. They asked several questions regarding the issue and were very
curious in discovering new matters. I believe, through this festival, I could achieve
something. Which is reaching the community members, understanding their needs and
make them more aware of their health-Cynthia
 The most enjoyable are the field work and activities we did like the Geitawi Garden
Health Festival-Tarek
 I really enjoyed the Geitawi session, it was new experience for me with the community
directly, and made me feel I have accomplished something good to the community, and
more importantly learned lots of new things-Ziad
 Wow. It’s hard to pick ONE single session that I enjoyed the most from this course; I
would say the Geitawi Festival was a special day. I was exposed to something New
something Concrete. It was a very beautiful and productive experience. It was my first
experience in direct contact to people. It was a challenge for me as well, to be able to
coordinate among all stations and people, examining the person first, pick the best
approach, and using communication skills to be persuasive or credible. I also loved the
team spirit, and I had very positive vibes by the end of the day. I also liked the last
session, where we had lunch altogether; I also had a lot of positive vibes. We had fun, we
ate, and I talked about my personal experience with smoking. It was a very beautiful way
to celebrate and end the course-Ribal
 The most enjoyable session for me is when we visited the hospital right before
Christmas and we distributed gifts to the little patients in the Saint George Hospital.
That was very touching and was full of care and love. We as health professionals to be,
aim to make equilibrium between the total health of the body and the emotional one as
well. Moreover, the factors that made such activity useful is the spirit of love and care
we had as a team of students with our Dr May, to give children at the hospital a sense of
hope and Christmas spirit-Caroline
 Moreover, another session that made my heart smile yet my eyes filled with tears is when
we visited the St. Georges Hospital during Christmas. As I mentioned earlier, I enjoyed

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the one hour we spent at the hospital. The smiles that we drew on the children’s faces
while singing Christmas Carols and giving them the gifts was just PRICELESS !!! I
definitely want to repeat this-Cynthia
 Dr Norbert Hirschhorn session was really enjoyable and beneficial. I had the honor to
meet such a great man, talk to him, ask him questions, and learn more about tobacco
and smoking and ways to deal with it. It was among the most memorable sessions I will
remember from this course. The class collaboration, Cynthia’s efforts to collect the
questions and provide us with reading material and assist our guest speaker are all
factors that made it enjoyable and useful-Mia
 I would say the most enjoyable and beneficial session was the one where Rania came to
our class and we got the chance to practice public speaking and get comments from a
professional whose advice would be taken to heart to work and become a better speaker. I
now perceive public speaking as a challenge rather than a fear, and now I have the will to
become better and fight for confidence in front of a big crowd. The factors that made it
enjoyable were the fact that all of us were taking the matter as fun, yet serious. We got to
be vulnerable in front of each other and it was funny instead of scary. The useful factor
was having a professional with us in class to walk us through the right way of achieving a
good speech, we were lucky enough to have done this session in this class because no
other class or teacher has ever really explained to us about public speaking, nor about
how to do it and what to do while doing it-Ranya
 The most useful sessions where the guest speaker’s sessions since we had the chance to
meet people in the field who have made a change and gave us motivation to work hard
and give the public health our best. In addition the meeting added to our
communication skills and gave us the chance to experience how well are we equipped
as graduates on the University of Balamand to have discussions with such experts in the
field-Tarek
The River Code: Where do I see myself?
 I see myself one step close to cross the river. I got empowered with skills and i
will certainly use them throughout my journey. The river is my college life
(exterior and interior), the rocks and the rapid flow of water are the obstacles
faced (stress of exams, friends, family, competition…). I will be graduating at
the end of January and i can say that i got a wall built. i learned a lot to handle
another river.

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 I am still the one crossing the river. I am still working to reach the goal I wanted
since I began my first academic year in University. Therefore, I believe that
these stones represent the obstacles and the aspects that try to test my
strength as I believe. However, I think that this course gave me a big push to
the front in my academic life because it added so much knowledge and
improved my team work abilities, which is a priority in Public Health and
Development Sciences major.
 At this stage of the course development, I believe I have already crossed to the
other side of the river. I believe that this course helped me gain a lot of
knowledge, not only in terms of issues related to healthy lifestyles, illnesses or
diseases, but also in terms of team building, developing leadership and sharing
my own experience to help my peers benefit through peer education.
 I believe I am the individual in the river code who learned how to cross the river
by himself. At first I lacked all the knowledge to cross the river and the skills.
With the help of my Dr May of this course, the guest speakers, and my
classmates I learned a lot of skills and grabbed knowledge as much as possible.
It was really a great experience and very beneficial, yet one of a kind and
special because the methodology was new and interesting. The course required
hard work and effort to stay up to date, attend classes, and use mass media
such as facebook, whatsapp, and IT skills. It was challenging yet I was
encouraged to work more on myself. At some phase in the course I got
overwhelmed and faced different obstacles but learned to manage to get out
and cross any obstacle anyone could face in order to succeed. Now I believe I
am on my way to cross that river. I did not cross it yet. I still have a lot to
accomplish, final exams, having a healthy lifestyle, accumulated work, and
health issues that I still need to improve only through adapting to a healthy
lifestyle. When all of the above is accomplished I would have crossed the first
river for this semester. There are yet more rivers to cross in the coming years in
my life and career. It is just the will to learn and knowing to reach key people in
your life to increase your knowledge and skills to cross the upcoming rivers.
 The river stories is one of the most important stories with a very strong moral,
it makes you watch your steps- so to speak. The story makes you evaluate what
you have done, what can do, and what you will do. I don’t think I have
completely crossed the river, but I am also not the person sitting aside and
waiting for someone to save them. I believe I have acquired the skills to cross,

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but I also believe I have so much more to learn in order to not only cross the
river, but to fly over the river and know that I have made it this far due to my
capabilities and skills.
 I see myself empowered with enough skills to cross the river. Considering the
river as being my life, the rocks and the rapid flow of water as the many
obstacles I face each day (stress of exams, friends, family, competition…), I am
now capable of overcoming each obstacle using the right tools. For example, to
overcome stress, I use the deep breathing exercise or meditation.
 I see myself as the third man who had the chance to learn from the man how to
cross the river, since I got empowered by the course in different skills such as
communication skills and some time management skills.
o Being on the other side of the river makes me with bigger responsibility now to
lead others to the second side just like some did to me.
o Showing people the proper way and the right steps to maintain a healthy
lifestyle needs us to be always in continual update of new researches and
trends in health, in addition to new health problems.
 I believe I am in the middle of the river, not yet crossed it but definitely with
the tools, skills and knowledge to cross it. At the beginning of the course I knew
very little regarding how to reach people and teach them all the important
things or changes they must do to their lives, however after participating in the
activities with the community and FHS, and after presenting to the class
regarding chapters related to techniques and issues everyone faces in their
lives, and learning from my class mates topics from our chapter that relate to
our lives and teaches us ways to prevent certain issues.
o As I continue and enter the job market I will be able to use the tools and
knowledge I have learned to finally cross the river, and become the person who
helps and teaches people to cross the river like the man in the story.
 I believe that throughout this course I learnt a lot. I guess the baggage that I hold
is empowering enough with the skills to be able to cross the river. I see myself
with skills that I’m using and taking actions upon: Living in healthy conditions,
healthy lifestyle. I covered a huge material: CVD, Cancer, DM, Mental Health,
Stress management, tobacco quitting, Healthy sexuality, Drugs and addiction,
Public speaking, communication skills, smart snack, healthy diets, importance of
breakfast, relaxation techniques, teamwork, happy hormone, peer evaluation,
self-assessment…

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Competencies1
in course tracks
Students listed the top valuable competencies that you have developed in
this course as follows:
Community work,
pro-active and fight for a good cause,
learned how to make a good public speech!
1. Public speaking.
2. Activities done in the Geitawi Festival, which helped me learn more about real
cases, we see in our surrounding, and the teamwork done was lovely.
3. Personal skills were very effective. We learned much about evaluating
ourselves, preventing the bad habits, and working on a change!
 Being integrated in the community, understanding people’s needs, being able to
reach the community members. (Most importantly through the Geitawi festival in
addition to the Heart Day at the FHS).
 Developing educational materials as in preparing the presentation in a creative
way and the reading material.
 Having a very clear and detailed knowledge about what healthy lifestyle is how to
apply it in our lives and its applications.
o Personal skills
o Variables of a healthy lifestyle
o The use of social media.
-Teamwork
- Public speaking
- Creativity in ideas and projects
Projects organization and Community action,
Technical topics
Concepts of healthy lifestyle choices, health, wellness
- Communication skills ( among peer + The public)
1
Competencies refer to enabling skills that go beyond the classroom set-up. Competencies are about
behaviors and not only knowledge; they refer to the ability to act and link theory into work and action.

397
- Discussing health topics in proper scientific terms in class and simplifying it to
the public.
- Being open for new topics and taboo ideas.
-
 Leadership (my role in the Geitawi Festival Parade)
 Coaching and activating (being a stimulus, activating others, adding energy)
 Communication skills such as: Speaking from my own experience, appropriate
body language use, let go of judgment-be respectful.
 Projects organization, and Community action
 Health and wellness variables
 Personal skills
-
Rating our competencies
The following chart demonstrates how students rated their competencies at the
end of this course:
Highly
competent
Competent
Somehow
competent
Incompe-
tent
Concepts of Healthy lifestyle
choices, health, wellness 6 responses 3 responses
Pathogenesis and risk factors of
several health conditions and
diseases
4 responses 5 responses
Personal skills: using quizzes,
hand-washing, breast self exam,
waist circumference, BMI,
condoms etc.

398
Technical topics such as: Non-
communicable diseases (cancer,
CVS, Diabetes etc.), Mental
Health, Sexual health, etc.
Health and wellness variables:
Physical activity, stress
management, mind-body
communication, healthy eating,
no tobacco, using drugs
responsibly, healthy
relationships etc.
Participatory, interactive and
creative learning approaches
and materials
8 responses One response
Be the Change Action Guide:
(Basics, I can do more,
Educating and influencing
others, Community Projects)
Peer education and support
Skills in team building and
working together 8 responses One response
Values and principles 6 responses 2 responses
Projects organization
and Community action 4 responses 5 responses
Personal skills: summarizing,
concluding, authoring, designing
materials, researching etc.
Leadership skills: class teaching
One
response

399
Leadership skills: reaching out
to other students and
community members
Dialogue with experts and
resource people 4 responses 3 responses
One
response
Developing a useful
bibliography 3 responses 4 responses 2 responses
Using social media
(PDPH 246 Facebook group,
PDPH 246 Whatsapp group)
One
response
OTHER (Please add) Group
activities at
class level
RESTART?
Students expressed ideas if this course to be re-started as follows:
 Maybe less home works.
 More Field trips maybe. In which we meet real cases . Other than that, Everything is
perfect!
 I would not change anything in this course, if I had the chance from starting from all over
again. Since every session from this course made me grasp new ideas, analyze different
health matters, critically think how to approach a community, learn more about
developing healthy habits and influencing others to be engaged in these practices, change
my habits to the better, understand more about various forms of diseases and more and
more and more… 
 I would have preferred if we had a moodle account where we could have a calendar

400
with all the due dates, presentation, dead lines, guest speakers, extra sessions. The
course was amazing. But it lacked some kind of organization at least for me since I am
not an expert in social media and I am not that active on facebook.
 To restart this course I would add more activities, more interaction on the field (like the
geitawi), more public speaking, and issues educating us on how to talk to people during
surveys and activities as public health students.
 I think I would have preferred more organized filed visits, and maybe less home works.
 The course is highly managed and was a great experience, now after the course is over I
understood the way this course was given and how effective the education methods
used are.
 If I restart this course I will NOT change anything.
 The only thing I would like to be changed is when it comes to the festival and events we
have done it would be great if more planning would have been done to further impact
the community better, perhaps dedicating 10 min every session to the event so that we
preplan it better. Other than that I would not have anything changed. All the session
was great and we learned lots of things from them.
 It’s one of the best courses that I’ve ever taken; it might sound weird, but I guess one
semester is not enough for this course, or any similar course. We need more courses like
that. I wouldn’t like to see anything changed, or maybe a bit less Homework.
OPEN COMMENTS
 I am glad i will be graduating with a fresh memory of this course.
o I really enjoyed every class and learned alot, and it was a pleasure for me to attend
because i was curious to see what will be given and how, and thus got motivated.
o I also got motivated through you Doctor May, and with all respect, you are just an
amazing person, and thank you for giving your all to us, to feed us with strong

401
knowledge in simplicity and fun!!! <3
 Since the first day for me in the University, I have never enjoyed and loved a course
such as PDHP246. The Dr May has a very brilliant way of teaching!
 Thank you for everything!
 Thank you Dr. May for all your efforts in making this course a unique, educational
as well as an entertaining one. I benefited through this course a lot, because we have
covered everything regarding different matters.
 Thank you.
 It was a pleasure to have taken this course, thank you doctor May for turning this course
into something different and special, rather than ordinary and boring. It was an honor to
be a part of this class and part of the group in this class, it was a fun trip and definitely a
beneficial ride (with yummy snacks of course).
 Thank you again Dr. May, without you, none of this would have been possibly achieved,
especially in UOB. It was really something else.
 I enjoyed every second of the course.
 I also enjoyed writing this take home exam 
 Thank you Dr May for giving me this opportunity to be a part of your class, to participate
in the activities and event you organized and introduced me to meditation and deep
breathing.
 Lots and lots of love
 The course was an amazing experience and a great way to end my last semester in the
university, the classes are enjoyable and interactive and advice all students to take. Dr.
May made a special touch to the course with her experience and special knowledge. I

402
wish everyone in the best of luck in their future lives and careers.
 Thank you Dr. May for a truly exceptional course and thank you for teaching us all the
different aspects of course and helping us take better decisions in our lives and help
others do better decisions as well. Furthermore teaching us practical work rather then
theoretical only.
 Dr. May, it was such an honour having met you. I loved this course. I hope we could
meet again in other courses or any other engagements (on a professional/educational
level). Thanks a lot for being always present and supportive, and for your flexibility and
patience. I appreciate it a lot. You’re a real role model. LOVE

403
PDHP 246 Competencies
Among PDHP 246 course competencies:
Note that several of the materials, readings and references are listed at the last pages and
throughout this document. Additionally several of the handouts and students reports/home
works/images/videos/Flipagram are posted on PDHP 246 facebook group
Competencies Activities during the course Materials, readings
& references
Concepts of
Healthy lifestyle
choices, Health,
Wellness
 Class discussions, mind-map,
dialogue survey, readings, home
works, quizzes, final exam, PDHP
246 Celebrations
 Healthy declarations (Human
rights, Alma Ata, Declaration on
nutrition, CEDWA etc.)
 Readings from “Health &
Wellness” & “Public Health in
the Arab World”
 Readings from Hesperian Health
Guides HHG
 Articles by CDC & other
 Key web sites
Pathogenesis
& Risk Factors
students’ presentations/talks,
PPP, readings, collating students’
questions & concerns, quizzes,
home works, final exam & PDHP
246 Celebrations.
 Focus on the conditions:
Cardiovascular diseases, Cancer
(breast cancer), Diabetes Mellitus,
Mental health, Sexually
transmitted diseases /infections
etc.
the Arab World”
 Readings from HHG
 Articles
 NCDs in Lebanon hand-out
 Web links & search
Health &
wellness variables
students’ presentations/talks,
PPP, readings, collating students’
questions & concerns, quizzes,
home works, final exam & PDHP
246 Celebrations.
 Part of best practices & peer
support activities
 Focus on Physical activity, Stress
the Arab World”
 Readings from Hesperian Health
Guides/Healthy declarations
 Articles
 Web links & search

404
management, Mind-body
communication, Healthy eating,
No tobacco, using drugs
responsibly, Healthy relationships
etc.
Achieving wellness  Leading exercises during classes:
laughter yoga, meditation,
breathing, visualizing, hand
massage, yoga etc.
support activities
 Class presentation /talks
/PPP/party game/ exercises
/public speeches by:
o Rim: Mind-Body Communications
(included a review of
psychosomatic conditions &
somatization disorders)
o Ziad: Stress management
o Ribal: Mental Health & Mental
Illness
 Ch. 2, 3 & 4 from “Health &
Wellness”: Mind-Body
Communications Maintain
Wellness, Managing Stress:
Restoring Mind-Body Harmony
& Mental Health-Mental Illness
 PPP & reading materials by Rim,
Ranya, Ziad & Ribal
 Articles about psychosomatic
conditions & somatization
 NGOs & centers concerned
about mental health in Lebanon
Physical activiy  Exercises integrated into classes
(stretching, martial arts, dancing
etc.), World Heart Day (football) &
during Geitawi Garden Health
Festival (yoga for kids, dance
movement for women &
stretching exercises for elderly) &
PDHP 246 Celebrations
 Collating students’ questions &
concerns, home works, quizzes,
final exam
support activities
 Class presentation /talk/video
/article/ PPP by Mia: Physical
Activity for Health & Wellness
 Ch 7 from “Health & Wellness”:
Physical Activity for Health &
Wellness
 Hand outs on stretching
(University of British Columbia)
 PPP, reading materials & articles
by Mia
Healthy eating  Experiencing & learning: smart
snacks, healthy breakfasts,
healthy meals
 Bye Bye Anemia booklet
 Creative Health Campaign games
(Bye Bye Anemia board games,
Powerful world board game,

405
support activities
 Talk by Rana Karam on healthy
cooking
 Integrate best practices &
activities into the Geitawi Health
Festival
 Talk by Mia about Nutritional Iron
Deficiency Anemia
 Creative Health Campaign games
on Bye Bye Anemia & No Junk
foods
 Introduction to souk al-Tayeb &
farmers’ markets
 Integrated into understanding &
preventing diseases sessions of
Diabetes, CVS, cancer etc.
health crown, No junk cards etc.)
 Healthy declarations in Nutrition
 Hand out: World Nutrition Day
 Foods: fruits, veggies, fool
breakfast, salads, soups, snacks
etc.
Eliminating
tobacco use
 Talk by Dr Norbert Hirschhorn:
Tobacco, What’s New
support activities
 Collating students questions &
concerns, quizzes & interactive
links
 Class presentation /talk/PPP
/video /interviews by Cynthia:
Eliminating tobacco use
 Ch17 from “Health & Wellness”:
Eliminating Tobacco Use
 PPP (2) , reading materials,
summarizing Dr Hirschhorn’s
session by Cynthia
 Quizzes & interactive links
 Campaigns in Lebanon
 No smoking sign circular
Sexuality
& healthy
relationships
 Values
 Team building exercises,
communication skills
 Learning how to use the condom
/game/video by Tarek: Sexuality &
healthy relationships
Sexuality & healthy relationships
 CDC article on condom use
 PPP by Tarek
 Condoms
Cancer:
understanding risks
& means of
prevention
 Class & community activities
(Geitawi health festival) during
breast cancer month Nov. 2014
 Our questions from Breast Cancer
Action flyers
 Computer lab-2 activity: Elements
for World Cancer day 2015,
quizzes & interactive links
 Setting the challenge quiz
 Hand-outs on breast cancer
month, breast self examination
etc.
 Breast Cancer Action flyers
 Breast cancer ribbons
 Web quizzes & interactive links
 World Cancer Declaration
Cancer: understanding risks &

406
 Class presentation/talk by Alissar:
Cancer
means of prevention
Cardiovascular
diseases: Risks
& prevention
 World Heart Day activity:
interviewing students & football
game
 Quizzes
/demonstration /images &
video/hospitality/interviews /talk
to a cardiologist by Caroline:
Cardiovascular diseases: Risks &
prevention
Cardiovascular diseases: Risks &
prevention
 PPP, handouts & reading
materials by Caroline
 Readings from World heart day
 Students reports about world
heart day activity
 Quizzes
 Mia’s public speech about heart
friendly Environemnet
 Our necklaces: heart power
Using Drugs
Responsibly
 Talk & PPP by pharmacist Nadia
Dalloul
 Talk by Tarek, PPP by Ribal
 Competitive game by Ranya
 Zaka wa Dawa flyers
 PPP by Tarek & Ribal
 Q & A by Ranya
 PPP by Nadia
 Flyers: Zaka wa Dawa
 Zaka wa Dawa campaign in
Lebanon (intro)
Diabetes Mellitus
type 1 & 2
 Readings, quiz, homework
 Healthy breakfast
 Competitive game
 Quiz
 Readings from World Diabetes
Federation
 On-line quiz , interactive links &
reading materials
 Blue circle cutout
Other topics  Alzheimer, lead poisoning, food
allergies, hospital acquired
infections, facial expressions,
acupuncture etc.: Topics chosen
by students for developing PPP,
class presentations & public talks
 PPP by Ziad, Caroline, Mia,
Alissar, Rim etc.
Personal skills:
hand-washing, breast
self exam, waist
circumference,
using condoms & other
 Geitawi garden health festival,
class discussions, students’
presentations
 Integrate best practices, posters,
flyers & activities into the Geitawi
Health Festival
 On line quizzes
 Flyers and posters
Wellness”, CDC, WHO & other
Using quizzes  Computer lab sessions, home
works, students’
 On line quizzes
 Study guide & self assessment:

407
presentations/talks etc.
 Quizzes included: personal
challenges, Physical Activity,
Nutrition, BMI, Target heart rate,
Cancer, Breast cancer, Smoking,
Diabetes Mellitus, Heart disease
etc.
“Health & Wellness”
Participatory,
interactive,
appreciative &
creative learning
approaches
 Circle, small working groups,
competitions, dialogue, games,
images, certificates, story-telling,
learning through entertainment,
etc.
 Communication skills
 Reading about communication
skills
 Readings from HHG
 Literature about interactive,
participatory learning
 Appreciative inquiry theories
and practices
Best practices  Tools to examine and improve our
own practices (role play, our own
lifestyle, weekly agenda, peer
support groups…)
 Behave model
 Be the change action guide
Be the change
action guide
 Focus activities: practices that we
are currently doing, what we can
do better, educating and
influencing other, Community
projects
 Readings from Be the Change
action guide
Peer education
& support
 Small working groups
 Whatsapp group and sub-groups
 Students taking leadership in all
aspects of the teaching: setting
learning objectives, leading a
presentation, developing reading
materials, exam questions, peer
grading etc.
 Literature about peer education
Values & principles  Stories: The river code about self
reliance, the stone soup about the
assets that we bring in
 Examining our principles in
analyzing our photos that we liked
 Human sculpture exercise
 Readings from Training for
Transformation, Community
Building etc.
Team building &
working together
 Exercises: balloon games,
parachute games, human knot
Several resources on team
building and community

408
game etc.
 Organizing projects together
 Examining roles and relations
organizations
Project
organization &
Community action
 Geitawi Garden Health Festival
(includes evaluation)
 World Heart Day
 Mapping Geitawi area
 Visit to the Pediatric ward
 PDHP 246 Celebrations
 Students reports and
installations
 Slogans from the festival
 Etc.
Personal skills:
summarizing,
concluding,
authoring,
researching,
etc.
 Practice through home works,
class exercises, reports, computer
lab sessions, personal research
etc.
 Students’ home works, reports,
final exam etc.
 Resources used throughout the
course
Other skills:  Leadership skills: class teaching and reaching out
 Using resources: people/books/ web/ articles/groups etc.
 Dialogue with experts & resource people
 Developing useful bibliography
 Using social media: PDHP 246 facebook & Whatsapp groups

409
Students Appreciation Scheme
What Introduction
Students’ talks
& presentations
15%
Students’ talks and presentations refer to students taking charge of
presenting in-front the class. Students have prepared for these
presentations.
Several home works and other class exercises have been linked to this
category and are graded within other categories (home works,
bibliographies, final exam and projects)
Three main talks/presentations are selected as follows:
(1) Students’ talks and presentation of topics of interest. The students
had used PPP and discussions in their talks – Topics included:
Alzheimer (Ziad), Acupuncture (Rim), Facial expression (Ranya), Lead
poisoning (Caroline), Tobacco (Cynthia), Food Allergies (Mia), Addiction
(Tarek), Drugs (Ribal) and Hospital Acquired Infections (Alissar).
(2) Students’ public speech (free topics) – Topics were: Stress
management (Ziad), Cancer (Alissar), Girls scouts (Rim), Sexual health
(Tarek), Self image (Ranya), health inequities (Caroline), Women’s
health (Cynthia), Mental health (Ribal) and Heart friendly environment
(Mia).
(3) Selected chapters from the book “Health & Wellness”- The chapters
included: Mind-Body Communications (Rim), Managing Stress (Ziad),
Mental Health (Ribal), Physical Activity (Mia), Sexuality (Tarek), Cancer
(Alissar), Drugs (Ranya) and Tobacco (Cynthia).
Note that students got the 5% if they completed both (1) and (2) and
up to 10% for (3). Peer evaluation was used in the latter where
students graded their peers’ talks as extra-ordinary, excellent, very
good, good, and satisfactory. In terms of numerical figures, the
following code was adopted: Extraordinary=10 out of 10, Excellent= 9
out of 10, Very good =8.5, good=8, Satisfactory=7.5

410
Projects
15%
Projects refer to activities implemented by students outside the class-room
set-up. 4 main projects have been implemented as follows:
(1) Mapping exercise of the Geitawi area: students investigated the area
for enabling factors that promote healthy lifestyle and presented their
finding to others using installations, maps, posters and talks.
(2) World Heart Day: Students mobilized other university students
through interviews and a football exercise. The activity was
implemented at the FHS building and the students’ lounge. An estimate
of 30 other students has been reached through this activity. Students’
reports have been graded under home works.
(3) Geitawi garden health festival: Prior to festival implementation, the
students interacted with the Geitawi garden community of children,
women and elders. They also visited the ASSABIL center and met
people in charge. Based on their interactions, the students organized
the health festival. They succeeded in engaging 15 other volunteers
(included were university students); decorating the garden with
banners and posters; organizing a parade; organizing mobile and fixed
interactive educational stands; preparing handouts and take home
materials and wrapping up the festival. A total of 100 people are
estimated to take part in the event. Several related documents and
reports are graded under home works.
(4) PDPH 246 Celebrations: PDPH 246 Celebrations included two activities:
(a) Happy hormone activity whereby students presented to classmates
activities that help release tension and invite happy hormones; (b)
preparing for our dialogue with the dean and participating in the
meeting. Note both events were implemented on Jan. 12. Originally,
three activities were planned: (a) participation in meditation and yoga
class with Dr Hisham Nasr- an open activity to all students (an
administrative decision was made to cancel), and (2) PDPH 246
Celebrations whereby PDHP 246 students show the university students
competencies that they have learn (event was modified as 4 of the
students had to be in another course function that was conflicting with
the timing).
Note that students got 15% if they actively participated in (1), (2), (3)
and (4).
All written related papers were graded under home works.

411
Tasks/
Home works
(HW)
30%
A total of 40 tasks were given as home works and assignments and have
been graded in this course.
The graded tasks were (note the following does not include all the
exercises and assignments of PDPH 246):
 Course planning: Expectations, Comments on Syllabus
 Our practices: Self appraisal (life style choices and practices),
weekly agenda, More veggies and fruits, Our breakfasts, Set
yourself a challenge
 Concepts: Wellness and health, risk factors and lifestyle changes,
Global Wellness
 Global health days: World heart day (our reports about the activity
of heart friendly environment), World Cancer Day (applications),
World Diabetes Day (Key points)
 Free topics: PPP prepared by students on topics of interest (Stress
management (Ziad), Laughter Therapy (Rim), Stress management
(Ranya), Lead poisoning (Caroline), Tobacco Smoking (Cynthia),
Food Allergies in Children (Mia), The Misuse of Drugs in Lebanon
(Tarek), Drug Abuse and Drug Addiction (Ribal) and Hospital
Acquired Infections and Control (Alissar) , Best practices per topics,
 Geitawi garden: Geitawi community -interactions reports, My role,
Communication skills, Responding to our questions in evaluating
the health festival,
 Breast cancer: our questions based on breast cancer action
readings (facts, myths, environment, risk factors, mammogram,
what to do if someone you know has been diagnosed)
 Computer lab exercises: computer lab -1: Key resources, Videos,
Quiz, Social media etc.; computer lab-2: Web quizzes (smoking,
cancer, nutrition, BMI, calories count, target heart rate etc),
Interactive links etc.
 Using resources: My favorite public health book, Ranking my
chapters from “Health and Wellness” and “Public Health in the
Arab World”, Introduction to the international book resources from
the Hesperian Health Guides (our questions and responses),
Healthy declarations
 Diabetes Mellitus: Interactive tools, Risk factors, Am I at risk test,
etc.
 Home works by other students: Rim (mind-body), Ziad (Stress
management), Ribal (Mental health), Cynthia (Tobacco), Mia
(Physical activity), Caroline (CVS), Tarek (Sexuality), and Ranya
(Drugs)
 “Health and Wellness” reading materials and related questions (to
be integrated into the final exam

412
Students were graded A if they delivered the HW on time and complete;
and B if they delivered the HW incomplete, or not on time; and C if not
done.
The above grading mechanism applied to all with the exception of students
HW from Health & Wellness chapters, the reading materials and the exam
questions where delivery on time was not an issue.
Take home
final exam
30%
 Composed of 7 sections with a total of 20 main questions.
 The sections are (grading per 300 points):
o I. Healthy lifestyle (50);
o II. Healthy choices (30);
o III. Health conditions (40);
o IV. Best practices and peer support (75);
o V. Our chapters from “Health and Wellness” and “Public Health in
the Arab World” (50),
o VI. Recommendations to the FHS-Balamand (25) and
o VII. Course Evaluation (30).
 Students were graded based on a rubric that also considered the
responses among the students themselves.
 Note that selected materials and questions from the students
themselves have been integrated into sections IV and V.
Bibliographies
10%
 Students developed a list of their bibliographies that they
learnt/used during PDPH 246 building on the original bibliography
of the course.
 Grading was based on students’ comparative efforts in developing
the lists and timely delivery (by Jan. 17).
 Students received a full grade for delivering on time and evidence
in task seriousness whereby they cite the titles/topics/links.
Students lost grades for late delivery and/or incomplete citing of
the title/topics/links and less qualitative performance compared to
peers. Other forms for presentation are accepted with evidence of
genuine student’s efforts.
Bonus  Students had bonus for extra work, initiatives and papers that they
have done throughout the course.
 Bonuses were also given to students who were the first to submit a
home work (students’ home works and materials for the final exam

413
not included).
 Students who had 5-9 bonuses, 10-14 bonuses and 15-20 bonuses
received 1, 2 and 3 grades respectively.

414
List of Attachments, PPP,
Face book page links and reports
Related pages
in this manual
1. Course Syllabus-Update
2. Bibliography 19 9 14
3. List of class exercises and home works
4. Students expectations (cumulative)
5. Students comments on syllabus (cumulative)
6. Our life-style (cumulative)
7. Students life style choices and practices
8. Looking at the wider picture of health (cumulative)
9. Lifestyle main links
10. Our reports: World Heart Day (cumulative)
11. Towards Heart Friendly Environment at the Balamand-posters
12. Health, Wellness, Illness and Disease (reading)
https://www.facebook.com/download/preview/628342730619828
13. Comparing the three models of health (cumulative)
14. Risk factors and life style changes (reading)
15. Global Health Risk Report
16. Typical Health Issues-College students
17. Students comments on risk factors and life style changes
18. Events of October 2014 (reading)
19. Interactions with the community of the Geitawi Garden (students reports)
20. Computer lab-1 (exercises)
https://www.facebook.com/notes/pdhp-246/class-at-the-computer-room-13-

415
10-14/973334446016926
21. Computer lab-2 (exercise)
22. My weekly agenda
23. Our results-set yourself a challenge (cumulative)
24. Our questions about breast cancer based on Breast Cancer Action readings
25. Breast Cancer Facts
26. Breast Cancer and the Environment
27. What to do when someone you know have been diagnosed with breast cancer
28. Breast Cancer Myths and Risks
29. Should I have a mammogram booklet
30. Statistics on breast cancer –Lebanon
https://www.facebook.com/notes/pdhp-246/statistics-on-breast-cancer-in-
lebanon-the-arab-world-and-across-the-world/967553489928355
31. Students PPP about free topics and using references
 Alzheimer (Ziad),
 Acupuncture (Rim),
 Lead poisoning (Caroline),
 Tobacco (Cynthia),
 Food allergies (Mia),
 Misuse of drugs in Lebanon (Tarek),
 Stress management (Ranya),
 Laughter therapy (Rim),
 Drug abuse and drug addiction (Ribal),
 Hospital acquired infections (Alissar)
32. Students: Educating and influencing others (cumulative)
33. Global Age Watch index
34. How we see our role in Geitawi festival (cumulative)

416
35. Geitawi Garden Health Festival: concept paper
https://attachment.fbsbx.com/file_download.php?id=734346006658079&eid=
ASvNf8zCGE66hjl1axbIYOhsY159XLRHtF0d7A5Ihu7yGPs8ghsBou9DWoXEB8nU
wd4&inline=1&ext=1419283421&hash=AStJX1KoF9d7BBPA
36. Festival slogans and posters
37. Geitawi festival flyers
38. Secrets to smarter snacking (reading)
39. Best practices: Geitawi Garden Health Festival
40. Our evaluation: Geitawi Garden Health Festival
https://www.facebook.com/notes/pdhp-246/our-responses-geitawi-festival-
draft/991431440873893
41. Diabetes Mellitus: healthy breakfast (handout)
42. World Diabetes Day- images
43. More veggies and fruits (cumulative)
44. Bye Bye Anemia guide (reading)
45. Smart Use of Medicine (readings)
46. Speech writing (handout)
47. NCD-Lebanon (handout)
48. My expectation by the end of the course (cumulative)
49. Tools and readings about Diabetes Mellitus
50. DM: students responses (cumulative)
51. Our questions about mind-body communications, stress management, mental
health, physical activity, tobacco, sexuality, CVS, drugs and cancer (cumulative)
52. Our readings from international book resources (cumulative)
53. Report about the talk by Dr Norbert Hirschhorn (by Cynthia)
54. Mind-Body Communication PPP (by Rim)
55. Mind-Body Communication readings (by Rim)
56. Are We Abusing Medicine PPP (by Nadia Dalloul)
57. Tobacco Use PPP (Cynthia)
58. Tobacco Use readings (Cynthia)
59. Physical activity PPP (Mia)

417
60. 10 ways to boost your exercise motivation (reading)
61. Cardiovascular diseases PPP (Caroline)
62. Cardiovascular diseases reading (Caroline)
63. Managing stress PPP (Ziad)
64. Mental Health PPP (Ribal)
65. Sexuality and intimate relationships PPP (Tarek)
66. CDC: Condom use
67. Using Drugs Responsible (Ranya)
68. Cancer (Alissar)
69. Index of our Flipagram
https://www.facebook.com/notes/pdhp-246/our-flipagrams-update-4-10-
14/965885000095204
70. Anti-smoking posters
71. Mind Body and Wellness images and quotes
72. Images about our chapters
73. Images about our breakfasts
74. PDHP 246 Talks-posters
75. Selections from our resource books (book covers)
76. PDHP 246 Facebook group
https://www.facebook.com/groups/960731717277199/
77. Be the Change Action Circle handbook

418
EXTRACTS FROM THE FACE BOOK GROUP
Examples of photo albums

421
Readings & references (19 9 14)
TEXTBOOKS:
Selected chapters and pages from two textbooks will be used during the course. The textbooks are:
 Public Health in the Arab World, Edited by Samer Jabbour, Rita Giacaman, Marwan Khawaja and Iman
Nuwayhid, Cambridge University Press, 2012
 Health & Wellness, Gordon Edlin and Eric Golanty, Tenth Edition, Jones and Bertlett publishers, 2010
REFERENCE MATERIALS & READINGS:
 Additional materials will be extracted from other book, articles, internet sites, blogs, social media
materials, images, slide shares etc.
 Students will be encouraged to build their own reading portfolio on an accumulative basis. Specific
readings will be notified on a weekly basis.
 The following are potential references that can be used in the course pending on topics and students
interests. Students are not expected to read all of these references.
SITES AND LINKS
World Health Organization
Health topics http://www.who.int/topics/en/
Risk factors http://www.who.int/topics/risk_factors/en/
Healthy Lifestyle- Mayo Clinic
http://www.mayoclinic.org/healthy-lifestyle
http://www.mayoclinic.org/search/search-
results?q=healthy%20lifestyle
NHS http://www.nhs.uk/Livewell/Pages/Topics.aspx
Healthy Lifestyle- City of Toronto
http://www1.toronto.ca/wps/portal/contentonly?vgnextoid=182a1d5be5d32410VgnVCM10000071d60f89RC
RD&vgnextfmt=default

422
CDC http://www.cdc.gov/
SELECTIONS: ARTICLES/CHAPTERS
Selection of articles that have been posted on PHAW’s list (Public Health in the Arab World)
CDC: Lifestyle Changes Can Reduce Death from Top 5 Causes
http://www.cancer.org/cancer/news/news/cdc-lifestyle-changes-can-reduce-death-from-top-5-causes
Improving Six Risk Factors Could Delay 37 Million Deaths
http://www.jwatch.org/fw108788/2014/05/05/improving-six-risk-factors-could-delay-37-million-deaths
Lancet Health in the Arab world: a view from within
http://www.thelancet.com/series/health-in-the-arab-world
Connection between Wealth and Health
http://download.thelancet.com/pdfs/journals/lancet/PIIS0140673613623557.pdf
Chapters from Mark Walters book:
Seven Modern Plaques and How We Are Causing Them, Island Press, 2014
The Social Patterns of Health and Illness
http://www.healthknowledge.org.uk/public-health-textbook/medical-sociology-policy-economics/4a-
concepts-health-illness/section7
SELECTIONS: TOPICS
GENERAL: NON-COMMUNICABLE DISEASES NCD
Non Communicable Diseases
WHO, Global NCD action plan 2013-2020
http://ncdalliance.org/sites/default/files/rfiles/WHO%20Global%20NCD%20Action%20Plan%202013-2020.pdf
The NCD Alliance
http://www.ncdalliance.org/who-we-are
World Heart Foundation
http://www.world-heart-federation.org/
International Union against Tuberculosis and Lung Disease
http://www.theunion.org/

423
CANCER
American Cancer Society
http://www.cancer.org/
UICC
http://www.uicc.org/
Winship Cancer Institute
http://www.cancerquest.org/cancer-by-type-introduction.html
Cancer Prevention Among Adults Aged 45–64 Years
http://www.sciencedirect.com/science/article/pii/S0749379713006405
Why is Cancer So Common? (Includes short video what is cancer) htp://www.bbc.co.uk/science/0/22028516
How to avoid cancer
http://premaseem.wordpress.com/2012/12/19/how-to-avoid-cancer/
World Cancer Day 2015
http://www.worldcancerday.org/
http://www.worldcancerday.org/wcd2014-resources
***
DIABETES
International Diabetes Federation
http://www.idf.org/
Diabetes Atlas
http://www.idf.org/sites/default/files/EN_6E_Atlas_Full_0.pdf
Quinn Barbara and al, The Diabetes Detour Diet, 2009 by Rodale Inc.
Scalpi Gretchen, The Everything Guide to Managing and Reversing Pre-Diabetes, Published by Adams Media,
2011
***
NUTRITION and EXERCISE
Selections from Michael Pollan’s book: Food Rules, Penguin Books, 2013
Dr Andrew Weil’s Guide to Healthy Eating- DrWeil.com
Selections: Morning Health Forum- social media
Selections: Videos

424
What all must see https://www.youtube.com/watch?v=MNr4tgTEOMs&feature=share
Organic foods https://www.youtube.com/watch?v=SCA6P9lsEfw&feature=player_embedded
Edible land scapes https://www.youtube.com/embed/xAeOS_mDX6U
Obesity linked to top ten cancers
***
SMOKING
Chapters from Allen Carr’s: Easy Way to Stop Smoking,
Published by Allen Carr Easyway International, 2011
Advice to help you stop smoking
http://www.nhs.uk/smokefree
Graphic anti smoking add
Income, Income Inequality and Youth Smoking in Low- and Middle-Income Countries1
http://www.ncbi.nlm.nih.gov/pubmed/23216738
My Health Tips (video)
https://www.facebook.com/photo.php?v=10201475153655268
Tobacco body
http://tobaccobody.fi/n_en.php
Selections: Morning Health Forum- social media
***
ANXIETY AND STRESS
Selections from Healthy Mind and Body by Gillian Burn, 2010
Martha Langley: The Mind fullness Workbook, 2013
Psychosomatic Disorders
http://www.patient.co.uk/pdf/4664.pdf
Somatisation/Somatoform Disorders
http://www.patient.co.uk/pdf/4665.pdf#
50 common signs and symptoms of stress
http://www.stress.org/stress-effects/
RATIONAL USE OF MEDICINES

425
Smart Use of Medicines handouts
http://www.anera.org/wp-content/uploads/2014/01/med-sense-Final.pdf
http://www.anera.org/wp-content/uploads/2014/01/RUMBoxesEnglishTranslation.pdf
***
CHAPTERS DOWNLOAD FROM THE INTERNATIONAL BOOK RESOURCES
 Where Women Have No Doctor
http://en.hesperian.org/hhg/Where_Women_Have_No_Doctor
 Where There is No Doctor
 Helping Health Workers Learn
 Where There is No Dentist
http://en.hesperian.org/hhg/Where_There_Is_No_Dentist
*******
HEALTH RELATED DECLARATIONS
http://www.healthydocuments.org/index.html
Focus on:
 Ottawa Charter on Health Promotion
 Universal Declaration of Human Rights
 World Declaration on Nutrition
http://www.healthydocuments.org/nutrition/doc31.html
 The International Code of Marketing of Breast milk Substitutes,
 The United Nations Convention on the Rights of the Child,
 Convention on the Elimination of All Forms of Discrimination Against Women
http://www.healthydocuments.org/women/doc41.html
http://www.uicc.org/world-cancer-declaration

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Notebook: PDHP 246