A Story about Love Essay Example | Topics and Well Written Essays - 500 words

A Story about Love - Essay Example is the strangest as it shows how a loving wife would suffer through an abusive husband since she loves him to the extent that she would do anything for him. The characters note with this example that love occurs without any regard for sensibilities or the idea of right and wrong. This is certainly true since love is often considered a maddening predicament which has no room for rank or social standing and even practicalities become mere inconveniences when it comes to love (Chekhov, 1918). I feel that this is a very idealistic approach to love which may not really exist in the real world where practicalities often become more important than love itself. As per the story told by Chekhov (1918), love demands sacrifices and it demands that the lovers be prepared to give up on everything they want the most. As the story shows, when it comes to love, a person may have to suffer through the most gut wrenching moments without flinching and accept that what is good for the person they love must be good for themselves as well. Of course this may not be always true as it was in the case of Alehin, but the situation demanded that the beloved be given precedence over the lover. This precedence also stems from the viewpoint which the lover takes of the beloved when she is described by him with these words: â€Å"Her eyes, the elegant refined hand she gave me, her indoor dress, the way she did her hair, her voice, her step, always produced the same impression on me something new and extraordinary in my life, and very important (Chekhov, 1918, Pg. 1)†. For Chekhov, this becomes the essence of love since the supreme sacrifice a lover can make is to give up on the love which sustains him/her if giving up that love will make life easier for the beloved. Alehin does that for Anna and even though she is also in love with him, her love is perhaps not as great a love as Alehin has for her. While he is willing to give up what he feels for her just so that she can be happy, she is not

Technology Studies Case Study Essay Example | Topics and Well Written Essays - 4500 words

Technology Studies Case Study - Essay Example It is no surprise that moisture is one of the main dilemma of the hotel maintenance department because UK copes up with something like 25,000 gallon of water annually. Nearly all moisture problems are much less severe than they actually look. Moisture can be very dangerous to our health. It can intensify respiratory problems and it can even encourage mites and moulds to grow. The properties of moisture can be very serious and even makes the whole surrounding cold and unpleasant to see. Moisture can be anywhere. They could be on the roof, on the walls, on the floors, windows, doors and pipeline. Oftentimes, the presence Saturated up through permeable materials like concrete hollow blocks into the floors and walls of the home, and it usually occurs in building which did not have any waterproofing in the track of its construction. Consequently, rising moisture can be detected easily. We can conclude that there is rising moisture in the area if, the wall is in contact with the ground, if the walls feel dampy and cold to touch and if there are stains on wall decorations. Nevertheless, rising moisture rarely goes up above one meter on the wall. Penatrating moisture is frequently caused by the building plumbing. The trouble comes in when the water is tolerable to enter the property. Symptoms of rising moisture frequently becomes noticeable during the rainy season. It usually affects roofs, ceilings and walls. Water marks appear if water continues to enter the house. It can be caused by groove or roof problems which had allowed rainwater to trickle in and soak area of walls. This is frequently seen in old houses that has solid wall. Penetrating moisture is very Not easy to find and may require proficient help. There are many ways of treating moisture. Rising moisture is worse at the bottom of a wall than at the top. Aside from blocked airbricks, the most frequent cause is 'bridging", this is when soil from the garden climbs up directly on the house wall and trap moisture. This problem is frequent and it can be easily worked out. Excavate the soil from the house so that the soil can no longer knock against the wall. A technique used in old properties is the inoculation of chemical in the problem areas. If the moisture is getting higher through the floorboard, a moisture-proof membrane maybe frayed so it is best to have a refitting. Penetrating moisture More often than not forms when water get into the property. Check up in details grooves, downpipes, flashings and window frames. It will be best to check everything inside and around the property area. Check the sealing of window frames to make sure that there must be a drip groove to get rid of rainwater. If there are blocks, clear them comprehensively. An ill-fitted roofing on a flat roof will probably cause moisture and a fractured wall can let water in. Repair a fractured wall with protective material and fit insulation rubber to all door frames. Application of Outdoor water proofing fluid will be helpful if the outdoor brickwork is already absorbent. A moisture proof track is also one means of avoiding increasing moisture. This is a process where in two layers of bricks with a space between can avoid moisture. This is frequent

Violence and the Emergency Room Essay Example | Topics and Well Written Essays - 1750 words

Violence and the Emergency Room - Essay Example Many of these elders must be cared for in the home which puts them in harm's way when violence occurs. The stress of caring for them at home and the lack of funds increases the chance of violence and or the use of alcohol. All of these things affect the emergency room on a daily basis and many times they are fueled by alcohol which makes the encounter that much more volatile. This paper will examine domestic violence fueled by alcohol and how it might affect the emergency room. Intentional and unintentional violence and its effects take a toll on human health and the quality of life. Globally more than 5 million people die from injuries every year; violence kills more people than HIV/AIDS and malaria combined, yearly (World Health Organization, 2002). Every week in Wales and England, two women are killed by their current or former partner (Reeves & Sully, 2007) and many more are damaged for life. This is not an unusual statistic throughout the world at this time. This kind of violence in families has a very long history. It consists of a pattern of coercive control that is designed to isolate the victim (Davis, 2007). This all presents in major health issues in which the cost is high. Those in the violent situation and the communities in which they live have lost positive community participation and increased costs in healthcare. This type of violence usually manifests itself in physical, sexual, and or psychological abuse which involves fear, intimidation , and emotional depravation of not only the victim but those around them (Davis, 2007). It often engrains the victim in poverty that becomes difficult to climb out of. When fueled with alcohol, the violence can be much more sudden and heightened for the victims as well as the emergency room staff. There are some social, political, and legal context in Australia that should be considered here. In the last decade of conservative Federal government in Australia, there has been an erosion of services to women living with domestic violence. There has been a concerted move toward the consolidation of family which may force a situation in which the perpetrator is in the victims life longer. This has also caused the dismantling of policies and services that are available, including such things as child care subsidies, youth training schemes, youth allowances, legal aid, supported accommodation schemes, and movement to negotiated settlements. All of this affects programs that support women and children in trouble (Wright & Waugh, 2007). This makes it more difficult to get these women and children to safety and keep them there. When violence occurs the victims often come to the emergency room and many of them have never seen a primary physician so the violent episode may just be the tip of what is wrong with them. There is a often a revolving door situation in which the same victims come back with injuries on a regular basis. They may also keep coming back with complaints of things like headaches and stomach pain in an attempt at safety. Studies show that this may be the only safe place in which these victims can disclose or plan for escape. These same studies show that a woman's decision to expose abuse can depend on the attitude of the clinician that is caring for her as a victim (Janssen & Holt, 2002) and that nurses attitude may be the victims only hope for escape. It should be noted,

A Story about Love Essay Example | Topics and Well Written Essays - 500 words

A Story about Love - Essay Example is the strangest as it shows how a loving wife would suffer through an abusive husband since she loves him to the extent that she would do anything for him. The characters note with this example that love occurs without any regard for sensibilities or the idea of right and wrong. This is certainly true since love is often considered a maddening predicament which has no room for rank or social standing and even practicalities become mere inconveniences when it comes to love (Chekhov, 1918). I feel that this is a very idealistic approach to love which may not really exist in the real world where practicalities often become more important than love itself. As per the story told by Chekhov (1918), love demands sacrifices and it demands that the lovers be prepared to give up on everything they want the most. As the story shows, when it comes to love, a person may have to suffer through the most gut wrenching moments without flinching and accept that what is good for the person they love must be good for themselves as well. Of course this may not be always true as it was in the case of Alehin, but the situation demanded that the beloved be given precedence over the lover. This precedence also stems from the viewpoint which the lover takes of the beloved when she is described by him with these words: â€Å"Her eyes, the elegant refined hand she gave me, her indoor dress, the way she did her hair, her voice, her step, always produced the same impression on me something new and extraordinary in my life, and very important (Chekhov, 1918, Pg. 1)†. For Chekhov, this becomes the essence of love since the supreme sacrifice a lover can make is to give up on the love which sustains him/her if giving up that love will make life easier for the beloved. Alehin does that for Anna and even though she is also in love with him, her love is perhaps not as great a love as Alehin has for her. While he is willing to give up what he feels for her just so that she can be happy, she is not

Violence and the Emergency Room Essay Example | Topics and Well Written Essays - 1750 words

Violence and the Emergency Room - Essay Example Many of these elders must be cared for in the home which puts them in harm's way when violence occurs. The stress of caring for them at home and the lack of funds increases the chance of violence and or the use of alcohol. All of these things affect the emergency room on a daily basis and many times they are fueled by alcohol which makes the encounter that much more volatile. This paper will examine domestic violence fueled by alcohol and how it might affect the emergency room. Intentional and unintentional violence and its effects take a toll on human health and the quality of life. Globally more than 5 million people die from injuries every year; violence kills more people than HIV/AIDS and malaria combined, yearly (World Health Organization, 2002). Every week in Wales and England, two women are killed by their current or former partner (Reeves & Sully, 2007) and many more are damaged for life. This is not an unusual statistic throughout the world at this time. This kind of violence in families has a very long history. It consists of a pattern of coercive control that is designed to isolate the victim (Davis, 2007). This all presents in major health issues in which the cost is high. Those in the violent situation and the communities in which they live have lost positive community participation and increased costs in healthcare. This type of violence usually manifests itself in physical, sexual, and or psychological abuse which involves fear, intimidation , and emotional depravation of not only the victim but those around them (Davis, 2007). It often engrains the victim in poverty that becomes difficult to climb out of. When fueled with alcohol, the violence can be much more sudden and heightened for the victims as well as the emergency room staff. There are some social, political, and legal context in Australia that should be considered here. In the last decade of conservative Federal government in Australia, there has been an erosion of services to women living with domestic violence. There has been a concerted move toward the consolidation of family which may force a situation in which the perpetrator is in the victims life longer. This has also caused the dismantling of policies and services that are available, including such things as child care subsidies, youth training schemes, youth allowances, legal aid, supported accommodation schemes, and movement to negotiated settlements. All of this affects programs that support women and children in trouble (Wright & Waugh, 2007). This makes it more difficult to get these women and children to safety and keep them there. When violence occurs the victims often come to the emergency room and many of them have never seen a primary physician so the violent episode may just be the tip of what is wrong with them. There is a often a revolving door situation in which the same victims come back with injuries on a regular basis. They may also keep coming back with complaints of things like headaches and stomach pain in an attempt at safety. Studies show that this may be the only safe place in which these victims can disclose or plan for escape. These same studies show that a woman's decision to expose abuse can depend on the attitude of the clinician that is caring for her as a victim (Janssen & Holt, 2002) and that nurses attitude may be the victims only hope for escape. It should be noted,

Cultural and Teamwork Map and Self Reflection Essay Example for Free

Cultural and Teamwork Map and Self Reflection Essay 1. Introduction and Purpose Sharing of knowledge across the border is becoming very widespread phenomenon. Companies are well aware that hidden in their disperes, global operations is a treasure trove of ideas and capabilities for innovation(Wilson Doz, 2012). Therefore, working with multicultural groups is getting more and more common very rapidly since last decade. However, in global teams, team memebers have different feed back techniques, different uniqueness levels and different communication patterns. People belonging to different cultures have difference in values, geography, ethencity,belief system and lauguage. These difference can lead to cuture clash . In this paper I am writing about where I find myself in a cultural and team work map and my reflections about my placement thereon. I have judged myself with reference to my placement in high and low context  cultures, cultural paradigm , my preffered and performed roles in my team keeping in mind Belbin‘s team roles and my position in Johari window. Purpose of this assignmnet is to judge where I find myself right now in a cutural map in context of team work and to bring improvement in myself if I am away from the normal scale .The actual purpose of this assignment is to save me from cultural clash by giving a chance to get self-awareness and to make us conscious about behaving accordingly for future interactions. Just like these two rivers in the below mentioned picture are merging, people from different cultures should merge the same way. These two rivers have different native base but after merger nobody can find any clash between them. 2. Self-assessment Below mentioned is my self assessment and reflections thereon. 2.1 First impression My first impression on my team members was that I am trust worthy. When asked, they answered that they made this impression from my body laungauage and my tone of voice. I believe that my such impression was made because of my uniqueness levels i.e. personality culture and human natur. After practicaly working with them my group as well as me have assessed that I focused on working collectively as i believe collectivism is the key to group success. 2.2 Assessment with reference to Communication Patterns On the cultural map I find my self as the person who works better in the middle of high and low context. l worked more better after every next team meeting because in meetings we discussed our desired outcome by spoken words and I shared all my ideas and problems with my team. Secondly, I was not fully relying on what was shared among us through emails. But I cannot say that I am just a high conext person because, contrary to high context couumincation patterns, I wanted detailed information about the assignment and I used direct speech during the whole correspondance .It helped me to exchange ideas quickly . Looking further into communication pattern ,I find myself as a person who is more task oriented than people oreinted.I prefer to do work first.Relations are aligned after task completion. In gropu, I only talked about assignment till the work is finished. After submition of assignemnt I discussed my personal things and hobbies with them. My time orientation is ploy cronic. I was working on the assignment as well as I was seeing the others part also. More over, I was comparing my work with the wok done by other groups in the class. I kept on updating the absent team mebers about activities (relevent to assignment) conducted in class through a social network simultaneously. Hence I can say that my communication pattren is neither high context nor low context.Its somewhere in the middle of both. 2.3 Assessment regarding Placement in Belbin’s team roles My preferred team role is team worker. The reason of saying so is that I remain mild and gentle. I like to work in depth but I am not willing to work in pressure and tried to avoid working under stressful situations. I played the role of team worker in practical. We revised the work plans many times  initialy and I accepted that without much resistance which indicates that I am easy to be influenced. I remained mild and friendly. I worked on that part of assignment which required extensive out of the box research and long working hours. My second preference is the role of resource investigator. I always look to find smart opportunites or methods to get work done effectively, efficiently and economically. I performed the role of resource investigator in passive manner in the group. I was enthusiastic in suggesting my fellow colleagues which part of assignment should be done by whom. I also shared few articles with them.I guided one memeber about how he can do his part more accuratly. However I was little over optimistic because we spent alot more hours on assignment then i initially predicted. My third preference was to perform the role of Shaper because I am having tendencies to fit things into frame and strives to get the action start immediately. However I could not execute this role in my group as the assignment work was very dynamic and it was being revised too quickly. Secondly, one of my fellow colleagues was performing this role better than me. My third performed role was of finisher. I proof read the document many times, found the errors and gave ideas to team members to revise few workings. I was not willing to rely on other team members for final proof reading and I was worried for the acuracy of assignment. I focused to create a balance in three roles that I performed in group and tried to avoid overlapping. However team worker was the frequently performed role. 2.4 Johari Window The Johari Window, named after its inventors, Joseph Luft and Harry Ingham, is a model that provides a dynamic framework for understanding and improving self-awareness. Helping one to become more self-reflective, to learn about oneself, and to become more therapeutic is an exercise in self-awareness(South, 2007). In the context of Johari window, my arena (open area), has increased and I became aware of blind spots. Eventually my hidden areas are disclosed. During the group work, I experienced that my open arena has been gradually broadened and my blind spot has been subsequently decreased after every next working step. 3. Conclusion The combination of roles i.e. two from people oriented frame (resource investigator and team worker) and one from task oriented frame (shaper)  shows that I am not on any of extreme on cutural map. On the culture paradigm, I find myself on the middle, niether too weak nor too strong. I can infer that I am flexible, observant and non-judgmental. l Communicated respect and sake knowledge and understanding. I am in the last stage of confrontation and entring into adjustment phase. I am passing through W-model quickly because of level of education and support from family and network i.e. swede friends.In Johari’s window, my arena has broaden which indicates that I am more self aware after completion of group assignment. Bibliography Wilson, K. Doz, Y.L. (2012). 10 Rules for Managing Global Innovation. Harvard business review, 85 (10), 84-90. South, B. (2007). Combining mandala and the Johari Window: An exercise in self-awareness. Teaching Learning in Nursing,2 (1), 8.

Epidemiology Of Cholera John Snow Health Essay

Epidemiology Of Cholera John Snow Health Essay It has been over a century and a half when John Snow undertook the study of the Cholera epidemic of 1854 in London. His work, which was published in the 1855 book On the Mode of Communication of Cholera, is considered a milestone in epidemiology. The observations by Snow of the water-born transmission of cholera and the handle of the Broad Street pump was a work of genius that continues to inspire epidemiologists. Appearing before the local body of government on September 7, 1854, John Snow argued that the source of the outbreak of a cholera epidemic was water from a communal water pump. His investigation identified the pump at Broad Street near its intersection with Cambridge Street as the source of contaminated water. Cholera which is an acute, diarrheal illness caused by infection of the intestine with the bacterium Vibrio cholerae, causes significant morbidity and mortality in many developing countries. This paper examines the cholera epidemics (and pandemics) in recent history i ncluding the outbreak of 1854 in London and the role played by John Snow which had laid the foundations for the modern principles of epidemiology. Introduction It has been over a century and a half when John Snow undertook the study of the Cholera epidemic of 1854 in London. His work, which was published in the 1855 book, On the Mode of Communication of Cholera is considered a milestone in epidemiology. The observation by Snow of the water-born transmission of cholera, and the handle of the Broad Street pump was a work of genius that continues to inspire epidemiologists. Appearing before the local body of government on September 7, 1854, John Snow, an anesthetist in London, argued that the source of the outbreak of a cholera epidemic was water from a communal water pump. Working with the data reproduced in table 1 (Bingham et al., 2004), Snow identified the pump at Broad Street near its intersection with Cambridge Street as the source of contaminated water. What followed is best told in his own words: I had an interview with the Board of Guardians of St. Jamess parish on the evening of Thursday, 7th September, and represented the above circ umstances to them. In consequence of what I said, the handle of the pump was removed on the following day (Snow, 1855). Each year, outbreaks of cholera to cause death estimated at 120,000 worldwide, with the vast majority occurring in children (WHO, 1995). Epidemiology of cholera is characterized by several key principles including (i) Cases tend to be concentrated in specific location and occur during a specific season (ii) the highest infection rates in children of 1-5 years in areas where infection is endemic (iii) antibiotic resistance patterns often change from year to year, (iv) pathogen strain often exhibit clonal diversity, and (v) prevention measures against the disease include sanitation, hygiene and immunity improvement. Cholera has been ranked as one of the emerging and reemerging infections (Satcher, 1995) facing many developing countries. Several recent events highlight the importance of epidemiological disease include the 1991recurrence of cholera in Latin America (Levine, 1991) ( Ries et al., 1992); the 1994 outbreak of cholera which took place in a Rwandan refugee camp in Goma, Zaire, which resulted in approximately 70,000 cases and 12,000 deaths in (Siddique, 1995), and the outbreak of V. cholerae O139 in the India subcontinent from 1992 to 1993, possibly marked the start of the eighth cholera pandemic (Ramamurthy et al., 1993)(Swerdlow et al., 1993). Pathogenesis and transmission of Cholera Vibrio Cholerae are comma-shaped, gram-negative bacteria that have been the cause of several great long-lasting epidemics and pandemics of diarrheal disease. Many of these pandemics began in the Ganges Valley of India and Bangladesh, which is never free from cholera. Although there are 140 serotypes of V. cholera, until recently only 1 stereotype was associated with several diarrhea. Beginning in 1992, a new V.cholerae stereotype (0139, also known as Bengal) has been associated with sever, watery diarrhea (Faruque et al., 1998) The vibrios never invade the epithelium but instead remain within the lumen and secrete an enterotoxin, which is encoded by a virulence phage. Flagellar proteins involved in motility and attachment are necessary for efficient bacterial colonization, as has been described for Campylobacter. The vibrio hemagglutinin, which is a metalloprotease, is important for detachment of Vibrio from epithelial cells. The secretory diarrhea characteristic of the disease is caused by release of cholera toxin. Cholera toxin is composed of five binding peptides B and a catalytic peptide A (McKenzie et al., 1984). The B peptide, serving as a landing pad, bind to carbohydrates on GM1 ganglioside on the surface of epithelial cells of the small intestine, enabling calveolar-mediated endosomal entry of toxin subunit A into the cell (Laloi et al. 1996). Reverse transport of the subunit A from endosome into the cell cytoplasm is followed by cleavage of the disulfide bond linking the two fragments of peptide A (A1 and A2). Catalytic peptide A1 is generated, leading to the following sequence (Dertzbaugh et al., 1993): A1 interacts with 20-kD cytosolic proteins called ADP-ribosylation factors (ARF). The ARF-A1 complex catalyzes ADP-ribosylation of a 49-kD G-protein (called GsÃŽÂ ±) (Randazzo et al., 2000). Binding of NAD and GTP generates an activated GsÃŽÂ ±, which in turn binds to and stimulates adenylate cyclase. ADP-ribosylated GsÃŽÂ ± is permanently in an active GTP-bound state, resulting in persistent activation of adenylate cyclase. The activated adenylate cyclase generates high levels of intracellular cAMP from ATP. Cyclic AMP stimulates secretion of chlorides and bicarbonate, with associated sodium and water secretion. Chloride and sodium reabsorption is also inhibited. The reabsorptive function of the colon is overwhelmed, and liters of dilute rice water diarrhea containing flecks of mucus-up to 14 L/day, equivalent to the circulating blood volume, causing dehydration and electrolyte imbalances. Because overall absorption in the gut remains intact, oral formula can replace the massive sodium, chloride, bicarbonate, and fluid losses and reduce the mortality rare from 50% to less than 1% (Sharma et al., 1997) Epidemiology of Cholera Early Pandemics Since the beginning of the first pandemic in 1817, seven cholera pandemics have occurred (Pollitzer,1959), excluding the seventh pandemic, which took place on the Indonesian island of Sulawesi in (65), pandemics occurred in the Indian subcontinent in the Ganges delta and spread to other countries over many years (Snow, 1855). In 1830, the epidemiological and public health approaches to cholera developed in the context of some understanding of the nature of certain infectious diseases, including smallpox and syphilis, with little agreed differentiation of the fevers. In his late 18th century doctrine, Benjamin Rush describes there was but one fever in the world (Shryock, 1936) had received broad support. Exciting factor in the cholera epidemic was sometimes considered as shaping existing fevers into its own image, and the arrival of cholera coincided with an increase in mortality and/or transferred deaths between categories was questioned. The second cholera pandemic of the early 1830s invaded the British Isles, and was marked by epidemiological observations made by John Snow on the waterborne cholera transmission in London between 1847 and 1854(Snow, 1855). Ships carrying Irish immigrants caused the second pandemic in Canada (Marian, 1957). During the third pandemic (1852-1859), cholera was raging in the United States, and during the 1870s at the end of the fourth pandemic, towns and villages along the Ohio, Missouri, and Mississippi, rivers experienced cholera (Billings et al., 1975). The fifth pandemic mainly affected South America; causing large epidemics in several countries with Argentina, Chile, and Peru suffering high casualties. (Gil et al. 2004). Robert Koch isolated the cholera bacterium, known as comma bacilli during the fifth pandemic in feces of patients in Egypt in 1883 and India in 1884(Koch, 1884). Between 1899 and 1923, the sixth pandemic involved populations expanded in the Balkan Peninsula and the Middle East (Pollitzer, 1959). Apart from a large epidemic in Egypt in 1947 (Shousha, 1947), cholera was confined to southern and Southeast Asia since the mid-1920s until the 1961 outbreak of the seventh pandemic in. Both the sixth pandemic and possibly the fifth pandemic were caused by V. cholerae of classical biotype. The Seventh Pandemic The seventh pandemic is considered the largest of the pandemic in the geographical distribution, and was caused by V. cholerae O1- biotype El Tor (Table 2). The 1961 pandemic first invaded the island of Sulawesi in Indonesia and spread to other islands, including Borneo, Sarawak Java, Taiwan, the Philippines, and Sabah. It affected the entire archipelago of South Asia at the end of 1962 (Kamal, 1974). , In Asian mainland, from 1963-1969, the pandemic affected Cambodia, Thailand, Vietnam, Malaysia, Burma, India, Pakistan, and Bangladesh. Cholera reached Pakistan shortly after El Tor, and outbreaks were reported in Iraq, Iran, Afghanistan, and in the neighboring republics of the Soviet Union (Kamal 1974). By 1970, El Tor cholera had reached the Arabian Peninsula, Syria and Jordan, and to a lesser degree, in Israel (Cohen et al., 1971). The seventh pandemic was in sub-Saharan West Africa in early 1970, causing explosive epidemics as a result of more than 400 000 cases of high mortality, attributed mainly a lack of background immunity of the population, and lack of healthcare infrastructures (Goodgame et al., 1975). During this epidemic, cholera invaded the coast and the interior through waterways and continued to spread to the interior of the Sahel countries by land to travel to nomadic tribes. During the 1970 cholera epidemic, 28 were newly affected were reported and 16 are in Africa (Kaper et al., 1995). In South America, the seventh pandemic which began in Peru in January 1991 caused a return of cholera to the continent after more than a century in an explosive epidemic (Levine, 1991) (Ries et al., 1992). Subsequently, neighboring Ecuador and Colombia also reported cholera epidemic. In each of these countries were people of low socio-economic status, lack of clean water and sanitation, the most affected (Pan American Health Organization, 1991). In April 1991 a small outbreak was reported in Santiago, the capital of Chile (Levine, 1991). Cholera then invaded more countries in South and Central America along the Pacific coast. The Pan American Health Organization estimated that during 1991 and 1992 there were 750,000 cases of cholera and 6,500 deaths in the Americas (Pan American Health Organization, 1991). Recently, the July 1994 outbreak in Goma, Zaire, (Siddique, 1995), is considered one of the worst outbreaks in recent history. Nearly a million people were displaced to Zaire and sheltered in refugee camps as a result of Conflicts between tribes in neighboring Rwanda. Outbreak of cholera in refugee camps affected by poverty caused an estimated 12,000 deaths among Rwandan refugees during a period of three weeks (Siddique, 1995). The seventh pandemic was active causing seasonal outbreaks in several developing countries. However, in 1992, V. cholerae belonging to serogroup non-O1 (now known as O139) caused massive epidemics of cholera in Bangladesh and India and spread to other countries, which could represent the beginning of the eighth pandemic Conclusion John Snow achievement was based on the logical organization of his remarks. He recognized a natural experiment, and its quantitative approach to the analysis of the occurrence of disease in human populations, which is actually a summary of the views of modern epidemiology. It has been over a century and a half since Dr. Snow had published his findings. And in spite the medical and epidemiological advancement in combating the disease, yet, the threat of cholera remains very real and cholera continues to be a global threat to public health and an important indicator of the lack of social development, especially in developing countries which suffer from lack of access to drinking water and lack of sanitation. The disease continues to challenge the increasing proportion of vulnerable populations living in unsanitary conditions, such as slums and refugee camps. The treatment centers and water purification units in poor nations are only interim measures, and steady decline in the spread of the illness should not be seen as a complete victory.