Exam practice

Most often we visit the doctor in person: at a health post, a clinic or a hospital, where the doctor sees us, asks questions and examines us. Sometimes we phone a doctor we know, or ask a pharmacist (a person who sells and explains medicines). Today some hospitals also give advice by video call: the doctor sees and talks to the patient on a screen.

Tele- means “far” (as in telephone, television), so telehealth is health care from far away: a doctor and a patient in different places meet over a phone or a video call, and the patient’s reports and test results are sent over the internet. The picture beside the questions shows it: a doctor on a screen holds up an X-ray for a patient who is sitting in another place.

Across: 1. PSYCHOTHERAPY 2. TRIAGE 3. DEPLOY 4. ICU
Down: 5. INCORPORATE 6. DIAGNOSIS 7. UNDERSERVED 8. PANDEMIC

Telehealth is a way of providing medical care remotely, usually through video chat, so that patients and clinicians can meet from any location with an internet connection.

Telehealth services can be faster, safer, more effective and, in the long run, less expensive. They let specialists reach patients anywhere there is internet, they protect patients and staff from infection during an epidemic, they let doctors watch patients’ health from far away, and they let doctors in different places work together on a patient.

There are two reasons. First, the COVID-19 pandemic: social distancing, avoiding physical contact and the shortage of hospital beds pushed hospitals to use telehealth. Second, the shortage of medical professionals: more and more people need care because the population is aging and chronic diseases are increasing, and people in rural areas are underserved.

During a pandemic, patients can get medical care without going to a hospital. This keeps physical contact to a minimum, so it protects both the patients and the hospital staff from the infection, and it helps hospitals keep caring for patients at home when beds are short.

Because there are not enough resources (doctors, hospitals, equipment) near them, and they have to travel long distances to the cities for care.

1. A lack of infrastructure to run telehealth well.
2. Insufficient hardware.
3. Not the right technology for each specialty.

Chang also names unreliable networks (broadband, 4G, Wi-Fi), which make it hard to reach rural areas and mobile clinics, and the learning curve: users must learn new tools, online booking of virtual visits, triage steps and billing. Either can be given as one of the three.

Many people in rural areas would welcome telehealth, because it could save them a long, expensive journey to the city just to show a report or ask a question. Old people and pregnant women, who find travel hard, would gain the most. But some might feel unsure: they may not trust a doctor they can’t touch, they may not have a smartphone or a steady signal, and some may not know how to use the apps.
It could be improved in several ways. The health post could have a computer and a good internet line, so that villagers can talk to a city doctor with a health worker beside them. Health workers could be trained to take measurements and send them. The calls could be in Nepali and local languages, and the service could be cheap or covered by health insurance. And it should never stop people from going to a hospital when they really need to.

She says, “If I were you, I’d go to a dentist.” She puts herself in the girl’s place and says what she would do. It is a polite, friendly way to advise someone.

• a.A: I’m so tired, but I just can’t sleep at night. B: If I were you, I’d have a hot drink before going to bed.
• b.A: I’m freezing. There’s no heating in our flat. B: Why don’t you put a sweater on?
• c.A: It’s my friend’s birthday tomorrow, and I have no money for a present. B: How about picking a bunch of flowers from your garden?
• d.A: I’ve hurt my leg playing football. B: You’d better go to see a doctor, or it might get worse.
• e.A: I’m not feeling well today. B: You should take a rest for a while.

• a.Why don’t you read a short English story every day and write down the new words? If I were you, I’d ask the English teacher which mistakes I make most often. You ought to talk in English with a friend for ten minutes a day.
• b.You’d better tell your class teacher today, before someone takes it home. Why don’t you look in the lost-and-found box? If I were you, I’d write my name on every book from now on.
• c.You should eat fewer fried snacks and sweets. You ought to walk or cycle to school instead of taking the bus. You’d better not skip meals, or you’ll eat even more later.

Should is used to ask for advice and to give advice: the teacher asks the boy what the right thing to do would be (What should you do?), and the boy answers with advice to himself (I should study a little more). Notice the question: the question word, then should, then the subject: What should you do?

Two or three paragraphs: the problem first (what he does and why it is unhealthy), then the advice (what to stop, what to start). Use the unit’s advice words, and vary them: should, ought to, had better, if I were him, why doesn’t he…. End with what will happen if he follows the advice.

A healthier life for Aayush

Aayush is a fourteen-year-old boy from Biratnagar, and he has a problem: he has become a couch potato. Every day he sits on the sofa for hours, watching TV and eating chips, biscuits and fried snacks. He hardly moves his body, and he eats far more than he uses. If he goes on like this, he will put on weight, feel tired all the time, and run a higher risk of diseases such as diabetes and high blood pressure later in life.

First, Aayush should stop sitting in front of the TV for so long; an hour a day is plenty. He ought to replace the packets of snacks with fruit, roasted chana or a glass of water, and he had better not eat while watching TV, or he will not notice how much he is eating.

Then he should start moving. He could walk or cycle to school, play football with his friends in the evening, or help at home. If I were him, I would also go to bed early and get up early. Small changes like these, made every day, will help him become fitter, happier and healthier.

He is a king: he wears a crown and a long red robe with a white fur edge, and he sits on a seat with his robe spread round him. A wrestler would not dress like that.

Probably by eating too much and moving too little: lying in bed or sitting all day, being served food, and never walking or working.

No. His big belly shows he is obese (far too fat), and a body like that has to work harder; he probably gets tired easily and could get diseases of the heart and blood.

a. Obesity b. benevolent c. strenuous d. devotee e. couch potato

Because he was very lazy: he did nothing but eat and sleep, staying in bed for days, weeks and months, instead of doing his work as a king.

To make the king fit and healthy again: he had become so fat that he could not move his body.

Because the holy man told him that he could easily cure the king, after all the expert doctors had failed.

Because walking was the treatment. He knew that walking every day would make the king lose weight and become active and healthy again.

So that the king would keep walking to his place every day. If the holy man had met and “treated” him, the king would have stopped coming; by staying away, he made the king walk for two whole weeks.

By walking to the holy man’s home every day for two weeks. The daily walk made him lose a lot of weight and become lighter and more active, and he soon regained his health.

Health is wealth: good health is worth more than money, and it can’t be bought. We stay healthy through our own habits: eating sensibly and being active every day. A lazy life makes us ill, and no doctor can do for us what we must do ourselves.

Once upon a time there lived a kind and generous queen. Her people loved her kindness, but they were unhappy, because she was very lazy: she stayed in her bed all day, eating sweets and sleeping. Slowly she grew so heavy that one morning she could not even lift her foot, and people began to call her the “bulky queen”.
The queen called the best doctors in the land and promised them great rewards, but none of their medicines worked, and all her money was spent in vain.
One day a wise old woman, a healer, came to the kingdom and told the queen’s minister that she could cure her. But she lived far away, and she would not come to the palace: the queen had to come to her, and on foot. With great effort, and leaning on her maids, the queen reached the healer’s hut. The healer praised her as a good ruler and told her to come back the next day for her treatment.
The next day, and every day for two weeks, the queen walked to the hut, but each time the healer was away. Then the queen noticed that she felt lighter and stronger, and could walk without help. She smiled: the walk itself had been her medicine. Soon she was healthy again, and her people were happy.

Keep the events in the same order, but tell them in your own words, in the past tense. Change every he, him, his for the queen to she, her, and you may change other details too (a healer instead of a holy man, maids instead of followers). Keep the lesson at the end.

• a.I see three things we do to keep clean: trimming the nails, washing hands with soap and brushing the teeth. They are all parts of personal hygiene.
• b.Yes. I wash my hands before eating and after using the toilet, I brush my teeth every morning and night, and I cut my nails every week. I do these things because they remove dirt and germs, which keeps me from getting ill, and because they keep me clean and fresh among other people.

• Wash your hands with soap and water for about 20 seconds, especially before eating and after using the toilet.
• Brush your teeth for two minutes, morning and night, and change your toothbrush every three months.
• Take a bath every day, or as often as you can, and dry yourself well, especially between the toes.
• Keep your nails short and clean; never bite them.
• Wear clean clothes and socks, and dry your clothes in the sun.
• Cover your mouth and nose with your elbow or a tissue when you cough or sneeze.
• Don’t share towels, combs or toothbrushes.
• Girls: change sanitary pads regularly during menstruation, and wash with clean water.

• a.Second (came … would be treated): a condition for the future, seen from the story’s past: he would get treatment only on that condition. (This is also reported speech: the holy man said, “I will treat him only if he comes on foot.”)
• b.Second: Sarita doesn’t have an Android phone, so she doesn’t join the virtual class.
• c.Third: the king didn’t live an active life, and his health did get worse.
• d.Third, without if (Had she studied = If she had studied): she didn’t study hard and didn’t get the best result.
• e.Third: we didn’t listen to the radio, so we didn’t hear the news.
• f.Second, with the result first: I don’t know whether he knows the answer, but it is quite possible.

• a.would have seen (third: you didn’t come earlier)
• b.would fly (second: I am not a bird)
• c.were (second, after provided that: you are not twenty)
• d.would not have seen (wouldn’t have seen; third: he did come)
• e.won (second: an imagined future)
• f.had come (third: she didn’t)
• g.didn’t eat (did not eat; second)
• h.had asked (third)
• i.had driven (third)
• j.turned (second: an imagined situation)

(Rs. 1,00,000 is one lakh rupees, written the Nepali way; in the international way, 100,000.)

• a.If you had studied well, you would have passed the exam.
• b.If you asked me, I would help you.
• c.If we had gone to the cinema, we would have seen the new film.
• d.If you spoke English, you could talk to the tourists.
• e.If they listened to me, they would understand the problem.
• f.I would send you a card if I had your address.
• g.If I had known about it, I would have taken part in the contest.
• h.If it weren’t so hot, we would walk to the museum.
• i.I would swim in the sea if there were not many sharks there.
• j.She would have reached home on time if she had taken the right bus.

(Other endings are right too, if the forms match: an if + past goes with would + base form; an if + had + past participle with would have + past participle.)

Kwati (sprouted bean soup)
Serves 4. Time: about 40 minutes, after the beans have sprouted.

Ingredients

• 2 cups of sprouted mixed beans
• 2 tablespoons of ghee, and 1 teaspoon more for the seeds
• 1 onion, chopped
• ½ teaspoon of cumin seeds and ½ teaspoon of carom seeds (jwano)
• 2 bay leaves
• 1 tablespoon of ginger-garlic paste
• 2 tomatoes, chopped
• ½ teaspoon each of turmeric powder, coriander powder and red chilli powder
• salt and garam masala to taste
• 4 cups of hot water

Method

1. Melt the ghee in a pressure cooker.
2. Add the onion, then the bay leaves and the ginger-garlic paste, and fry until the onion turns golden.
3. Now add the sprouted beans, then the red chilli powder.
4. Fry for 5–6 minutes, stirring now and then.
5. Add the tomatoes, turmeric powder and coriander powder.
6. Fry until the tomatoes are soft.
7. Pour in the hot water, then add the salt and garam masala.
8. Close the lid and cook for about 4–5 whistles, until the beans are soft. Let the pressure go down before opening the cooker.
9. In a small pan, heat the last teaspoon of ghee and fry the cumin and carom seeds until they crackle. Pour them over the kwati.
10. The kwati is ready: serve it hot, as a soup or with rice.

a. biology b. psychology c. zoology d. archaeology

• a.False (he was kind, but lazy)
• b.True
• c.False (he refused; the king had to go to him)
• d.True
• e.False (he gave him no treatment at all: the walking cured him)

• a.You shouldn’t (should not) eat junk food every day.
• b.Pemba should see a doctor.
• c.You had better not take an umbrella. (You’d better not…)
• d.Should I wash my hands before eating?
• e.If you exercised every day, you would feel better.
• f.Had Kamala slept early, she would not have been tired.

a. should b. had better not c. had known d. wouldn’t have fallen e. followed
(should + base form, no to; had better not, with not after better; had known … wouldn’t have fallen: the third conditional, about last year; followed … would miss: the second conditional, an imagined situation now.)

• a.At Shree Janajyoti Secondary School.
• b.Six hours, from 9 a.m. to 3 p.m.
• c.Any two of: blood pressure, blood sugar, eyes, teeth.
• d.By video call (telehealth).
• e.Their old reports and a list of the medicines they take.

(A practice notice written for this page.)

How to wash your hands properly
Washing your hands well takes only twenty seconds and keeps many diseases away. First, wet your hands with clean running water. Next, put soap on them and rub your palms together until they foam. Then rub the back of each hand with the other palm, and lace your fingers together to clean between them. After that, rub each thumb inside the other hand, and scratch your fingertips on your palm to clean under the nails. Keep rubbing for about twenty seconds. Finally, rinse your hands well under the water and dry them with a clean towel. Do it before every meal and after using the toilet.