Monday, September 8, 2014

Clean is not the same as Sanitary

The last distribution of Handwashing Hygiene stations included stations placed at two clinics where women were in labor and there was no access to hand washing.   A number of LOEP donors were shocked to see that and want to understand how such a situation could exist.  

It all relates to water quality and accessibility in Africa  -  Liberia in particular.

In Liberia running water is not available in most homes.  There are no water treatment plants or sewage treatment facilities.  Household water for cooking and washing is ground water accessed by pumps and pulled from depths that would not meet health standards in other parts of the world.  Ground water is not drawn from deep wells but is close to the earth’s surface and vulnerable to contaminants.  In Liberia, conventional plumbing is uncommon, latrines are everywhere and open defecation is practiced.  Bottled water is only available to very few who can afford it and everyone else uses what is available.  The World Health Organization estimates that up to 40% of Liberians have no access to safe, clean water protected from outside contamination, particularly fesces.  It is common in Liberia for clinics and hospitals, including those treating Ebola patients, to use water that is accessible - there are no alternatives to contaminated ground water.

The lack of access to safe, clean water is, in and of itself, a health crisis in Africa.  According to WHO statistics, more than 65% of hospital patients in African hospitals are treated for illnesses related to contaminated water.  In this time of Ebola that statistic is chilling considering how unsanitary water is in Liberia.  Washing with ground water can remove dirt or blood, for example, and the skin surface may appear clean.  But water alone does not remove bacteria and viruses and only bleach can remove Ebola virus!  Clean is a woefully insufficient standard when ebola is a threat, especially in a setting with sick patients.  Clean just is not the same as sanitary.  
Health officials are looking closely at Nigeria where the Ebola virus seems to have been successfully contained.  According to Michael Ojo, country representative of global water charity Water Aid, a handwashing campaign was immediately put in place as a direct response to the Ebola outbreak in Nigeria.  Ojo believes the handwashing campaign may have played a major role in Nigeria’s (so far) successful containment Ebola.

There is no data directly linking the ebola outbreak to lack of access to clean water, but there is plenty of data that proves hand washing with soap in clean water is the first line of defense in basic disease prevention. 

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