What ‘Ebola’ taught us about hand washing

I was in a foreign embassy office last week in Abuja for a visa interview, as I was about to enter the gate, the security politely told me “please don’t be offended, you have to wash your hands with this liquid before you are allow to enter” and he dropped it in my 2 hands. My […]

I was in a foreign embassy office last week in Abuja for a visa interview, as I was about to enter the gate, the security politely told me “please don’t be offended, you have to wash your hands with this liquid before you are allow to enter” and he dropped it in my 2 hands.
 My executive assistant who happened to be a microbiologist gave me a small bottle of Dettol and also encouraged having it always in our office toilets and began a massive campaign on facebook about Ebola. The Emir of Kano, His Royal Highness Mallam Muhammad Sunusi 11 during a recent lecture in his palace of which I was the guest speaker called on all his district heads to emphasize the benefit of hand washing as a preventive measure against Ebola.
Our port health offices in our airports which hitherto were only active in Abuja and Lagos are now busy in all domestic airports across Nigerian applying the ‘Ebola test’ on incoming and outgoing passengers and they were well protected with hand gloves and masks. These steps are really encouraging and we should continue even if we have tamed the Ebola Viral Disease in our midst.
Beyond the Ebola preventive measures, simple hand washing with soap can prevent us from a lot of diseases. Diarrhoea disease is the second leading cause of death in children under five years old, and is responsible for killing around 760,000 children every year. Diarrhoea can last several days.
Most people who die from diarrhoea actually die from severe dehydration and fluid loss. Children who are malnourished or have impaired immunity as well as people living with HIV are most at risk of life-threatening diarrhoea. Simple hand washing before and after eating and after use of toilets can make a difference between life and death for our under-five children. Infection is spread through contaminated food or drinking-water, or from person-to-person transmission as a result of poor hygiene. Interventions to prevent diarrhoea, including safe drinking-water, use of improved sanitation and hand washing with soap can reduce disease risk.  
The source of diarrhoea are; water contaminated with human faeces, for example, from sewage, septic tanks and latrines, is of particular concern. Animal faeces also contain microorganisms that can cause diarrhoea. Other causes: Diarrhoeal disease can also spread from person-to-person, aggravated by poor personal hygiene. Food is another major cause of diarrhoea when it is prepared or stored in unhygienic conditions.
Water can contaminate food during irrigation. Fish and seafood from polluted water may also contribute to the disease. Let’s take Cholera as an example which is an acute diarrhoeal infection caused by ingestion of food or water contaminated with the bacterium Vibrio cholerae. Cholera transmission is closely linked to inadequate environmental management. Typical at-risk areas include peri-urban slums, where basic infrastructure is not available, as well as camps for internally displaced people or refugees, where minimum requirements of clean water and sanitation are not met. The consequences of a disaster – such as disruption of water and sanitation systems, or the displacement of populations to inadequate and overcrowded camps – can increase the risk of cholera transmission should the bacteria be present or introduced. Hand washing with soap all the time can do the magic of taming Cholera.

Why Handwashing?
According to Global Campaign on Hand Washing, hand washing with soap is a “do-it-yourself vaccine” that prevents infections and saves lives. Here is why we should continue to encourage hand washing: Human feces are the main source of diarrheal pathogens. They are the source of shigellosis, typhoid, cholera, all other common endemic gastro-enteric infections and some respiratory infections such as influenza and pneumonia.
A single gram of human feces can contain 10 million viruses and one million bacteria. These pathogens are passed from an infected host to a new one via various routes but all of these illnesses emanate from faeces. Removing excreta and cleaning hands with soap after contact with faecal material – from using the toilet or cleaning a child – prevents the transmission of the bacteria, viruses and protozoa that cause diarrheal diseases.
Other measures (food handling, water purification, and fly control) have an impact on these diseases as well, but sanitation and handwashing provide the necessary protection against faceal contact. They start by creating initial barriers to faecal pathogens from reaching the domestic environment. Handwashing with soap stops the transmission of disease agents and so can significantly reduce diarrhea and respiratory infections, and may impact skin and eye infections.
Research shows that children living in households exposed to handwashing promotion and soap had half the diarrheal rates of children living in control neighbourhoods. Because handwashing can prevent the transmission of a variety of pathogens, it may be more effective than any single vaccine. Promoted on a wide enough scale, handwashing with soap can be thought of as a “do-it-yourself” vaccine because it is easy, effective, and affordable. Ingraining the habit of hand washing could save more lives than any single vaccine or medical intervention.
In conclusion, let us always wash our hands regularly with soap and clean water – and use clean towels to dry them.
All comments to Dr Aminu Magashi at [email protected]