Proper sanitation and hygiene practices key to reducing the disease burden

We all at one point have had health issues due to poor hygiene and sanitation. You will be surprised by how many of us, young and old, visit clinics for outpatient consultations just because we are having stomach discomfort. And all this is most of the time due to poor hygiene and sanitation in our households or environment. According to the World Health Organisation, sanitation refers to the provision of facilities and services for the safe disposal of human waste. Inadequate sanitation is a major cause of disease worldwide. Sanitation can also mean the maintenance of hygienic conditions through services such as garbage collection and waste disposal. Hygiene itself refers to conditions or practices conducive to maintaining health and preventing diseases, especially through cleanliness. Sanitation has many benefits, but one of the most important is its contribution to the healthy living of a community. Proper sanitation and hygiene practices such as proper hand-washing after visiting toilets or before and after meals, just to mention a few, are key to reducing the spread of intestinal worms, parasitic worms and trachoma (bacterial infection of the eyes) which are neglected tropical diseases that cause suffering for millions worldwide. Lack of proper menstrual hygiene facilities and toilets in schools often deters attendance, particularly for adolescent girls. I recall one story, during one of my social community medicine course visits where I asked a 23-year-old mother why she didn’t finish her primary education. She told me she was in class when she had her first menses and couldn’t go to the toilet because it was shared with boys, who were laughing at her, so she decided not to go back to school after that incident. Lack of access to improved water and sanitation facilities and poor hygiene practices in Rwanda, particularly in rural areas, is contributing to high incidence of water, sanitation and hygiene related mortality and morbidity. Despite the fact that hygiene would save around 300,000 people per year, it has not been prioritised internationally. Yet even with sanitation and safe water, still some infections won’t be prevented without hygiene. For example, fecal-oral infections( spread of microbes, viruses, bacteria or parasites from human or animal stool to your mouth) like cholera, typhoid fever, diarrhea and amoebiasis and intestinal worms (round worms, tapeworms and pinworms) Diarrhea, a disease related to poor hygiene, unsafe water and sanitation, has been shown to kill more children than malaria and HIV AIDS with the WHO reporting that each year diarrhea kills around 760,000 children under five, thus making it the second leading cause of death in children under five years old. Surprisingly it is both preventable and treatable. A significant proportion of diarrheal disease can be prevented through safe drinking-water and adequate sanitation and hygiene. Cholera, also transmitted via contaminated water, does almost the same on a single outbreak. Statistics from the WHO/UNICEF joint monitoring programme for water supply and sanitation show that Rwanda, considered the most densely populated country on the African continent, serving almost 12 million people with 72 per cent rural access to improved water and 71 per cent rural access to improved sanitation. January 1, 2016 marked the official ‘set-off’ of the Sustainable Development Goals (SDG’s). Goal #6 is about clean water and sanitation, which aims at ensuring availability and sustainable management of water and sanitation for all. In August this year, the Rwanda National Police and City of Kigali signed an MoU to promote hygiene in the capital together with security. This shows the commitment from different government institutions in raising public awareness on improving community sanitation and hygiene. A WHO study in 2012 showed that for every $1 invested in sanitation, there was a return of $5.50 in lower health costs, more productivity and fewer premature deaths. Proper sanitation and hygiene practices require everyone’s contribution, starting from our households. Prevention is better than cure, therefore a healthy nation is a wealthy nation. Gerard Mbabazi is a final year medical student