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How does handwashing help prevent undernutrition?

Three-year old Asha died last night, her tiny body wracked with diarrhea. Two-month old Abu is vomiting. His mother is dead and his grandmother is finding it difficult to prepare safe artificial food for him. Asha and Abu are just two reasons why Food Safety is the theme of World Health Day 2015. Asha and Abu became ill because their porridge and milk were contaminated with lethal bacteria.

Food safety means ensuring that food remains safe to eat as it travels along its path from ‘field’ to ‘plate’; and in these days, where many food paths  are very long, it is not only the responsibility of governments but international producers, processors, and retailers too.

Safe food is food that is uncontaminated by:

  • Pathogenic micro-organisms including bacteria, viruses, amoebae, or giardia
  • Parasites such as roundworm eggs or tapeworm cysts
  • Toxins such as aflatoxin or cyanide in bitter cassava
  • Harmful chemicals such as pesticides, fertilizers, and heavy metals

These things can cause immediate food poisoning or more long term chronic conditions such as roundworm infection (ascariasis) that infest tens of millions of children living in communities where water, hygiene, and sanitation conditions are poor.

A fish market in Africa. ©Felicity Savage King and Ann Burgess 1992; artist Jill Last
Figure X “A fish market in Africa.” ©Felicity Savage King and Ann Burgess, 1992; artist Jill Last. Used with permission.

Food safety seems to be slowly improving in many developing countries–when we go to a local market the foods are usually hygienically displayed off the ground (Figure X) although much progress still needs to be made. Hygiene conditions in supermarkets, where an increasing number of people from both urban and rural areas shop, are usually good.

Even so, it is not easy in many rural and urban communities to prevent food and water-borne disease; pathogen loads are often high, sanitation and water supplies often inadequate, and few homes have refrigerators or safe conditions for protecting or storing food. Added to this is the increasing availability and use of ‘ready-to-eat’ meals and snacks prepared by a variety of food vendors, often under non-ideal conditions. As more women work outside the home, these ‘street foods’ are becoming a popular way of feeding children. It is small wonder, then, that few have escaped bouts of food poisoning and many have had worm infections during childhood.

If we examine why Asha was fed contaminated porridge and became sick, we find several underlying reasons–her family is short of fuel, clean water, hand washing facilities, and time. The milky porridge her mother prepared each morning was easily contaminated and, because it was fed throughout the day, bacteria could multiply exponentially.

One of the chief dangers of food-borne diseases is that they are an immediate cause of undernutrition, especially in young children, because they lead to nutrients  being poorly absorbed or lost due to diarrhea, vomiting, and fever, and reduced food intake due to decreased appetite.

 Figure xx [11.1] Breast milk – the safest food of all Figure XX © Felicity Savage King 1985, artist Sara Kiunga Kamau.
“Figure xx Breast milk – the safest food of all.” © Felicity Savage King 1985, artist Sara Kiunga Kamau. Used with permission.

However, there are simple measures which, if followed, can help mothers and other family caretakers keep food and water safe at the household and community level:

  • Wash your hands with soap
  • Use a safe water supply
  • Use a toilet and keep it clean
  • Keep food covered
  • Cook food thoroughly
  • Eat meals soon after they are cooked so that bacteria have little time to multiply
  • Allow children and pregnant women to be dewormed.

Of these, the most important message is ‘washing hands properly.’ How many of us know or follow the six steps for safe handwashing?

  • Wet hands with running water
  • Apply soap
  • Rub hands vigorously to produce foam. Rub the backs of hands, between fingers, under fingernails and wrists
  • Clean nails
  • Rinse
  • Shake hands dry, do not dry on clothes.

As World Health Day reminds us about food safety this year and in the future, let us think carefully how we can protect children like Asha and Abu from food and water-borne diseases. In many situations, the most important actions are working with and supporting women. Not only do they need better resources, facilities, and information within the home, but their own health and nutrition needs protecting so that they remain healthy and able to exclusively breastfeed their babies (Figure xx). Therefore, our additional key food safety message is to ‘protect and promote breastfeeding.’

Image Credit: “Tammanna Akter and Joy in Barisal, Bangladesh” by Bread for the World. CC by NC 2.0 via Flickr.

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