Handwashing, solution to reducing cholera

Good hand hygiene is the foundation to achieving safe healthcare. Since the emergence of the pandemic in 2019, Ghana has yet to record a single case of cholera.

Despite COVID-19 focusing our attention on the importance of hand hygiene to prevent the spread of diseases, most schools, particularly those in developing countries, still do not have access to handwashing facilities.

Even if handwashing facilities are accessible, soap and water is scarce. Handwashing is cost-efficient and a public health measure that is crucial to protecting individuals against a range of diseases like pneumonia and diarrhoea.

People living in rural areas, urban slums and disaster-prone areas are more likely to be the most affected by cholera.

The World Health Organisation (WHO) has said that 829 000 people die each year from diarrhoea as a result of unsafe drinking-water, sanitation and hand hygiene

According to the United Nations Children’s Fund (UNICEF), about 2.2 billion people still lack access to safe drinking water, while more than half of the global population does not have access to safe sanitation. Three billion people do not have access to handwashing facilities with soap and 673 million people practice open defecation.

If this should continue, the country and UNICEF will not be able to achieve its aim of ending cholera in 2030, with a reduction in deaths by 90 per cent.

Growing up in a clean and safe environment is a right of every child, including access to clean water, basic toilets and good hygiene practices.

Handwashing

The Ghana Demographic and Health Survey has revealed that while more than half of Ghanaian households have a designated place for washing hands, about one household out of every five has water or other cleansing agents available at home.

Where hand hygiene facilities are available, research has shown that people, especially men, do not make use of them constantly. A behavioural change is needed for improvements in the policies, strategies and actions that drive sustainable change.

Handwashing is known to lessen diarrhoeal diseases by 30 per cent, and also plays an important role in reducing the transmission of outbreak-related pathogens such as, cholera, COVID-19 and Ebola.

Hand hygiene can also protect against hospital-associated infections, and has been linked to benefits beyond disease reduction such as, increasing the awareness of some preventable diseases.

Cholera is an acute diarrhoeal infection caused by ingestion of food or water contaminated with the bacterium Vibrio cholera.

Although the disease is curable, it can be prevented through the provision of safe drinking water, good sanitation and enhanced personal hygiene.

Cholera was first reported in Ghana in 1970. Since 1990, large-scale epidemics have occurred – 1991, 1999, 2011, 2012 and 2014, with the latter representing the largest epidemic to affect the country.

In 2015 and 2016, the Ghana Health Service recorded 618 cases with five dead, and about 150 cases of the disease with no known death recorded in the Central Region.

The Director-General of the Ghana Health Service (GHS), Dr Patrick Kuma-Aboagye, said zero cases of cholera in 2020 was due to the safety protocols set up to combat the COVID-19 pandemic.

He noted that the GHS had conducted an assessment in several health institutions to ensure facilities were well equipped.

Meanwhile, due to changes in the weather patterns; the onset of the rainy season and the floods, there was a possible cholera outbreak in the country.

Since the reduction of COVID-19 cases in the country, it can be observed that less people are washing their hands and keeping good hygiene practices.

Therefore, the public should be advised to wash their hands with soap under safe running water regularly.

Interventions, treatment

Open defecation has been a major sanitation challenge for the government. With the aim of reducing such problems, the government, through the “Toilets for All” programme under the Ministry of Health, has constructed at least about 109, 000 household toilets benefiting some 856,000 people across the country.

Interventions such as these can prevent a wide range of other water-borne illnesses, and contribute to achieving goals related to poverty, malnutrition and education.

Majority of people can be treated successfully through prompt administration of oral rehydration solution (ORS).

Wash

UNICEF has come out with the water, sanitation and hygiene (WASH) initiative, with the aim of expanding water and sanitation access and improving key hygiene activities across the country.

“Over 700 children under age five die every day of diarrhoeal diseases due to lack of appropriate WASH services,” the organisation said.

In areas of conflict, it has been known that children are nearly 20 times more likely to die from diarrhoeal diseases than from the conflict itself.

A long term solution to cholera will lie in economic development and universal access to safe drinking water, good hygiene practices and adequate sanitation.

The WASH solutions for cholera are aligned with Sustainable Development Goals six (SDG 6) of the United Nations Educational, Scientific and Cultural Organisation (UNESCO).

The writer is a National Service Person, Graphic Communications Group Ltd.  E-mail: jaddae574@gmail.com