4.

FOOD & WATER SAFETY,

HYGIENE & SANITATION

4 Nutrition Counselor Guideline

4.2 LEARNING OBJECTIVES

1. Understanding country food, water safety,

hygiene and sanitation situations.
2. Describe how infections from unsafe food and
water contribute to malnutrition.
3. Explain how to make food and water safe.
4. Counsel clients on food and water safety and
hygiene.
4.3 HYGIENE AND SANITATION

▪ Hygiene is keeping the body clean to

maintain health and prevent disease.
1. Sanitation is keeping the
environment (including food and
water) healthy to prevent human
contact with waste and
microorganisms that cause disease.
 LINKAGES BETWEEN WASH
4.4 AND NUTRITION

❑ Access to WASH is strongly correlated with household

energy and food safety and security.
❑ Water related diseases reduce food absorption.
❑ Intestinal worms rob their host of calories and nutrients.
❑ Diarrheal diseases prevent food from properly
nourishing its consumers.
❑ WASH is essential for a better nutritional
❑ Lack of safe water close to home has many indirect
effects on nutrition.
❑ People are often left with no choice but, to drink unsafe
water from unprotected sources.
 I M P O RTA N C E O F F O O D S A F E T Y,
4.5 WAT E R S A N I TAT I O N A N D H Y G I E N E

❑ Water, sanitation, and hygiene health are closely related.

❑ Inadequate quantities and quality of drinking water, lack of
sanitation facilities, and poor hygiene cause more than 3.4 million
people to die each year.
❑ Diarrhea, acute respiratory infections (ARIs), intestinal worms,
polio, cholera and a range of other diseases common in Afghanistan
are caused by poor access to WASH.
❑ A clean and hygienic environment facilitated by adequate sanitation
and water access contributes to lowering infection rates among
community members especially mothers and new born babies.
❑ Hand washing with soap and water and other key hygiene practices
are crucial for prevention of diarrhoea and other communicable
diseases.
4.6 THE IMPORTANCE ………..
 4.7 CAUSE OF SICKNESS

❖ Germs are very small living things, too small to see with the
naked eye.
❖ Germs can also make food smell bad, taste horrible, and
look disgusting.
❖ Dangerous germs can make people sick and sometimes
even kill them.
❖ Good bacteria live in our intestines and help us use the
nutrients in the food we eat and make waste from what's left
over.
❖ Germs are everywhere, but are mostly found in human and
animal feces, in soil, on all living things and in
contaminated food and water.
 2. THE MOST COMMON WAYS
4.8
OF GERMS TRANSMISSION
▪ Unclean/unwashed hands contaminate food and
water.
▪ Flies, cockroaches, and other insects
▪ Rates, mice, chicken and other animals
▪ Dirty containers and dishes
▪ Most germs grow by multiplying.
▪ Micro-organisms get into water when people or
animals defecate or wash in or near drinking
water supplies.
4.9 FECAL DISEASE
TRANSMISSION TO BABIES
 GERMS BREED FASTEST IN
4.10
FOOD WHICH IS:

➢ In warm and wet, such as porridge;

➢ Contains animal protein-such as milk, meat, fish,
stews and other cooked foods;
➢ Contains some sugar such as sweetened porridge.
➢ Viruses, amoebae, giardia, and worm eggs do not
breed in food.
 4. COMMON REASONS, FOOD
4.11 BECOME UNSAFE

▪ People prepare food with water which contains human or animal feces.
▪ People who prepare food do not wash their hands before cooking.
▪ People keep cooked food warm for several hours before they serve it.
▪ People use unclean dishes for cooking and eating purpose.
Other reasons include:
▪ Eating raw food, such as fruit, without washing or peeling it.
▪ Eating the food which has fallen on the ground.
▪ People put cooked food into dirty containers or dishes.
▪ People keep cold cooked food for a longer period before they eat it.
▪ People do not cover cooked food.
▪ Existence of flies and other pasts around the markets or fast food place.
▪ Human feces are left where flies, cockroaches, rats, or pets can reach
them.
4.12 WHERE DO GERMS LIVE?

▪ In human and animal feces

▪ In soil (1 teaspoon of soil contains
more than 1 billion germs)
▪ On all living things
▪ In contaminated food and water
 C A U S E S & S Y MP TO MS O F F O O D ,
4.13 WAT E R B O R N E I L L N E S S :

❑ Un safe food and water contain dangerous germs and toxic chemicals that
cause health risks.
❑ Diarrheal disease, Hepatitis, Scabies, Trachoma, Typhoid, TB, Polio – myelitis
and etc, which is related to contaminate drinking water and improper hygiene
and sanitation.
❑ Infections with intestinal helminths are transmitted by eggs present in human
feces which in turn contaminate soil in areas where sanitation is poor.
❑ Exposure to natural toxins, metals, and environmental pollutants; chemicals for
treating animals; pesticides; cleaning chemicals; and some food additives.
❑ Food grown near highways or roads where vehicles use leaded fuel can cause
lead toxicity.
❑ Now a days Afghanistan large cities are facing with huge challenge on
pollution problems which cased due to smoke, smoke of generator, lead
poisoning etc.
❑ Open defecation and preparation of street food can also cause environmental
contamination leading to food and water contamination and diseases.
 S Y M P TO M O F I L L N E S S E S , U N S A F E
4.14 F O O D A N D WAT E R

➢ Symptoms may occur quickly after eating food or

drinking contaminated water, or they may take days or
even weeks to appear.
What is the outcome of disease?
❑ Increase child mortality and morbidity
❑ Malnutrition, chronic malnutrition (Stunted growth) in
children.
❑ Anaemia and micronutrient deficiency disorders
❑ Due to malnutrition and anaemia in women most
babies will deliver LBW.
4.15 S Y M P TO M O F I L L N E S S E S C O N T I N U E …

How to prevent harmful microorganisms

from food and water
❑ The most important thinks that often a
nutrition counselor can do are to:
✓ Help the community to improve their
water supply and storage
✓ Teach people how to prevent germs from
reaching food and multiplying in it.
4.16 KEEPING FOOD AND WATER SAFE

▪ Keep food safe by preparing, cooking,

and storing food properly to prevent
contamination and food-borne illness.
▪ Keep water safe by treating and
storing water properly to prevent
contamination and water-borne illness.
 IMPORTANT WAYS TO KEEP
4.17 FOOD SAFE AND CLEAN

When buying food:

• Always try to buy fresh foods
such as milk, fish, and meat on
the same day that people cut
them.
• Try to choose food which have no
danger signs.
• Avoid buying and eating can
food.
• Avoid buying and eating frozen
food such as meat, chicken, fish
and etc.
 IMPORTANT WAYS
4.18 CONTINUE…

When storing food:

• Keep fresh food as cool as possible.
• Put in a clean container and cover with a cloth which
is kept damp.
• Store in an airy place such as a food safe where air can
get to it but protect it from reach of flies.
• Store in a refrigerator.
• Make sure that flours, legumes, and oil seeds are dry,
and keep them in a cool dry place protected from mice
and other pests.
4.19 SAFE AND UNSAFE FOOD

To keep us healthy and food that we eat and the

water that we drink must be clean and safe. It
should contain:
➢ No harmful micron-organisms (Germs,
viruses, amoeba or giardia)
➢ No parasites (such as roundworm eggs,
tapeworm cysts)
➢ No toxin (food poisons such as aflatoxin)
➢ No harmful chemicals such as pesticides.
 FOOD HANDLING AND
4.20 PREPARATION
Adhere to all personal hygiene practices like keeping fingernails short while handling food.
1. Construct a tippy tap close to the kitchen to ensure hand washing with soap, before preparing
food.
2. Wash:
• Area where food is prepared at least daily, with water and detergent (Dettol, bleach/Sehat
liquid if available, otherwise soap).
• Raw vegetables and fruits under running water to remove germs, insects, and chemicals,
before storing them.
• All the knives, cutting boards, and plates used after cutting fresh meat with soap and water.
• Utensils used to handle cooked and ready-to-eat food, wash with soap and water and store
on shelf or wall.
3. Prepare raw meat or fish away from other raw foods. Don’t allow juices to touch other foods.
4. Store:
• Fresh and cooked food separately to avoid cross contamination.
• Food on a high rack or shelf inside the kitchen area or inside a cupboard.
• Raw meat, poultry, fish separately from other foods in a bowl, plastic sack, or container.
 FOOD HANDLING Cont…
4.21

5. Keep:
• fingernails short and clean.
• animals (such as chickens, dogs) away from food preparation area.
6. Cook all meat and eggs until boiled or well-cooked throughout.
7. Heat leftovers thoroughly until you see steam or bubbles. Stir to ensure
they are heated evenly. Reheat leftovers only once then dispose.
8. Construct a dish rack near dish washing area to dry and store dishes.
9. Dedicate two or three cloths or nets for covering food. Store with clean
dishes and utensils.
10. Cover:
• Food, especially hot milk with net, tray, or cloth to protect food from
germs and flies.
• Change covering cloth 2-3 times per week. Wash used cloths with soap
and water.
4.22 WHEN PREPARING FOOD

❑ Wash fruit in clean water to remove micro-organisms

and worm eggs.
❑ Prepare food on a table so that dust cannot reach easily.
❑ Cut meat into small pieces so that it cooks to the
middle.
❑ Boil animal milk for two or three minutes, stirring
constantly.
❑ Do not cough, sneeze, spit, or scratch your hair or body
near to food.
❑ Do not pick your nose or lick your fingers when you
prepare food.
4.23 Left over foods should keep
clean and boil before eating.
4.24 Cleaning utensil with soap
before and after eating
foods.
 K E Y M E S S A G E S : 5 WAY S TO K E E P
4.25 FOOD SAFE AND CLEAN

1)Keep clean.
2)Separate raw and cooked foods.
3)Cook foods thoroughly.
4)Keep food at safe temperatures.
5)Use safe water and raw materials
when preparing food.
 STREET FOOD
4.26

Street food is ready-to-eating food or drink sold in a street

or at public place, such as a market or fair, by a vendor,
often from a portable stall. Fried fish, fried meat, fried
potatoes/cheeps, chicken pea soup, kebab, rice, street fruit,
cake & biscuit and chips are common major examples for
today’s street food.
Reasons for purchasing street food
▪ To obtain reasonably priced
▪ Flavorful food in a sociable setting
▪ To experience ethnic cuisines
▪ The urban poor do not have kitchens in their homes.
4.27 Street Food and Hygiene

Some effective ways of enhancing the safety of street foods

are:
▪ Through advocacy and raising public awareness;
▪ Through comprehensive guidance of food safety for the
vendors, traders and retailers of the street food sector;
▪ Through mystery shopping programs;
▪ Through training and rewarding programs to vendors;
▪ Through regulatory governing and membership
management programs;
▪ Through technical testing programs.
4.28 THE DANGER ZONE

➢ In order to substantially decrease your risk of food

poisoning you must keep your foods at a safe
temperature and out of the infamous "danger zone."
Now what exactly is this "danger zone?"

What is the Danger Zone?

➢ As the name suggests, the danger zone refers to the

most dangerous temperature for foods, between 5-
60°C.
4.29 WHY SO DANGEROUS?

➢ A single bacterium can multiply to trillions in

just twenty-four hours when between 5°C
and 60°C.
❑ This is because bacteria double
approximately every twenty minutes under
the right conditions: food, moisture, oxygen
and warm temperature.
❑ Many foods, with their rich supply of
nutrients and moist quality, offer the perfect
environment for bacteria to grow.
❑ You don't want to spur this bacteria growth by
providing a warm temperature as well.
4.30 WATER:
Water is a colorless, odorless and tasteless fluid which
makes around 65% of human body weight. Without water,
life is impossible. The average water use for drinking,
cooking and personal hygiene in any household should be at
least 15 liters per person per day.
Water is used for the following purposes:
▪ Home purposes
▪ Public purposes
▪ Industrial purposes
▪ Agriculture
▪ Energy production
4.31 SAFE DRINKING WATER

➢Safe water is the water

which is free from
harmful bacteria/germs,
toxic materials, or
chemicals, and does not
have taste, smell or color.
It must come from clean
sources such as conduits, Safe and unsafe water sources
hand pumps, covered
wells, covered springs,
and covered canals.
 SAFE DRINKING WATER
4.32

Water sources: are divided into improved &

unimproved:
✓ Improved sources of drinking water are:
Piped water into dwelling, piped water to
yard/plot, Public tap or standpipe, Tube well or
borehole, protected dug well, Protected spring,
Rainwater.
✓ unimproved sources of drinking water are:
unprotected spring, unprotected dug well, cart
with small tank/drum, tanker-truck, bottled water.
 MAKING WATER SAFE TO
4.33 DRINK

Common methods of cleaning water

in Afghanistan
▪ Boiling method
▪ Chlorination method
▪ The sunlight method
▪ Filtration method (Biosand method)
 BOILING & CHLORINATION
4.34 METHOD

➢ Boiling is the common method of cleaning

water in our country. The most reliable method
is to boil the water for at least 3 minutes,
because this kill even the toughest germs.
➢ Chlorination method: To eradicate pathogens
which cause the diseases. There are different
types of chlorine used for treatment of water
such as chlorine gas, solution, sodium hypo
chlorite and solid chlorine.
4.35 THE SUNLIGHT METHOD

➢ This is a very useful method in

communities that have little or no
fire wood for boiling, or cannot
afford to buy bottles of Chlorine
solution.
➢ Done correctly, it is very effective
at killing the germs that cause
diarrhea.
➢ All that is needed for this method
are clear plastic bottles that have
caps.
4.36 FILTRATION/BIOSAND METHOD

❑ The water should be filtered in a

container and pass through three
layers (oval sands, chickpeas sands
and small size sands).
❑ We do not add any chemical to
change the taste or color of the water.
❑ It is a simple way of removing some
disease-causing germs and eggs of
some worms.
❑ This method is the best way to reduce
the health risk of drinking unsafe
water.
 HANDLING AND
4.37 S T O R A G E O F S A F E WAT E R

➢ Drinking water should

be stored carefully to
avoid contamination.
➢ Safe storage requires
that water containers
are designed
according to the
specific criteria.
4.38 HOW TO USE CHLORINE?

➢ Normally 1.5mg chlorine is enough to disinfect one liter of

water. Chlorine should remain at least 30 minutes in water to
disinfect it.

➢ As chlorine is a harmful substance, be careful while using it

and do not bring chlorine close to the skin. Safety cloths,
gloves and mask to be used, do not inhale the stream of
chlorine.

➢ The effect of chlorine on microorganism in water depends on

water clarity, the amount of Chlorine and the time that
chlorine is present in the water.
 POTABLE (CLEAN/SAFE)
4.39 WATER

Potable water should have the following qualities, with

references to (WHO) guidelines:
a) Physical properties: It should be odorless and colorless and
pleasant to taste
b) Biological properties: It should be free from pathogenic
agents (worms, germs and bacteria)
c) Chemical properties: It should be free from any toxic
substances, e.g. arsenic, mercury, lead and nitrates
d) Have essential chemicals: It should contain calcium, iodine,
magnesium, iron and zinc in proper ratio
e) Radioactivity: It should not contain any radioactive elements,
e.g. uranium and radium
4.40 Sources of water

Natural sources: Rain, Ice, rivers, lakes, spring

and streams.
Artificial sources: Canals, wells, hand pump, tube
well, pools and tapes.
 REASON FOR WATER
4.41
CONTAMINATION
❑ Drinking water can be tainted with chemical, physical and
radiological contaminants with harmful effects on human health.
❑ Access to drinking water may be particularly important for
women and children who often bear the primary responsibility
for carrying water, especially in rural areas, often over long
distances.
Water can be contaminated through different ways as following:
▪ Presence of wastes and excreta near to the sources of water;
▪ Defecation near to the source of water;
▪ Use of contaminated and uncovered utensils for drinking water
storage;
▪ Contact of unclean hands and utensils with safe water;
▪ No care from the source of water.
 4.42 HOUSEHOLD PURIFICATION
OF WATER
Commonly applied methods for purifying water on an individual or
domestic scale.
a) Boiling
▪ Ideally all water that does not come from a safe water system should be
boiled before drinking. This is especially important for small children
and at times when there are known cases of diarrhoea, typhoid,
hepatitis, or cholera in the area.
▪ To be effective, the water must be boiled for 5 to 10 minutes
▪ It kills all bacteria, spores, cysts and ova and yields sterilized water
▪ Water should be boiled preferably in the same container in which it is to
be stored
▪ Boiled water usually becomes tasteless, but it is perfectly safe for
drinking.
4.43 HOUSEHOLD PURIFICATION
OF WATER Cont…

b) Chemical Disinfection Bleaching Powder

▪ Bleaching powder or chlorinated lime is
white in color with a pungent smell
▪ Add 2.5 grams of bleaching powder in 1000
liter of water and keep it for one hour
▪ The principle in chlorination is to ensure
“free” residual chlorine of 0.5 mg/liter at the
end of one-hour contact.
4.44

INTRODUCTION TO

4 SANITATION
Nutrition Counselor Guideline
4.45 WHAT IS SANITATION?

❑ Sanitation generally refers to the provision of facilities and

services for the safe disposal of human urine and feces.
❑ Inadequate sanitation is a major cause of disease worldwide.
❑ Improving sanitation have a significant beneficial impact on
health both in households and across communities.
❑ Maintenance of hygienic conditions, through services such as
garbage collection and wastewater disposal.
❑ An improved sanitation facility is defined as one that
hygienically separates human excreta from human contact.
❑ Improved sanitation can reduce diarrheal disease by more than
a third.
❑ Improved sanitation facilities for excreta disposal include
flushing or pouring flush into a piped sewer system, septic
tank, or latrine; ventilated improved pit (VIP) latrine, pit
latrine with slab, and composting toilet.
4.46 2. WHAT IS LATRINE?

➢ The word latrine can refer to

a latrine or a simpler facility
used as a latrine, generally
without bowl.
➢ It can be a communal trench
in the earth in a camp, a
simple pit, or more advanced
designs, including pour-
flush systems or ecological
latrines.
4.47 TYPE OF LATRINES

▪ The dry latrines: that do not use water for human waste disposal.
▪ The flush latrines: are meant for areas where water availability is not
a serious problem

Dry latrines:
Dry latrines are usually of two types
a) Pit Latrine
b) Ventilated Improved Pit Latrine (VIP)

SAFE LATRINE
Safe latrine is a protected latrine which does not spread germs; bad smell to
the outside and should have the following characteristics:
▪ Safe sanitation refers to the secure and effective management of human
excreta.
▪ Without sanitation facilities to safely contain and dispose of human
feces, the health of everyone living nearby is put a risk.
 CHARACTERISTICS OF SAFE &
4.48 SANITARY LATRINE

▪ The latrine site should be on the lower portion of a slope at least 20

meters from any dwelling, river, spring, or well
▪ Side by side wall separated latrine should be used
▪ The latrine should have a window net,
▪ The latrine should have pipe ventilation
▪ The pit should have a depth of at least 1 meter
▪ The top of the pit should be covered by a tightly sealed concrete or
wood platform, laid on top of logs or some other support.
▪ There should be an opening in the top of the frame for urination or
defecation, and this opening should have a cover.
▪ The latrine should have walls and a roof for protection and privacy.
▪ The latrine should be built for away from water sources.
 CHARACTERISTICS OF SAFE &
4.49 SANITARY LATRINE
 CHARACTERISTICS OF SAFE &
4.50 SANITARY LATRINE

A safe latrine is one which does not:

▪ Pollute or contaminate soil
▪ Pollute or contaminate ground water
▪ Pollute or contaminate surface water
▪ Act as medium to fly breeding or access to flies
and animals
▪ Require handling
▪ Produce odor and give ugly sight
▪ Require huge amount and high technology.
4.51

INTRODUCTION TO

4 HYGIENE PROMOTION
Nutrition Counselor Guideline
4.52 WHAT IS HYGIEN PROMOTION

❑ Hygiene promotion is a new way of encouraging practices

to prevent diarrhoeal disease in the home.
❑ Hygiene Promotion is a planned approach to preventing
diarrhoeal diseases through the widespread adoption of
safe hygiene practices.
Personal Hygiene
❑ Personal hygiene is a concept that is commonly used in
medical and public health practices; it involves
maintaining the cleanliness of our body and clothes.
❑ Personal hygiene is defined as a condition promoting
sanitary practices to the self.
❑ We need to learn the proper practice of personal hygiene
and use this for the prevention and control of important
public health diseases that are prevalent in your locality.
 PERSONAL HYGIENE &
4.53
ENVIRONMENTAL HYGIENE

Difference between cleanliness and hygiene:

❑ The term cleanliness should not be used in place

of hygiene.
❑ Cleaning in many cases is removing dirt, wastes
or unwanted things from the surface of objects
using detergents and necessary equipment.
❑ Hygiene practice focuses on the prevention of
diseases through the use of cleaning as one of
several inputs.
4.54 BATHING
❖ Bathing daily during the summer when heavy sweating occurs is
desirable.
❖ The first task in body hygiene is to find water, soap and other
cleaning materials, taking a bath or a shower at least weekly.
❖ The genitals and the anal region need to be cleaned well because of
the natural secretions of these areas.
❖ Dry the body with a clean towel after thorough rinsing and avoid
sharing soaps and towels with others.
❖ Bath every day, or even more frequently when the weather is hot.
❖ Bath after working hard or sweating.
❖ Frequent bathing helps prevent skin infections, dandruff, pimples,
itching, and rashes.
❖ Sick persons, including babies, should be bathed daily.
4.55 TEETH WASHING

❑ The mouth is the area of the body most prone to

collecting harmful bacteria and generating infections,
teeth and gum infections could be a result of poor oral
hygiene.

❑ In older people, the gums may become swollen and red

because of infection. This later causes the roots of the
teeth to become infected and the teeth to fall out. Teeth
should be brushed after every meal, if possible,
especially at night before going to bed.

❑ A brush, Meswak, toothpaste, or salt and soda

compound can be used. Cleaning/washing the mouth is
necessary for everyone.
 4.56 Method of Teeth Brushing

▪ Start brushing your teeth from the right side; brush the outer parts of the
upper and lower teeth in rotation.
▪ Then start brushing from the left side and do it in the same way as the right
side of your teeth.
▪ The chewing parts of the teeth should be brushed from front to the back.
▪ Then the interior parts of the upper and lower teeth should be brushed.
▪ At the end, the surface of the tongue should be softly brushed so that the
germs remaining on the surface of the tongue are removed.
Never spit carelessly
▪ Spitting is not a good habit among most Afghan people. Spit contains
germs that can cause diseases.
▪ Advise people not to spit on the ground, street, public places, and where
children are plying.
▪ When you have to spit, you should spit into a special cloth or a container.
4.57 NAIL CARE

Nails cutting
▪ A nail is hard tissue that constantly grows, long
fingernails tend to accumulate dirt underside.
▪ The dirt could be as a result of defecation or
touching infected and contaminated surfaces.
▪ Keeping nails trimmed and in good shape weekly
is very important in maintaining good health.
▪ Microorganisms collect with dirt under
fingernails and are not easily washed away.
4.58 Wearing Shoes
▪ Shoes or sandals keep feet clean and should be worn
when walking outside.
▪ Walking with bare feet causes skin problems and
injuries as well as providing a way for hookworms to
enter the body.
▪ Foot hygiene is important in the treatment of
podoconiosis, sometimes known as mossy foot.
▪ This disease causes swelling in the feet and lower
legs; it is a reaction in the body to very small soil
particles that have passed through the skin of the feet.
▪ Podoconiosis can easily be prevented by wearing
shoes at all times.
 4.59 CLEAN CLOTHS, WASHING
HAIR
❑ Wearing clean clothes is the sign of good personal hygiene, wearing dirty clothes can cause people to
keep germs on themselves.
❑ Clothes hygiene is an important aspect of one’s dignity. Changing used clothes for clean ones every
day is recommended.
Combing/ washing hair
❑ The scalp has sweat glands and is a surface for the accumulation of dead skin cells, the oil, sweat
and dead cells all add together and make the hair greasy and look dirty.
❑ Poor hair hygiene could cause dandruff and skin infections.
❑ Head hair is a good harbor for head lice and nits. The head louse is a tiny insect that lives by
sucking blood.
❑ Lice spread from one head to another when there is close contact as in school environments.
The recommended procedures:
❖ Use clean water to wash your hair regularly, with body soap or shampoo.
❖ Massage your scalp well; this will remove dead skin cells, excess oil and dirt.
❖ Rinse well with clear water.
❖ Conditioner is helpful if you have longer hair as it makes the hair smoother and easier to comb.
❖ Use a wide toothed comb for wet hair as it is easier to pull through.
❖ Dry the hair and the head with a clean towel.
❖ Comb the hair to look beautiful for the day.
 4.60 HAND WASHING

➢ The cleanliness of our hands is very important in all our daily

activities. In our normal activities, our hands frequently get dirty, there
are many communicable diseases that follow the route of feco-oral
transmission, hand washing (hygiene) plays a critically important role
in preventing this transmission.
Who should wash their hands?
➢ Everyone should wash their hand, adults, young people, adolescents,
children, and babies. If children are unable to wash hands by
themselves, an adult should help them.
With what should we wash our hands?
➢ We should wash our hands with water and soap. Soap is the best
cleanser to use, but if no soap is available or affordable, you can use
ash, sand, or even mud as an alternative to soap. You should then rinse
under a stream of water.
4.61 HAND WASHING
4.62 STEPS OF CORRECT HAND WASHING

1. Wet hands with clean water

2. Apply soap on your hands
3. Rub your hands together and clean under your nails.
4. Rinse hands under poured or flowing water to remove dirt
and germs.
5. Dry your hands in open air.
 4.63 WHEN SHOULD YOU WASH
YOUR HANDS?
▪ Before handling food ▪ After going to the toilet
▪ Before/after preparing and cooking ▪ After handling rubbish
food ▪ After handling raw meat or poultry
▪ Before/after eating ▪ After handling chemicals or
▪ After changing a baby’s diaper/cloth pesticides
▪ After blowing your nose ▪ After touching animals
▪ After caring for someone who is sick ▪ Urinating or defecating

Critical situations in healthcare activity include:

▪ Before and after contact with an infected wound.
▪ After contact with blood or body fluids (e.g. vomit).
▪ Before and after dressing wounds.
▪ Before giving care to an at-risk person (attending delivery, attending a baby).
▪ After giving care to an infected person.
4.64 HAND WASHING
4.65 ENVIRONMENTAL HYGIENE:

❑ Involves keeping home environment clean and free from vectors.

Environmental hygiene encompasses solid waste management,
liquid waste management and vector control.
❑ Solid waste is defined as any unwanted residue, remains, leftovers,
discarded materials or by-products that are no longer
required/needed by the initial user/producer.

Objectives of proper solid waste disposal

❑ To prevent diseases
❑ To maintain a clean environment
❑ To encourage resource recovery through salvaging
❑ To prevent contamination of water, land and air
❑ To reduce rate of fly breeding and other vermin like rats and mice
❑ Solid waste is classified under domestic waste, street waste,
commercial waste, industrial waste, agricultural waste and
medical/hospital waste.
6.66 DISCUSSIONS