REVIEW OF RELATED LITERATURE
Microbial load on unwashed hands
There are grave consequences when people do not wash their hands or wash them improperly. It is known that hands are the main media for contaminants getting to people, whether the infections are airborne, oral or tactile. Infectious diseases that are commonly spread through hand to hand contact include the common cold, and several gastrointestinal disorders such as diarrhoea (WaterAid, 2006). Human hands usually harbour microorganisms both as part of a person’snormal microbial flora as well as transient microbes acquired from the environment (Lindberg et al, 2004). According to Kartha (200!), many people consider handwashing a waste of time. However, they are unaware that hands are hosts to many bacteria and viruses that can cause infectious diseases. Every human being comes in contact with germs and bacteria in their daily life. These harmful microorganisms are present all around – on door knobs, faucets, light switches, tables, and railings. People touch these things during the day while doing their routine work without much thought, and then touch their face, eyes, nose, and sometimes eat food too. Through these acts, the microorganisms get into the body, causing several diseases. People, who are careless at washing hands, risk catching flu, or cold, or any gastrointestinal illness (Kartha, 2001). Mayo Clinic (2009) also asserted that as people touch one another, surfaces and objects throughout the day, they accumulate germs on their hands. In turn, they can infect themselves with these germs by touching their eyes, nose or mouth. Hands serve as vectors transmitting pathogens to foodstuffs and drinks and to the mouths of susceptible hosts (Huttly, 1997). Many food borne diseases and pathogenic microorganisms are spread by contaminated hands. If pathogens from human faeces enter a person’s mouth, they will cause diarrhoea. School going children are exposed to greater risks of diarrhoeal disease by consuming contaminated water and food (Dasgupta, 2005). Students in schools or colleges are more likely to take meal and water without washing hands and may be exposed to risk of infection (Tambekar et al, 2007). If proper treatment is not given, this can prove fatal, particularly to children (WHO, 2006). In Ghana, funeral celebrations are very important social functions at which hundreds of people gather. From experience, one important activity during such gatherings is handshaking. Indeed, it is considered offensive and disrespectful for cultural values when one does not proffer his hand for shaking. It is however unfortunate that when people are served snacks and food during such occasions, handwashing facilities are not made available. People therefore eat with unwashed hands. The advent of some serious gastrointestinal illnesses (for example, cholera) had been traced to such gatherings.
Handwashing is defined as the act of cleansing the hands with water or other liquid, with or without the inclusion of soap or other detergent, for the purpose of removing soil or microorganisms (Biology-online, 2011; Medconditions, 2011). 2.6.1 Attitudes of handwashing
Handwashing has been an age old practice globally. It is carried out for varied reasons, including religious, cultural, health and moral reasons. Attitudes towards handwashing are very important. They go a long way to determine the practice of handwashing and its effect on health. In a study by Hoque et al (1995), 90 women from randomly selected households in rural Bangladesh were observed washing their hands after defaecation. Thirty-eight percent of the women used mud, 2% used ash, 19% used soap, and 41% used water only without a rubbing agent. A total of 44% of women washed both hands, while 56% washed only their left hands. About 78% of the women dried or wiped their hand on their clothes and the rest let them air dry. According to SHEWA-B (2007), in Bangladesh (and in some...
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