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Contextualising COVID-19: Hygiene Practices

Social distancing and self-isolation are essential in slowing the spread of COVID-19. This is considerably more challenging without access to a household toilet. Shared facilities pose a greater risk as they are more likely to be a source of both airborne and contact exposures to the disease, especially if there is not adequate water and soap (Caruso et al, 2020). 

Who is at most risk?

32% of sanitation in urban Sub-Saharan Africa is shared. Women are disproportionately at risk due to more frequent use for meeting their own needs such as menstruation, but also for assisting dependents. Open defecation practices may increase to avoid the potential risks at facilities. However, this untreated human waste can spread deadly and chronic diseases in the environment (Caruso et al, 2020).

The pandemic has highlighted the importance of everyone having access to clean water to prevent the spread and has exposed how governments have continually neglected to invest in clean water, soap and decent toilets.

The promotion of sustainable sanitation systems combined with knowledge of good hygiene practices are a strong defence against COVID-19 as well as future disease outbreaks. Sustainable sanitation systems are those which capture ‘human waste in a safe, accessible and dignified setting’ which is then stored in a tank, treated and disposed of safely and reused where possible (worldtoiletday, 2020).

WHO and UNICEF have identified a range of measures that must be implemented for schools to operate safely during and beyond the COVID-19 pandemic. They recommend ‘all schools enforce regular handwashing, ensure daily disinfection and cleaning of surfaces, provide basic water, sanitation and waste management facilities, and follow appropriate environmental cleaning and decontamination procedures.’A recent survey undertaken in Nigeria revealed that only 14% of rural schools had soap and water available in the girls’ toilets. Even fewer schools had covered bins and mechanisms for disposing of menstrual products. 

Interestingly, girls are also more likely to use soap when washing their hands than boys. For example, in Yemen, 52% of girls reported always using soap compared with 32% of boys (WHO & UNICEF, 2020). 

Thus, it is necessary to promote a culture of hygiene in schools and the wider community. Providing soap and water is crucial but will not make much of a difference if the importance of handwashing is not iterated and enforced with both genders, but especially to boys to reduce the spread of disease outbreaks such as COVID-19. Physical distancing in queues along with the regular cleaning of facilities is also important but this should not be assigned disproportionately to women. 


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