Familie Kieviet in Senegal

“Who has washed his hands before joining the table?” asks one of the nurses in a loud voice. I am just about ready to start a class on hygiene, when a grateful patient brings in a big plate of food. Without hesitating, the employees start eating. We all eat from the same large plate, as common here in Senegal. Some use a spoon, most eat with their hands. I have started coordinating the teaching on Friday afternoons, for the medical personnel of about 25 people. Each time I teach myself, I always involve one of the nurses; this time Yvette. Many of the patients we treat daily have diseases related to hygiene. Diarrhoea caused by dirty water, scabies because of lack of personal hygiene, various worms and parasites through unwashed hands, but also malaria and worms live in still water and crawl through the skin.

I explain some things on the common syndromes and Yvette shares animatedly how water and sanitation are arranged in the district where the clinic is located. “Most people in this neighborhood do have running water in their homes, but there will often be no water from the tap. They must still walk to the well. The water they drink is – unfortunately – usually not filtered.” We round off with advice on hygiene for our patients and for ourselves. Because good care also means good professional hygiene. The fact that the clinic ceases to have water every day after 11 o’clock is put forward as most urgent point to improve. How else can we properly wash our hands? Even in a large study on most effective hygienic measures, washing one’s hands is proven to be the most important (Fewtrell et al. 2004). We close with a contest: “which percentage of the Senegalese has running water in the house?” The correct answer: 39%, a bottle of bleach is quickly earned!