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For Somalis, Despite its Wonderful Contribution to Public Health, Sanitation still a Taboo!

by Noah Arre
Wednesday, October 12, 2016

The other day, sitting at a cafeteria in Hargeisa for a cup of coffee, a friend of mine and I had just had a casual talk. He is one of the old folks who went to school in the British era and throughout the progressive days of Somalia when education was competitive and excellence was based solely on merit. Additionally, he has a post-graduate degree from Colombia University, New York, USA and with over forty years work experience in different fields. That literally means he is an expert in many fields: teaching, program management, science and technology, management, etc. And he is also a famous trainer of the young generation in this country for years.     


By profession I am in the water, sanitation and environment sectors and knowing of their great role, value and place in human health, any mention/discussion of them takes me into a familiar territory where I can answer all my why's and how's!


First, working in those areas for over 30 years, I understand that water is the source and sustenance of all life. And provision of adequate, safe and sanitary water and the proper maintenance of hygiene and sanitation are the basis for a healthy living; whereas poor hygiene and sanitation in your home or in the environment can have devastating impacts on your life and well-being.  


Unfortunately, water becomes easily contaminated. In fact, some reports say that one gram of a healthy person's feces (let alone a sick one) for instance, can pollute thousands of gallons of water because poop contains countless microorganisms many of which are pathogens that have the potential to make a whole community sick or dead.  


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My dear friends, did you know that our Earth is awash with microorganisms? And believe it or not, it is estimated that there are 5, 000, 000, 000, 000, 000, 000, 000, 000, 000, 000 or  5X1030 microbes in it... (SIGS's)…the Earth Microbiome Project 2011 (world's population is 7,125,000,000 or 7.125X 109). Many of these microbes are uni-cellular, many others are multi-cellular yet microscopic. And despite their unbelievably, tiny sizes and primitive body development, conditions favorable to them, many have the potential to cause epidemics that can destroy communities as large as the population of Hargeisa or that of any other town in days.


Fortunately, most are harmless and in fact are helpful. And it is only the pathogenic group that causes diseases; but through proper hygiene and sanitation, and/or treating wastes (including that of humans) and disposing them (wastes) off safely to the environment, we can control killer microbes and thereby, protect ourselves from the diseases they cause.

Catherine Guthrie in (Experiencelife.com) says " the average person has one hundred trillion bacteria cramming inside his/her gut; scoop them up and they would weigh over a kilogram..." (poop is 60% microbes); "and linked end-to-end, they would circle the whole globe two and a half times". Fortunately, without the harmless majority, you could not digest your food; and digestion is only part of what these miracle achievers accomplish.  And during their residence in the intestines, they help power 60 percent of the body’s immune system.

"However, because our gut is porous (that is how it absorbs nutrients from food), it is also vulnerable to invasion to murderous microbes. Over a person’s lifetime, the gastrointestinal track handles roughly 60 tons of food. And while food brings nourishment, it can also be the Trojan Horse for diseases."


Friends, does this sound alarming? Yes, but do not panic because majority of world's microbes are harmless. On the contrary, they are helpful. For instance, without them, you would not be able to digest the food you eat so that it (food) is utilized by your body for nourishment and growth. Without them, our environment would be inundated with wastes because it is they that help decompose them (wastes) into their basic ingredients sending their (wastes) components back to the environment (soil) so that plants may use them for food. And without them, the whole soil could lack the fertility it always needs to support plant life and thereby support ours.


Additionally, it is the nitrogen-fixing bacteria that helps maintain the nitrogen cycle so that the right form of nitrogen is available to plants in its absorbable form....(nitrates) thereby contributing to formation of the basic blocks of the living human/animal/plant cells.


However, in history, microbes played havoc on human health. For instance, smallpox (430 BC. - 1979); killed more than 300 million people worldwide; Spanish Flu (1918 - 1919):  killed 50 to 100 million people worldwide in less than 2 years; Black Death (1340 - 1771): killed 75 million people worldwide; Malaria (1600 - today): kills about 2 million people per year; the Cholera pandemics (1817 - today): kill hundreds of thousands yearly worldwide; Typhus (430 BC. - today): kills 3 million people between 1918 and 1922 alone  (Ref: Oddee Entertainment Blog, 2007 Report.

In general, epidemics are from waterborne disease caused by infected people who relieve themselves in the open air or in waters; but in the process they (epidemics) may wipe out entire communities. In the olden days, when this happens it often resulted that panicky survivors (thanks to ignorance) packed up their belongings and fled from the "evil spirits" inhabiting their place of residence to some other place.

Nonetheless, as civilizations progressed, more people clustered into cities sharing communal water, food, stepped on excrement from casual discharge or spread as manure. But people of those days had no idea the true cause of their misery and often believed a divine retribution caused plagues and epidemics.

So, they asked, if it is not a divine retribution:

1.               What else would cause such agonizing deaths, accompanied by fever or hallucination; the body wracked by yellow, green, or black vomit or excreta?

2.               Why else would such sickness remain for months, then leave suddenly and reappear years later?

3.               Why else such miseries were replaced by a plague that is much more deadly?


Later, cholera (water borne disease) had proven as one of history's deadliest killers. The good news however, is that it was through cholera epidemics that epidemiologists finally discovered the link between sanitation and public health, which provided the drive for modem water and sewage systems.


So, having all these facts at the back of my mind, I said to my friend in that cafeteria talk, "it is sad that all wastes (liquids or solids) including that of humans, from our towns and villages are discharged into this country's environment without treatment. Do you know that these pollute our water sources (ground and surface water) and when we drink them you can get sick?  No wonder, many here are sick queuing up at understaffed and ill-equipped hospitals in droves."


Surprisingly, apparently confused and irritated, my friend asked me... "What else would you do to filthy human feces?" and my answer was "using simple and cheap technology, we could collect wastes, treat them to safe levels and reuse them as water/fertilizer. In fact, all countries, developed or underdeveloped, rich or poor, do just that.


"And fortunately, doing that has dual advantages: it destroys killer microbes in the wastes and what is left is a highly useful product (humus) that is awash with nutrients for plants (farms)... It is a fertilizer. And in fact, this could be a profitable and sustainable business for anyone who ventures into it!"


To my surprise, my friend spontaneously exploded and angrily said, "You are disgusting! How can you even mention dealing with human feces? It does not matter if it brings a lucrative business that could make you a billionaire in days? A human waste is a waste ....a dirt that is too sickening to mention let alone handle!"


Jolted and taken aback in shock, I whispered, "Is this the typical mindset of the typical Somali...be he/she a layman or an intellectual? Does my friend really know that scientifically proven estimates say that 80% of patients in hospital beds in Third World hospitals are there because of poor hygiene, sanitation or waterborne diseases?  What a shame!"


My dear readers, I assume that we know that hygiene and sanitation improved man’s health significantly.

I assume that we know that diseases that once scared man by killing thousands in one go are no more.


Indeed the World Health Organization writes:

(a) "Sanitation is the cornerstone of public health."

(b) "Improved sanitation contributes enormously toward human health and well-being."

(c) "And through proper hygiene and sanitation interventions alone, the risks of contracting diarrheal disease can be reduced by a third."


Despite these established facts and glaring realties of the roles pathogenic microbes played and continue to play in human health, today, (September 2015), wastes, including human feces, inundate our environments untreated in every town and village in this country! 


So, my dear readers, let me ask you:

1.                  Is Somaliland really on par with the above WHO facts?

2.                  Did you ever ask yourself "why are our hospitals beds always full with patients?"

3.                  Did you ever ask yourself "why are diseases like diarrhea, dysentery, hepatitis, cholera, etc. rampant and recurrent here?"

4.                  Did you ever ask yourself "why is the life span of the people here less than 50 years, when that of the developed world people is over 80 years?"

5.                  Did you ever ask yourself "does human waste (feces) from our towns that is discharged into our waterways or to the environment untreated have a devastating impact on our health?"

6.                  Did you know that treatment of water and wastewater contributes to public health and that is why it is also one of the primary indicators of a national development?

7.                  And did you know that Somaliland cities and towns are probably the only few places in the world where wastes including human feces are discharged to the environment untreated?

8.                  Did you know that if a nation treats its wastes (liquid/solid), its people's hospital visits will nosedive dramatically?


And finally, friends since all wastes in this country, (including pathogen rich domestic wastes), are discharged into the environment untreated, it may be a high time we act decisively and do something about the looming catastrophe that may follow! Otherwise, the health and well-being of our people will remain in the doldrums for decades if not for centuries to come!

Noah Arre
[email protected]

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