Hygiene Personal hygiene is an important part of preventing the contraction and spreading of communicable diseases. Hands should be washed in the following circumstances: before touching the eyes, nose and mouth, before eating or handling food, after using the toilet, when hands are contaminated by respiratory secretions from coughing or sneezing, after touching public installations or equipment, such as door knobs, after handling soiled articles. The proper way to wash hands is: 1. Wet hands under running water. 2. Apply liquid soap and rub hands together to make a soapy lather. 3. Away from running water, rub the palms, backs of hands, between fingers, backs of fingers, thumbs, finger tips and wrists. Do this for at lease 20 seconds. 4. Rinse hands thoroughly under running water. 5. Dry hands thoroughly with a clean cotton towel, a paper towel, or a hand dryer. 6. The cleaned hands should not touch the water tap directly again. The tap may be turned off by using a towel wrapping the faucet. (Guidelines for Good Handwashing, www.chp.gov.hk/files/pdf/grp-handwashing-en-2004052100.pdf)
It is also important to note that towels should never be shared and used paper towels should be disposed of properly. Personal towels to be reused must be stored properly and washed at least once daily. It is even better to have more than one towel for frequent replacement. If hand washing facilities are not available, hands should be rubbed with 65-95% alcohol solution to disinfect. Sanitation Poor sanitation and the absence of minimal facilities for safe wastewater disposal contribute to the degradation of groundwater, rivers, and coastal resources. Poor sanitation translates into squalid living conditions, high vulnerability to environmental hazards such as flooding, and increased prevalence of water-related infections and diseases. (The World Bank Group's Program for Water Supply and Sanitation, The World Bank Group, 7) One reasonable theme that emerged from case studies by the Building Partnerships for Development in Water and Sanitation Organization is the sanitation ladder. This is a tool used to outline the sanitation options available to individual households. The method focuses on gradually improving sanitation for a given household or community. The lowest rung on the sanitation ladder is the communal toilet block, which is open to anyone (www.bddws.org). While it may not be the most ideal situation as the latrine will have many users, it is the first option that can help a community move into better options. The next step up is a shared latrine, which may be shared by a small group of people. The ladder shows how a household can eventually move up the ladder to a household latrine for the members of the household on up to a toilet that has a sewage connection. The sanitation ladder helps someone see where they are and envision where they want to go in terms of sanitation. (David Schaub-Jones, Kathy Eales, and Linda Tyers, BPD Sanitation Series: Sanitation Partnerships, Harnessing their potential for urban on-site sanitation, www.bpdws.org, 4-5) The cheapest and most simple form of sanitation is the pit latrine, which consists of a square, rectangular or circular pit in the ground, covered by a cover slab or floor. A hole in the cover slab or floor allows excreta to fall down into the pit. Depending on user preference, a seat can be installed and a lid to cover the hole. The latrine is covered with shelter and a door is added. It should be situated at least 30 or more meters away from water sources and should be at least 6 meters away from any house so that it is easy enough to reach, but not so close that odors are a problem. A pit latrine should be located downhill from your water source and should not be built uphill of a well because fecal matter can find its way into the well. The pit should not penetrate groundwater and should be at least two meters above the water table. The site should also be well drained and above the flood level. (Water Supply and Sanitation, CRS, Simple Pit Latrines)
One of the problems with pit latrines is their conduciveness to fly breeding. Flies should be kept from breeding in the latrine as they can carry disease from the latrine to food. The common house fly lays its eggs in excreta and crawls and feeds on it, picking up germs as it does so. Flies are attracted by light and odor and avoid darkness and dark surfaces. All openings that lead to excreta must be kept clean and closed when not in use. A tight seal between the pit and the squat hole is important as is a door that seals properly. Keeping flies out of the shelter will go a long way in keeping them from coming in contact with excreta.
The pit must be lined to keep it from collapsing and to contain the contents. Many different materials can be used to line the pit. Examples include concrete blocks, bricks, cement-stabilized soil blocks, masonry, stone rubble, perforated oil drums, and rot-resistant timber. When blocks, bricks, masonry or stones are used, the lining joints should be fully mortared in the top 0.5 meters of the pit. Below this, the vertical joints should be left un-mortared to allow the liquid part of the excreta to flow into the soil. The base or foundation is a solid foundation upon which the floor can rest. It prevents flooding of the pit by surface water and helps prevent the escape of hookworm larvae, which can climb up the pit walls, and the entrance of burrowing rodents into the pit. The base should be high enough to raise the floor at least 100 to 150 millimeters above the level of the surrounding ground to protect the pit from flooding. The base or collar may be circular or square. The floor or slab supports the use and covers the pit. It should fit tightly and be flush with the outer edge of the base. The slab must be larger than the pit and rest firmly on the foundation or base to avoid the danger of collapse. It can be made of reinforced concrete, rot-resistant wood or bamboo covered with a layer of mud and cement mortar. The slab should have a smooth surface and slope toward the squat hole to provide drainage for urine and water used when cleaning the floor. The opening should be no bigger than 250 millimeters so that it is too small for a young child to fall through. It is important to use a lid to cover the squat hole or seat as it keeps light out of the pit and helps to stop flies and odors. The lid is usually made of wood. The shelter can be constructed from local materials and gives privacy and protects the latrine from the weather. It should be high enough for comfort and openings of 100 to 150 millimeters width should be provided at the top of the shelter walls for ventilation. These openings will have to be covered with fly netting to keep flies out. The roof should cover the shelter completely and have a large over hang to protect the walls from drainage from the roof. The latrine will require routine maintenance that will help prolong its existence and maintain ideal conditions. Grass or plants growing around the latrine should be trimmed and the door should be kept closed. The floor should be kept clean by using water or ashes. Tins, glass, or plastic should not be thrown in the pit. When the contents of the pit reach a level of 0.5 meters from the surface, the contents of the pit should be covered with soil and a new pit dug. During an epidemic the floor of the latrine should be cleaned daily with a disinfectant such as bleach. To keep mosquitoes from breeding in the pits, it is important to keep the area as dry as possible. If too much water enters, ashes or dry horse or cow dung thrown in the pit will help to absorb water and odors. Disinfectants should not be added into the pit. (Water Supply and Sanitation, CRS, Simple Pit Latrines) While I do not have personal experience with a pit latrine, a friend from Kenya has seen the practicality of this type of pit in use. A detailed documentation of this type of pit latrine construction can be obtained from Catholic Relief Services. They can provide you with a CD-ROM titled, “Water Supply and Sanitation”. Copies of this CD can be obtained by e-mailing firstname.lastname@example.org. This CD also contains many other options for well and latrine construction and other resources, which you may find helpful.