Small Germs, Big Risks

Author- Dr Azuka Chinweokwu  Ezeike,  MBBS, FWACS, FMCOG, MSc(PH) WHO Fides Member

‘Small germ no dey kill African person’

One thing that working in medical communications has given me is a heightened awareness of my surroundings.

The other day, I was at the market. Sugarcane is a common fruit in the northern part of Nigeria, and vendors often hawk it around markets and streets, carrying the canes on their shoulders.

On this particular day, I was at a shop when one of the shop occupants called over a sugarcane trader. When the trader arrived, the man paid for the sugarcane, and the vendor brought the cane down from his shoulder, cutting out a portion for him.

To my surprise, he started eating it immediately. When I asked why he didn’t wash it first, he replied, “Small germ no dey kill African person”(Nigerian pidgin English) 

 He believed that whatever germs were on the unwashed sugarcane were too insignificant to cause harm.The issue wasn’t the unavailability of water. 

It was a problem of perception and understanding. But how far is this from the truth?This underscores the urgent need for community education on infection prevention practices. 

This is why WASH (Water, Sanitation, and Hygiene) programmes must be integrated and effectively communicated to African communities. Proper WASH practices are crucial for maintaining health and well-being.

An effectively implemented WASH programme can significantly reduce the burden of Neglected Tropical Diseases (NTDs) and diarrhoeal diseases.

 The World Health Organization (WHO) supports governments by providing and disseminating evidence-based guidelines and data to member countries.

What is WASH, and how does it affect health?

• W – Water: This includes both drinking and recreational water. By 2020, about 26% of the global population still lacked access to safely managed drinking water. Contaminated water remains a major health risk, contributing to an estimated 485,000 deaths from diarrhoeal diseases annually, along with worsening malnutrition and other illnesses. Microbial or chemical pollution of recreational water also poses health risks.
• S – Sanitation: Proper sanitation involves the safe disposal of human and animal waste. Poor sanitation led to approximately 432,000 deaths in 2020. It is also linked to increased antibiotic resistance. 
• H – Hygiene: Personal hygiene is essential for health promotion and disease prevention. Key aspects include:
  • Handwashing
  • Menstrual hygiene
  • Food hygiene

Inadequate hygiene behaviours are a significant risk factor for infectious diseases. In 2016 alone, poor hygiene was estimated to have caused 165,000 deaths from diarrhoea

.From these statistics, it is clear that unsafe WASH practices are detrimental to health. Governments, health organizations, non-governmental organizations, and other public health stakeholders must take this message to the grassroots.

No germ is too small to be harmful. 

To rephrase the statement we started with: Germs can kill an African person.

Key statistics and information sourced  from the Compendium of WHO and other UN guidance in health and environment, 2024 update