Transmission of Infections: Rich at Funeral Grounds in Ghanaian Culture

When was the last time you shook hands with someone either at will or out of compulsion? Did you know where the person you shook hands with was coming from? Were you aware of what the person had used the hands for and what the person had come into contact with? This reminds me of someone who I obviously saw sneezing into the palms and later stretching forth to shake me. The rest is in the details. Out of love, you cannot suppress handshake in the Ghanaian culture but these could be done with caution to prevent the spread of infection.

At funeral grounds, one thing you cannot avoid is the regular handshake with the family and friends available. In doing so, be mindful that “up to 80 percent of all infections are transmitted by hands, according to estimates by the US Centers for Disease Control and Prevention (Read more at https://www.channelnewsasia.com/news/singapore/bacteria-living-on-your-hands-10067062).”

Where do we get germs from?

Naturally, we have some germs on our human body including the hands which are commonly used for handshaking. The germs are either on the surface of the palm or hiding under some “crevices” created by injury or scars after healing.

On the palms of our hands, we have some germs like Staphylococcus epidermidis, propionibacteria, corynebacteria, dermobacteria, and micrococci. What readily comes to mind is that some of these germs are associated with pimples and other skin infections. We also have some fungi (Pityrosporum (Malassezia) spp) which are resident skin flora commonly associated with skin eruptions (“krɔ”: in Ashanti Twi ). Other infections that can be spread by germs on our hands include Methicillin-resistant Staphylococcus aureus (MRSA) and E. coli.

“Feces (poop) from people or animals is an important source of germs like Salmonella, E. coli O157, and norovirus that cause diarrhea, and it can spread some respiratory infections like adenovirus and hand-foot-mouth disease.” These kinds of germs can get onto hands after people use the toilet or change a diaper and get hands contaminated with invisible amounts of poops. “A single gram of human feces—which is about the weight of a paper clip—can contain one trillion germs.” So imagine shaking someone with such contaminated hands at the funeral grounds.

Another common observation is that germs can also get onto hands if people touch any object that has germs on it because someone coughed or sneezed on it or was touched by some other contaminated object. When these germs get onto hands and are not washed off, they can be passed from person to person and make people sick.

Below are pictures of organisms that were grown from human hands after some exercises that are routinely done without caution.

How germs can cause infection?

When Kofi Nimo greeted Ololo at the funeral, little did he know that Nimo had just returned from responding to nature’s call. Without making sure his hands were cleaned, Ololo at a later time used his contaminated hands to wipe his itchy eyes. This could lead to an infection of the eye because germs that are not expected to be there from Nimo’s hand had been introduced.

Common among some people is the jamming of the fore-finger into their itchy ears to get relief. Ololo, could introduce the germs he picked from Nimo during the handshake and that could cause an infection too.

Ololo right after the handshake with Nimo, took out his phone to browse and make some calls. He had also introduced the germs from Nimo on his hands to the mobile device. Not cleaned when he went home, his young daughter who usually plays with Ololo’s phone took it and intermittently licked it. They wondered why she developed severe diarrhoea three days later.

We all have a responsibility to curb the transfer of germs from person to person.

What can we do?

Handshaking is obviously a cultural thing that cannot be overlooked. Most especially at funeral grounds and functions that bring people together. But we could take some cautions to minimize the spread of germs from people to people.

The person who went to the funeral with unwashed poops contaminated hand may exchange with those who had come to that same grounds with unwashed sneezed and cough contaminated hands. Tit for tat you may say but one may also think it is not fair to the one who came with cleaned hands.

There is nothing like sterile hands. Germs are all over us and in fact, we even need them to survive. The “hygiene hypothesis” will tell you that it is dangerous to have so much cleaned environment.  Your body’s immune system that does not get the opportunity to meet several germs to learn how to fight them may even start fighting your own body with the least trigger in what we may describe as autoimmune conditions.

However, too much of everything is bad. A load of germs beyond a certain threshold could be harmful and even when not much depending on the location of the germ, just “one” could cause serious infection.

It is abundantly clear that just handwashing makes a huge difference in preventing infection transmission. We are in a system where the preacher of good hygienic practices is likely to be stigmatized as “Mr Hygiene”. People, therefore, shy away from doing what is right even if they could afford it. What can bring everyone on board?

CDC advises as below;

In general, resident flora is less likely to be associated with infections but may cause infections in sterile body cavities, the eyes, or on non-intact skin

Handwashing with soap removes germs from hands. This helps prevent infections because:

• People frequently touch their eyes, nose, and mouth without even realizing it. Germs can get into the body through the eyes, nose and mouth and make us sick.
• Germs from unwashed hands can get into foods and drinks while people prepare or consume them. Germs can multiply in some types of foods or drinks, under certain conditions, and make people sick.
• Germs from unwashed hands can be transferred to other objects, like handrails, tabletops, or toys, and then transferred to another person’s hands.
• Removing germs through handwashing, therefore, helps prevent diarrhea and respiratory infections and may even help prevent skin and eye infections.

Recommended Interventions

We need a deliberate public health education on how to control disease transmission at personal levels and public gatherings. Knowing this will let everyone know that, we do not live on islands but as a community in everything we do. This will make everyone conscious.

We can set up hand-washing points with “Veronica buckets” and soap at points on funeral grounds to enable everyone to wash his/her hands after exchanging greetings and necessary pleasantries as custom demands.

For those that could afford, hand sanitizers could add to improving hand hygiene and others may benefit from herd-effect of such practices.

Anytime you are going to shake a hand, be kind enough not to contaminate the person. Keep a cleaned hand as much as possible.

Our children should not be innocently exposed to germs and infections.

Disclaimer: DAG is a lover of handshake and hugs where appropriate without discrimination. But these keep coming to mind anytime infectious disease prevention comes to mind.