Health/hygiene, sanitation, and water: Is cleanliness next to whatever has replaced godliness?

Astier M. Almedon
Heny R. Luce Professor of Science and Humanitarianism at Tufts University, Boston, US

The old dictum, Cleanliness is next to godliness, attributed to the theologian and philosopher Saint Thomas of Aquinas may ring hollow in the ears ofmany in the world today, to whom access to appropriate sanitation and safe drinking water is denied. During St Thomas’ lifetime, about 800 years ago, godliness was the highest moral virtue to which believers aspired; and cleanliness of the body and the spirit was next. In this day and age of globalization however, where some highly educated, trained and skilled physicians reportedly still do not bother to wash their hands after touching one infected wound or contaminated object, before they go to touch the next patient; it seems hard to decide whether cleanliness is a virtue or a vice, or both; and where it sits in relation to godliness, or whatever has replaced godliness.

There are“global giants”, multinational companies such as Unilever, who have amassed excessive amounts of wealth by means of highly skilled and successful social marketing of soap and other detergents for domestic use in both rich and poor countries , ethically. What once seemed to be a simple act of washing hands with water and soap to remove dirt now seems no less complicated and worthwhile than
the art and science of heart surgery, at least in terms of getting it absolutely right – without killing the patient. The only difference might be that a doctor will take pride in her/his surgical competence and want to show off, but not feel the same way about mastering the art of washing hands with soap, rubbing between fingers and scrubbing nails to remove all traces of contamination in the course of her/his daily ward round.

This volume brings home to the reader some of the subtle and intractable issues facing African health care systems, health workers, hospital patients, and people in the community today. Specifically, three research papers focus on hygiene practices in Keren hospital, Eritrea (Samuel et al.,) set in the wider context of prevention and control of hospital acquired infections (HAI), otherwise known as nosocomial infections internationally; adoption of improved sanitation-related hygiene practices in the Eastern Cape Province of South
Africa (Nuntsu et al.,), and drinking (spring) water quality in two parishes of Kampala, Uganda (Haruna et al.,)