Microbial Quality of Communal Hand Washing Water at African Funerals in the Mangaung Region

Abstract

African people’s lives are defined by various ritual practices. At funerals a cleansing ritual is performed to wash away bad omens attracted at the cemetery. This ritual entails the washing of hands in a communal hand washing bowl of standing water outside the gate of the bereaved family’s house. Many mourners wash their hands in the same bowl without replenishment of the water. Depending on mourners’ hygiene practices, they introduce microorganisms into the water during the ritual. These microorganisms may be pathogenic or of faecal origin. Because mourners allow their hands to air dry and traditionally eat their funeral meal with their bare hands, they are at risk of ingesting pathogens. Therefore, the aim of this study was to investigate the microbial quality of communal hand washing ritual water at 42 African funerals in the Mangaung region of Central South Africa. Microbial water quality was determined for water samples collected from the yard tap (the control), and from a communal hand washing bowl before and after the ritual. Total aerobic bacteria were enumerated using the heterotrophic plate count (HPC) method, while coliform bacteria and Escherichia coli were enumerated using the Colilert-18 method. Residual free chlorine was also determined as an indicator of efficacy of the disinfection process. A health potential index (HPI) that describes the potential health threat of a water sample was also calculated for each sample. Residual free chlorine levels, HPC values, number of coliforms and number of E. coli were all within the prescribed limits for all yard tap samples. Free chlorine levels were mostly less than the prescribed limit for more than 50% of the samples taken before the ritual, while all samples taken after the ritual had less free chlorine than prescribed. Percentages of funerals with compliant water samples taken from the bowls before the ritual were for HPC, 95.2%, for coliforms, 78.6% and for E. coli, 88.0%. This demonstrates that some bowls were contaminated before the commencement of the ritual. A substantial decline in water quality was evident for the samples collected after the ritual. The percentage of compliant funerals for the water samples taken from the bowls after the ritual were for HPC, 45.2%, for coliforms, 2.4% and for E. coli, 47.6%. The calculated HPI also showed that all the yard tap water samples were safe. The water samples collected before and after the ritual showed an increase in the number of samples that posed an intermediate or high health threat to mourners. For the samples collected before the ritual, 7.1% funerals posed an intermediate threat and 7.1% funerals posed a high threat to mourners. For the samples collected after the ritual, 26.2% funerals posed an intermediate threat and 59.5% funerals posed a high threat to mourners. This study supports the notion that the water in the bowls used for the hand washing ritual were contaminated before the ritual, which can only be attributed to prior contamination of the bowls before or during the preparation of the ritual water. Usually the bowls are also used for other domestic purposes, which could have contributed to the contamination of the bowls. Furthermore, the high levels of faecally derived microorganisms in this ritual water may also be indicative of a lack of proper hand hygiene practices by the people preparing the water. The high levels of faecally derived microorganisms in the water after the performance of the ritual are indicative of the introduction of microorganisms by the hands of the mourners during the ritual. This evidence supports the idea that proper hand hygiene practices were not observed by a large number of mourners. Mourners are thus at risk of being exposed to harmful pathogens, when eating the funeral meal with their bare hands. This study strongly suggests that hand washing ritual practices at African funerals have the potential for disease transmission convergence. This study has shown that disease transmission could be linked to poor hand sanitation and poor personal hygiene practices, which puts mourners in a vulnerable position, particularly children, the elderly and the immune-compromised.