Friday, October 26, 2007

Taking on the Superbugs: Engaging in Hand-to-Hand Combat

Headlong into this election season, one concept that may readily come to mind is the ‘doctrine of clean hands.’ This concept though, belongs to the legal profession, where it refers to the rule of law that a person coming to the court with a lawsuit or making a petition, must approach the court without previous wrongdoing with respect to the matter at hand, i.e. the person must approach the court with ‘clean hands.’

The doctrine of course can similarly be applied to politics where candidates coming to the ‘court’ of the electorate with their petitions for votes, must likewise do so with ‘clean hands’ and must not have committed any wrongdoing. Here though, the matter at hand is quite open and it refers to candidates generally having to be of ethical character. Additionally, by law, a person who has been previously convicted of a crime is debarred from seeking public office. The use of the phrase ‘clean hands’ also conveys good imagery. After all, it is with a handshake that we acknowledge each other and ‘seal the deal,’ and who wants to do that with anyone who has soiled hands?

Soiled hands though, do have real and serious consequences and societal impacts. One leading negative impact of soiled hands is staph (staphylococcus) or MRSA (methicillin-resistant staphylococcus aureus) infections, as has been highlighted by the spate of such infections in the United States within the last few years: the latest victim being a middle school student in Canarsie, New York City who succumbed from a staph infection last week. According to the US Centers for Disease Control (CDC), MRSA caused more than 94,000 life-threatening infections and 19,000 deaths in the United states in 2005. Trinidad and Tobago, has also had a rash of reports of staph infections in our public health institutions within the last few years.

Conspicuously though, a most basic activity that may prevent the incidence of this grave infection is hand-washing. This is the most elementary of hygiene practices which we are all taught from about the time we learn to talk. It is clear here though that we all are being taught one of the most familiar of life-lessons: never forget the basics. Humankind has achieved such advances in science and technology it seems utterly foolhardy that we ignore what has long been the hallmark of basic human hygiene: clean hands. It seems that with our modern and busy lifestyle, many people have discarded or forgotten the importance and benefit of an age-old simple practice.

The Mayo Clinic in an online article “Hand Washing: An Easy Way to Prevent Infection” reminds us that

“Infectious diseases that are commonly spread through hand-to-hand contact include the common cold, flu and several gastrointestinal disorders, such as infectious diarrhea.”
… “Inadequate hand hygiene also contributes to food-related illnesses, such as salmonella and E. coli infection.”

The advent of these superbug or antibiotic resistant staph infections, also has many people pointing their fingers at doctors’ over-prescribing of antibiotics and the agribusiness sector, where it has been found antibiotics are used too extensively to ward off diseases in livestock, being administered intravenously or as an additive in the feed. However, the antibiotics from livestock do not make their way to us only through meat consumption. Antibiotics also leave the livestock via waste, enter the natural water supply and so becomes part of the food chain. Notwithstanding all this, hand-washing is still undoubtedly the most elemental way we can stave off the danger of coming into contact with these pernicious pathogens.

While having all the latest technology in our health institutions is something from which we can all benefit, we cannot hold fast to the belief that having state-of-the-art facilities is the singular factor in delivering good health care. Importantly, all medical personnel must be vigilant in the simple practice of hand-washing, as they should all know, far better than the rest of us, about the increased potential for infection in health instititutions.

We should all remember and go back to the basics, like washing our hands and keeping our rooms neat and tidy. People in Trinidad and Tobago, of my generation and older, can remember of having to hold out our hands for them to be inspected every morning by the teacher before entering class in primary school. Hands had to be clean and fingernails absent of dirt and neatly trimmed.

Modernity while good, has perhaps also made us too reliant upon everything external to ourselves, where people reach for a pocket calculator for even the most basic arithmetic problem. Prescriptions are available for almost any ailment or in the least, we are encouraged to ask our doctor whether drug X “ right for you?” We seem to forget that we are no more or less human than people living centuries ago. We must remain appreciative of our own instincts, and senses and also recognize the obligation and basic need we must all fulfill in following basic human hygiene.

And so, we must all approach each other with clean hands: reflective of our character and our cleanliness. Clean hands are therefore not only a requisite for public office but for the office of life which we all occupy, sometimes hugging, shaking or just holding hands as we go along.

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