Experts on how to use public toilets

Health experts have warned that many infectious diseases could be contracted from public toilets lacking in proper hygiene and sanitation. This is increased, if individuals don’t wash their hands, particularly after using the toilet. But water and soap are not provided in public toilets. So, how do the users wash their hands after using these facilities?

Some of the diseases that can be contracted this way include, gastroenteritis, diarrhoea, hepatitis, typhoid fever, and worm infestation. The germs that cause these diseases are transmitted directly by the faecal-oral route or indirectly by vectors, such as houseflies making contact with people and their food.

Dr. Nkechi Asogwa, President, Doctors Health Initiative, a non- governmental organisation in Surulere, Lagos, said there are plenty of microbes lying in wait in public restrooms, including both familiar and unfamiliar suspects, such as, streptococcus, staphylococcus, and shigella bacteria, hepatitis virus, the common cold virus, and various sexually transmitted organisms. These toilet diseases can be contacted from dirty toilet, the doorknobs and handles, by touching toilet surfaces with fingers or not washing hands after using the toilet.

She said: “Toilets generally should be neat, hygienic, well ventilated and free of agents carrying diseases. They should be washed regularly with disinfectants. Wiping the toilet seat with tissues, saliva and water before sitting is very essential, because saliva contains enzymes capable of fighting t bacteria and virus. The hands should be washed before and after cleaning. The toilet seats should not be sat on directly. Tissues can be laid on the public toilets, if it cannot be avoided.

“Students in academic hostels should use personal potties or buckets instead of the general toilets. Water, soaps and sanitisers should be supplied in the toilets, so that people will not have the excuse of littering the rest rooms with feaces and urine. Proper flushing of the toilet and seats should be done before and after using them.”

However, Dr. Grace Ikpa, a family health doctor with Doctors Health Initiative in Surulere, Lagos, said the so-called ‘toilet infections,’ generally believed to be contracted from public toilets do not belong to this group.

She said: “These diseases are often temporary and can be treated, using appropriate antibiotics and other medications, depending on the offending organism. It is preferable to seek treatment from a medical doctor or an appropriate health care provider, where there is no doctor.

“It is advisable to use a paper towel or tissue paper to turn on the water tap before washing your hands, another to turn it off after use and yet another to turn the door handle, when leaving. This is because touching these surfaces with our hands after washing ends up contaminating our hands again.

“Unfortunately, most public toilets in our country do not have functional flush handles or even running water. And even where they are available, it is not advisable to rush into the toilet just as the person who used it before you, walks out, as the germs from his/her flush may still be in the air. So, it is good to wait for a few seconds before going in. After use, flush the toilets, when you are ready to leave, just before washing your hands. It is always better to leave the place cleaner than you met it, out of respect for the next person, who would use it after you”.

Ikpa said it is good to cover the toilet seat with toilet paper; disinfect it with antibacterial wipes or any other form of disinfectant, if you are in a place you do not trust.

“Using the toilet seat reduces the possibility of splashing urine or water from the lavatory around, thus improving environmental hygiene,” she explained. “However, this may not be practicable, where the kind of toilet available is a public squat toilet. In which case, one has to squat, as this kind of toilet has no seat.

“Do not put your bag, purse, phone or any of your belongings on the floor or shelf. It is better you leave it somewhere safe before entering the toilet. Phones, if used while in the toilet, should be disinfected with a wipe before washing your hands, as doing otherwise would be similar to contaminating your hands again. Also, it is advisable not to take food items into the toilet. Washing of hands after use of toilet is the most important rule of all because it protects you, your loved ones and anyone else you meet after using the restroom. Washing hands is one simple and effective way of preventing most infectious diseases.

“A discourse about public toilets takes for granted that these toilets are available and fully functional. The reality in some parts of our country supports the contrary view. In some places, people do their lavatory business in nylon bags, which they throw into bushes or drains; or urinate in the open place. Hence, the first step to preventing these diseases would be the provision of good and functional toilets with running water, in public places.

“Due to heavy use, most public toilets require more frequent cleaning than private household toilets. Frequency of cleaning and disinfection may vary, depending on the location and the number of users. Cleaning should also take into consideration those areas with the greater likelihood of harbouring most germs.”

Ikpa disclosed that hand dryers were made more popular in our environment in 2014, following the Ebola Alert campaign of that period. However, over the last two years, it seems most people and places have reverted back to status quo, since Nigeria was declared Ebola free.

She said: “The use of hand dryers help to solidify the gains from hand washing. Having functional dryers in each public toilet area would go a long way to reduce the risks of acquiring diseases from the toilets.

“Some toilet infections last for a short while and can be treated easily with mild antibiotics. When left untreated, especially in women, toilet infections can lead to pelvic inflammatory disease (PID), which is the main culprit responsible for infertility in women.”