We think the number one problem is dirt.

Now, “dirt” is an interesting word, with several meanings. For us as doctors, we are thinking in terms of what the dictionary describes as “unclean soiling of things,” particularly body waste or excretions. A farmer may thinks of soil as dirt. We are thinking of matter that grows germs.

IN some countries with good water and sewage systems, a lot of the problem with dirt is

 taken care of by the government. In other countries, such dirt is a personal responsibility. Why it dirt a problem? Because in it germs can live and grow. Most parasites, diarrhea, hepatits A, and even respiratory infections are spread by what we could call “dirty habits”.

Not much more than 200 years ago, no one knew about germs. At first a Dr. Semmelweis noted that the women on his ward seemed to get infections that appeared to be related to when certain doctors were working on a particular shift. He began to insist on his junior doctors washing their hands between each patient. The infection rate fell to every low levels.

The older doctors thought he was crazy. It took a few years to get everyone to believe that infection was somehow being spread on the doctors’ hand. In fact, they put Dr. Semmelweis in a mental hospital. Today we know that germs are microscopically small organisms that cause disease. This is why cleanliness is so important.

What are some common situations in which cleanliness is very important? Clean sinks and toilets are the first places to begin fighting dirt.

Clean food is important. In kitchens the sink in which we wash our dishes is often a very dangerous place; often dirty as far as bacteria are concerned. Little bits of food get into the cracks and onto the dishcloths. Here they decompose and help bacteria grow quickly. Some studies have shown more germs in people’s sinks than in their toilets.

Of course, feces are full of billions of germs. Sometimes such germs are dangerous. A person may have developed resistance to his or her own germs, but the same germs could make someone

 else seriously sick.  Kitchen sinks and toilets should be carefully washed with soap and water daily. The cloths used in this cleaning also need to be washed daily. People with microwave ovens can place the washed wet cloth inside and “zap” it for a minute to sterilize it. Others can hang the cloth to dry in the sun, which kills many germs.

Another dirty habit is spitting. Now there’s a dirty habit! People cough up chunks of thick mucus, which may contain dangerous germs, and spit them onto the ground. We need to teach our children while they are very young that spitting is dirty, unhealthy, and not kind to others.

Coughing and sneezing are also dangerous. When we cough and sneeze, we spray small drops of mucus and the germs in our nose or airways into the air. Other people who

 breathe this can get infected. So we should teach our children to cover their mouth and nose if they cough or sneeze. A tissue or handkerchief will catch the spray. The tissue is then full of dirty material and needs careful disposal. In the case of a handkerchief, washing with soap and water and then drying is necessary.

When we cough on our hands, we need to wash our hands. Careful washing of hands must include the fingernails and between the fingers. Dirt beneath the fingernails carries with others if we have sneezed in them, unless we have washed them clean.

There are many health habits, but the number one place to begin is with cleanliness. A daily total body wash is helpful in reducing ski infections. We don’t need expensive - Allan R. Hanysides