Similar to other developing countries, Central America struggles with issues related to improper food sanitation and contaminated water. Between 1993 and 2002 in Latin America and the Caribbean, the Pan American Health Organization and the World Health Organization discovered there were 10,400 outbreaks of food and waterborne illnesses causing 500 deaths. Outbreaks may be attributed to:
- Hygiene issues
- Lack of refrigeration
- Cross contamination
- Improper food handling and preparation
Infants and children are especially susceptible to diarrheal illnesses when they ingest contaminated food or water. Multiple incidents of diarrheal illness can cause loss of key nutrients, potentially causing malnutrition and a weakened immune system. Exclusive breast-feeding until six months of age and good sanitation practices with infant foods are extremely important health measures to prevent diarrheal illness.
The Role of Water in Food Sanitation
Water sources, especially in rural areas of Central America, are usually contaminated and may be far from the community, thus limiting its accessibility for cooking, drinking and hygiene. Although community residents may understand the need to improve food and water sanitation in their communities, but they may be unaware of proper sanitation methods. Health educators should educate community members on the concept of germs, especially those in unclean water that may contaminate food when it's used for cleaning produce and cooking.
Working within the means of locally accessible water sanitation systems is imperative to helping community members develop realistic and sustainable food sanitation behaviors.
Strategies to Improve Food Safety
In Central American communities where much of the population uses primitive kitchens and does not have access to clean water sources, it's important to teach community members how to safely prepare, consume, clean and store food. Below are food safety methods to teach community members.
Preparation: Before preparing food, the cook must wash their hands with soap and clean water, even if they appear clean.
Educators should explain the concept of cross-contamination in kitchen preparation areas, food vessels and utensils. If utensils or dishes are used to prepare raw meat or fish they should be thoroughly cleaned with soap and clean hot water before being used again to prepare fresh fruits or vegetables. Utensils can also be sanitized with boiling water or with a sanitizing solution containing chlorine. Keeping preparation areas clean of insects and animals is important for avoiding pathogens carried by these species to food items.
Consumption: A hand-washing station must be available to everyone, and they should be taught to wash hands before eating. Alternatively, hands may be rubbed with an alcohol-based solution.
Because the concept of germs is not well understood, there may be considerable sharing of utensils, bowls and glasses. There may also be contamination of prepared food by tasting or using dirty utensils for stirring or turning. Education about cross-contamination should include this issue.
Clean up: Once food is prepared, all preparation materials should be cleaned with clean hot water and soap or sanitized with boiling water or with a sanitizing solution. Clean utensils and kitchen tools should be dried thoroughly either with a clean cloth or air-dried in an area away from bacteria and dirt. Dry, clean kitchen tools should be stored away from soiled areas, dust, animals or any area where contamination is possible.
Storage: Once food is cooked it should be covered as soon as possible to avoid possible contamination by flies and other insects that may have come in contact with animal waste.
Leaving food out at room temperature for more than two hours or at temperatures above 90 degrees Fahrenheit (32° Celsius) for more than one hour can cause bacteria to grow. Community members should understand that properly preparing, cooking and storing food items can prevent pathogen contamination and growth which could ultimately cause illness.
Milking and Slaughtering and Safety Measures
In dairy communities, the issue of milk safety needs to be addressed, as all fresh milk contains bacteria that can proliferate if the milk is left out at room temperature. Animal udders need to be properly sanitized before milking, containers need to be sterilized or cleaned with potable water and milk needs to be consumed or turned into cheese quickly. Milk products such as soft cheese and custards require care in handling as well.
Animals are often slaughtered in unclean conditions and educating community members to cook meat promptly and thoroughly after slaughtering is important. All fresh meats should be refrigerated or kept on ice until they can be cooked. If meat is unable to be cooked immediately, it should be processed for preservation by drying, salting or other forms of preventing bacterial growth. To kill germs effectively, meat should be cooked at high heat. All parts of the food must reach at least 160°F(70°C). Identifying potential food poisoning sources in communities is the key to prevention.
Tips for Communicating and Working With Community Members
Before explaining proper sanitation methods, health educators should plan interventions that are culturally acceptable with an understanding of local customs and beliefs about food sanitation.
Because health educators from the developed world are typically unaccustomed to managing food preparation in developing world conditions and because health educators from the developing world may be unaware of pathogen control measures, it's essential to work as a team in identifying practical actions that families can take to avoid foodborne illness.
Using graphics with limited text and including some sort of interaction in the education session are effective teaching strategies. Providing demonstrations on how to correctly prepare, cook and store food will enhance the learning experience.
- World Health Organization. Five Keys to Safer Food Manual. 2006.
- World Health Organization. Improving Nutrition Outcomes with Better Water, Sanitation and Hygiene: Practical Solutions for Policies and Programmes. 2015.
- Center for Science in the Public Interest. Food Safety Around the World. Center for Science in the Public Interest. 2005; 1-89.
- Hanak E, Boutrif E, Fabre P, Pineiro M. Food Safety Management in Developing Countries, Proceedings of the International Workshop. 2000; 1-15.
- FAO Newsroom. Improving Food Safety in Latin American and the Caribbean. FAO newsroom. 2005. Accessed May 1, 2016.
- Marino DD. Water and food safety in the developing world: Global implications for health and nutrition of infants and young children. J Am Diet Assoc. 2007;107(11):1930-1934.
- Pan American Health Organization. WHO "Golden Rules" for Safe Food Preparation. Pan American Health Organization. Accessed May 1, 2016.