publication incap mdi/008

Publication INCAP MDI/008

FIVE KEYS TO SAFER FOOD

MAnuAl

Veterinary Public Health Unit, Pan American Health Organization Institute of Nutrition of Central America and Panama (INCAP)

Guatemala, may 2008

ii

Coordinated by:Genaro García, PAHO/ WHORegional Advisor in Food Safety. Veterinary Public Health Unit, PAHO/ WHO

Adapted by:María José Coto Fernández, INCAP/ PAHOKathryn Janzen, PAHO/ WHO

Revised by:Verónika Molina, INCAP/ PAHOMagda Fischer, INCAP/ PAHO

Acknowledgements:This document is a product of the project “The Adaptation and Validation of the WHO Five Keys to Safer Food Manual for Elementary Schools in Guatemala”. Funds for its implementation were provided by the Department of International Development (DFID) through the WHO Department of Food Safety, Zoonoses and Foodborne Diseases.

An interdisciplinary team participated in the preparation and implementation of the project. This team consisted of professionals from the Ministries of Education, Health and Agriculture; Municipality of Guatemala; Non-Governmental Organizations such as INTERVIDA and Catholic Relief Services (CRS), with the coordination and technical assistance of professionals from PAHO/WHO and INCAP. We are grateful for the following participants’ support in the technical revision of the manuals and in the validation process:

Angel Fulladolsa Gabriela RosasLaura Teresa Rodríguez Ana Virginia Palma EscobarRosalina Villeda Retolaza Ana Lucrecia BarrascoutAnnette Salamanca Hilda María WalterMarvin Sánchez

A special acknowledgement is given to the directors, teachers, students and parents of the following elementary schools that provided us with their support, interest, dedication and valuable contributions during the validation process:

• Escuela Panamericana, Colonia La Florida, Guatemala

• Escuela Oficial Rural Mixta, Santa María Dolores, Ixcán, Quiché

• Colegio Ecológico de Guatemala, San Raymundo, Sacatepéquez

• Escuela Oficial Urbana Mixta, Caserío Berlín II, Coatepeque, Quetzaltenango

• Escuela Oficial Urbana Mixta No. 112, Félix Hernández Andrino, Guajitos, Guatemala

• Escuela Oficial Urbana Mixta, Club Rotario, Lotificación San Isidro, Coatepeque, Quetzaltenango

• Escuela Oficial Urbana Mixta No. 619, El Jagüey, Canalitos, Guatemala

• Escuela Oficial Urbana Mixta, Santa Ana Berlín, Coatepeque, Quetzaltenango

• Escuela Oficial Rural Mixta, Esperanza de la Comunidad, Chinautla, Guatemala

• Escuela Oficial Rural Mixta No. 605, Aldea Las Canoas, Guatemala.

• Escuela Oficial Rural Mixta No. 910, Aldea Sabana 3, Chinautla, Guatemala

• Escuela Oficial Rural Mixta, Choaxán, Aldea Montúfar, San Raymundo, Sacatepéquez

This is the English version of the document “Manual Las 5 Claves para Mantener los Alimentos Seguros”, Publication INCAP MDE/166, Guatemala. 2007.

MDI/008

INCAP/ PAHO/ WHO“Five Keys to Safer Food” Manual. INCAP/ PAHO/ WHO.Guatemala: INCAP, 2008.llus. 63 pagesISBN 978-99922-960-1-11. MANUALS 2. FOOD 3. FOOD HANDLING

4. NUTRITIONAL EDUCATION

iii

PROlOGuEMalnutrition and foodborne diseases are common in developing countries and represent one of the main causes of morbidity in children and other vulnerable groups.

Health education is a central strategy in primary health care and in the development of healthy environments. Elementary schools represent one of these environment since they are a place where girls and boys, as well as their families and the educational community, can be motivated to adopt healthy lifestyles.

This publication presents the adaptation and validation experience of the WHO Five Keys to Safer Food Manual in a sample population of rural and urban schools in Guatemala. Accompanying this manual are a teacher’s manual, an activity book for teachers and a guide for the Parent-Teacher Association entitled “How to make a water and food safety plan for our school.”

The Ministry of Education reviewed the materials and, by way of the official technical report No. 01-2006, determined that “the proposed objectives are achieved through activities designed for students; a style which is simple and easy to understand; the materials are considered adequate for the level they were designed for and they comply with the minimum requirements regarding vocabulary, context and gender”. It is expected that including these tools in the national school curricula will contribute to a reduction in malnutrition and morbidity and mortality rates caused by water and foodborne diseases, especially in children; in reducing the repetition and drop-out rates in school-aged children; and, among others, in reducing health expenditures. The methodology presented in this publication represents a useful reference for the manuals’ application and adaptation in other countries in the Americas.

Mirta Roses PeriagoDirectorPan American Health Organization/World Health Organization, PAHO/WHO

v

TABlE OF COnTEnTS Page

PRESEnTATIOn 1 I InTRODuCTIOn TO THE MAnuAl 5 II FIVE KEYS TO SAFER FOOD 10 Key #1: Use safe water and food for your consumption 13 Key #2: Keep clean 29 Key #3: Separate raw meat, poultry and seafood from other foods 41

Key #4: Cook food thoroughly 45 Key #5:

Keep food at safe temperatures (very cold or very hot) 49

III HOW CAn WE PREVEnT FOODBORnE DISEASES? 54

IV REMEMBER... 56

V BIBlIOGRAPHIC REFEREnCES 57

VI GlOSSARY 60

1

PresentationIn many countries in the Americas, diseases related to inadequate measures to protect food and environmental sanitation represent a serious problem to the population’s health. Every day, people get sick from the food or water they consume. Such diseases are called foodborne diseases (FBD) and are caused by eating food or drinking water contaminated by microorganisms or dangerous germs and/or toxic chemicals that can cause stomach problems and even death.

These diseases represent a serious health hazard, affecting mainly children, pregnant women and the elderly. Every year, millions of children die of diarrheic diseases, while another hundred million suffer from frequent diarrheal episodes that seriously affect their nutritional status. According to the World Health Organization (WHO), 70% of diarrheas are caused by consuming contaminated food or water.

According to a report published in Health in the Americas 2002�, the most critical risk factor associated with outbreaks of diarrhea in Latin America and the Caribbean is bacterial contamination of food caused by improper handling practices. In 17 countries in the region, diseases caused by diarrheas are among the five main causes of death among all age groups. They represent the first cause of death in five countries and the second cause of death in four countries of the region.

According to data reported in La Semana Epidemiológica en Guatemala2

Bulletin (in English, the Epidemiological Week in Guatemala) published by the Ministry of Public Health and Social Welfare – MSPAS - (for its abbreviation in Spanish), in 2005 there were 376,162 cases of water and/or foodborne related diseases reported, 5% less than the previous year, and an accumulated national incidence rate of 2,962 per 100,000 inhabitants. An increase in the cases reported was observed as a consequence of the tropical storm Stan. The bulletin also reported that the total national incidence rate of acute pesticide poisonings was 6.2 per 100,000 inhabitants.

1 PAHO/ WHO. 2002. Health in the Americas: Volume 2. Scientific and Technical Publication No. 587, Washington, D.C.2 MSPAS. 2005. La Semana Epidemiológica en Guatemala (status of the main epidemiological surveillance events). Week No. 47-2005. MSPAS, Guatemala. www.mspas.gob.gt.

2

In countries such as Guatemala, especially in rural areas, a considerable number of etiological agents contribute to diarrhea and foodborne diseases. Infectious agents such as bacteria, parasites and viruses, in addition to non-infectious agents such as chemical products, poisonous fungus and heavy metals, can be found in food and water. These agents affect not only the body’s ability to absorb food and water, but can also cause diseases and even death.

The majority of these types of dis-eases can be attributed to handling food improperly, including:

1) Poor health or deficient hygiene habits by food handlers (people handling the food).

2) Contamination of cooked food by raw food or by contaminated surfaces; and

3) Not cooking food thoroughly and therefore not killing all germs found in the food.

Foodborne diseases can be prevented if steps are taken to limit the spread and survival of germs in food. It is important to teach the educational community and personnel in charge of food preparation in schools, as well as the general population, that by

following proper food hygiene practices, we can ensure that the food we eat is “safe”. This will guarantee that people eating this food are not at risk of contracting a foodborne disease.

Considering the importance of this subject, and the need to have tools specifically related to food safety and the promotion of healthy lifestyles, WHO developed a manual about five basic keys to avoid food contamination during its preparation and storage.

This manual has been adapted so that its contents can be taught in elementary schools in Guatemala, as part of the Healthy Schools World Initiative promoted by the WHO, the Pan American Health Organization (PAHO) and the Institute of Nutrition of Central America and Panama (INCAP). This initiative considers schools not only as a place where subjects such as science andculture are taught, but also as a place where the healthy development of children, as well as parents and teachers, can be promoted.

The purpose of this “5 Keys to Safer Food” manual is to provide the educational community (Parent-Teacher Association, teachers and elementary school students) with an educational guide and reference

3

material so they can teach and learn the five basic rules to keep food safe and avoid its contamination.

The contents have been adapted so that personnel in charge of preparing food in schools can also be trained on this subject, therefore guaranteeing safe and healthy meals for the benefit of the students.

Accompanying this manual is an Activity Book containing activities that will help teachers reinforce the contents taught in the classroom. A guide for the Parent-Teacher Association (PTA) is also included

to support them in the creation of a water and food safety work plan for their school.

It is expected that these materials will improve school education on this subject, so that boys and girls, as well as their families, can learn and put into practice these five keys, therefore reducing the incidence of foodborne diseases and, at the same time, improving the health and nutritional status of the whole family. These educational materials can also be used as a tool to assist other institutions involved in school lunch programs in the promotion of healthy environments and in food and nutrition educational activities.

5

I. InTRODuCTIOn

What are microbes or germs?

Microbes*, also called germs, are very small living organisms, so small that the human eye cannot see them. They are so small that it takes a million of them to cover the head of a pin. They are found in dirt, water, air, food and often on people, including those who prepare or handle food.

To multiply and survive, germs need FOuR things:

1. WARMTH: which helps them multiply quickly.

2. HuMIDITY: which creates an ideal environment for their multiplication.

3. FOOD: which provides them with nutrients so they can grow.

4. AIR: which allows them to breathe, and therefore, to survive.

Bacteria, viruses, molds and parasites are all germs. There are three different types of germs: good ones, bad ones (related to spoilage) and really dangerous ones. One bacterium can become two bacteria in just fifteen minutes. This means that within six hours, one bacterium can multiply to over 16 million bacteria!!

Go to Activity # 1:How do germs multiply? Activity Book, page 3.

* You can find the definition of all underlined words in the glossary on page 60.

6

Good germs are very useful. They can be used to:

• Make food (for example cheese and yogurt)

• Make medicine (such as penicillin)

• Help digest food

In general, spoilage germs are not harmful to us, but they make food look disgusting. Even though spoilage germs are not usually harmful, there are some that can be dangerous. Examples of these dangerous ones are green or white mold which contain invisible toxins that can be transmitted by food.

Dangerous germs cause diseases such as diarrhea or vomiting, and can cause death. The majority of these germs do not change the appearance of food, therefore, we are often not aware that what we are eating contains dangerous germs because we can´t see or smell a difference in the food.

Examples of these dangerous germs are:

• Salmonella typhi which produces typhoid fever and fevers, intense headaches, intestinal

problems and, in some cases, internal hemorrhages (bleeding inside the intestine).

• Vibrio cholerae which causes cholera and produces vomiting, frequent diarrhea, severe dehydration and, in some cases, death.

• Shigella which produces shigellosis disease and causes

abdominal pain, colic, diar-rhea, vomiting, and blood and pus in feces. This disease can be caused by eating chicken or eggs that have not been thor-oughly cooked or by drinking water contaminated by feces.

• The virus that causes hepatitis A which can damage the liver. Symptoms include: fever,

nausea, lack of appetite and a yellowish coloration of the skin and eyes.

7

Introduction

Where do germs live?

Germs are found everywhere, but most commonly:

• Inwater and dirt.

• In and on people (in their hair, mouth, nose, ears, stomach, hands, fingernails, cuts and on their clothes).

• In and on pets and farm animals (for example dogs, cats, cows, chickens and turkeys).

• In and on rats, mice and pests.

They also live and grow in food such as raw meat (beef and pork), poultry, seafood, cooked rice and pasta, liquid milk, cheese, cream, mayonnaise, eggs, fruits and vegetables. Germs can grow on both raw and cooked food, IF THEY ARE NOT STORED PROPERLY

DID YOu KnOW THAT...?• On average, 100,000

bacteria can be found

on each square centime-

ter of human skin.

• People have more bacteria in their

intestines than cells in their whole

body.

How do germs move?

Germs rely on something or someone to move around. They can even use our body as a vehicle. The transfer of germs from one surface to another is called cross-contamination. If you touch raw chicken with your hands and then pick up a fruit, the spread of the germs from the chicken to the fruit is an example of cross-contamination.

Cross-contamination can occur directly or indirectly. Sources of cross-contamination include our hands, towels, rags, cutting boards, kitchen utensils, plates, kitchen surfaces and pets. We often get sick by consuming food contaminated by these sources.

Hands and contaminated water are some of the most common ways

8

germs are move from one place to another.

Go to Activity # 2: How are germs spread?Activity Book, page 6.

Don’t forget about chemicals:

Germs are not the only cause of foodborne diseases. Poisonous chemicals, for example products used to kill insects, can also cause diseases when they are not used properly. Certain chemicalproducts can be dangerous to people’s health and can cause poisoning and even death.

Chemical contamination of food can be caused by:

• General chemical contamina-tion of the environment.

• Use of unauthorized additives.

• Improper use of fertilizers and pesticides.

• Inappropriate storage (i.e. storing these products in the same place where food is stored).

The following are examples of toxic chemicals, which if used in excess, can cause diseases related to poisoning:

• Pesticides used on crops

• Chemicals used for veterinary purposes

• Chemicals used for cleaning, such as detergents to clean floors

• Metals and other chemicals derived from environmental contaminants or pollutants

• Food additives when not used properly

FERTILIZERS can be organic or inorganic, natural or synthetic substances that improve the quality of soil so that plants obtain the nutrients they need to grow. Inorganic fertilizers (ones that

9

Introduction

contain chemicals) must be applied with precaution to avoid chemical contamination.

PESTICIDES are substances or a mix-ture of substances used to prevent, destroy or control pests that cause damage during the production, storage or transportation of agricul-tural products.

The following are types of pesticides:

• Insecticides (used to kill insects)• Herbicides (used to kill weeds

that harm crops)• Algaecides (used to kill algae

and other weeds in water)• Fungicides (used to kill fungus)

ADDITIVES are substances or compounds that are added to food to preserve and/or improve their flavor. Some examples of these preservatives are antioxidants (vitamin E) and citric acid.

Many of the above chemicals are applied to fruit, vegetables and other foods that we eat daily.Simple measures such as washing and peeling food minimize risks associated with these chemicals that can be found on these foods.

How can you tell if you have a foodborne disease?

According to the World Health Organization (WHO), foodborne diseases (FBD) represent one of the most common health problems around the world. A foodborne disease is caused by eating food and/or drinking water that contains enough germs to affect a person’s health.

Every year millions of people contract a foodborne disease without ever knowing that their sickness was caused by food. It is estimated that 3% of all foodborne illnesses lead to long-term health problems. These delayed symptoms are often not recognized as being related to a foodborne disease.

The MOST COMMON SYMPTOMS of foodborne diseases are:

• Diarrhea• Vomiting• Stomach pain

10

A person may also experience:

• Nausea• Fever• Headaches• Itching• Cramps• Respiratory problems

Symptoms depend on the cause of the intoxication and may occur almost inmediately after eating the food or up to several days after.

Prevent germs from causing diseases by applying the

FIVE KEYS TO SAFER FOOD:

1. Use safe water and food for your consumption

2. Keep clean

3. Separate raw meat, poultry and seafood from other foods

4. Cook food thoroughly

5. Keep food at safe temperatures (very cold or very hot)

Symptoms usually appear within 24 to 72 hours after eating the contaminated food.

In children, people with severe illnesses such as cancer and HIV/Aids, pregnant women and the elderly, the consequences of foodborne diseases are usually more severe and can be fatal.

You can change things!!!

In the following chapters, each of these five keys is explored in depth. Each key contains basic messages which, when applied, will ideally prevent us from contracting a foodborne illness.

INCLUIR PORTADILLA FULL COLOR (ARCHIVOS EN

FREEHAND) CLAVE �

13

Use safe water and foodfor your consumption

What does safe water and food mean?

Water and food are “safe” when they do not contain dangerous germs (bacteria, viruses, parasites or fungus), toxic chemicals or physical external agents (dirt, hair, etc.) that represent a risk to our health. A safe food is also called innocuous.

Food can become contaminated by both germs and dangerous chemicals. Toxic chemicals can form in moldy or spoiled foods (foods that have gone bad). Take care in choosing your foods!! Simple measures such as washing and peeling food can reduce the risk of chemical contamination.

DID YOu KnOW THAT…?

Throughout the world, a child dies every 15 seconds from diarrhea caused by poor sanitary conditions and lack of safe water.

What is “safe” water?

Safe water is water that has undergone a treatment of purification, killing germs and toxic chemicals, making it safe for drinking or preparing food.

“Safe” water should have no color or odor. To avoid foodborne diseases use safe water for human consumption (drinking), for washing food (fruits and vegetables) and kitchen utensils and when preparing food.

Key #1: Use safe water and food for your consumption

14

Key #1

REMEMBER:Water used in restaurants, cafeterias and places where food is sold should be safe.

Many activities at school and at home require safe water. It is needed for:

• Washing fruits and vegetables

• Preparing food (cooking)

• Making drinks

• Making ice

• Washing utensils used for cleaning and preparing food

• Brushing your teeth

Using safe water at school and at home can contribute in raising awareness within the community about the importance and benefits of hygiene and sanitization, as well as the prevention and control of infectious diseases, thus promoting better health and, consequently, an improved quality of life. Water filtration technique3:

Water collected from certain sources is often unclear (cloudy) because it contains sediments, soil and other solid objects, therefore making it undrinkable. To remove these solids from the water, a filtration technique can be used that will make the water clear, but it will NOT DISINFECT IT. To disinfect the water, a purification method, such as those described later on, should be applied after filtering the water.

As shown on the following page, all you need to filter water using this method is a plastic container that holds 20 liters and a piece of clean, tightly-woven cloth (i.e. a clean cotton cloth or a piece of clothing).

3 Taken and adapted from: Hernández, H. 2002. Agua y Saneamiento: opciones prácticas para vivir mejor. Publication of the Pan American Health Organization. Page 29.

15


Steps to filter water

Step 1: Wash the plastic container with soap and water.

Step 2: Take a piece of tightly-woven cloth and fold it three times. This piece of cloth should be clean and disinfected.*

* To disinfect the cloth, put it in a pot with water and boil it for two minutes.

Step 3: Place the cloth over the spout of the container, in such a way that it covers the whole spout.

Step 4: Pour the untreated water through the cloth into the container. This will ensure that the particles found in the water are trapped in the cloth.

Step 5: Take the cloth off the spout and disinfect the water using one of the purification methods described on the following pages.

16

Key #1

Methods to purify (disinfect) water

Water purification is the process used to destroy or inactivate dan-gerous germs found in water that can cause foodborne diseases.

Proper water purification and storage are very important in the prevention of diseases caused by consuming contaminated water.

Techniques that can be used to purify water and make it safe to drink and use for preparing food include:

a) Boiling

b) Chlorination

c) SODIS method

Described below are the steps that should be followed for each of these techniques:

a) Boiling4:

• If the water is unclear (cloudy), filter before boiling following the

4 Taken and adapted from: Hernández, H. 2002. Agua y Saneamiento: opciones prácticas para vivir mejor. Publication of the Pan American Health Organization. Page 29.

steps for water filtration found on page 15.

• Fill a pot with the water you want to purify.

• Boil water for five minutes (start timing five minutes from the time the water starts to bubble).

• Remember that the containers used for storing the boiled water should be completely clean and have a lid. Clean storage containers again when empty.

Advantages

• Kills all viruses, parasites and pathogens

• Simple to do

• Uses local materials

17


Disadvantages

• Lots of energy is needed to boil the water (wood, gas or electricity) and therefore it can be expensive.

• Time consuming.

• If using wood, can contribute to deforestation.

• Does not eliminate solids found in water.

• Water has to be boiled for at least 5 minutes to kill all germs.

b) Chlorination5:

Chlorine is one of the most effective and inexpensive disinfectants found on the market. It is found in different forms including liquid chlorine (sodium hypochlorite) and powdered chlorine (calcium hypochlorite); and in different concentrations, the most common being 5%.

When chlorinating water, take into consideration:

5 Ministry of Public Health and Social Welfare. 2004. Cartilla Ambiental, cuidado de la salud y el ambiente. cartilla No. 1: agua. Publication of the Regulation Department of Health and Environmental Programs, Guatemala.

• The quantity of water you want to disinfect.

• The form and concentration of chlorine to be used.

The following table describes how to disinfect water using 5% concentration liquid chlorine:

Table1

Amount of chlorine (5% concentration) to add to water�

For … Add …

1 liter1 drop of liquid

chlorine

1 gallon3 drops of liquid

chlorine

1 tinaja*

(4 gallons)

12 drops of liquid

chlorine

5 gallons15 drops of liquid

chlorine

1 barrel4 caps (of a soda

bottle)

6 Ministry of Education/ Ministry of Public Health and Social Welfare. 2006. Guía para la maestra y el maestro: promoviendo la salud en escolares, Guatemala.

* A tinaja is a recipient for water storage and transportation made of clay or plastic, used primarily in rural areas of Guatemala.

18

Key #1

After adding the chlorine to the water stir well and let stand for 30 minutes.

REMEMBER:If water is cloudy, filter first in order to eliminate any solids in the water.

Advantages

• Eliminates bacteria and viruses.

• A chlorine residue is left in the water, protecting it for an extended period of time.

Disadvantages

• Must have both economical and physical access to chlorine.

• Does not eliminate sediments in water.

• Calculating the amount of chlorine to add to the water may be confusing.

• The taste of the chlorinated water may not be acceptable to some people.

• Chlorine disintegrates with time, affecting its ability to kill germs.

c) SODIS method:

Solar Water Disinfection (SODIS) is a simple and inexpensive method to improve water quality for human consumption, eliminating dangerous germs that may cause diseases.

Through solar radiation (UV rays), this method raises the temperature of the water, destroying any dangerous germs found in the water, thus disinfecting it.

People without access to drinkable water can use this method both at school and at home, as it uses locally available resources, such as plastic bottles and sunlight.

Since this method requires exposure to sunlight to purify the water, it is a method that is best used during summer months. In winter or during days of continuous rainfall, SODIS will not work, so other methods, such as those previously described, should be used instead.

19


Instructions for purifing water using SODIS

STEP 1

Wash transparent plastic bottles (i.e. 1-2liter soda bottles) with detergent. The bottles should have a cap so they can be sealed tightly.

STEP 2

Pour clear untreated water into the transparent plastic bottles and close tightly with the cap.

Cloudy water stops the sunlights ability to kill germs; therefore it is IMPORTANT TO FILTER cloudy water beforehand.

This method consists of filling transparent plastic bottles with water and exposing them to sunlight for at least six hours.

20

Key #1

STEP 3Place the plastic bottles in a place where sunlight will shine directly on them for at least six hours.

The bottles should be placed on an angle, preferably on something that will reflect the sunlight (i.e. metal sheeting).

STEP 4Leave the bottles in the sunlight for at least six hours. During this time the sunlight will destroy any germs in the water that cause diarrhea, disinfecting it.

The bottles should be exposed to the sunlight for:

• A minimum of six hours on a bright day.• 2 consecutive days when cloudy.

STEP 5After the bottles have been exposed to the sunlight for the correct amount of time, the water is ready to drink. Let the water cool and drink in a clean glass or cup.

What type of bottles

should be used?

In order to ensure the effective-

ness of this method, bottles that

are in good condition and that

comply with the following char-

acteristics should be selected:

• Made of transparent plastic

(NOT colored)

• Not be broken, have cracks,

or be scratched up

• Be clean

• Have a capacity of 1 or 2 liters

21


Some tips for preserving plastic bottles:

The length of time that the plastic bottles can be used will depend on how they are handled. Bottles that are treated well and are used EXCLUSIVELY for disinfecting water can last up to 2 MONTHS, on average.

Over-exposure to sunlight may produce algae growth. This algae doesn´t present a health problem, but to prevent this algae from growing DO NOT keep the bottles in the sun FOR MORE THAN THREE DAYS and store them in a dark place in the school or home, away from exposure to sunlight.

If you observe algae growth in the bottles, you can clean them by placing some sand or salt inside the bottles and shacking vigorously. Afterwards, wash them with safe water and detergent.

Advantages

• Simple and inexpensive, there-fore is ideal for use at school and at home.

• Destroys dangerous germs found in water.

• Uses solar energy that is available and free.

• The risk of contamination is minimal since water is treated

and stored in the same container.

• No chemical is added to the water, and therefore, the water does not change color or taste.

• Uses locally available resources (plastic bottles).

• Does not use firewood, therefore does not contribute to defores-tation.

Disadvantages

• Requires specific weather condi-tions: sunlight.

• Requires relatively clear water (NOT cloudy).

• Not practical for treating large quantities of water (limited to purify water for consumption).

Go to Activity # 3:Installing a SODIS system in our school, Activity Book, page 8.

22

Key #1

How should we properly store the water we have treated?

THE CORRECT STORAGE OF TREATED WATER is very important, especially because this water will be used for different purposes at school and at home, for example, preparing food, washing hands, brushing teeth and drinking.

There are different types of containers that are commonly used to store water, but most of these containers have characteristics that can make the water inside easily contaminated. For example, some containers have a large spout with no cap, making it easy to stick hands or contaminated utensils into the container. Also, if the containerhas no lid or is not covered, dust, animals, birds and insects can contaminate the water.

In order to avoid contamination, a container that will be used to store safe water should have the following characteristics:

1 A capacity of 10 to 30 liters, with handles to carry it and a stable base so it can’t easily tip over.

2 Be made of a durable material that will not rust or crack easily, that is easy to clean, light and transparent.

3 A wide enough opening so it is easy to fill and clean, but small enough that a child can’t stick their hand in the container, and/or utensils or a glass can’t be used to take the water out.

4 A screw-on cap that is connected to the container with a rope or chain so it doesn’t get lost.

23


If you do not have access to a container like the one described on page 22, be sure to do the following with the container that you have:

• Wash the container regularly with soap and water (at least once a week).

• Store the container on a table or shelf out of reach of animals, in a cool place that is not exposed to sunlight.

• ALWAYS keep the container closed or covered with a lid or

clean cloth in order to protect the water from dust, insects and pests.

• AVOID taking water out of the container with contaminated dishes or utensils (glasses, cups or serving spoons). Be sure to wash the dish or utensil every time you want to take water out of the container.

• Do not wash or PUT your hands

in the container.

The following figure shows some examples of containers commonly used for storing water.

BuCKETBARREl TInAJA POT

24

Key #1

In summary, the following are SAFE and UNSAFE water sources:

“SAFE” water is...

• Water that has been boiled, has had chlorine added or has undergone the SODIS method.

• Purified bottled water.

• Rainwater collected in clean covered tanks that are pro-tected from birds, insects, flies and other animals and are cleaned regularly.

“unSAFE” water is from…

• Rivers and streams.• The tap.• Wells.• A pila*

Go to Activity # 4: Which are safe water sources? Activity Book, page ��.

Go to Activity # 5: Word search: the importance of safe water,Activity Book, page �5.

* A pila is a sink or basin made of cement that has two sections; one where water is stored and the other which is a flat surface that is used for washing clothes and/or dishes.

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The importance of using safe food:

An ALTERED FOOD is a food whose smell, taste, color, texture and/or appearance has deteriorated. These spoiled and/or moldy foods often contain toxic substances.

Be careful selecting the food you use to prepare meals. Simple measures such as washing fruits

To disinfect fruits and vegetables, follow the steps described below:

STEP 1Fill a clean container with water.

STEP 2Add 4 DROPS OF CHLORINE for every liter of water.

STEP 3Mix well.

STEP 4Immerse the fruits and vegetables in the water, ensuring the water completely covers them.

and vegetables thoroughly with safe water and peeling them can reduce the risk of intoxication.

The correct way to wash fruits and vegetables:

It is important to wash and disinfect fruits and vegetables, especially those that will be eaten raw (i.e. lettuce, spinach, cabbage) in order to eliminate dirt and/or chemicals.

26

Key #1

STEP 5Let stand for 20 MINUTES.

STEP �Strain the fruits and vegetables using a clean strainer.

When buying food or getting ready to cook:

• Select fresh food

• Select meat, poultry and seafood that has a firm consistency and pleasant smell

• Avoid food that is damaged or rotting

• Wash fruits and vegetables with safe water before preparing meals, especially if you are going to eat them raw (i.e. in salads).

• Do not use food after its expiry date (i.e. canned food)

• Throw away dented, rusty or damaged cans. DO NOT EAT THESE FOODS!!


FREEHAND) CLAVE 2

29

Keep clean

Be sure that both you and the area where you are preparing food are clean.

Why? Dangerous germs are commonly found on the floor, in the air, in water, and in and on animals and people. These germs are spread by our hands, dishcloths, kitchen utensils and cutting boards. The slightest contact with these items can transfer germs to food and cause foodborne diseases.

To ensure the food we prepare is safe, use safe water to wash and prepare food, and cook in a clean and disinfected place. Just because something looks clean does not mean it is safe.

DID YOu KnOW THAT…?

It takes over 2 billion bacteria to make a cup of water look cloudy, but in some cases, it takes only 15 to 20 bacteria to make us sick.

The importance of washing your hands

Hands can spread germs from one place to another, so washing our hands is an important thing we can do to prevent diseases. Studies have shown that by washing our hands properly the incidence of diarrheic diseases can be reduced by 40% to 50%.

However, in many regions, families and schools do not have access to water and soap making proper hand washing difficult.

Go to Activity # �: Look at the amount of germs on my hands! Activity Book, page �8.

Key #2: Keep clean

30

Key #2

When should I wash my hands?

Before: After:

• Handling and preparing food

• Eating or feeding children

• Handling raw food (especially poultry, seafood, beef or pork)

• Using the bathroom

• Changing a baby’s diaper

• Blowing your nose

• Handling garbage or dirty cloths or touching dirty surfaces

• Handling chemicals (including ones used for cleaning)

• Playing with pets

31

Keep clean

What is the proper way to wash your hands?

The steps that should be taken to wash your hands are illustrated in the following figure.

Taken from: INCAP/ PAHO. 2004. CADENA: Contenidos Actualizados de Nutrición y Alimentación. Second edition. INCAP MDE/152, Guatemala.

Washing your hands properly can help prevent diarrhea related sickness in 40 to 50%.

WASH YOuR HAnDS WEll WITH SOAP AnD ClEAn WATER BEFORE COOKInG, PREPARInG AnD HAnDlInG FOOD.

1. Wet your hands under running water

2. Apply soap and lather up to your elbow

3. Rub hands together for at least 20 seconds. Make sure to wash the whole surface of your hands, fingers and wrists, and around and under your fingernails

4. Rinse thoroughly under running water

5. Dry with a paper towel or a clean towel

32

Key #2

Go to Activity # 7: Wash your hands with soap and water, Activity Book, page 25.

As previously mentioned, hand washing is commonly not practiced since water and soap are often not available. The use of a home-made faucet called a Tippy Tap can help promote hand washing in populations that do not have a water source nearby.

The Tippy Tap is made from a large plastic bottle and other easily obtainable materials, and does not require piped running water. The original Tippy Tap was designed in Africa using pumpkin or gourds, and was later adapted for use in Guatemala.

The Tippy Tap reduces the amount of water used when washing your hands; in other words, it helps ration water and therefore less water has to be carried from the water source.

This system is more effective in eliminating bacteria than using buckets (where more than one person washes their hands in the same water).

Advantages of this technology:

• Inexpensive to make• Light• Saves water • Easily replicable (can be copied

locally)• Saves time

Materials needed to

make a Tippy Tap:

• 1 plastic container with

a handle (5 liters or 1.5

gallons)

• 1 candle

• 1 pack of matches or a

lighter

• Pliers

• 1 nail

• 1 rope or cord (synthetic

or natural)

• 1 wooden stick (branch)

• 1 bar of soap

• 1 empty (small) tin can

33

Keep clean

Instructions for making a Tippy Tap:

Step 1: Select a 5 liter or 1.5 gallon plastic container with a handle.

Step 2:Carefully heat the bottom part of the handle with the candle until the plastic is soft on all sides of the handle.

Step 3:Withdraw the candle and immediately pinch the softened part of the handle with the pliers, sealing the plastic so that no water will be able to pass through the handle. Keep pinching the plastic with the pliers until the plastic is cool, so that the plastic remains well sealed.

Step 4:Heat the tip of a small nail with the candle. When the nail is hot use it to punch a small hole in the handle, directly above the section that was sealed with the pliers. This hole is where the water will flow out of the container, like a tap.

Step 5*: Heat the nail again and make two larger holes on the other side of the container. The holes should be placed in the middle of the container, approximately 2 cm. in distance from each other. The holes should be placed far enough away from each other that when the bottle is hung it hangs at a 45º angle.

34

Key #2

Step �:Thread the rope through both holes and tie the ends of the rope to a branch. Tie another small piece of rope to one side of the rope that goes from the branch to the bottle. This small piece of rope will be used for hanging the soap.

To do this, make a hole in the center of both the soap and the empty can. Place the soap over the tin can and flip upside down

(as shown in the drawing) and thread the rope through both to protect the soap from rain and sun.

Hang another piece of rope to the lid of the container. When this piece of rope is pulled, the container should tilt and water will pour out of the handle.

Step 7:Pour water into the container, up to the level of the holes on the back of the container. Using a branch, hang the container in the bathroom, outside on a tree or near the outhouse.

Clean the outside of the container every day with a cloth and soap and clean the inside once a week with clean water and soap.

Cleaning areas where food is prepared

The terms CLEAN and DISINFECT are often confused or used interchangeably. The two terms are NOT the same. Let’s see what the difference is…

* The container can also be hung using a plastic net. The soap can then be hung from a piece of rope attached to the net.

35

Keep clean

• CLEANING is the process of physically removing dirt, crumbs, grease and other substances.

• DISINFECTING is the process of physically or chemically killing germs; i.e. by boiling water or wiping counters with detergent or chlorine.

It is important that surfaces where food is prepared are clean and

disinfected. Pay special attention to utensils and dishes used for drinking and eating since they are in contact with your mouth and the food you eat.

Use different cloths for cleaning dishes and wiping surfaces to prevent the spreading of germs. It is important to wash or change cloths and/or sponges regularly.

How to properly clean dishes and utensils:

• Use water, detergent and a dishcloth or sponge.

• Rinse with safe water.

• Leave dishes to air dry or dry them with a clean dry cloth (hold

silverware by the handle and glasses from the bottom, NOT from

the edges where you eat or drink).

• Do NOT forget to thoroughly disinfect cutting boards and utensils

(such as knives, forks, spoons, etc.) that have been in contact with

raw meat, poultry or seafood.

Don´t forget to wash and dry sponges, cloths, brushes, etc. since germs

can quickly multiply on them when they are damp. While preparing food,

clean continuously so that germs do not have a chance to spread.

ClEAn EVERYTHInG THROuGHlY! All leftover food and crumbs are hiding places for germs.

36

Key #2

Cats carry the parasite Toxoplasma gondii, which can cause humans to become very sick, especially babies or people with severe diseases such as cancer, HIV/Aids or malnutrition.

How can we keep food safe from pests?

• Keep animals such as dogs, cats, rats, cockroaches and flies away from areas where food is prepared.

• Keep food covered with a clean cloth or place in a container with a lid.

• Remove garbage regularly and keep the garbage can covered.

• Keep food preparation areas in good condition.

REMEMBER: Avoid having rats, cockroaches or flies in your kitchen. Before you start cooking, clean surfaces with soap and water.

Go to Activity # 8: What should I do when preparing food? Activity Book, page 27.

PESTS: How to protect the areas where we prepare food from pests

Why should we protect food from pests?

Pests are a proliferation of animals such as rats, mice, cockroaches, flies and other insects that can trans-port germs and contaminate food. Areas where food is prepared need to be protected from pests and pets to avoid contamination. If you see signs that your food has been in contact with pests, do NOT eat it.

Pet´s fur and paws can also carry germs to food preparation areas, therefore do not allow animals (dogs, cats, chickens) to enter these areas and use traps or insecticides to kill pests.

37

Keep clean

An IDEA:

Make a cover to keep food safe

Materials:

• Mesh or sheer fabric

• Wire or plastic rubber bands

• Wooden rods (bamboo) or thin metal wire

Using one (or more) of the wooden rods, make a circular base for the

frame. Using the wire or rubber bands, tie together several large pieces

of bamboo or rattan rods, in order to form an upside down basket. Sew

the mesh over the top of the wooden rods.

When finished, you will have a simple and inexpensive cover you can

use to stop flies and other insects from contaminating your food or

cooking utensils.

38

Key #2

Important notes:


FREEHAND) CLAVE 3

41

Separate raw meat, poultryand seafood from other foods

Raw food, especially meat, poultry, seafood and their juices may contain dangerous germs which can be transferred to other foods during preparation and/or storage.

Therefore, it is important to keep these raw foods separate from others, as well as old foods from fresh ones to prevent the spread of germs and avoid cross-contamination.

Cooked food can become contaminated by raw food with just minimal contact with raw food or their juices.

What is cross-contamination?

CROSS-CONTAMINATION occurs when germs are transfer from food, surface or utensil to another, contaminating it. For example, if you touch raw chicken with your hands and then pick up a fruit, the spread of germs from the chicken to the fruit is called cross-contamination.

Go to Activity # 9: What is cross-contamination?Activity Book, page 30.

What should we do to ensure meat, poultry and seafood are kept separate from other foods?

• Always separate raw meat, poul-try and seafood from other foods, even when you are buying them,

Key #3: Separate raw meat, poultry and seafood from other foods

42

Key #3

to avoid their juices from con-taminating other food that will be eaten raw, such as fruits and vegetables.

• Use different utensils and dishes, such as knives and cutting

boards, for raw foods and cooked foods. If this is not possible, be sure to wash them with soap, and dry them, before using them with foods that will

be eaten raw or that have already been cooked (i.e. salads, fruits, bread, etc.).

• Store food in containers with lids to avoid contact between raw and prepared foods.

• If you have a refrigerator, store cooked foods on the upper shelf, and raw meat (beef, pork,

poultry and/or seafood) on the bottom shelf to stop their juices from dripping onto cooked food or fruits and vegetables.

• Make sure that dishcloths that have been in contact with raw meat do not touch other foods and that they are not used to clean counters and other surfaces.

• Do NOT forget to separate fresh food from old food. Old food might contain germs that can contaminate fresh food. Consume leftovers as soon as possible (if they are still safe).

• DON´T FORGET to wash your hands after handling raw food, especially meat, poultry and seafood.

Go to Activity #10: Let’s avoid cross-contamination!Activity Book, page 32.


FREEHAND) CLAVE 4

45

Cook food thoroughly

It is very important to cook food thoroughly to kill any dangerous germs it might contain. Pay special attention to foods such as: ground beef, roasts, thick pieces of meat, poultry, seafood, pork and eggs.

Some foods are more likely to cause a foodborne disease. This is because

they have certain characteristics (such as humidity and nutrients) which enable germs to multiply quickly in and/or on this food.

Some potentially dangerous foods, according to their risk level, are summarized in the following chart.

Key #4: Cook food thoroughly

HIGH risk MEDIuM risk lOW risk

• Raw foods such as:

beef, pork, fish, poultry

and seafood.

• Milk and dairy products

(fresh cheese, butter,

cream)

• Mayonnaise

• Leafy vegetables such

as lettuce and spinach

• Fruits such as

strawberries and

blackberries

• Foods filled with dairy

products, such as pies

or cream-filled donuts

• Cooked pasta

• Eggs

• Reheated

food

• Beverages

such as atole*

• Dried foods

• Food that is served

hot and eaten

immediately

• Boiled vegetables

• Soups and broths

served hot

7 Taken and adapted from: FAO. 2000. Capacitación de vendedores callejeros de alimentos: Guía didáctica. Santiago, Chile. 107 pp.

* Atole is a traditional Guatemalan beverage made of corn.

Examples of foods and risk level in causing a foodborne disease7

46

Key #4

In the case of meat, poultry and seafood:

Cook them until they are very hot and their juices and inside are no longer pink. Bacteria are often found on the outside and inside of these foods. Therefore, it is very important that these foods are cooked thoroughly.

• In the case of soups, sauces and stews, boil them for at least five minutes.

• In the case of eggs, cook until the egg yolk and egg whites

are thoroughly cooked (no longer runny).

• Reheat cooked food until it is steaming hot or has boiled for at least 5 minutes.

Go to Activity #11: What did I eat last night?Activity Book, page 35.

Go to Activity #12: Independence Day celebration at my school, Activity Book, page 37.

Go to Activity #13: Answer and you will win!Activity Book, page 40.


FREEHAND) CLAVE 5

49

Keep food at safe temperatures(very cold or very hot)

If food is left at room tempera-ture for more than two hours, germs may begin to grow and multiply rapidly on this food. Food should be kept very hot or very cold, since at these tempera-tures germs cannot spread.

What should we do to ensure that food is kept at safe temperatures?

• Do not leave cooked and perishable food (food that spoils easily) at room temperature for more than two hours. If you have a refrigerator put this food in the refrigerator or use one of the storage ideas discussed later on.

If you have a refrigerator, make sure to do the following:

Do not allow the refrigerator to get very full since it makes it harder for the cold air to circulate.

Clean the refrigerator and defrost the freezer regularly.

Don´t leave the refrigerator’s door open for long periods of time since this makes the temperature inside the refrig-erator change.

Since food can spoil even when it is in the refrigerator or freezer, label leftovers

with the date they were made so you can tell if they are still safe to eat.

• In the case of liquids (like soups or sauces), boil before serving.

Key #5: Keep food at safe temperatures (very cold or very hot)

50

Key #5

• Cool and store leftovers immediately. To avoid storing too many leftovers, don´t cook large amounts of food; instead cook only the amount you think you are going to eat during the day. If you buy perishable foods (such as meat and cheese), and

you do not have a refrigerator, use them immediately.

• If you have leftovers, store them in a refrigerator and eat them within 2 or 3 days of preparing them.

• Don´t thaw frozen foods at room temperature. Thaw them in the lower part of the refrigerator.

Cold temperatures Hot temperatures

• Raw meat (beef, pork, poultry)

• Raw fish and seafood• Cheese • Liquid milk• Cream• Butter• Mayonnaise

Heat food thoroughly, especially:• Meals prepared with meat,

poultry or seafood• Corn-meal beverages (atoles)• Soups• Leftovers

Examples of foods that have to be kept at safe temperatures are shown in the following chart:

51


Go to Activity #14: Where should we keep food?Activity Book, page 43.

Go to Activity #15: Boiled milk is safe!Activity Book, page 48. Go to Activity #1�: Yeast balloons.Activity Book, page 50.

Ideas of how to store food at school and at home when there is no refrigerator available

A series of technologies that can be used to store fresh or prepared food when no refrigerator is available are presented below.

Refrigerating shelf

A wooden shelf (i.e. bookshelf) can be made into a good cold storage space. Place a pot with water on the top of the shelf. The shelf should be raised off the floor with pieces of wood or bricks. Cover the shelf with a damp cloth so the middle of the cloth sits in the pot full of water and the sides of the cloth drape down over the shelf. Make sure the cloth doesn´t touch the floor. Place the food you want to keep cool on the shelves, under the cloth.

Make sure the cloth is always kept damp by re-filling the pot with water regularly since the water will evaporate. This will ensure that the air inside the shelf remains cold, preserving the food inside for several days.

Foods that can be stored using this technique include: milk and other dairy products, vegetables or fruits and leftovers.

Refrigerating containers

Using two pots, a small one and a larger one with a lid, place the small pot inside the larger one and fill the space between the pots with water.

Place the food you want to keep fresh in the small pot. Cover the larger pot with the lid. Make

52

Key #5

sure that the space between the large pot and small pot is always filled with water.

This technique will create a humid

and fresh environ-ment that will preserve

food for one or two days.

Foods that can be stored using this method include: milk and other dairy products (cream and cheese).

Clay flowerpots and their bases can also be used to create a similar system. Place a brick on a base for a flowerpot (the round, deep kind). Fill the base with water, up to the top of the brick.

Place the food you want to store in a container on top of the brick. Dampen the flowerpot with water and place it upside down on the base, making sure it is touching the water.

Refrigerating basket

A bamboo or rattan interwoven basket can also be used as a type of refrigerator. Place the basket over a stone or bricks in a large, round or square, porcelain or metal container. Cover the basket with a damp cloth, making sure that the bottom edge of the cloth is in the water.

Several containers with food can be placed inside the basket and stored for up to 3 to 5 days.

Make sure the basket is completely covered with the cloth to avoid cold air from scaping. Remember to keep the cloth damp and replace the evaporated water every day.

Foods that can be stored using this system include COOKED rice and beans or other prepared foods (leftovers), vegetables for salads like lettuce or spinach, eggs and fruits.

53


Other ideas for storing food properly:

EGGS

• When there is no refrigerator available, eggs can be stored in

a fresh and clean place, in covered containers, or by covering

them with lime (calcium carbonate).

• Do NOT wash eggs before storing them. This weakens the shell

and the pores of the shell may open up making it easier for

germs like Shigella to enter into the egg.

FRuITS AnD VEGETABlES

• Fruits and vegetables should be washed and stored in a fresh,

dark, well ventilated, dry place so they last longer.

• Avoid storing fruits and vegetables one on top of another as this

creates heat and makes them ripen faster (they will not last as

long).

CEREAlS AnD GRAInS

• Clean grains and throw away any that are

damaged.

• Store grains in plastic containers with a lid,

in a dry and dark place. To avoid problems

with humidity, place a small cloth bag filled

with salt in the container (change the bag

every six months).

54

As previously mentioned, to prevent the contamination of food and water during preparation and storage, and therefore, prevent foodborne diseases we need to follow the FIVE BASIC KEYS, as well as practice other healthy habits.

Other healthy habits that should be practiced along with the five keys include:

• Eating well. This includes eating a variety of foods, including fruits, vegetables, cereals (such as corn and rice), beans, meat, and dairy products such as milk and cheese. If we eat well, our body will receive the necessary nutrients to stay strong and prevent diseases.

• Caring for our personal hygiene. This includes taking a bath, washing our hands and brushing our teeth regularly.

• Caring for our environment. Living in a clean and tidy house prevents the presence of rats, cockroaches, lice and other insects that can cause diseases. It is also important to use a latrine or toilet to prevent the propagation of flies, the contamination of our food and water and the incidence of diseases.

• Put garbage in its place to avoid the accumulation of bacteria.

• Make sure there is no stagnant water near your school or home such as puddles, or objects in which water can accumulate (like tires, cans, etc.). Stagnant water often contains germs and insects that can carry diseases.

Go to Activity #17: What can we do to prevent foodborne diseases? Activity Book, page 53.

III. HOW CAn WE PREVEnT FOODBORnE DISEASES?

55

What should we do if we contract a foodborne disease?

If you have stomach problems caused by eating or drinking contaminated food or water, remember the following:

• As soon as symptoms appear, drink plenty of safe water or an oral rehydration solution to prevent dehydration, especially if you have diarrhea.

• Avoid handling food. If this is not

possible, wash your hands with soap and water before handling or preparing food.

How to prepare an oral rehydration solution?

In a glass of safe water add...

• 1 teaspoon of sugar

• A pinch of salt

Mix well until ingredients are dissolved, and drink the whole solution

• Seek medical assistance if you have diarrhea, bloody feces, vomiting or prolonged fever, and/or if symptoms last for more than three days.

• If you work at a school preparing food, notify your employer if you have: diarrhea, vomiting, fever, Hepatitis A, sore throat, skin rash or discharge from your ears, eyes or nose so he/she can suspend you for the day or change your responsibilities so that you will not be in contact with food.

56

IV. AnD REMEMBER…

To ensure the food you are eating is safe……

1. Use safe water and food for your consumption.

2. Keep clean: this prevents germs from spreading.

3. Separate raw meat, poultry and seafood from other foods:

this prevents germs from multiplying and spreading from

one food to another.

4. Cook food thoroughly: this kills germs.

5. Keep foods at safe temperatures (very cold or very hot).

Go to Activity #18: Five Keys to Safer FoodActivity Book, page 56.

Go to Activity #19: Identifying germsActivity Book, page 58. Go to Activity #20: Food Safety Inspector Activity Book, page 6�.

57

V. BIBlIOGRAPHIC REFEREnCES

• CDC/ PAHO. Sistemas de agua segura para el mundo en desarrollo: manual para la ejecución de proyectos de tratamiento y almacenamiento seguro de agua en el hogar. Department of

Health and Human Services. Centers for Disease Control and Prevention, CDC/ CARE USA, United States of America.

• CDC. Tippy Taps: A design for simple, economical and effective hand washing stations. Visited in September, 2005. http://www.cdc.gov/ safewater/publications_pages/tippy-tap.pdf

• FAO. 2000. Capacitación de vendedores callejeros de alimentos: guía didáctica. FAO, Food and Nutrition Office, Regional Office for Latin America and the Caribbean. Santiago, Chile.

• SODIS Foundation. 2005. Desinfección solar del agua: guía de aplicación. Second edition. EAWAG/ SANDEC and SODIS Foundation, Cochabamba, Bolivia.

• SODIS Foundation. Guía de rotafolio SODIS: una buena alternativa para desinfectar el agua, Bolivia.

• INCAP/ PAHO. 2004. Contenidos Actualizados de Nutrición y Alimentación –CADENA-. Second edition. INCAP MDE/152, Guatemala.

• INCAP. 1999. Curso a Distancia: diagnóstico, tratamiento y prevención

de intoxicaciones agudas causadas por plaguicidas. INCAP MDE/025, Guatemala.

• Hernández, H. 2002. Agua y saneamiento: opciones prácticas para vivir mejor. Pan American Health Organization.

• Hurtado, E. ‘Tippy Tap’ saves water. INCAP PCI/098, Guatemala.

• Lean, G. De un vistazo: agua y saneamiento. OUR PLANET Magazine: The magazine of the United Nations Program for the Environment. Volume 14, No. 4. Visited in August, 2005. http://ourplanet.com/imgversn/144/spanish/glance. html

58

• Molina, V. and V. Valdés. 2003. Curso de Educación a Distancia sobre Comunicación en Salud. INCAP/ PAHO/ ANDEGUAT, Guatemala.

• Molina V. and L. Gallardo. 1999. Curso de Educación a Distancia: Escuelas Saludables. Módulo 1: Escuelas saludables, concepto y proceso. INCAP/PAHO. INCAP MDE/113, Guatemala.

• MSPAS. 2004. Cartilla ambiental, cuidado de la salud y el ambiente. Cartilla No. 1: el agua. Regulation Department for Health and Environmental Programs. MSPAS, Guatemala.

• MSPAS. 2004. Cartilla ambiental, cuidado de la salud y el ambiente. Cartilla No. 8: tratamiento y desinfección del agua a base de cloro (manual para técnicos). Regulation Department for Health and Environmental Programs. MSPAS, Guatemala.

• MSPAS. Libro de salud para la alumna y el alumno: escuelas saludables. Health Promotion and Education Department, Guatemala.

• MSPAS/ MINEDUC. 2006. Guía para la maestra y el maestro: promoviendo la salud en escolares. MSPAS, Guatemala.

• MSPAS/ MINEDUC. Guía del alumno: programa “Cuerpo Sano”. MSPAS, Guatemala.

• PAHO/ WHO. 2002. La Salud en las Américas: Volume 1. Scientific and technical publication No. 587, Washington, D.C.

• PAHO/ WHO. 2002. La Salud en las Américas: Volume 2. Scientific and technical publication No. 587, Washington, D.C.

• United Nations System. 2003. Grupo de Seguridad Alimentaria y Nutricional. Situación de la seguridad alimentaria y nutricional de Guatemala, Guatemala.

• _________, Low-cost hand-washing technology. Updated: Tuesday 21 June, 2005. Visited in July, 2005. http://www.irc.nl/page/13215.

59

Pages visited to obtain information regarding SODIS method.(Visited in August and September, 2005)

• Presentación Desinfección Solar (SODIS): un método alternativo para el tratamiento de agua de consumo humano. http://www.cnea.gov.ar/xxi/ambiental/agua-pura/presentaciones-encuentro/ARGENTINA%20SODIS.pdf

• Desinfección solar de agua: una opción de tratamiento de agua para el año 2000 y más allá: síntesis de la conferencia de SODIS. 1999.

http://www.dodis.ch/Text2002/T-emailConferencia-span.htm

• Treinta mil bolivianos usan el agua desinfectada por el sol. 2002. http:// www.aguabolivia.org/prensaX/Prensa/2002/Noviembre/noviembre4/

E5-1_36. htm

• El agua que baja de Semapa es buena, en el camino corre riesgos. 2001. http://www.aguabolivia.org/prensax/prensa/2001/febrero/17-23/Seb180201.htm

• Sobsey, M. Manejo del agua en la vivienda: beneficios acelerados para la salud derivados del abastecimiento de agua mejorada. WHO.

http://www.who.int/water_sanitation_health/dwq/wsh0207/es/print.html

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VI. GlOSSARY

AdditivesSubstances or compounds added to food for preservation or to improve flavor. Examples of preservatives are antioxidants (vitamin E) or citric acid.

AlgaecideA chemical product used in agriculture to eliminate algae.

AntioxidantA substance used in the food industry, which is added to foods to prevent or reduce the destruction of fats by oxidation. Examples are vitamin E and betacarotene.

BacteriaA microscopic organism wich may be found in the enviroment, in foods and on animals. According to their shape, bacteria receive different names (coccus, bacillus, spirochetes, vibrios, etc.).

Chemical productsA substance composed of materials that have been transformed from their natural state. Examples include beauty, cleaning and agricultural products, plastics food additives, medicines, gasoline, among others.

CleaningThe process of physically removing dirt, crumbs, grease or other

undesirable materials from any surface, equipment or utensil.

ContaminantAny biological or chemical agent, foreign matter or other substances not intentionally added to food that may compromise food safety or suitability.

Cross-contaminationThe introduction of microorganisms or disease agents from raw foods into ready-to-eat food, making unsafe. This can happen in three ways:

1) Raw foods or their fluids coming in contact with cooked foods or ready-to-eat foods;

2) Contaminated hands coming in contact with food;

3) Using the same equipment or utensils for raw food and cooked food.

DiarrheaA disorder of the intestine marked by abnormally frequent and fluid evacuation of the bowels.

DisinfectionThe reduction by means of chemical agents and/or physical methods, of the number of microorganisms in the environment, to a level that does not compromise food safety or suitability.

61

Etiological agentsThe cause of disease or illness; in other words, the microorganism or virus that cause a disease.

FertilizersA organic or inorganic, natural or synthetic substances, wich improves soil quality therefore improving plants’ growth and yield. Inorganic fertilizers (ones that contain chemicals) must be applied with caution to prevent chemical contamination.

FoodAny plant or animal product prepared or sold for human consumption. Includes drink and chewing substances and any ingredient, food additive or other substance that enters into or is used in the preparation of food. Does not include substance used as a drug or medicine.

Foodborne Diseases (FBD)A general term used to describe any disease or illness caused by eating contaminated food or drink. Traditionally referred to as “food poisoning.”

Food contact surfacesSurfaces of equipment and utensils normally in contact with food.

Food handlerAny person who directly handles packaged or unpacked food, food equipment and utensils or food contact surfaces, and is therefore expected to comply with food hygiene requirements.

Food hygiene practicesAll conditions and measures necessary to ensure the safety and suitability of food at all stages of the food-chain.

Food preparationThe manipulation of food intended for human consumption by processes such as washing, slicing, peeling, shelling, mixing, cooking and portioning.

Food safetyAll measures to ensure that food will not cause harm to the consumer when it is prepared and/or eaten according to its intended use.

Heavy metalsA group of elements that can be toxic at relatively low concentra-tion, and produce enviromental contamination and destruction. When these heavy metals are present in water consumed by hu-mans, they can cause serios harm.

62

Incidence rateNumber of new cases in a determined period of time.

InnocuousThat which does not cause any harm or adverse affect.

IntoxicationThe state of being infected with a poison or other toxic substance.

Kitchen utensilsObjects such as pots, pans, ladles, scoops, plates, bowls, forks, spoons, knives, cutting boards or food containers used in the preparation, storage, transport or serving of food.

Microbes (microorganisms)Microscopic organisms such as bacteria, molds, viruses and parasites, which may be found in the environment, in foods and on animals.

nutrientsSubstances (carbohydrates, pro-teins, fats, vitamins and minerals) that are metabolized by an organ-ism to provide energy and build tis-sue.

ParasiteAn animal or plant organism that lives in or on a host (another animal or plant); it obtains nourishement

from the host, weakening it but not killing it.

Perishable foodFood that spoils within a short amount of time.

PesticideAny substance or mixture of sub-stances intended to prevent, de-stroy or control pests that can cause damage during the production, storage or transportation of agricul-tural products.

Poisonous fungusFungi that contain toxic substances and can cause diseases, and even death, in plants, animals and people.

PurificationIn the case of water, is the elimination of germ from the water using methods such as chlorination, boiling or SODIS.

RiskIs the severity and likelihood of harm resulting from exposure to a hazard.

Safe foodFoods free of dangerous germs (bacteria, viruses, parasites or fungus), toxic chemicals or external physical agents (i.e. soil or hair) that can be hazardous to our health.

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SanitizationThe process of desinfecting something wich can be achieved by applying an approved chemical product, or extreme heat.

Toxoplasma gondiiIntracellular protozoa that produc-es the disease known as Toxoplas-mosis. The disease can causes fe-ver and alterations in the nervous system that can produce convul-sions and mental retardation.

VirusA non-cellular, microscopic infectious agent that relies upon a host cell to reproduce.

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