While public health and sanitation standards have greatly improved today in perhaps the developed countries, countries in Africa and for that matter Ghana are among several developing countries still battling with major disease conditions that are of public health concern. Among them are the blood borne infections at risk of being transmitted through the practices of barbers in various parts of Ghana. Among such viral blood borne infections transmitted by the activities of barbers are hepatitis B (HBV), hepatitis C (HCV) and HIV/AIDS. These are real lethal threats in the barbershop!

Historically, the word barber originates from the Latin word “Barba” meaning beard. A barber is a person whose occupation is to cut any type of hair, give shaves, and trim beards.1 To a larger extent, barbers are also involved in circumcision, incision, and drainage of abscesses, especially in rural areas.

The irony is that millions of Ghanaians regard HIV/AIDS as a condition for the “other person” and not them. The thinking is that the condition is far away from them as long as they did not engage in unprotected sex. However, here lies the case of a public health threat starring at the face of every one yet much attention is not given to it.

On any given day, either sex of the human race always find a way to enhance his/her outlook hence a good number of Ghanaians visit barbering or hair salons to trim their hair or for pedicure or manicure yet many care less about the safety of tools used on them.

The story was not different for a 26-year old apprentice who tested positive to HIV twelve years ago even though he had not engaged in any sex and after eliminating all other possible sources of contraction this is the narration he gave “my parents and siblings all tested negative to HIV and after eliminating all other possible sources of contraction, I decided to observe how my barber goes about his barbering activities and I realised that he ignored most safety precautions and consequently likely to be the source of my predicament’’.2

Reports from Pakistan, Japan, Egypt, Israel, USA, Bangladesh, India, Iran, and Italy showed that HCV and HBV respectively can be transferred by blade sharing and barber-related instruments 4, 5, 615. This seems that majority of countries face the risk of infections which could be spread through the use of instruments such as those used by barbers and hair dressers. Hence it would be much prudent that such operations of business are controlled. If studies from such countries show that the above mentioned diseases could be spread through the use of blades and general sharps then what faith is left to Ghanaians.

Studies carried out in Kumasi, Ghana had indicated that certain activities such as throwing used blades in the waste bin, using the same towel and combs for more than three clients were practised by more than three-quarters of barbers.16  Again, majority of UV sterilization chambers seen in barbering shops are not functioning properly and dozens of them are ‘white elephants’ without bulbs. In Accra, sterilisation practices in the barbering shops and salons are poor and unsatisfactory. Chances are that only 30 % are effective against microbial growth and some classes of virus. 21 Moreover, the method and degree of sterilization could be questionable because most barbers use less that 70% ethanol due to further dilution. This may be due to the high level of illiteracy or sheer ignorance in the barbering business.

Although in cities, razor blades may not be reused, it is suspected that in rural areas of Ghana many barbers still reuse the razor blade on multiple clients thereby contributing to the spread of HBV or HCV from one person to the other in line with reports of higher HBV prevalence in rural areas of Ghana.18,19, 20

An interview with a barber’s client said “I have thought about this a lot and when I went to test for HIV and reported negative, immediately I went to purchase a clipper for myself’’

In Cameroon, study shows that 90% of barbers’ instruments used are not under hygienic rules (single Razor blade for about 10 persons) used without sterilisation.15,14

In developed countries activities of barbers are regulated through a comprehensive training, licensing and monitoring programmes.17 For one to be involved in such profession in countries like U.S and U.K, Canada etc, one has to attend an accredited school or under study as an apprentice with someone who is a licensed barber within a specified number of years (normally 2 years). However, in Ghana there is no regulation of such sort.

Whiles sterilization and disinfection techniques are the best way to mitigate the risks, and are vital to every successful barber, in Ghana most of the barbers have no training and have little knowledge regarding proper sterilization processes to safeguard the health of the public. Most barbers started their practice at a very young age of 10-12 years, at that age they have no idea about transmission of diseases from the instruments used3,16,21.

One barber interviewed said ‘’I know that our activities could be a source of transmission of an infection, I am unaware of the particular infection condition and I wish the government or some health personnel will educate us on that’’

It seems whiles we are at higher risk of contracting all forms of infection through the negligence of the barbering industry, if not all, majority are most concerned about beautification, sound system, availability of television in the shop and decoration of their barbering shops and are not paying attention to the awareness and risk factors associated with their profession in the prevention of diseases.

Often most barbers working have less than secondary level education. In Ghana some barbers have open-air shops; where they place a table, chair and mirror under a tree at some public place like a bus stop and start their work. This type of practice should be banned.

The big question left unanswered is: which regulatory body is responsible for such activity in the country?

The Ghana Association of Barbers and Saloon owners should be empowered to do their work.

We recommend that city authorities and public health department should take this practice as a priority area to deal with this menace. The public health is compromised hence risk factors are enormous.

 

Authors: Promise Edem Nukunu, Mary Nafaye, Prince Opoku Sarpong, Sharon Antah, Prof. Major (Rtd.) George Asare.

 

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