Cheap Diseases: Sad Story Of How Scores Of Ghanaians Risk Contracting Infections For As Cheap As 50 Pesewas

The popularity of their activities in the capital is risking the lives of many unsuspecting Ghanaians. But for those who patronize the services of these roving pedicurists, it's a matter more of accessibility and affordability than style, class or even good health.

That notwithstanding, health experts are wary many Ghanaians may be buying for themselves, all manner of infections for as low as 50 pesewas on the streets of Accra…

Millions of people get pedicures each day without giving it a second thought. Manicures and pedicures can be a pleasurable experience for you, but your skin may feel differently because of the chance for micro-injuries, skin breaches or contagious infections, amidst the pleasure.

For 50 pesewas, clients can get a street version of bespoke pedicure and foot spa treatment from their sharp razor blades, knives and scissors nearly any time of the day.

However easily accessible these services are on the street, market centers or even workplaces, health experts believe the propensity of contracting all sorts of blood-based and skin infections through these services is easier and cheaper than ever before.

These guys, many of whom are thought to have fled war-torn African countries have been struggling with many adaptions in Ghana, key among which is the language!

But they find solace and source of income from engaging in cutting, buffing and filing the toe and finger nails of their clients in the nooks and crannies of the Ghanaian capital with brazen passion!

In many of the cities’ slum-dens, live these roving pedicurists – waking up each day, looking forward to servicing as many clients as possible.

For watchers, the trade gaining popularity in the face of widespread health concerns of stakeholders signals a manifestation of the harsh living conditions the average Ghanaian is confronted with.

Up-close with the Roving Pedicurist
Twenty-two year old Issaka, a native of Mali, has been living in Ghana for the past eight months. He tells me he's been engaging in the pedicure business since he came into the country. Apart from the Hausa language, Issaka speaks no other Ghanaian language.

I had to engage the services of Nabu as an interpreter to interact with the 22-year old. Sporting a lemon green tee over a blue-black pant brushing just below his knee, the skittish, or rather indifferent Issaka would not open up. The shy-looking boy is fixated on giving his nails a clean brush, while he struggles to answer my questions – through my interpreter.

From Monday to Saturday, he wakes up in the morning together with his other colleagues, looking forward to getting as many clients as possible before dusk. Issaka tells me he lives in one of Accra’s most densely populated slums, with over hundred others, who are all into the pedicure business.

His services are not too expensive, for clients who cannot afford his 70 pesewa charge, he beats it down to 50 pesewas upon the client's plea; on a good day, he could rake in as much as eighty cedis and thirty cedis on very lean days – but for all that its worth, Issaka feels the only way out of poverty and squalor is this!

Kwame is a bus conductor at Tema station, who had just engaged his services. I enquire from him why he chose Issaka as opposed to trimming his nails by himself, oblivious of the health implications.

For Kwame, tiresome work schedules as a bus conductor affords him very little time to be able to clean himself up. “I report to work as early as 05:00 a.m every morning and close after 10:00 p.m; I am unable to trim my nails during this time. It’s much easier contracting these guys who do this so well in less than five minutes,” he tells me.

Kwame is not alone in this – his colleague Joe shares in the same story. For him, the expertise displayed by the roving pedicurist is enough motivation.

Curious to have a first time feel of how it all works, I engaged Issaka for a fingernail trim.

For a first-timer that I was, the pain was evident. The force with which he scraped off the surface of my soft nails with the same razor he used for Kwame only minutes ago confirmed my apprehension.

Momentarily, I thought my finger nails were literally being yanked off! How painful! Deep into the flesh on the sides of my nails, the sharp knife sank – from that point; I knew I had been given a dose of what I called for. Torment!

So through my interpreter, I enquired from Issaka how he would handle a cut if I sustained one through this process – but like I read his mind, he simply tells me there's nothing he'll do, except if I had a personal medical aid kit. This rather startling revelation petrified me the more.

Boakye is a self-employed businessman in his mid-thirties who had just contracted one of these roving pedicurists to give him a quick clean trim at the Madina Market. Minutes after the session, he realized a cut in the flesh on his second left toe, from which blood flowed, but was helpless. He admits opening himself up to such a huge health risk is something he regrets.

“I told him I was not going to pay him if I saw any open cut. But he inflicted this on me. I’m just noticing it, I wouldn’t have paid him had I noticed this earlier,” he told me.

“For now, I don’t know if I am open to any diseases, this is my lesson. Never again”!

Many more Ghanaians have had to endure this kind of misfortune, without taking any serious action - the probability of infection transfer from one person to another is the greatest risk scores of Ghanaians are inadvertently opening themselves up to.

How they work
On a regular day, with a pair of scissors, sometimes two, a short pocket knife, a piece of foam/ sometimes rag and a small bottle of soap solution they roam through the crevices of the most clustered areas; markets, bus terminals and slums calling out for prospective clients with the slapping together of two metal pieces......

For a client, they first apply the soap solution onto the nails, as I have come to learn – to soften the nails...then with the pair of scissors, they begin cutting off the cuticles and dead skin around the nails. Intermittently, they rub the solution on the nails to clean up the debris.

Sporadically, a piece of foam is used to wipe off the particles....what happens in case of a cut? As Kwame told me, if the client has a first aid kit on them when the cut occurs, it could be used, however for clients who do not have any, a mere soap water clean is enough....

Then onto the next client!
For all the clients they engage, the same very sharp tools are used, with careless abandon. The health implications may be unpleasant...but for many of these people who patronize their services, it's a cheaper and accessible way to get a quick trim on their toe and finger nails amidst their usually busy schedules to put body and soul together.

Another common mistake made by these pedicurists is cutting nails too aggressively on the sides. This, health experts reckon can lead to painful ingrown toenails that break the skin, sometimes requiring surgical treatment.

But who would care?
Professional Therapy Options
Call it ignorance or maybe indifference, make that unconcern – many Ghanaians give these roving pedicurists the opportunity to expose them to various viral, fungal and bacterial infections. Before the popularity of this form of activity however, there existed the nail spas and salons, with staff who offer manicure and pedicure services to clients at a fee.

About 75 percent of salons and spas in the U.S. reportedly don't follow state protocol for disinfection, according to studies conducted in 2014. While it’s impossible to be completely sterile, salons and therapy spas are to sterilize their tools using an autoclave – a machine used in medical environments that produces steam and pressure for disinfecting equipment.

Many nail salons however used and continue to use liquid disinfectants to clean tools, but this method is only effective if therapists soak the instruments for around 20 minutes.

When shops get busy, tools are often removed early and used on the next client. The situation in Ghana is all too familiar. With no proper regulation or streamlining of the activities of nail spas in the country, individuals and groups are running their own enterprises; some with safety regimes others solely fixated on the income.

At one of Accra's popular men's grooming hubs, a number of clients are seen undergoing various stages of manicure and pedicure processes. The attendants are seen in protective gear – hand gloves and clean wipes. The contrast between what I find here and what persists with the roving pedicurists is glaring.

Lorraine is a professional therapist who works with X-men grooming parlour in Accra. She shares with me a few tips on best practices in offering manicure and pedicure services to clients.

The processes here are well-defined. From the inspection stage where the client is assessed for a ‘contraindication or pedicure contra-actions’ (investigations into whether a client has blisters or any cuts around the feet or nails) to the feet-soak in the booth bath, then to the removal of the hanging cuticles, through to the clipping of dead skin cells of the foot area (called callus removal) and the smoothening phase with the use of a Pedi foot file.

According to Lorraine, all the devices used at the facility are sterilized and recommends highly that one trimmer or blade should not be used for more than one client.

“For us here, we adhere to professional standards. We carefully take our clients through all these processes just to ensure we are not exposing them to infections,” she explained.

She further noted “the staff are all in gloves as well, we must also protect ourselves from possible infections as many of our clients may come in with different conditions.”

Owing to the various groups of clients and their special needs, it is recommended that tools used for one client are not repeated, especially with the razors, trimmers and cutters.

But, for all those roving pedicurists, these processes may be painstaking – a wild wander into another world.

Diseases closer to our ‘doorsteps’ than ever before

The city of Accra on a regular day is awash with many of these guys, roaming market centers, bus terminals and slum areas, with every 200 meter-walk providing an opportunity to meet a dark, usually 5 ft. 4 male frame, slapping two blades of his scissors together creating their signature call out sound.

From our neighborhoods, to the workplace, nine time out of ten, one is likely to come across one or more of these guys before close of day. For the most daring ones, a visit to the homes of their clients is more rewarding.

While they carry out their activities and charge their fees, they leave majority of their clients with infections for as cheap as fifty pesewas.

What’s more?
Majority of Ghanaians who patronize their services are unable to communicate with them due to the language barrier – as a result, there arises a gap. An opportunity for a feedback is absent; in the event there’s a skin breach or cut, save for the empty rants of the affected clients.

But how deadly can patronizing the services of these roving pedicurists be the unsuspecting public?

What really is the FUSS!?
Health Expert Views
The consensus points to one direction; there clearly is a problem – a cause for concern.

According to Doctor Dennis Bortey, a senior health officer at the Adabraka Polyclinic, the activities of roving pedicurists pose a serious public health threat, adding, those who patronize their services are susceptible to various blood-based infections.

He explained that many members of the public are susceptible to contracting HIV/AIDS, Hepatitis B and C as well as other skin infections like scabies and foot-related infections.

“Because of the sharp objects they use, once there’s a cut, the organisms could be transferred from one person to another, especially considering the fact that some of these disease-causing viruses and bacteria can stay active for days,” he highlighted.

Dr. Bortey noted that even in cases where the client receives no visible blood cut after the session, the skin-breach means the body is still prone to microscopic bacteria and fungus.

He further noted “the potential of disease transfer from clients to these roving pedicurists themselves is also high in view of the fact that they don’t wear protective gloves on their rounds.”

Considering “the fact that many people are always wearing socks and shoes also, the propensity of providing a fertile breeding ground for microscopic bacteria and other organisms are high, as a result once these unsupervised individuals come into contact with such clients, it’s an easy route to contract some of these infections,” he lamented.

For many health experts, a regulation of a sort from the Health Directorate and other stakeholders is the way to go, to prevent what they describe as an imminent epidemic.

The call on these institutions to regulate the activities of these roving pedicurists may be the way to go, but Dr. Bortey provides an alternative.

How about this?
Doctor Bortey believes members of the public must endeavour to take charge of their own lives – prescribing that another way out of the situation is for people to acquire these manicure and pedicure devices and equipment, and only engage the services of the professionals at a fee for their time and expertise.

He noted public education is required to help address the situation, while throwing the ultimate baton at the doorstep of the Health institutions – Ghana Health Service and other health directorates to formulate some regulations to check the activities of these roving pedicurists in the capital.

Other health experts reckon no matter how careful these guys are, there may still be small, microscopic cuts which may serve as a portal to infections. They have shot down claims by a section of the public to the effect that the roving pedicurists clean the blades and knives with a soap solution they carry around.

According to them, only if the guys washed their tools (scissors, knives, and blades) with carboxylic acid soaps (antiseptic soaps), can our fears be allayed, a provision they conclude is not the case.

Way Forward?
Yes – they are everywhere! Easily accessible and many times affordable too! But the long term consequences of patronizing their services may leave an indelible scar in the event the tables turn.

As much as possible, Health Experts are cautioning against opening ‘ourselves up’ to the plethora of diseases – some life-threatening, others permanently deforming too. Perhaps, if walking into a pedicure and manicure salon may be a burden in every sense of the word, then try otherwise.

Affordability and accessibility versus infection contraction, which would you choose?

To buy a disease for as cheap as Fifty pesewas or err on the side of caution? I choose the latter!

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