1. Session 5: Food and Water Safety Nutrition Management with HIV and AIDS: Practical Tools for Health Workers

2. Session 5: Food and Water Safety Nutrition Management with HIV and AIDS Training Slide 2 Objectives Identify food safety challenges in the community List ways to prevent bacterial contamination of food, integrating local methods

3. Session 5: Food and Water Safety Nutrition Management with HIV and AIDS Training Slide 3 What is “Food Safety”? The process of keeping foods free from insects, flies, cockroaches, mice, rats, bacteria, mould and other contaminants Do this to prevent getting sick Do this to keep food fresh and healthy to eat Food and water safety are important for everyone

4. Session 5: Food and Water Safety Nutrition Management with HIV and AIDS Training Slide 4 Food and Water Bacteria, parasites, viruses in food or water Prevention with good hygiene and food safety practises Parasites from contaminated water can cause weight loss, stomach discomfort, hunger, and malnutrition People with weak immune systems are more likely to get sick from contaminated food and water

5. Session 5: Food and Water Safety Nutrition Management with HIV and AIDS Training Slide 5 Conditions for Bacteria Growth Food containing protein Moisture in foods or air (ex: liquids or foods kept in damp conditions) Temperature (ex: foods kept at room temperature) Bacteria grows more over time Exposure to oxygen or air

6. Session 5: Food and Water Safety Nutrition Management with HIV and AIDS Training Slide 6 Potentially Hazardous Foods Cooked foods Meats, chicken, fish, eggs Milk and any milk products like cheese Foods with cream, dressings, or mayonnaise (ex: salads)

7. Session 5: Food and Water Safety Nutrition Management with HIV and AIDS Training Slide 7 Temperature Keep refrigerators below 5 degrees C Cooked food should be bubbling or steaming hot and over 60 degrees C Potentially hazardous foods that are kept at room temperature (or between 5 and 60 degrees C) can start to grow bacteria after 2 hours

8. Session 5: Food and Water Safety Nutrition Management with HIV and AIDS Training Slide 8 Personal Hygiene Wash hands with clean water and soap: Before and after preparing foods Before eating Before preparing food for infants and children After using the toilet/latrine After touching raw meats, chicken, or eggs After changing an infant’s nappy If no soap available, wash hands with salt or ash and clean water

9. Session 5: Food and Water Safety Nutrition Management with HIV and AIDS Training Slide 9 Water Use water from safe supply Treated, piped water Boreholes or protected wells If water supply is unsafe (ex: from river or pond) Boil water for 5-10 minutes to kill bacteria, or Put water in a clear plastic bottle, paint one side of bottle black. Set bottle in sun for at least 5 hours to kill bacteria

10. Session 5: Food and Water Safety Nutrition Management with HIV and AIDS Training Slide 10 Water Store and carry water in clean, covered containers (preferably with a tap) Do not dip hands into water

11. Session 5: Food and Water Safety Nutrition Management with HIV and AIDS Training Slide 11 Food Preparation and Storage Cover and store foods in clean containers Throw away old or spoiled foods (foods with mould or bad smell) When in doubt, throw it out! Use FIFO method (First In, First Out) Wash all surfaces where food is prepared, utensils and dishes with clean water and soap or ash

12. Session 5: Food and Water Safety Nutrition Management with HIV and AIDS Training Slide 12 Food Preparation and Storage (2) Cook food thoroughly, especially meat, chicken and fish Serve cooked food immediately after preparation Avoid storing cooked food unless refrigeration is available If no refrigeration available, cook one meal at a time Store fresh food in cool place or refrigerator Keep raw meats, chicken or eggs away from already cooked food and foods that will be eaten raw, like vegetables and fruits

13. Session 5: Food and Water Safety Nutrition Management with HIV and AIDS Training Slide 13 Food Preparation and Storage (3) Do not cough, spit or scratch your hair or body while preparing foods Do not pick your nose or lick your fingers when preparing food

14. Session 5: Food and Water Safety Nutrition Management with HIV and AIDS Training Slide 14 Clean Environment Throw away garbage or food in covered bins Keep latrines clean

15. Session 5: Food and Water Safety Nutrition Management with HIV and AIDS Training Slide 15 Where Does Food Come From? Open markets Supermarkets Homestead

16. Session 5: Food and Water Safety Nutrition Management with HIV and AIDS Training Slide 16 Shopping in an Open Market Avoid buying foods covered with flies Buy meats that were slaughtered that day only and keep separate from other foods Make sure vendors do not use hands to scoop cooked foods, fruits or vegetables; use a clean cup/tin instead

17. Session 5: Food and Water Safety Nutrition Management with HIV and AIDS Training Slide 17 Shopping in a Supermarket Do not purchase dented or damaged canned foods Check expiry dates on all foods, especially milk, cheese, yoghurt, eggs, and meats Keep raw meats separated from fresh vegetables and fruits

18. Session 5: Food and Water Safety Nutrition Management with HIV and AIDS Training Slide 18 Food from the Homestead Wash all foods well before cooking Use latrines or ventilated improved pit (VIP) toilets instead of an open field If latrine or VIP unavailable, bury faeces immediately after defecation or use a bucket and dispose of waste in sanitary place Always wash hands with soap and water after using the latrine

19. Session 5: Food and Water Safety Nutrition Management with HIV and AIDS Training Slide 19 Danger Signs of Unsafe Foods Fresh foods Bad smell Unusual taste Mould on food Fish: pale gills, dull eyes, loose scales, soft flesh

20. Session 5: Food and Water Safety Nutrition Management with HIV and AIDS Training Slide 20 Danger Signs of Unsafe Food Dry foods like beans, sugar, grains, groundnuts are damp or mouldy Soak beans overnight before cooking, but throw away this water and use clean water to boil beans Oils and fats have unusual smell and taste Cans are swollen, dented, leaking, food smells, looks or tastes unusual

21. Session 5: Food and Water Safety Nutrition Management with HIV and AIDS Training Slide 21 Food Safety Group Activity

22. Session 5: Food and Water Safety Nutrition Management with HIV and AIDS Training Slide 22 Key Points 1.Keep foods safe and free of contaminants to prevent sickness 2.Keep cold foods cold and hot foods hot 3.Potentially hazardous foods kept at room temperature can start to grow bacteria after 2 hours (cooked foods, meats, eggs, milk, salads, etc) 4.Wash hands with clean water and soap 5.Throw away garbage or food in covered bins and keep latrines clean