A One-way Ticket to Heaven: Washrooms in Mosques Producing Disease

12 November 2013

Ma’areb Press – Al Thawra – Yemen

“Bilal Al Qallam” rushes for sunset prayers along with many others for a group ablution in a washroom that belongs to the old neighbourhood mosque in the capital San’a. The smell of mold is everywhere, and in some corners mucus and polluted weed swim in stagnating water, which affects 80% of the people with feet fungus or intestinal infections or diarrhoea, according to dermatologists.

Most people here are not aware of the dangers posed by immersing their feet in those basins after completing their ablution, or in taking a dip is some of the “tubs” or “pools” set for washing the entire body – although they are supposed to be safe places for cleanliness – in line with a tradition inherited from the Zaidi sect thousands of years ago. With the passing of time, and due to lack of hygiene, those basins have turned into a haven for skin and intestinal diseases that spread among the people, many of whom come to those washrooms for cleaning. When it harms them they justify it by calling it “fate”.

Abdul Aleem Qa’ed (35 years), who does his noon prayers in the Al Oseimi mosque near his home in the neighbourhood of Sab’a (which is led by a Salafi majority), says: “No one cares about these things (hygiene), we are in the hands of the Almighty God, and nothing will happens to us unless he ordains it.”

This report exposes how those basis have turned from places for spiritual and physical purity into a source of danger. Samples taken from the washrooms of 10 out of 1300 mosques in the capital San’a have revealed record levels of pollution due to the carelessness of the Ministry of Awqaf (Islamic Affairs) which is responsible for supervising houses of worship and maintaining their cleanliness.

Diseases at different levels of depth in the water

Those basins and washrooms are usually located in the backyards of mosques, often designed as exposed outdoor platforms with different sizes and heights. Some of those basins are more than 30 centimetres high as it is the case in 70% of the total number of mosques in San’a, while the pools are usually one meter high. The basins and pools in mosques that are not connected to the government’s main water pipe system are usually fed by trucks, according to demand and depending on the expenses available to the mosque whose toilets lack the minimum hygienic requirements.

Those supervising the mosques say the water in the foot basins (used to clean the feet before and after going to the toilet, and before entering the mosque) is changed twice a day. But this cannot be applied to the basins of old mosques, often called “pools”, where people dip their bodies and wash in stagnating water, and which contain high levels of pollution.

At the “pool” of the Qubbat Al Mahdi mosque, which was built 1000 years ago in the Old City, people who come to pray will wash all their body parts included in the ritual ablution. Sounds of gurgling and sniffing and spitting of water that only gets changed once every five days are heard, according to the caretaker of the mosque, Humoud Al Shahari.

Fungus, infections, diarrhoea … and cancers too

The results from the tests carried out for this investigative report, which took three months to prepare, have shown excremental traces in the basins of all the ten mosques included in this microbiological analysis. This was clear from the appearance of colonic bacteria, the E-Coli, resulting from human excrement , in addition to the possibility that more dangerous viruses exist in the water, which could be confirmed if more advanced lab facilities are available, according to doctors who spoke to the author of this report.

Results from one sample have revealed 2400 cells-millimetre of colonic bacteria. Yemeni specifications for non-bottled drinking water stipulate that it should be empty of colonic bacteria in any 100 millimetres of any sample.

E-Coli is responsible for many widespread diseases in Yemen, especially intestinal illnesses such as diarrhoea, and it is one of the most dangerous pollutant, according to doctors, which levels the level of danger threatening people who use those basins.

The situation also appears to be catastrophic when it comes to pools attached to the old mosques. Two pool samples have shown “100% pollution” according to Dr. Yahiya Raj’aa, a teacher in social medicine who took part in reading the results. He adds that six out of the ten samples were full of fermented material that causes skin diseases.

Dr. Rajaa explains: “these samples were polluted with excrement, which was clear from the appearance of E-Coli,” which indicates the possibility of finding other harmful bacteria that causes diseases like Typhoid and Shigella. “Just having E-Coli indicates its ability to survive in different climates. But the fact that we do not have proven the existence of other bacterias does not mean that other forms of dangerous bacteria do not exist. If the right resources are available to follow safety procedures in preserving the samples then we might find other kinds of bacteria.”

In the capital, Sanaa, there are 360 mosques with pools similar to the one attached to the Qubbat Al Mahdi mosque. The doctors who took part in reading the test results consider this a fertile ground for spreading skin and intestinal diseases, such as food poisoning and stomach illnesses caused by E-Coli and Salmonella and Dysentery which is caused by Shigella, in addition to other diseases like Cholera, ascaris, urinary tract infections and others.

The government has no statistics on skin and intestinal diseases, in a country with a population of 23 million. But Dr. Balqees Jarallah, a skin disease consultant, says that 80% of people who use wash facilities in mosques suffer from foot fungus.

In addition to foot warts, Dr Jarallah says that “fungus and bacterial infections are the top skin diseases that spread among people by contact of contaminated water with the skin.”

She believes that communal washrooms are dangerous because they increase the likelihood of suffering from warts, as well as some forms of skin cancer.

Illnesses among the young

As well as experts, many people praying in the mosque were shocked to learn the results. Fear increased among people who used public pools of the spread of skin and intestinal diseases, especially when cases of infections appeared. But few people such as Jamal Hussein can be sure that their skin diseases was caused by using a public pool in one of Yemen’s 75,000 mosques.

Jamal Hussein (21 years), says he caught foot warts (infectious skin viruses that appear in the form of rough skin in different parts of the body) at Khaizaran mosque from the water filled in the attached pool there. This was confirmed by his doctor, Balqees Jarallah.

When he got the warts, Jamal Hussein quickly infected his brother, Abdul Malek, and succumbed to familial pressure to treat the disease through the traditional ways. The warts, however, increased in size and began to spread, so he underwent surgery and several sessions of electrical treatment to burnt out those highly infectious viruses, which are not guaranteed to be fully curable, according to dermatologists.

Jihad Hanash (19 years) also suffers from warts in his left foot, which forced him to stop going to secondary school in order to undergo a surgery, which isn’t guaranteed to be successful.

Jihad confirms that the infection happened at Al Hai mosque in the north of the capital, and he adds: “So far I had one surgery to take out the viruses but the pain hasn’t gone away, and now the warts are coming back.” He points at his foot.

Between the two homes of Jihad in the north of the capital, and Jamal in the south, there are hundreds of pools and probably thousands of individuals with skin diseases that are ready to spread to a new “host”.

Treatment does not mean an end to pain

In her elegant clinic in the middle of the famous Zubeiri street, Dr Balqeen Jarallah appears to be exhausted from the long queue of patients with different skin fungus. She says the main symptoms are “a white layer between the toes, scaling and abrasions, and fungus that can easily spread through scratching from one part of the body to another.”

She adds that during the last three months she received about 400 patients, in both her private clinic and in the Republican Hospital clinic. The most common diseases were “warts on the feet, hands and mouth, and fungus and bacterial infections,” which indicates the three most common diseases that spread through the use of contaminated basins.

If the traditional ablution ritual continue this way, then it could increase the number of infected individuals. Most of the infected, according to doctors, receive their medicine straights from pharmacies or unlicensed clinics, and often at an advanced stage in the diseases. Dr Muhammed Shami, a dermatological consultant, says those diseases usually begin skin infections, especially in the nails and toes. But the most dangerous thing, according to Dr Balqees Jarallah, is that “some medicines used for treating fungal infections can affect the liver, especially if a patient uses them for a whole year to treat toe infections, or six months to treat nail infections.”

From ablution to the mosque

A large number of people praying at the mosques who were shown the test results said told that they became afraid of the waters in those basins. They mostly recounted names of people they know who displayed the same symptoms that the doctors told us about. Their fears soon turned into despair as they learnt that, according to doctors, those diseases might also spread by using the prayer mats.

Medical consultations, as well as scientific studies published on the internet (such as the study published end of last year by Dr. Khalifa Sifaw Qanqish, a microbiologist at the Medicine Faculty at Tripoli University in Libya), show that the mouldy air that people inhale from the mat fibres while kneeling in prayer is evidence to the presence of contamination (from excremental bacteria).

The number of infected people could increase due to the deterioration in living and health conditions and a sharp increase in water supplies, which forces the poor to use public water facilities in mosques to wash their household material, in a capital that is considered to be one of the poorest in the Arab world in terms of water.

According to doctors, few are lucky to enjoy a strong immune system that allows them to avoid getting infected by skin diseases. Open wounds and skin cracks increase the risk of infection, as explained by Dr. Muhammed Shami: “It makes it easier for bacteria to enter the body and cause infections,” because skin is the first line of defence, and if this bacteria enters then it could spread poisons that lead to paralysis, and in some cases it could enter the blood stream and cause severe infections inside the muscle tissue.”

Pain and fears

Saleh Shumeikh, the caretake of the old Nahrein mosque in the old city, says the lack of cleaning material is a clear reason behind water contamination. “We only get cleaning material once every three months from the ministry, and only in very limited quantities,” he says. “The caretakers received very low salaries that range from 5.000-10.000 Riyals a month (£25-50).”

The ministry’s record reveal that hygiene is not a top priority for the government at the moment. According to statistics, the Ministry of Awqaf (Islamic Affairs) only supervises 502 out of 1.300 mosques in the capital Sanaa. One hundred other mosques among them are managed by other bodies, which means that 700 mosques rely on the local communities as well as charities and donations of some businessmen.

The head of the mosque management department in the local office in Sanaa, Ibrahim Sinan, says: “We face many difficulties, mainly the lack of financial and human resources to supervise all mosques.” He adds that meager allowances do not even cover the salaries of cleaners, estimated at 420 individuals.

“If the resources were available to supervise the mosques, then most problems could be solved. But removing the basins requires a ministerial decision.”

In response to that, the agent of Awqaf, Dr Mahid Muteiri, says that “lack of finances is the reason behind the lack of hygiene in mosques. Awqaf has no government support to meet the requirements of mosques on a regular and frequent basis.”

Muteiri, however, promised to issue an instruction to remove foot basins that either either buying water externally, or the ones where the water is changed once every 3-4 days. This will be conditional on the availability of water faucets near the mosques and away from any filthy areas. But he insisted that pools used for ritual ablution “must be preserved because they are historically part of the old mosques.”

Even monitoring procedures concerning the pools require support from the central government, according to Muteiri who says that “if there is central support, then we would rearrange washing and ablution facilities according to modern standards. We demand that the government allocates finances for cleaners.”

Some Sharia decisions unfathomable for the faithful.

The harm is not only hygienic, but it also extends to the validity of worship. The deputy of the Republic’s Mufti (grand cleric) Sheikh Muhammed Ghuneim says that: “If it is proven that such diseases exist, then one cannot use that water, because the Prophet, peace be upon him, says: “No harm and no detriment”. “

He explains that “religious scholars are in agreement that if water changes in taste or colour or smell then it becomes filthy and it cannot be used, either for ablution or other purposes.”

Sheikh Jabri Ibrahim – the Imam of Ghazwat Bader Al Kubra mosque – agrees with Sheikh Ghuneim: “The amount of water that gets poured in the feet basins is very little and it barely reaches 100 litres, and this is why we notice that it changes in colour and smell, and one must not use things that cause harm to people.”

While waiting for new instructions by the Awqaf Ministry to put a limit to this phenomenon, thousands of individuals in Yemen’s mosques remain potential victims of contaminated ablution basins.

This investigative report was prepared with the support of the Arab Network for Investigative Journalists (ARIJ), under the supervision of Khaled Al Harouji

More facts

– In the capital Sana’a there are 1300 mosques, 70% of them have basins allocated for washing feet before and enter going to the toilet (the basins are approximately 30 centimetres deep). The Pools are one meter deep, where individuals dip their bodies to wash the parts included in the ritual ablution, including the genital area.

– This is a tradition that dates back to the Zaidi era (897-1962 AD), where the imams put the foundations for those basins using black stones and flint stones for people to wash their feet after going to the toilet, as well as places allocated for ablution before entering the mosque. Muhammed Zaid, the caretaker of Al Ansar mosque which is believed to be three decades old says that “washing in basins prevents filth from entering the mosque, and this is something good.”

– Basins and pools are usually located as elevated platforms in the backyard of a mosque.  Mosques that are not connected to the government’s water-grid order private trucks to feed those basins with water. This depends on the finances available to each mosque, and many of their toilets lack the minimum hygienic standards.

– Results from microbiological testing carried out for the purpose of this investigation have revealed excremental contamination in the washing facilities of all ten mosques included in this investigation. Those basins and pools have become a haven for skin and intestinal diseases.


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