Is your bathroom a death trap?

The bathroom seems like a safe place, doesn’t it? It is not. Far from it.

On the evening of April 17, 2013, Oscar Anthony Mito became yet another victim of a slippery bathroom, which is silently leaving its victims paralysed. Or dead.

“My family is one of the reasons I am still alive. Their care and support since that incident has been of great encouragement for me,” he says.

Thanks to quack contractors and poor quality or inappropriate ceramic tiles, bathrooms are increasingly turning into cubicles of death. While there are no statistics on bathroom injuries and fatalities in Kenya, doctors say that it is now common for patients to show up in hospital following injuries sustained from bathroom falls.

“Bathroom falls are common incidents especially in middle-class  homes,” says Dr Dennis Otwori, a medical practitioner at the National Spinal Injury Hospital. 

Home owners, in the name of saving money, do not engage professionals, rather, hire quacks, who are unintentionally laying death traps in their bathrooms.

As it is, doctors have classified the bathroom as the second most dangerous room after the kitchen.

Ask Mr Mito.

On that day, he had only wanted to take a hot shower after a hard day’s work. While in the shower, he slipped and fell. When his wife came to his aid after he called out, she discovering that he could not stand or sit. She quickly called a neighbour who rushed her husband to the nearest health facility, Manywanda Health Center in Bondo, Siaya County, after which he was taken to Aga Khan Hospital, Kisumu. The worst had happened: an MRI scan revealed that Mito had suffered a spinal cord injury.

From a vibrant and energetic 50-year-old father of six, he is now paralysed from the chest down, a condition doctors call “flaccid paralysis of the lower limbs”. 

This means that he will never walk again.

“I consider myself very lucky,” says Mito, who was admitted for five months at the National Spinal Injury Referral Hospital as he underwent rehabilitation.

“Most bathroom falls are fatal. I am glad I survived,” he adds.

This optimistic attitude is the result of intense counselling that he went through to help him come to terms with the fact that he would never regain use of his legs.

The most obvious cause of bathroom falls is the wetness and the soap that makes the floor slippery, hence dangerous. The other cause is the glossy and polished tiles that homeowners fit on their bathroom floors, yet these are supposed to go on the walls. Ignorant homeowners use these beautiful and flowered wall tiles on the floors perhaps for aesthetic purposes, unaware that they are creating death traps.

The vice-president of the Architects Association of Kenya (AAK), Mr Gad Opiyo, says that it is a requirement of the building code that health and safety of the end users be assured. Contractors, architects and other professionals are required to build with the safety of the user in mind.

“You are supposed to fit non-slip ceramic tiles on the bathroom floor to prevent slipping. Also, ensure that there is efficient water drainage in your bathroom because water stagnation can make the floor slippery,” Mr Opiyo points out.

HARSH REALITY

It is a fact that many people constructing homes choose to bypass professionals such as architects and contractors and opt for the shortcut of overseeing the construction themselves, thinking that it will be cheaper in the long run.

They therefore end up using quacks or inexperienced fundis who work within a tight budget. What they do not know is that the poor workmanship and attempt to save money could cost their life or that of a loved one. Or leave them paralysed for life.

“The law requires that when building, you get a registered architect, contractor and other professionals for proper supervision. Many people take short cuts, but in the end, it becomes very expensive,” Mr Opiyo points out.

One minute, Mito was, for instance, enjoying a hot shower, and looking forward to a relaxed evening, the next, he could neither stand, sit, nor feel his limbs.

“I have come to terms with my situation with the help of professional counselors. My family has been my greatest pillar though. They have helped me to adjust socially and helped me get the best medical care they can afford. My condition is not cheap,” he says.

Before the accident, getting to work and back home was easy, something he took for granted, today, the Teachers Service Commission employee tells a different story. The daily commute to work is cumbersome and expensive since he has to take a taxi to and from work, and depends on others to move him around.

When you spend all your time on a wheelchair, you are bound to develop pressure sores due to the long seating. Your bones also weaken because you no longer use them, and so they are susceptible to fractures - Mito suffered a bone fracture in 2014 on his left leg.

A doctor fitted a metallic plate to correct the injury but it got infected, leading to hospitalisation for 10 days.

Even worse, a hole on his knee, which was used to drain the infected wound, also turned into another wound, which doctors refer to as “septic arthritis”, and which is why at the time of the interview, Mito had a bandaged knee awaiting yet another surgery. He is currently on antibiotics and other drugs to treat the septic arthritis.

And then there are the frequent muscle spasms, uncontrollable jerks that assail him since his lower body is disconnected from the spinal cord, making his brain unable to send messages to his lower body. Although he has medical insurance, it is often never enough.

“At times I have to fly from Kisumu, where I live, to Nairobi for treatment when I fall sick - my medical cover of course does not cater for this. You need lots of money to survive in this condition,” he points out.

Being on a wheelchair in his condition also requires him to enlist the services of a professional nurse or at least a caregiver with basic nursing knowledge, who will understand how to treat and clean the pressure sores.

The caregiver must also know how to position her patient to prevent the sores from worsening. Such caregivers do not come cheap - they are paid at least Sh30,000 a month.

Then there is the use of catheters, which have to be changed on a weekly basis, and which are not catered for by the National Hospital Insurance Fund, NHIF, or medical insurance. A good wheelchair costs around Sh60,000, while a motorised one will cost about Sh300,000.

As you read this, Mito is in need of another wheelchair because this mode of transport is prone to wear and tear, and therefore short-lived. Add to that the fact that he is in regular need of physiotherapy - a sessions costs him Sh1,000. He needs one every week.

COMMON PROPBLEM

According to the US Center for Disease Control and Prevention (CDC), every year, about 235,000 people over 15 years old visit emergency rooms due to injuries suffered in bathrooms. Almost 14 per cent are hospitalised.

These injuries are caused by trips, slips and falls and when getting into or out of bathrooms - CDC analysed data from a nationally representative stratified probability sample of 62 hospitals’ emergency departments in the US.

“In Kenya although we have no local statistics, we occasionally receive serious cases of bathroom casualties. Most injuries occur around tubs or showers. These are followed by injuries that occur near the toilet,” explains Dr Otwori.

Few are lucky to escape with non-impact injuries such as contusions (bruising) and cuts. 

“If a person sustains a spinal cord injury, the best case scenario is to be paralysed from chest or waist downwards. The worst case scenario is that this person is not able to use his hands and legs.

If they land on the head and get injured high up in the neck, they have limited chances of survival,” says the doctor.

For those who injure their spine and get paralysed, life changes drastically. They experience incontinency of the bowel and bladder, which affects them psychologically and limits their social interaction.

This also means that they have to use diapers, which can be embarrassing for an adult who was used to being independent and in control of their faculties.

People on wheelchairs also have to cope with several digestive problems such as constipation, a big problem.

They also have to be constantly on antibiotics because of frequent Urinary Tract Infections (UTIs). Most of all, movement is limited, and they can no longer work as well as they did.

Mito was the breadwinner before that accident, working for long hours to adequately provide for his family, now, life on a wheelchair has grossly limited his capacity to work. He is however thankful that TSC has allowed him to keep his job.

“We spend very little time in the bathroom, so rarely do we give thought it - a safe bathroom is one that is properly constructed to prevent falls or accidents, most of which are fatal,” he says.

At the National Spinal Injury alone, 20 per cent of the total trauma cases are due to falls, including those falls that occur in the bathroom.

Some of the injuries include contusion and cuts, sprains, strains, cuts, head and neck injuries, fractures and dislocation of the lower and upper limbs, hip fractures (especially for the elderly), and spinal cord injury.

According to Dr Otwori, those above 65 years are more likely to suffer these injuries near the toilet than near the shower or bathtub areas.

This can be attributed in part to vasovagal syncope, a condition that causes fainting and which can be triggered by bowel movements (Valsalva maneuver). Standing too fast after prolonged sitting on the toilet can also lead to postural hypotension, causing dizziness.

This is especially so when individuals are advanced in age; their risk factors for cardiovascular conditions are heightened. Those at risk are therefore advised to take their time getting up from a sitting position.

Women tend to suffer bathroom-related injuries more often than men.

This is partly because women spend more time in the bathroom than men do, and also because health seeking behaviour differs between the two sexes, thus giving more statistics for females visiting emergency rooms.

The difference in physical activities further makes the lower body strength for men more than that of women, increasing their stability during the process of falling.

***** 

SAFETY TIPS

1. Involve professionals when designing your home, otherwise you might be constructing a death trap. 

2. Your bathrooms should be friendly to the elderly, children and people with disabilities. 

3. Clean bathroom floors regularly to prevent a buildup of slime, which makes the floors slippery. 

4. Consider modifications such as placing non-slip bathroom mats and fitting grab bars in your bathroom - these will help at the point of getting into or out of the tub. Additionally, place a towel or mat outside the bath area to dry off your feet and therefore prevent slipping when you get out of the bath. 

5. Never leave children unattended in the bath.