Dear Joe,
I recently received some photos from Larry Hadley in South Africa, a retired paediatric surgeon.

When I saw this photo, I thought of your post on the forum - which is the first time I had heard about the practice of eating soil on purpose:

Ascaris infection in X-ray image: Pica, the practice of eating soil (South Africa) by Sustainable sanitation , on Flickr

The description of this photo says:
"The practice of eating soil (called pica or geophagy) is not uncommon amongst children and pregnant women. The women do it on purpose. Obviously if you're going to eat soil you're going to eat whatever ova are in the soil and makes ascariasis a high probability. The soil particles show up as white on this plain Xray."

I could ask him more specific questions if we have any?
Larry has also sent me some important (and gruesome) photos of worms in the human body (visible in the same set on flickr) which I will post about in another thread soon.


Regards,
Elisabeth

Hi, I am still interested in comments on this phenomena.

I read that it is particularly common in Kenya and South Africa. Are you aware of it where you work?

It seems to me that this could be a source of infection outwith of sanitation.

I've just been looking at quite a number of research articles - for example this one - which talk about the cultural practices of eating soil. I read that it is common in many sub-Saharan countries.

The health risks of such cultural practices include ingestion of toxic metals, biological pathogens and ascaris hookworms.

Given that, I was wondering the extent to which WASH projects might (and perhaps already do) consider geophagy as a source of diarrheal disease.

Here are some quotes from that paper:

The habit of eating soil is a common phenomenon in some parts of Africa. In South Africa, the habit of eating soil has been observed in different groups of people especially the pregnant, breast feeding mothers and children. In children, the habit could either be voluntary or involuntary. This practice has a long old tradition, with the notion that eating soil is just as normal as eating fruits plucked directly from the tree.

And from the conclusion:

The present study revealed a significant difference in elemental concentration from all the geophagic soil samples collected from the same province. This may be as a result of differences in parent material or different levels of soil pollution around the area. When soils with high lead level are ingested by pregnant women, the vulnerable foetus might be at risk.
It will be extremely difficult to curb or stop the habit of eating soil from these areas because of its perceived benefits. It is therefore imperative for government and different stake holders to pronounce legislation on the permissible level of different elements in soil that are consumed by these groups of individuals.

This paper is only looking at heavy metals, I have found several others looking at pathogens.