Understanding culturally-related risk factors for antimicrobial resistance
Within Maasai pastoralist communities, milk provides a rich source of nutrients and income, especially for women, and plays a central role in cultural and religious ceremonies. Having milk means having livestock, and having livestock means the continuation of the Maasai people. While a vital nutritional and cultural resource, milk is also a potential food safety risk as well as a vehicle for the transmission of antimicrobial resistance (AMR).
This risk occurs as some Maasai do not boil their milk or observe withdrawal - the period of time necessary for antimicrobial residues to degrade - after administering drugs to their livestock. By not boiling their milk, people may be consuming milk teeming with bacteria, some of which may be resistant to antibiotics.
Indeed, a study published in 2018 in The Lancet Planetary Health showed that Maasai households who did not boil their milk had higher levels of antimicrobial resistant E. coli compared to households who regularly boiled their milk. Second, by not observing withdrawal from antimicrobials, the milk can contain antimicrobial drug residues that can selectively amplify resistant bacteria already present in the milk.
Since 2018, an FAO research team has been investigating the beliefs that drive food safety practices that impact AMR, such as those related to milk hygiene in the Maasai. “In the case of the Maasai, we have discovered that practices are often related to cultural beliefs surrounding livestock,” said Mark Caudell, FAO Regional Coordinator for the Social Science of AMR, providing an example of the belief that livestock and the food they provide are divine gifts. “An elder told us, ‘God gave us the cattle and he cannot allow it to harm us and we cannot destroy them’. As such, livestock and their products are imbued with a sense of purity and cleanliness, so boiling and a period of withdrawal may seem unnecessary,” he explained.
Some Maasai also rely on history, they simply have never seen anyone get sick after drinking milk. Even though most Maasai have been told to boil their milk, it is these beliefs that take prominence in milk hygiene practices. Identifying and then understanding these beliefs represents a critical first step in developing targeted behavioural change interventions with the capacity to improve food safety and limit the selection and transmission of antimicrobial resistance.
Read more in
- Frontiers in Veterinary Science
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