When practising hand hygiene becomes a challenge

We all are #handwashing often these days as a preventive measure against #COVID2019india

BUT, Are you washing your hands properly ??

Check out the correct way of #handwash below 🖼️ ⬇️#IndiaFightsCorona #HandWashChallenge pic.twitter.com/Gsv7QypHUS

— PIB India (@PIB_India) March 18, 2020

Over the past few weeks, the world has been remembering Ignaz Philipp Semmelweis, a Hungarian physician and scientist and the first person to have suggested the life-saving benefits of washing hands. Known as the saviour of mothers, Semmelweis implemented handwashing practices in obstetrical clinics, helping reduce puerperal fever and mortality drastically.

However, in 1847, when Semmelweis proposed the practice of washing hands with chlorinated lime solutions to the larger medical field, he was ridiculed. Doctors were not ready to accept the fact that they could also be responsible for spreading germs. Failing to convince the medical body, Semmelweis’s end was rather tragic. He supposedly suffered a nervous breakdown and died at the young age of 47, after being beaten by guards at the asylum he was admitted in by his colleague.

Today, nearly 145 years after his death, the world is reaping the benefits of what Semmelweis had proposed. With the deadly COVID-19 declared a pandemic and spreading across the world at alarming levels, governments, worldwide are working on a war footing to halt its progress.

Time and again, we are being reminded by Governments, doctors and health professionals about the need to wash our hands with soap and water for 20 seconds, or if this is not available, rub our hands vigorously with hand sanitizer.

While many have been consciously following hand hygiene, this, however, is easier said than done in a country like India. As per data, 50.7 per cent of the rural population does not have basic hand-washing facilities. More than 160 million people do not have access to clean water in the country – at 19 per cent of the world’s population, that is the highest in the world.

Further, as per a UNICEF report, 20 per cent of urban Indians, which is around 91 million people, lack handwashing facilities at home. This then forces them to rely on water from other sources such as drains and canals, which often harbour more dangerous pathogens. Without access to piped water, many rural and urban households have to fill water containers and refill them each time it gets, which requires time and effort.

Sanitation is a major concern - with the country not yet 100 per cent open defecation free (ODF), a large number of households do not have access to toilets. Hence, despite a consistent Swachh Bharat campaign, a majority of people still defecate out in the open.

Studies have also proven that not washing hands during critical times – after defecation, after cleaning a child’s bottom, before and after cooking and eating food and before feeding infants, can lead to faecal-oral transmission of pathogens, including COVID-19 virus. This is lacking in several rural and urban households in India. A survey by WaterAid conducted in 2017 showed that only 26.3 per cent of parents washed their hands before feeding their children.

These figures are alarming – with the second-highest population in the world, containing the spread of the virus is paramount. As of now, all the 300 plus cases reported have been through contact with someone who has travelled abroad or with an infected person. If the virus enters the community transmission stage (and there are worries that this may already be the case) things can spiral out of control.

Growing awareness

The constant reminders being sent out by officials and health professionals in the aftermath of the Covid-19 break-out has helped create awareness about the importance of washing hands.

Kerala has been a frontrunner in tackling the virus, testing and restricting its transmission. In a bid to spread awareness, Kerala’s Health Ministry, under the leadership of Health Minister KK Shailaja recently launched a mass campaign, called Break The Chain, which stresses on the importance of washing one’s hands. Under the campaign, dozens of hand wash centres have been opened across the state, especially at bus stops, with sanitisers/hand wash facilities available.

In another novel move, a video that has been now become viral, shows the Kerala police dancing to a song while showing the right way of washing hands.

In rural Chhatisgarh, a campaign by Mitanins, or rural health workers across the Ambikapur district, has caught the attention of the World Health Organisation (WHO). These groups have been visiting villages and interacting with women, informing them about the hand hygiene practices and the right way to wash hands. This has spread awareness and resolve among women to practice safe hand hygiene.

Women self-help groups in Trichy are being roped in to make hand sanitisers to supply health centres which are fast running out of essentials such as masks and sanitisers.

State governments and the Centre have taken a number of concrete steps to control the spread of the virus. However, what is also required are efforts such as the one employed by Kerala, to ensure that households across different strata of the society yahoohave access to water and soap, which should either be delivered to their households or kept at public places such as public bus stops, metro and railway stations, shops and food joints. Without such an effort, the poor, who are also the worst affected by any pandemic, will find it difficult to survive through the crisis.