What are your hand-washing habits? When you visited the ‘loo’ at the bank, did you hurriedly and mindlessly rinse your hands with water and wiped with that towel hanging on the rail next to the sink? Or – the taps were not flowing so you did nothing; you just moved on? Throughout the funeral of your best friend’s father a fortnight ago, you shook hands with several people of suspicious hand-hygiene. Afterwards, how thoroughly did you wash your hands before sinking your pretty fingers into kenkey and fish? You may have engaged in two risky behaviours in the above two scenarios. How many more of such risks do you take?
Supposing you regularly wash your hands with soap, should it bother you that other people don’t have hygienic hand-washing habits? Yes, it should because the paths of poorly-behaved hand-washers precariously cross the paths of the well-behaved – regularly. For instance, we buy and eat bread. What is the hygienic condition of the hands that package bread into thin plastic bags for sale? We shake hands too; a lot. By that, we share our germs frequently, all in the name of culture without pausing to wonder where and/or what those hands have just been and/or done.
Today is the first Global Hand-Washing Day. The day is set aside to focus global and local attention on hand-washing with soap as an important hygienic practice and the most cost-effective health intervention. This special day is also aimed at inspiring individual commitment to the habit of washing hands with soap – all the time. Awareness is not enough; actually making hand-washing with soap a second-nature practice is what can result in preventing diseases, and even save lives.
The same hands with which we touch to express love and show gratitude can, if not kept clean, become vehicles for transmitting diseases to the very people we love, and even to strangers. From the cradle to the grave, our hands can become contaminated with germs through the simple acts of living – sneezing, coughing, nose-picking, drooling, hand-shaking, hugging, urinating and eating, as well as touching bodily fluids and other fluids on surfaces (walls, railings, clothes and skin). Our hands – between fingers, in palms and under fingernails – are potential rental spaces for germs to survive and thrive, waiting to enter the mouth to make us ill.
Twenty-five percent of Ghanaian children under age five die of diarrhoea, a preventable hygiene-related disease. Before the fifth birthday, before experiencing the joy of entering class one, a child dies – its life robbed. If the dead child could answer for itself, it would say that it was killed by germs. Such tragedies are avoidable, for the most part, by an unapologetic habit of properly washing hands with soap and water.
Results from a 2003 consumer study by Research International provide disturbing statistics about our hand-washing behaviours. While hand-washing was found to be common, the study did not find hand-washing with soap as an entrenched practice in the population studied. Examining risk behaviours of women with children, the study also found that only 2.7% of respondents wash their hands with soap after defecation. As large as 32% of respondents merely washed their hands with water only. Similarly, only two percent of mothers washed their hands with soap after cleaning a child while 22% merely washed hands with only water.
One respondent in the study put it matter-of-factly saying, “I remember when I was a child, they kept telling me to wash my hands with water but they never mentioned soap.” This statement probably suggests that the practice of using soap as a necessary ingredient in hand-washing might not be adequately emphasized in this society; not as much as using soap for bathing and washing clothes.
By character, water does not have an inbuilt quality to clean effectively. Soap aids the cleaning process by loosening and breaking up dirt. Adding rubbing of hands in the cleaning process further agitates and quickens the removal of dirt. Using hot or warm water hastens further, the dissolution of grease and dirt.
In explaining the importance of hand-washing with soap, a Principal Pharmacist with the Ghana Health Service, Mrs. Angelina Larbi of the Mamprobi Polyclinic, offered this instructive example. In laboratory testing of the presence of organisms on hands – not washed, washed with water, washed with soap, and washed with disinfectants – she maintains that hands not washed have the most infectious organisms (e.g. bacteria, fungi) but “hands washed with soap and/or disinfectants show the least organisms.”
It is easy for infectious bacteria to be transferred from person to person. With such knowledge as a backdrop, it is worrying that facilities for hand-washing with soap are not readily available in most public spaces. The 2003 Research International study quoted above found that 68% of the population use latrines that lack hand-washing facilities. Even today, a visit to toilets of so-called reputable organizations (banks, ministries, universities) reveal the shocking reality of the absence of soap, water and paper towels to wipe hands. Even more disturbing is that schools are still being built without toilet facilities, let alone providing water and soap for hand-washing. Meanwhile, hygiene-related diseases top the diseases reported at our health centres; estimated to be as high as 80%.
Yet, Ghana was a pace-setter, the first developing country where a global hand-washing initiative began. Among African countries, Ghana also presents a posture of doing well in the provision of rural water. Advertisements from a successful nation-wide hand-washing campaign a few years ago won awards of excellence. But like other good ideas and programmes which are began and stopped unceremoniously, the hand-washing campaign was not sustained to concretize its behavioural change impact.
Hand-washing with soap is a good thing because germs fear the combination of soap and water. Such information should therefore be kept in the national consciousness all the time, not in a start-and-stop fashion. Unfortunately, like too many initiatives in our national life, hand-washing campaigns are funded by ‘development partners.’ This is not sustainable.
As corporate social responsibility initiatives, large, medium and small-scale businesses throughout the country could adopt educational institutions and sponsor periodic information dissemination on campuses about hand-washing with soap. Additionally, sponsoring organizations could provide soap dispensers and hand-drying machines in student bathrooms. In the absence of any corporate entity in the community taking on this important responsibility, Parent Teacher Associations could step in.
We do not however, have to go high-tech and fanciful about providing soap and water for hand-washing. In our peculiar circumstances, water does not always flow through taps. Providing buckets of water, cups and soap might be good enough.
As we promote the school feeding programme, hand-washing with soap should be woven into the plans. It is worth it, whatever the cost. The human cost of not incorporating it is higher.
While corporate entities do this for schools, they must themselves set good examples by providing water, soap and hygienic hand-dryers in their own corporate toilets. This should be considered a necessary part of doing business.
On the individual level, as we make hand-washing with soap second-nature, we should resolve never to touch towels hanging in public toilets even when they look clean. Those towels are germ-infected and dangerous. The same can be said about dirty handkerchiefs left stuck in pockets and handbags that are pulled out to wipe hands after a hygienic hand wash with soap and water.
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