February 10, 2017

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Hand Washing Saves Millions

Personal hygiene is very important for everyone to perform. We clean ourselves everyday. We do bathing, brushing our teeth, cutting our nails, washing our clothes and washing our hands. Once a child can take care of him/herself, parents teach how to practice basic hygiene. From the childhood to adolescence to adulthood, we learn gradually from the parents, teachers and elders to take care of our personal hygiene. From kindergarten to primary to middle & high school classes, students learn progressively about personal hygiene from the teachers. Hand washing with soap is one of the most important personal hygiene behaviors. At critical times hand washing must be practiced by all including children, adults and elderly people in our community to avoid a number of diseases.
Why Hand Washing is important
Every year, 1.7 million children do not live to celebrate their fifth birthday because of diarrhea and pneumonia. Hand washing with soap is among the most effective and inexpensive ways to prevent diarrheal diseases and pneumonia. This simple behavior can save lives, cutting deaths from diarrhea by almost one-half and deaths from acute respiratory infections by nearly one-quarter.  Hand washing with soap can make a significant contribution to meeting the Millennium Development Goal of reducing deaths among children under the age of five by two-thirds by 2015.
WHO Water Supply and Sanitation Collaborative Council (WSSCC), UNICEF, Water and Sanitation Program at the World Bank are major leading world bodies in promoting hand washing with soap through media, seminars, functions and campaigns particularly commemorating on 15th October of every year called “Global Hand Washing Day”. That is the global advocacy day dedicated to increasing awareness and understanding about the importance of hand washing with soap as an effective and affordable way to prevent diseases. Global Hand Washing Day is an opportunity to design, test, and replicate creative ways to encourage people to wash their hands with soap at critical times.
Hand washing as Non-pharmaceutical interventions (NPIs)
Non-pharmaceutical interventions (NPIs) are actions, apart from getting vaccinated and taking medicine, that people and communities can take to help slow the spread of illnesses like influenza (flu). NPIs are also known as community mitigation strategies. Outbreaks of seasonal flu occur every year, usually during the beginning of rainy season through early winter in Myanmar. A flu pandemic occurs when a new flu virus emerges among people, causing illness region-wide. It is important to learn how to slow the spread of flu if a pandemic does occur. Many of actions also can help during a regular flu season. Getting vaccinated is the best way to prevent the flu. However, since a pandemic flu virus is new, a vaccine may not be available right away. When NPIs are used together and early in a pandemic, they can be effective in slowing the spread of flu. Germs like flu viruses can spread easily in places where many people are in close contact with one another, so NPIs are especially important in community settings like schools, workplaces, and mass gatherings. Hand washing with soap is one of most effective NPIs which can help prevent diseases. In addition, NPIs also may be effective in slowing the spread of other infectious diseases. Keeping hands clean through improved hand hygiene is one of the most important steps we can take to avoid getting sick and spreading germs to others. Many diseases and conditions are spread by not washing hands with soap and clean, running water. If clean, running water is not accessible, as is common in many parts of the world, use soap and available water. If soap and water are unavailable, use an alcohol-based hand sanitizer that contains at least 60% alcohol to clean hands.
When should we wash our hands?
•    Before, during, and after preparing food
•    Before eating food
•    Before and after caring for someone who is sick
•    Before and after treating a cut or wound
•    After using the toilet
•    After changing diapers or cleaning up a child who has used the toilet
•    After blowing your nose, coughing, or sneezing
•    After touching an animal, animal feed, or animal waste
•    After handling pet food or pet treats
•    After touching garbage
How should we wash our hands?
•    Wet your hands with clean, running water (warm or cold), turn off the tap, and apply soap.
•    Lather your hands by rubbing them together with the soap. Be sure to lather the backs of your hands, between your fingers, and under your nails.
•    Scrub your hands for at least 20 seconds. Need a timer? The “Happy Birthday” song from beginning to end twice.
•    Rinse your hands well under clean, running water.
•    Dry your hands using a clean towel or air dry them.
What should we do if we don’t have soap and clean running water?
Washing hands with soap and water is the best way to reduce the number of microbes on them in most situations. If soap and water are not available, use an alcohol-based hand sanitizer that contains at least 60% alcohol. Alcohol-based hand sanitizers can quickly reduce the number of microbes on hands in some situations, but sanitizers do not eliminate all types of germs.
Hand sanitizers are not as effective when hands are visibly dirty or greasy. Some advocate to use ash as an alternative to soap but ash also can not kill all germs either.
How do we use hand sanitizers?
•    Apply the product to the palm of one hand (read the label to learn the correct amount).
•    Rub your hands together.
•    Rub the product over all surfaces of your hands and fingers until your hands are dry.
5 Facts about Hand
(1)    Hand Washing with soap is a “do-it-yourself-Vaccine” that prevents infections and saves lives.
Human feces (excreta) is the main source of the germs that cause diarrhea, including shigellosis, typhoid, and cholera, all other common endemic gastro-enteric infections, and some respiratory infections such as influenza and pneumonia.  A single gram of human feces can contain 10 million viruses and one million bacteria. These pathogens originate in human feces and are passed from an infected person to a new one through skin contact, food, and other routes. Hand washing with soap after contact with fecal material—from using the toilet or cleaning a child—prevents the transmission of the bacteria, viruses, and protozoa that cause diarrheal diseases.
Because hand washing can prevent the transmission of a variety of pathogens, it may be more effective than any single vaccine. Studies have found that children living in households where there is active hand washing promotion and available soap have half the rates of diarrhea compared to children who do not have these. Promoted on a wide enough scale, hand washing with soap can be thought of as a “do-it-yourself vaccine” because it is easy, effective, and affordable.
Diarrheal Disease:      A review of more than 30 studies found that hand washing with soap cuts the incidence of diarrhea by nearly half. Diarrheal diseases are often described as water-related but more accurately should be known as excreta-related, as the germs come from fecal matter. These germs make people ill when they enter the mouth via hands that have been in contact with feces, contaminated drinking water, unwashed raw food, unwashed utensils, or smears on clothes. Hand washing with soap breaks the cycle. The figure on the right shows the effectiveness of hand washing with soap for reducing deaths due to diarrhea in comparison to other interventions.
Acute respiratory infection:     Acute respiratory infections like pneumonia are the leading cause of death in children under the age of five. Evidence suggests that better hand washing practices—washing hands with soap after defecation and before eating—could cut the infection rate by 25 percent.  The full effect might turn out to be even bigger; a recent study in Pakistan found that hand washing with soap reduced the number of pneumonia-related infections in children under the age of five by more than 50 percent.
Intestinal worm and skin and eye infection:     Though not as extensive and robust as the research evidence for diarrheal disease and respiratory infections, studies have shown that hand washing with soap reduces the incidence of skin diseases, eye infections like trachoma, and intestinal worms, especially ascariasis and trichuriasis.
(2)    Hand washing promotion is extremely cost-effective when compared with other frequently funded health interventions.
A $3.35 investment in hand washing promotion brings the same health benefits as an $11 investment in latrine construction, a $200 investment in household water supply, and an investment of thousands of dollars in immunization. Investments in the promotion of hand washing with soap can also maximize the health benefits of investments in water supply and sanitation infrastructure and reduce health risks when families do not have access to basic sanitation and water supply services. Cost is not typically a barrier to hand washing practice; almost all households in the world already have soap—though it is commonly used for laundry, dishwashing, or bathing.
(3)    Everyone can improve their own health by washing hands with soap, especially after using the toilet and before touching food.
One person’s clean hands prevent disease transmission to others. A whole family’s clean hands can significantly improve the family’s health and reduce incidence of common illnesses. An entire classroom, office, or community with clean hands effectively stops disease in its tracks. Everyone, from young to old, can wash their hands and develop the habit of washing at critical moments, such as after going to the toilet and before handling food or eating.
(4)    Washing hands with water alone, a common practice around the world, is significantly less effective than washing hands with soap. Proper hand washing requires soap and only a small amount of water.
Washing your hands in water won’t always dislodge grease and dirt, and when the grease and dirt stays on your hands, so do the germs. Soap breaks down germ-carrying grease and dirt and facilitates rubbing and friction. With proper use, all soaps are equally effective at rinsing away the germs that cause disease.
(5)    Critical moments for hand washing are after using the toilet and cleaning a baby bottom and before handling/eating food.
Hands are the principal carriers of disease-causing germs. Hands should be washed with soap after using the toilet, after cleaning a child’s bottom (or any other contact with human excreta, including that of babies and children), and before any contact with food, such as before eating or before preparing food. Children and adults should also wash their hands after playing or working outside, touching animals and their dwellings.
Reduction in death due to diarrhea :      The following table shows that hand washing alone is a leading contributor to the reduction of death (44%) due to diarrhea globally. With combination of other water, sanitation and hygiene intervention, a significant reduction of death due to diarrhea diseases will be realized. So let us wash our hands with soap in critical times.
Reduction in deaths due to diarrhea
[%] per intervention type

Hand Washing with soap (44%)
Point-of-use water treatment (39%)
Sanitation (32%)
Hygiene Education (28%)
Water Supply (25%)
Source water treatment (11%)
Source: Global Hand Washing Day Planner’s Guide by FHI 360


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