- By Dr Aung Tun
Global Handwashing Day takes place on 15 October every year and is the Global Handwashing partnership’s and the worlds biggest platform for raising awareness about the importance of hand washing with soap as fundamental to good health and development. In 2019. The Global Handwashing Day theme is “Clean Hands for All.” The theme focus on the importance of handwashing equity. It implies that individuals in all areas of all nations have opportunities to approach essential handwashing facilities with soap and water.
The State of Global Handwashing
The Joint Monitoring Program (JMP) run by UNICEF and WHO define a “basic handwashing facility as the availability of a handwashing facility on the premises with soap and water.” Handwashing facilities can be ‘fixed or’ mobile. ‘Fixed’ facilities include sinks with taps, buckets with taps, and tippy-taps, while, mobile facilities include jugs or basins designated for handwashing. The term soap includes bar soap, liquid soap, powder detergent, or soapy water.
According to Global Handwashing Partnerships 2019 Global Handwashing Day Fact Sheet, The state of global handwashing can be summarized as follows:
• Only 60% of the worlds population has access to a basic handwashing facility.
• In the worlds least developed countries, only 28% of people have access to basic handwashing facilities.Currently, there are 17 countries where more than 10 million people lack handwashing facilities. The availability of soap and water at handwashing facilities varies substantially.
Geographic disparities often exist among rural and urban areas, with handwashing infrastructure lacking for many rural populations.
• Currently, only 34% of people living in rural areas have access to a basic handwashing facility.
• People in rural areas are less likely to have access to soap and water.
Globally, basic handwashing coverage among the richest wealth quintile was at least twice as high as coverage among the poorest quintile. Overall, wealthier individuals are more likely to practice handwashing with soap, as they can afford basic handwashing facilities with soap more readily.
For vulnerable groups, it is particularly important that soap and water are kept at a handwashing facility, as it can be more challenging for them to access these materials independently.
• Approximately 15% of the worlds population has a disability. For people with disabilities, accessing WASH facilities is often their most significant challenge of daily life.
• When hygiene and sanitation facilities are not well adapted, people with disabilities must touch sanitation surfaces that others do not – putting them at greater risk for disease.
Marginalized groups, such as displaced populations and indigenous groups, do not have equal access to handwashing facilities or soap. This makes them more susceptible to diarrheal diseases and other related illnesses.
• In conflict-affected settings, children under the age of 5 years old are 20 times more likely to die from diarrhea than they are from violence. This is, in part, due to insufficient functional handwashing facilities. In these circumstances, displaced individuals are often unable to buy their own soap or build their own facilities due to lack of finances and access to markets. • When people are displaced, they frequently share handwashing facilities. Sharing can cause people to worry about soap being stolen or wasted, which often results in people keeping their soap inside the house..
• Indigenous populations often do not have equal access to handwashing facilities or soap. This is because indigenous populations often live in geographically remote areas and are more likely to live in crowded or informal housing environments, making it hard to maintain facilities.
Only 53% of the worlds schools provide ‘basic handwashing facilities’ for their students.
This means that 900 million students currently have nowhere to wash their hands.
• Access to basic handwashing facilities is typically higher in secondary schools than primary schools and higher in urban schools compared to rural schools. Many schools have handwashing facilities, but soap and water are frequently unavailable.
• Globally, 57% of health care facilities have basic hand hygiene facilities at points of care.
• Data from 54 low- and middle- income countries showed that 35% of health care facilities do not have water and soap available for handwashing.
• There are inequities within countries and between levels of health care.
Handwashing situation in Myanmar
According to Myanmar Global School-based Student Health Survey (GSHS) 2016, overall, 7.0% of high school students never or rarely washed their hands before eating during the past 30 days. Male students (8.0%) are significantly more likely than female students (4.9%) to never or rarely wash their hands before eating. Overall, 8.8% of high school students never or rarely washed their hands after using the toilet or latrine during the past 30 days. Male students (11.7%) are significantly more likely than female students (6.7%) to never or rarely wash their hands after using the toilet or latrine. Overall, 6.9% of high school students never or rarely used soap when washing their hands during the past 30 days. Male students (7.3%) are significantly more likely than female students (4.8%) to never or rarely use soap when washing their hands. According to the 2015-16 Myanmar Demographic and Health Survey (2015-16 MDHS), just under half (48%) of households have an improved sanitation facility including handwashing facilities. Ten percent have a facility that would be considered improved if it were not shared. Overall, 42% of households in Myanmar have an unimproved facility. This includes 11% that have no facility at all.
Importance of Handwashing and Best Practices
Indeed! Handwashing with soap is considerably more effective at cleaning our hands than handwashing with water alone. However, washing hands with water is desirable over not handwashing by any means, Proper hand washing requires soap and running water. A study in Bangladesh found that while utilization of water alone helps decrease the danger of diarrhoea, utilization of soap is substantially more effective. Where soap is not available or difficult to obtain for handwashing, soap water is an effective low-cost alternative. Alcohol-based hand sanitizers can be used instead of handwashing with soap, particularly in health care setting and for times where access to soap and water is challenging.
Handwashing with soap helps prevent gastrointestinal diseases like diarrhea; respiratory diseases like pneumonia and influenza; and other infections such as Ebola and healthcareassociated infections. Handwashing with soap may also reduce soil-transmitted helminth infections, which infect over 1.5 billion people. Handwashing with soap is also an important part of food hygiene, a set of hygienic practice that keep food safe and prevent food-related illness. In addition to its impact on health, handwashing also benefits nutrition, education, equity, and the economic development of countries.
Research has shown that the two primary times to wash hands are after contact with feces (such as using the toilet or cleaning a child) and before contact with food (preparing food, eating, feeding a child, and so on).The U.S. Centers for Disease Control and Prevention (CDC) recommends washing hands:
• Before, during, and after preparing food
• Before eating food
• Before and after caring for someone at home who is sick with vomiting or diarrhea
• 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
To wash your hands properly, follow these five steps every time.
1. Wet your hands with clean, running water (warm or cold), turn off the tap, and apply soap.
2. Lather your hands by rubbing them together with the soap. Lather the backs of your hands, between your fingers, and under your nails.
3. Scrub your hands for at least 20 seconds. Need a timer? Hum the “Happy Birthday” song from beginning to end twice.
4. Rinse your hands well under clean, running water.
5. Dry your hands using a clean towel or air dry them.
Clean Hands for All
Handwashing has multiple benefits for overall health and well-being. This years theme, „Clean hands for All reminds us that we must be inclusive when addressing handwashing disparities. On Global Handwashing Day and every day, here are some ways you can help everyone enjoy the benefits of handwashing with soap:
• Wash your hands with soap at critical times, especially before eating, cooking, or feeding others.
• Model good handwashing behavior and remind or help others to always wash their hands before eating.
• Make handwashing a routine part of your family meals.
• Establish places to wash your hands in the household, in your community, in schools, workplaces, and in health facilities.
• Promote effective handwashing behavior change in research, policy, programs, and advocacy.
• Global Handwashing Day 2019 Toolkit, Global Handwashing Partnership, 2019
• Global Handwashing Day 2018 Report, Global Handwashing Partnership, 2018
• Global School-based Student Health Survey 2016, SH, DOPH, MOHS 2016
• Handwashing: Clean Hands Save Lives, CDC, USA, 2018
• Myanmar Demographic and Health Survey 2015-2016, MOHS, 2016
• The State of Handwashing in 2017:Annual Research Summary, Global Handwashing Partnership, May 2018