Hand Washing Habit I Best Protection Against COVID-19, Diarrhea, And Pneumonia

Author: Lt. Col. (R) Prof. Dr. Muhammad Ashraf Chaudhry | October 20, 2020

With the world facing the COVID-19 pandemic, washing hands and maintain hand hygiene has become all the more important and need of the hour. It is also one of the cheapest and easiest ways to prevent coronavirus. Till the time the scientists and health experts are coming up with a vaccine, the most important way to avoid getting infected is by washing hands regularly.

Handwashing with soap is the most effective and inexpensive ways to prevent diarrheal diseases, and pneumonia, which together are responsible for the majority of child deaths. Every year, more than 1.8 million children do not live to celebrate their fifth birthday because of diarrhea and pneumonia. In Pakistan, respiratory infections and diarrheal diseases contribute 8% and 6%, respectively of the total deaths every year, affecting children mainly under five. Yet, despite its lifesaving potential, handwashing with soap is seldom practiced and is not always easy to promote.

According to the National Nutrition Survey-2018, more than 20 million people in Pakistan do not wash their hands with soap and clean water after using the latrine, while more than 60 million don’t wash their hands after handling children or after changing babies diapers. Also, more than 50 million people do not wash their hands before feeding a child. Such practices have a negative impact on the health of children. More than 80 million people in Pakistan lack access to handwashing stations with clean water and soap. In institutions like schools and healthcare, hand washing facilities are missing, inadequate, not functional, or not inclusive. How can the general public be encouraged to adopt the handwashing habit and a hygienic lifestyle when the few public toilets available are filthy, short on basics like soap and water? 80% of all infectious diseases are transmitted by touch. Without a vaccine, the single most important thing you can do to prevent getting the COVID-19 is to wash your hands. Good handwashing is the first line of defense against the spread of many illnesses, from the common cold to more serious illnesses such as meningitis, pneumonia, influenza, COVID-19, hepatitis A, and E and most types of infectious diarrhea, intestinal worms (especially roundworms), eye and skin infections.

Every child has the right to live and a simple act of handwashing with soap and clean running water during critical times saves lives. It could reduce the incidence of diarrhea and respiratory infections by up to 40% and 21%, respectively, thereby saving the lives of millions of children. Hand washing plays an important role in reducing the transmission of outbreak-related pathogens such as cholera, Ebola, shigellosis, SARS and hepatitis E. Hand hygiene is protective against healthcare-associated infections and reduces the spread of antimicrobial resistance. Hand washing is also key in the fight against COVID-19. Handwashing with soap destroys the outer membrane of the virus and thereby inactivates it. One study found that regular handwashing with soap can reduce the likelihood of COVID-19 infection by 36%.

Lack of handwashing is also associated with the high stunting rate in Pakistan (40.2%) due to repeated episodes of diarrhea, which impacts on child’s cognitive skills for his or her entire life. Handwashing with soap and sanitation is one of the most feasible and sustainable options for improving public health in developing countries. But globally, hands are washed with soap in less than 20% of cases when they should be. Around the world, the observed rates of handwashing with soap at critical moments range from 0% to 34%. Although people around the world wash their hands with water, very few wash their hands at critical moments (for example, after using the toilet, while cleaning a child, and before handling food).

According to WHO, diarrhea kills almost 2 million children every year, making it the second leading killer of children worldwide. In Pakistan, where every year more than 250,000 children die from diarrhea, this message of handwashing becomes a message for survival. A simple hygiene habit- washing hands with soap – could halve this figure.

Cleaning your hands regularly throughout the day can help keep you out of the doctor’s office or the emergency room. Handwashing is effective in preventing the spread of disease in overcrowded, slum environments, research shows. Turning handwashing with soap before eating, and after using the toilet and after cleaning a child’s bottom into an ingrained habit could save more lives than any single vaccine or medical intervention, cutting deaths from diarrhea by almost half and deaths from acute respiratory infections by one-quarter. A study in Pakistan found that handwashing with soap and water reduced the number of pneumonia-related infections by more than 50 percent.

Pneumonia is a disease that takes the lives of 1.3 million children globally before reaching their fifth birthday. The latest UN estimates indicate that pneumonia accounts for 18% of child mortality, the primary cause of death among young children globally. In Pakistan, more than 352,000 children die before their fifth birthday and almost one of these deaths are due to pneumonia. Washing hands with water alone is significantly less effective than washing hands with soap in terms of removing germs. With proper use, all soaps are equally effective at rinsing away the germs that cause disease.

Proper handwashing requires only soap and only a small amount of water. One should cover the wet hands with soap, including palms, back, between the fingers, and especially under the fingernails for at least 20- 30 seconds, rinse well with running water (rather than rinsing in still water). Dry hands thoroughly with a clean towel or air dryer.

You should wash your hands at regular intervals. Also, after blowing your nose, coughing, or sneezing, after touching surfaces outside of the home, including money, after visiting a public space, including public transportation, markets, and places of worship. Also, after, and before eating.

We want our present and future generations to live by the right hygiene behaviors from the very beginning, which is why, from today onwards, let us learn and relearn the alphabet, as now H stands for Handwashing. In schools, toilets and handwashing stations are critical to students’ health and to reduce absenteeism. People’s handwashing behaviors can be changed through multiple mass media and interpersonal communication channels with specific messages designed to respond to their expressed needs and preferences. School programs can help to establish lifelong healthy habits. Religious leaders greatly influence public opinion in Pakistan and should be encouraged to help their congregations with the benefits of handwashing with soap. Sanitation is half faith. The theme for Global Handwashing Day 2020 is “Hand Hygiene for All, calling for all of society to achieve universal hand hygiene now and for the future”. For handwashing to be effective it must be practiced consistently at key times, such as after using the toilet or before contact with food. While habits must be developed over time, this theme emphasizes the importance of handwashing as a ritual behavior for long term sustainability. Habit formation is currently a hot topic in behavior change and the water, sanitation, and hygiene (WASH) sector.

Lt. Col. (R) Prof. Dr. Muhammad Ashraf Chaudhry, MBBS, DPH, MPH (USA), M.Sc. (Adv. Med Adm.), FCPS

Head of Community Medicine, CMH Lahore Medical College, Lahore

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