Hand washing: Best way to prevent diseases, infections

Washing of hands with soap has been described as an easy, effective, and affordable protection against infections and saves lives. People can protect themselves, their families, and communities through this method. And it requires just two items — just soap and a small amount of water. But the benefits are huge.

When hand washing with soap is practised regularly, and at key times, such as, after using the toilet or before contact with food, it can dramatically reduce the risk of diarrhoea and pneumonia, which can cause serious illness and death. Regular hand wash with soap also helps to prevent the spread of such other infections as influenza and Ebola. It can reduce the risk of diarrhoea by 30 to 50 per cent.

The first Global Hand-washing Day was held in 2008, when over 120 million children around the world washed their hands with soap in more than 70 countries. Since then, community and national leaders have used the occasion to spread the word about hand-washing, building of sinks and tippy taps, as well as, demonstrate the simplicity and value of clean hands. 

Each year, over 200 million people are involved in the commemoration in over 100 countries around the world. The Global Hand-washing Day is endorsed by a large number of governments, international institutions, and civil society organisations, non-Governmental organisations (NGOs), private companies, and individuals.

However, health experts have noted that the reason why many don’t wash their hands properly and regularly is due to lack of awareness and consciousness of its immense benefits.

Former President, Association of Resident Doctors in Lagos University Teaching Hospital (LUTH), Dr. Omojowolo Olubunmi, said regular and proper hand washing is perhaps the most important and effective public health means of preventing the spread of diseases.

He added that many communicable diseases, such as cholera and other diarrhoeal disease, typhoid fever and poliomyelitis, among others, are transmitted via the faeco-oral route. Regularly washing the hands with soap and water is the best way to reduce the number of germs in most situations.

Olubunmi said: “If soap and water are not available, an alcohol-based hand sanitiser that contains at least 60 per cent alcohol can be used. Alcohol-based hand sanitisers can quickly reduce the number of germs on hands in some situations, but sanitisers are not as effective as proper hand washing.

“Generally, the act of hand washing is low among Nigerians, and even health care personnel. Only about 30 to 40 percent of Nigerians wash their hands regularly, though this may increase to about 60 percent shortly before eating.”

He said: “The situation, where hand washing is very essential, include, but not limited to before, during, and after preparing food, before eating food, before and after caring to 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 and after touching garbage.

“Proper hand-washing, as recommended by the U.S. Centre for Disease Control and Prevention, include the following steps:
Wet your hands with running water and apply soap. Rub your hands together to make lather. Scrub well for at least 20 seconds. Pay special attention to your wrists, the backs of your hands, between your fingers, and under your fingernails. Rinse your hands well under running water. Use a clean towel to dry your hands, or air-dry your hands.

Senior Programme Officer for International Vaccine Access Centre (IVAC), Consultant in Nigeria, Dr. Obinna Ebirim, said washing hands with soap is very important in preventing diarrhoea and other diseases, especially those with faeco-oral (from faeces to mouth) mode of transmission.

Ebirim stated that when hands are properly washed with soap, under running water and by vigorously rubbing hands together, pathogens that cause diseases are mechanically, removed and contaminating flora inhabiting the hands are chemically killed.

However, he noted that in 2015 UNICEF report, about 750, 000 children in Nigeria die before their fifth birthday and diseases implicated include those that can be prevented by hand washing. These include diarrhoea, which is the second most common cause of death in this age group. Other diseases that can be prevented by proper hand wash include common cold, conjunctivitis, typhoid fever, hepatitis A and pinworm infection. All these underscore the importance of hand washing in maintaining good hygiene, health and wellbeing.

Ebirim said: “It is important to note that washing hands with soap is not the only means of preventing diarrhoea. Access to clean and potable water, good sanitation, adequate nutrition and vaccination with Rotavirus vaccine are also proven ways of averting sickness and deaths due to diarrhoea. Thus, while the public play its role by ensuring good hygienic practices, government at all levels must continue to ensure adequate and clean public water supply, strengthen the immunisation programme, especially by keeping to national plan of introducing Rotavirus vaccine into the routine immunisation schedule in 2018.” 

He explained that proper hand washing could reduce up to 30 percent episodes of diarrhoea and a little less proportion of respiratory tract infections. However, despite various awareness and sensitisation programmes, many Nigerians do not wash their hands appropriately, and frequently. The reasons for this is complex and include lack of access to clean water and soap, cultural practices, religious beliefs, unawareness of its benefits and lackadaisical nature to issues of good hygiene. Most people only wash their hands before eating and in the customarily improper way of jointly dipping their hands in a bowl of water.

“This hand-washing approach of joint dipping of hands in a bowl can transfer rather than prevent diseases. The best way to wash your hand is by applying soap, vigorously rubbing both hands and washing the soap off under running water.

“It is sad to note that after Ebola virus disappeared from Nigeria, most of the water sinks and soap placed at public places, such as schools and offices, have also disappeared or left unattended. What is required is a positive attitudinal change towards good hygienic practices and realisation that just as in the days of Ebola virus disease, hand washing can still prevent many deadly diseases. 

With about 10 percent of deaths in under-5 Nigeria children linked to diarrhoea, according to the same 2015 UNICEF report, about 75, 000 Nigerian children die annually due to diarrhoea, which translates to more than 200 children dying daily due to same disease. This is as tragic as one local airline, filled with children, crashing every day in Nigeria, without a survivor, when about 30 percent of these children can be saved by proper hand washing with soap.”