Fighting COVID-19 With Hand Hygiene: Lack Of Water And Handwashing Infrastructure Pose Challenge For The Poor

New Delhi: Sangeeta, 35-year-old domestic worker living in an unauthorized slum of Govind Puri in South Delhi spends the first two hours of her day standing in a long queue, where no social distancing is being followed, waiting to fill her buckets and plastic cans from Delhi Jal Board’s water lorry. For her, water is a limited and very precious resource which she and her family ration daily for various purposes like cooking, drinking, bathing and sanitation and frequent handwashing does not make the cut.

Also Read: Coronavirus Outbreak Explained: Experts Guide On “How To Wash Hands Properly” And Why It Is So Crucial

While talking to NDTV, she said,

I know that these days because of the new diseases (COVID-19) we should wash our hands frequently. I have seen on TV. But from where should we get water for that? The water we manage to store every morning, should we drink that and cook with that or spend it in washing hands the whole day. We are four people in the house. If all four of us keep washing hands for 20 seconds, what will we drink? We make sure that we wash hand after defecation in the community toilet and so sometimes when there is no soap there, we take our own soap.

According to experts, handwashing is evidently the first act of defence against COVID-19. World Health Organisation (WHO) and the United Nations Children’s Fund (UNICEF), and other health agencies like CDC (Centres for Disease Control) and ICMR (Indian Council of Medical Research) have advised washing hands more frequently than usual at this given point. Dr. Randeep Guleria Director, AIIMS (All India Medical Science), New Delhi said,

Wash your hands before you touch any sort of eatables. If you step out and visit a shop or neighbourhood, wash hands with soap and water again. Currently, India is under lockdown, we are not going out that frequently, but that doesn’t mean we will not wash hands. If there is a delivery of an item, I would suggest washing that parcel or package with a hand sanitiser or water and soap. After that, wash your own hands thoroughly.

In many low- and middle-income households, handwashing is not as frequent as required, according to V R. Raman, policy expert at WaterAid India. Mr. Raman highlights that there are significant gaps in water, sanitation and hygiene (WASH) facilities at home and even at the community healthcare facility in villages and slum areas. Lack of water is the biggest reason, he said. He pointed out that mostly, in poor households, women and girls are responsible for arranging domestic water supply. However, still, they are unable to access water for handwashing and good menstrual hygiene management. He said,

Most of the people from marginalised communities might not have even heard what hand sanitisers are. For them, clean hands can be achieved from soap and water but water is a kind of a luxury for them. Not easily accessible.

Also Read: Soaps Or Sanitisers? What Fights Coronavirus Better

Vikas Bagaria, Founder, Pee Safe, a manufacturer of daily hygiene products said that a topic such as hand hygiene was probably never discussed at a community level until the pandemic wreaked havoc. He highlighted that as per an estimate, less than 20 per cent of women have access to soap for washing hands and instead, they use materials like ash or even sand to rub their hands before washing. He said,

Lack of proper hand hygiene is the reason why the numbers of mother and infant child death cases are high. Communicable diseases such as diarrhoea and pneumonia are common occurrences, and now Covid-19 poses a great risk to these women. The lack of education or access to mass media in the form of TV and the internet also creates obstacles in spreading awareness among them. As an organisation dedicated to improving female hygiene in India, we are constantly trying to engage with these marginalized women and spread awareness among them by supporting information campaigns. We currently have limited reach but we will soon collaborate with WaterAid with a mission to change hand hygiene scenario among women and children from marginalised communities.

While talking about hand hygiene practices among women and children, Nicolas Osbert, Chief, WASH UNICEF India said that handwashing with soap, when done correctly, is one of the cheapest, most effective ways to protect children and their families from coronavirus, and numerous other infectious and diarrheal diseases.

Mr. Osbert further said that even after being one of the cheapest preventive measures, for millions globally, this effective practice is out of reach because they do not have access to basic handwashing facilities, water and soap – at home, in schools or in healthcare facilities. He said,

Children from the poorest families and those living in fragile ecosystems such as those affected by drought or urban poverty are at a greater risk. Beyond it being a resource problem, handwashing with soap is also about behaviour change. It is important for parents to reinforce children’s’ practice of handwashing at critical times, especially during the crisis brought on by COVID-19, and for children, in turn, to take home the hygiene lessons learned at school and from peers.

Mr. Osbert said that the current situation should be seen as an opportunity to cement handwashing as a standard behaviour that will have long term payoffs for the people and subsequent generations. Mr. Raman, on the other hand, recommended that the government must focus on providing water, as part of their relief package, to each poor and needy person so that they may be able to maintain hand hygiene.

Also Read: Only 2 Out Of 10 Poor Households In India Use Soap, Survey