New Delhi: According to the World Health Organisation (WHO), hands are the main pathways of germ transmission and thus hand hygiene is the most important measure to avoid the spread of infections and keep people healthy. With an aim to promote the practice of hand hygiene among people, particularly in health care settings, WHO launched a global campaign “Save Lives: Clean Your Hands” in 2009 which is celebrated annually as World Hand Hygiene Day on May 5. To mark the day, Professor Benedetta Allegranzi, Technical Lead, Infection prevention and control (IPC) department, WHO answers some common questions around hand hygiene and the link between clean hands and health.
— World Health Organization (WHO) (@WHO) May 4, 2021
How does hand hygiene save lives?
Professor Allegranzi: There is really overwhelming evidence that hand hygiene can prevent infections. It is also well known that it prevents the spread of COVID-19 and other acute respiratory viruses. But also, for many years we know that handwashing at the community level reduces the impact and morbidity of Gastroenteritis (stomach flu) which causes Diarrhoea which is still the third biggest cause of deaths among children less than the age of 10 years. So, handwashing is a very effective action that takes only a few seconds and is capable of saving many lives.
For how many seconds should one wash their hands?
Professor Allegranzi: In healthcare, the action of performing hand hygiene needs to be quite thorough. One needs to cover all surfaces of one’s hands and use specific movements to obtain complete surface coverage on hands. This means that with alcohol-based hand rubs, it takes 20-30 seconds to become fully effective while the whole procedure of handwashing with soap and water including drying takes 40 to 60 seconds to be the most effective.
Why is there so much focus on hand hygiene in health care?
Professor Allegranzi: Every year we have a theme and the focus this year is achieving hand hygiene action at the point of care. So what we mean by point of care is where care is delivered- any act of care is given to a patient, whether therapeutic or preventive including the vaccination sites. For example, these days as COVID-19 vaccination drives are going on, so at the sites where the COVID vaccine is being administered, that point is the point of care. So, this is the focus of the campaign this year.
Hand hygiene among health care workers is extremely important because unfortunately, during the ongoing pandemic, a number of health care providers died while providing care due to COVID-19 and also for other reasons. Improving hand hygiene along with other protective measures like providing personal protective equipment (PPE) is crucial for protecting the health care providers.
What should be provided in a health setting to ensure proper hand hygiene?
Professor Allegranzi: As a health care worker, one should be able to access hand hygiene facilities at any point of care. There needs to be a sink, soap, water, hand towels, alcohol-based hand rub and other such supplies and infrastructure for the health care workers so that they can perform hand hygiene when it is needed.
We see that we still have defective hand hygiene infrastructure, especially in low and middle-income countries. As per a survey that we recently performed, there are only 17 per cent health care facilities in low-income countries that have a continuous provision of alcohol-based hand rubs as compared to 75 per cent in the high-income countries.
What kind of products should one use to wash hands?
Professor Allegranzi: One can simply use plain soap and water to wash hands or alcohol-based hand rub. The hand rubs which are normally called hand sanitisers should contain 60 to 70 per cent of alcohol. Hand rubs can be kept in pockets and can be made easily available for exercising hand hygiene.
Are hand sanitisers more effective than handwashing?
Professor Allegranzi: Alcohol-based hand sanitisers have a high level of efficacy against a very broad range of pathogens from viruses to bacteria and fungi. It allows the faster killing of pathogen and a high reduction of the burden of these germs on our hands. That is why hand sanitisers are considered more efficacious. When the hands are visibly soiled, one should wash with soap and water. For COVID-19, handwashing is good, provided that it is performed in the right way.
If one washes their hand, can they shake hands with others?
Professor Allegranzi: As COVID-19 is still widespread, we recommend to avoid contacts between people including shaking hands.
Can salt and water clean hands?
Professor Allegranzi: No, there is no evidence that salt and water can help clean hands. Also, it can do harm probably as it is not good for your skin.
Can one use ash or sand to clean their hands?
Professor Allegranzi: Well, there is some evidence from years ago that using ash can be effective to prevent some bacterial infections. We recently performed a review of the evidence for the use of ash for respiratory viruses and Covid and at the moment there is no good evidence that this is effective.
NDTV – Dettol Banega Swasth India campaign is an extension of the five-year-old Banega Swachh India initiative helmed by Campaign Ambassador Amitabh Bachchan. It aims to spread awareness about critical health issues facing the country. In wake of the current COVID-19 pandemic, the need for WASH (Water, Sanitation and Hygiene) is reaffirmed as handwashing is one of the ways to prevent Coronavirus infection and other diseases. The campaign highlights the importance of nutrition and healthcare for women and children to prevent maternal and child mortality, fight malnutrition, stunting, wasting, anaemia and disease prevention through vaccines. Importance of programmes like Public Distribution System (PDS), Mid-day Meal Scheme, POSHAN Abhiyan and the role of Aganwadis and ASHA workers are also covered. Only a Swachh or clean India where toilets are used and open defecation free (ODF) status achieved as part of the Swachh Bharat Abhiyan launched by Prime Minister Narendra Modi in 2014, can eradicate diseases like diahorrea and become a Swasth or healthy India. The campaign will continue to cover issues like air pollution, waste management, plastic ban, manual scavenging and sanitation workers and menstrual hygiene.
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