​26 Oct 18 - Myanmar TimesImagine a world where nobody washes their hands… Ever! Pretty disgusting right? Most of us would consider this extreme scenario to be unacceptable, but multiple studies of hand-washing behaviour have shown that not everybody washes their hands the right way. A survey of more than 62,000 people across the world conducted by Gallup International in 2014 found that one in three people did not always wash their hands properly after using the toilet. The reasons for this usually stem from personal beliefs about hygiene and thinking that hands only need washing if they are visibly soiled. So why is it important to wash your hands?

Why wash?

Plenty of evidence shows that hand-washing prevents the spread of diseases, particularly diarrhoea, colds and flu. It can also save lives, especially in more vulnerable groups such as children and the elderly. For instance, Influenza is spread mainly through invisible droplets on hands rather than inhaling the virus from others. One of the most common causes of food-poisoning do not result from exceeding the expiry date, or insufficient cooking, but from the poor hand-hygiene of food-handlers who spread germs onto food when they are preparing it.

When and how to wash?

The most important times to wash our hands and break the chain of possible infection are before cooking, serving or eating food, and after coughing, sneezing, or using the toilet. This year's Global Handwashing Day (October 15th) focused on the links between handwashing and food and called upon families to make handwashing before eating an automatic part of mealtimes. Caregivers of babies and young children should ensure they wash their hands before feeding them and after changing nappies.

Use soap and water. The temperature of the water is not very important but using soap and covering every inch of your hands is. A quick wash may be better than nothing but the ideal time is around 20 seconds (the time it takes to sing the "Happy Birthday to You" song twice, preferably not out loud).

Water and sanitation in Myanmar

Washing hands thoroughly without running water is difficult. A majority of the population in Myanmar lives in rural areas where access to toilet facilities and running water are not always guaranteed. Only a minority of households has a piped water supply in their homes and in the Dry Zone, there are still many areas experiencing water shortages. However there is encouraging news of improvements in water and sanitation in the country from the Myanmar Living Conditions Survey 2017 produced by the Central Statistical Organization of the Ministry of Planning and Finance, UNDP and the World Bank. The report, published last June of this year, states that 83 percent of households in Myanmar have access to hand-washing facilities with soap and water.

Hand disinfectant made available on World Hand-washing Day on October 15. Photo - Supplied

Hand washing can prevent the spread of infections in hospitals

Hospitals are places where infections can spread from patient to patient like wildfire, usually via the hands of busy healthcare professionals. Alcohol-based gels are used to sanitise hands in many hospital wards worldwide, as they can be made available at the patient's bedside. Commercial brands are expensive but the World Health Organization recommends cutting costs by producing them locally.

There has been a rise in the spread of infections which are resistant to antibiotics in hospitals all over the world in recent years, and excellent hand-hygiene is one of the most effective ways to prevent this from happening. Studies have shown that health professionals can be lax about cleaning their hands frequently enough, and in some countries patients have been encouraged to challenge their doctor or nurse to clean their hands before examining them. Unsurprisingly this hasn't been very successful since patients often feel powerless to speak up. But given the important role of relatives caring for hospitalised family members in Myanmar, it is good to raise awareness about the importance of good hand-hygiene in the hospital setting.

Regular handwashing with soap and water leads to impressive health benefits for only a small amount of effort. So what are we waiting for?

Dr Elizabeth Ashley, Physician and Researcher, Myanmar Oxford Clinical Research Unit, Yangon.