As in every year, the Global Hand Washing Day was celebrated on October 15 just a few days ago. This day is dedicated to increasing awareness and understanding the importance of hand washing. Hand washing with soap is an effective and affordable way to prevent diseases. If water and soap are not available then hands can also be cleaned with ash in some circumstances. The Global Hand Washing Day was observed by many people irrespective of their designation, caste, creed, religion and region they belong to to raise awareness on protection from the spread of diseases caused by hand to hand contact. The theme of 2019 Global Hand Washing Day was “Clean hands for all”.
Nearly 80 per cent of your exposures to germs occur through touch. Most of the Hospital Acquired Infections (HAI) are commonly transmitted when hospital staff become complacent and do not practice correct hand hygiene regularly. Since medical staff move from patient to patient, they themselves serve as a carrier for spreading pathogens. Essentially, the staff members act as a vector.
About fie per cent of patients admitted to hospitals in the United States develop hospital acquired infection and five per cent (one lakh) of them die each year. In our opinion, considering the socio-economic conditions in our country, the situation could be worse. About 25 per cent of these infections can be prevented by healthcare workers themselves, if they take proper precautions during caring for every patient.
A prevalence survey conducted under the auspices of World Health Organisation (WHO) in 55 hospitals of 14 countries representing four WHO Regions (Europe, Eastern Mediterranean, South-East Asia and Western Pacific) showed an average of 8.7 per cent of hospital patients had nosocomial infections (originating in hospitals). A scientific review of studies performed also revealed an endemic burden of Hospital Acquired Infection (HAI) in India.
Hospital acquired infection are on rise in our country. Sometimes it becomes impossible to control it in spite of the best efforts of all stakeholders (patient, family, doctor and staff). The age old dictum of “prevention is better than cure” holds true in case of HAI and it should be endeavour of all stakeholders to tackle the menace of HAI.
New Delhi Metalloid-beta-lactamase (NDM) “Indian Superbug” has already unleashed a New Drug-Resistant Epidemic. It had been found in drinking water in New Delhi. It has been spread through the medical tourism in patients in more than 35 countries all over the world. It is very similar to what happens when you accidentally include a red shirt which gives off its colour in a wash mixed with your whites.
Overcrowding in patient’s room and personal hygiene of patient and medical personnel are two important causes of infection. There is such a wrong trend in our society that many visitors (relatives and friends) who have not at all met the person for years, but, are coming to meet the patient in the hospital to sympathise act as vectors to spread and acquire HAI, and at certain times it becomes difficult to deal with them by the treating doctor and the hospital administration especially in smaller setups.
Overcrowding by patient, staff and visitors should be avoided in hospital premises particularly in and near high risk areas like operation theater (OT) and Intensive Care Unit (ICU), geriatric and pediatric wards. Isolation and personal hygiene of the patient and staff have been proven to prevent infection and ultimately to reduce morbidity, mortality and healthcare cost.
It is best to avoid visiting hospitals except when absolutely necessary to prevent infection. If you do end up in one, refrain from touching other patients, and hospital and medical equipment, and if you do so, wash your hands often, particularly before preparing or eating food, before and after touching wound dressings or bandages and after using the washroom.
The hospitals are also social organisations. Kindly cooperate for yout benefit and that of the hospital, society and nation. At any time only authorized person should visit patient. Visitors should be only from immediate family (husband, wife, children, parents, grandparents, brothers, sisters) and close friends.
All visitors must follow the same procedures and precautions as hospital staff to adequately control the spread of infection. Visitors and healthcare personnel are equally to blame in transmitting infection. Moreover, multidrug-resistant infections can leave the hospital and become part of the community flora if steps are not taken to stop this transmission.
Madhya Pradesh government in our country holds the Guinness World Record for the most massive hand washing programme in which 1,276,425 children in 51 different district participated on October 15, 2014. But on other hand, country like Ethiopia only 300 people celebrated global hand washing day in Addis Ababa on October 15, 2013.
Now these incidences show that people are getting aware of hand washing throughout the world. Although this is a small number of people participating but it proves the Chinese proverb “A journey of a thousand miles begins with a single step”.
The habit of hand washing will contribute a lot in the personal hygiene as well as it is service to the society because humans learn by copying each others, especially in the bigger organisation like schools and hospitals. The habit of hand washing is very effective and will spread to the others especially in the younger children and newer recruits in any organisation.
The noted cricketer Sachin Tendulkar along with his team joined millions of school children around the country as part of the first global hand washing day in India in 2008.
Hand washing frequently is the single most important measure to reduce the risks of transmitting skin microorganisms from one person to another or from one site to another on the same patient. But across the world more than half (60 per cent) health workers do not adhere to proper hand hygiene. Gloves should not be regarded as a substitute for hand washing in hospital setup.
Millions of children are dying either of respiratory infection or intestinal infection all over the world which is more common in low socio economic countries. The simple inexpensive habit of hand washing will reduce death from diarrohea by almost half and death from acute respiratory infection by a quarter, it was observed in a scientific study published in 2015.
The hand washing should be a habit which should be taught to the children by the family and in the schools because a habit of good hand washing with soap before eating and after using the toilet can save more lives them any single vaccine or medical intervention.
The main problem found in the practice of hand hygiene in India is connected with the lack of continuous running water, available sinks and time-consuming performance of hand washing. An easy way to resolve this problem could be the use of alcohol-based hand rubs, because of faster application compared to correct hand washing.
sIn a study conducted in Kenya, research found that students were much more likely to wash their hand when another student is present. Peer influence is only successful if students know that hand washing is desirable action.
Any habit formation is easier to make it but it is difficult to get rid of that. Therefore this habit of hand washing should be inculcated in these school going children.
Hand hygiene and hand washing can play an important and critical role in prevention and control of infection and to achieve universal health coverage as envisaged by World Health Organisation.
The simple habit of hand washing will not only increase the longevity of an individual but will also improve the quality of life of an individual. When we, as an individual will be healthy, then our family, society and nation will be healthier and happier.
(Dr Gaurav Sanjay is an orthopaedic and joint replacement surgeon based in Dehradun. Dr BKS Sanjay is an orthopaedic and spine surgeon, and the founding president of State Chapter of Indian Orthopaedic Association)
