You may have noticed that things have been a bit quiet on the blog front, lately. There has been a good reason for this. The very best reason. Hand washing!!!!
Yep, I have had my head, arms and legs buried deep into the second of my major projects for the Solomon Islands’ Ministry of Health – the development and launch of a National Handwashing Strategic Health Communication Plan.
Handwashing is one of those things that we take for granted. As children, we are taught to wash our hands after the toilet, before eating, after eating, after blowing our noses, after playing with the dog/cat/bird/mice/guinea pigs/chickens, after gardening, after pretty much everything.
We are also taught the link between washing hands and disease – the fact that 80% of all infectious diseases are transmitted by touch, and that handwashing with soap and water at key times can halve the number of diarrhoea-related deaths, not to mention cholera, dysentery, acute respiratory infections, trachoma, scabies, etc. etc.
Our love affair with handwashing is also demonstrated through our investment into aesthetically pleasing and super-user-friendly hand washing facilities – think soft lighting and strategically placed mirrors, carved and sweetly smelling soaps, artistically folded hand towels, motion-sensor liquid soap and faucets, or basins built into toilet cisterns for eco-friendly water conservation.
Despite this, some bored researcher discovered that 14% of banknotes in America are contaminated with faeces. Either a whole lot of Americans (and I’m sure they’re not the only ones) fail to wash their hands as they should, or there are a number of rich people who are running out of toilet paper and using the next best thing. Either way, I have a newfound appreciation for my credit card.
The humble art of handwashing has been described as a self-administered vaccine. But, in fact, handwashing with soap and water at critical times has proven to be more cost-effective than any single vaccine. It is also more cost-effective than the distribution of malaria nets, the construction of sanitation, improvement of water, and every other public health intervention known to man (so far).
So why does the majority of the world’s people still fail to practice this one simple act?
Perhaps it is because handwashing is an action that needs to be repeated about 100,000 times during an average lifetime to be truly effective, unlike the single or triple dose of most vaccines.
Maybe it’s because handwashing is too subtle, unlike mosquito nets that tangle you up the second you climb into bed (with buzzing mosquitoes in the night to serve as an added reminder).
Possibly it’s just because handwashing isn’t sexy, unlike the sight of fresh, clean water flowing across the plump lips of a broadly smiling model.
Hopefully, this handwashing campaign will change that. At least for the Solomon Islanders.
We officially launched the campaign last week on 15 October, as part of Global Handwashing Day celebrations. Through a great team effort (I am so proud of the team), we held a large event at one of the rural schools, in a gorgeous setting sandwiched between the Pacific ocean and Visale’s towering hills. We even managed to drag a number of VIPs from the comfort of their urban offices to participate. In addition to speeches that actually stuck to time, we had great songs and dramas from the primary school children and San Isidro Care Centre – a school for the hearing impaired.
The event culminated in a mass handwashing activity, using home-made pressure taps from recycled 1.5L water bottles. If you ever need proof that children actually like washing hands, then this was it. The children were so keen that our guest speakers had to fight their way to the front to do the demonstration. Naturally, as 800-hands got washed, chaos and hilarity ensued.
It is estimated that only 5-10% of the Solomon Islands population currently wash their hands with soap and water at key times – far fewer than the proportion of the population that have access to clean water, proper sanitation, mosquito nets, malaria treatment, iron-fortified salt, and a full course of government-subsidised vaccines.
The impact of this is obvious. More than 34,000 cases of diarrhoea were recorded in the country’s health clinics in the last 12 months. I’m sure that’s only a fraction of the real number, given that many cases don’t even make it to a health clinic. This is despite local research showing high knowledge of the health impacts of washing hands.
The big gap lies in attitudes and, most importantly, practice.
For this reason, our national handwashing campaign will focus on improving the social norms around handwashing, and improve access to handwashing facilities at toilets and kitchens.
We hope to build habits young by targeting children aged 6-12 and the people most likely to influence their behaviour – peers, parents, teachers, community leaders, religious leaders, and popular media.
We also hope to do this through a long-term approach, starting with a two-year pilot and three-year scale-up.
Last week was just the beginning. The biggest and the best is yet to come.