A group of Nepali children dipped their hands into buckets of water and lathered them with soap. Chanting in unison, they sang, Sabun pani le haat dhowau, which means Let’s wash our hands with soap and water. In the rural town of Namsaling, the children were celebrating Global Handwashing Day but they were also learning how to protect themselves from threats to their health.
Global Handwashing Day, an annual campaign established in 2008 to promote hand hygiene, takes on special significance today.
In Nepal, despite strong advances in child health outcomes, diarrhea remains a leading cause of death for children under 5. As it turns out, one of the best defences against the disease is not only the cheapest but has taken on renewed relevance: handwashing. This simple act is an important barrier to disease spread, whether against diarrhea in Nepal or COVID-19 today.
According to the Centers for Disease Control and Prevention (CDC), handwashing can prevent about 30 percent of diarrhea-related illnesses. And according to the World Health Organization, handwashing is one of the most important measures in preventing COVID-19 along with physical distancing and mask-wearing.
In 2012, I worked with a local non-profit in Eastern Nepal, supporting hand hygiene education for youth. Eight years later, when COVID-19 struck and everyone became obsessed with handwashing, I was reminded that the practice is more than a health measure: it is an act of community, connection and solidarity.
Do you remember, in March, getting home from the grocery store and running to the sink? Everyone was lathering up, turning on the tap and washing their hands for 20 never-ending seconds. We did it to protect ourselves and others and because the evidence that it worked was clear. Handwashing with soap and water reduces the risk of viral infections.
As the second wave hits and the number of new COVID-19 infections rises, we must continue to do this simple act. If soap and water aren’t available, public health agencies recommend an alcohol-based hand sanitizer (with at least 60 per cent alcohol). In a recent statement, Dr. Theresa Tam, Canada’s Chief Public Health Officer, emphasized that we must keep up our “frequent and meticulous handwashing.” Much like for the children I met in Nepal, this could mean the difference between life and death.
The non-profit I worked with was called the Namsaling Community Development Centre. Along with my amazing colleagues Bhupal, Rashmina and Pradeep, we travelled, often by foot or rickety bus, to schools in remote areas. We carried red buckets and plenty of soap and we knew we had to bring the fun. Students only have so much attention span for PowerPoints on diarrhea prevention.
We organized relay races in which kids sprinted across the school yard to wash their hands on the other side (points were lost for poor technique). We held a speech competition, won by a 10-year-old girl named Usha. She stood in front of her neighbours, teachers and friends and spoke passionately about the importance of hand hygiene to keep her community safe. We even performed comedy sketches on the local radio station.
When it comes to public health messaging, a dash of joy doesn’t hurt. It now seems that yesterday’s radio sketches are today’s TikTok videos. One of my favorite videos that addressed handwashing and COVID-19, was with 31-year-old Vietnamese dancer Quang Dang. In a TikTok video, seen millions of times, he choreographed a dance that promoted handwashing, all to a catchy Vietnamese tune called “Ghen.” In response, people across the world rose to the challenge, posting their own videos of the handwashing dance.
Also educating the public were our Canadian TV news anchors. Back in March, a group of four CBC hosts took part in an experiment. They rubbed a glow-in-the-dark gel on their hands designed to mimic germs. Then, they washed their hands in different ways: some used soap, some didn’t, and some washed for 20 seconds and others for 10. When they put their hands under a UV light, those that lathered for longer, and used soap, fared much better. In Nepal, we had actually used this same teaching exercise. And likewise, the kids had similar “aha” moments when, placing their hands under the UV light, some saw remaining “germs” on their skin.
In addition to these workshops, my colleagues and I also tried to build solidarity. We worked best when we connected with other health workers in different villages. We were effective when we supported schools to incorporate handwashing in their daily routines. And we succeeded when we brought in different groups – like shopkeepers and politicians – and asked how they too might promote hand hygiene. In the end, we all have a role to play to protect community health.
But in Nepal, as in Canada, great disparities exist. According to a study in the American Journal of Tropical Medicine and Hygiene, 95 per cent of the wealthiest people in Nepal have a basic handwashing facility, while among the poorest, only 38 per cent have access. In Canada, while most households have places for handwashing, those living in prisons and homeless shelters often have reduced access to hygiene. There is a lot more we can do.
Today, we again mark Global Handwashing Day. This time the theme is appropriately named “Hand Hygiene for All.” It’s a call for us to unite and make hand hygiene a reality for everyone. To keep up the fight against COVID-19, we must continue to do something so simple yet so important. As those young Nepali kids once sang: Let’s wash our hands with soap and water.