IN the 19th century, washing of hands was not a regular custom. This could be gleaned from reading the novelists of the period as for instance, George Elliot or Charles Dickens. There is a factual story of a Hungarian doctor, who, in the earlier years of the century enthusiastically tried to disseminate the advice that hand-washing was one of the secrets of health. He was fiercely resisted and ridiculed and was eventually put away in a lunatic asylum.

With the advance of knowledge of Science, the relationship between bacteria and disease was firmly established but it took almost two generations for this knowledge to spread and be fully accepted by the public. By the beginning of the 20th century, this knowledge was accepted by nearly everyone and hand-washing was regarded as a healthy practice. But despite this was known, a sizable proportion of the world’s population still do not wash their hands when they should, even if there are facilities for hand-washing.

Much useful research on hand-washing has been done by American institutions, the main ones being the Food Safety and Inspection Service (FSIS) of the US Department of Agriculture, the Global Handwashing Partnership (GHP) and the Centre for Disease Control and Prevention. We will mention some of their findings but will not source them to the particular institution. We do this for easier reading but the institutions and their Reports could be accessioned online.

In America, people who wash their hands do not do so for the necessary 20 seconds and do not usually dry them with a clean towel. Or worldwide, only 19 per cent of people wash their hands after contact with excreta. In addition, the provision of handwashing facilities differs very greatly among countries, ranging from 100 percent in the Developed Countries to 10 percent in others.

It has been found that handwashing could prevent one in three diarrhoea-related illnesses and one in five respiratory infections such as colds or flus. It has been pointed out that germs from unwashed hands can enter the body through the eyes, mouth and nose and also from unclean surfaces such as doorknobs or Banknotes and coins. Germs could also enter food and drink from unwashed hands. The American institutions recommend using either anti-bacterial or ordinary soap, and either bar or liquid, though there seems to be a preference for liquid. If water is not available, one could use an alcohol-based sanitiser with at least 60 percent alcohol.

In Guyana, fortunately, soap and water are liberally available and are provided in the lavatories of all public places unlike in so many other countries. In Guyana, therefore, the main problem is not the absence of soap and water or handwashing facilities as in some desert countries; the problem is that Guyanese have to develop the handwashing habit and also how to wash one’s hands properly. It may be mentioned that some people are under the impression that it is preferable to wash their hands with hot water since there would be fewer bacteria in such water. Actually, if hot water is used repeatedly for handwashing, it may increase the risk of dermatitis.

PAHO/WHO has been helping in the process of educating Guyanese as to handwashing and they have produced an attractive poster illustrating the handwashing process with twelve simple pictures. The poster could be seen in a number of public lavatories but not with the ubiquity which they should be.

The steps given in the PAHO/WHO poster are the following: Wet the hands with clean running water, thereafter turning off the tap. Then soap the hands with either liquid or bar soap. If it is bar soap, rinse the bar since someone else would have used it. Rub the palms together, getting it into a lather and then rub the back of the hands and between the fingers and under the nails. The scrubbing of the hands should be done for a minimum of 20 minutes. Then wash the hands with clear, running water then drying the hands with preferably a single-use towel if available. In turning off the faucet, use a towel or paper napkin to do this.

In the restaurants or fast-food shops, customers should walk with their own sanitisers or wipe their hands with the paper or cloth napkins before beginning to eat. The waiters and other servers in the restaurants should always be reminded by management to avoid touching the food they would be serving to customers. For example, when filling an ice cream cone, the waiter should always have the cone wrapped in a serviette or napkin.

In educating the population about handwashing, it should be taught in the primary schools and all businesses should periodically remind their staff of proper handwashing. In restaurants and food shops, management must ensure the staff do not touch the customer’s food. Public Health officers should constantly give health tips to the street food sellers.