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| 250,000 children die of diarrhoea in Pakistan annually |
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Proper hand washing can reduce mortality by half: WHO
Wednesday, October 15, 2008
By our correspondent
Karachi
Proper hand washing with soap can reduce deaths arising out of diarrhoea and other diseases significantly, said Dr M. Rafiq Khanani, President Infection Control Society Pakistan.
According to World Health Organisation (WHO), diarrhoea and pneumonia kill more than four million children under five in developing countries every year, making these the leading killer of children worldwide. In Pakistan diarrhoea is rated as the number one killer of children accounting for about 250,000 deaths and unimaginable morbidity.
Estimated number of diarrhoea episodes in the country is more than 20 million annually. Proper hand washing with soap and water can reduce deaths from diarrhoea by almost half and deaths from acute respiratory infections (including influenza, Streptococcus, respiratory syncytial virus, common cold, SARS and Avian Flu) by one-quarter, he believes. Khanani said that hand washing with soap and water can also decrease incidence of salmonellosis, shigellosis, hepatitis A and E, giardiasis, enterovirus, amebiasis, campylobacteriosis, cytomegalovirus, typhoid, staphylococcal organisms, and Epstein - Barr virus.
A study in Pakistan found that hand washing reduced the number of pneumonia related infections in children under the age of five by more than 50 per cent. Studies have shown that hand washing reduces the incidence of skin diseases, eye infections such as trachoma, and intestinal worms, especially ascariasis and trichuriasis.
It has been observed that although people wash their hands with water, very few wash their hands with soap at critical moments (for example, after using the toilet, while cleaning a child, and before handling food). Hence, the challenge is to transform hand washing with soap into an automatic behaviour performed in homes, schools, and rural and urban communities, he said.
Turning hand washing with soap before eating and after using the toilet into an ingrained habit can save more lives than any single vaccine or medical intervention, he said. He said that using soap adds to the time spent washing, breaks down the grease and dirt that carry most germs by facilitating the rubbing and friction that dislodge them and leave hands smelling pleasant (which creates an incentive for soap’s use). “With proper use, all soaps are equally effective at rinsing away the germs that cause disease,” Khanani explained.
He was of the opinion that since there is no glamour involved in promoting hand washing with soap, health care professionals, communities and masses in general do not pay attention to this simple and most effective tool to improve the health of the nation, reduce the burden of diseases and improve the socio-economic status of the communities.
Events such as the Global Hand-washing Day being commemorated on October 15 (today) for the first time puts this often overlooked hygiene challenge at the forefront of the international agenda while keeping children at the heart of each country’s national and local initiatives.
Formative research suggests that people want clean hands for reasons of comfort, to remove smells, to demonstrate their love for children and to exercise their social responsibility. In certain communities the chief motives for hand washing is to nurture, to avoid disgust and to gain social status.
Khanani said that diarrhoea is both preventable and treatable, yet we continue to pay the price of this disease in lost lives, missed school days, reduced resistance to infections, impaired growth, malnutrition and poverty. He said that this is a vicious cycle and not by any heroic charisma but only with proper hand wash with soap, can the people break this cycle. When coupled with educational initiatives, hand washing with soap is one of the world’s most cost-effective preventive health interventions and has been proven to reduce the risk of not only diarrhoea but burden of cholera and dysentery can be reduced by 48 per cent to 59 per cent.
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ISSN 1563-9479 
