15 October 2019- Global Handwashing Day

Today is Global Handwashing Day, so here is a little history for you.

Hand hygiene and hand washing is one of the most important things you can do to prevent the spread of disease.

It is not the biggest contributor to the decline in mortality over the last two hundred years- that prize goes to clean water and sanitation – but it’s importance is uncontested- now.

Unfortunately that wasn’t always the case, the “father” of modern hand hygiene was Ignaz Semmelweis, a Hungarian Doctor who noticed in 1846 that the women who gave birth in the midwife run maternity ward had a much lower death rate from childbed fever than those in the doctor run hospital. It took him a while to figure it out- he tried changing the position the women gave birth in, and the habits of the priest thinking the women may die from fear. No luck. He took some time out, and when returning to the hospital heard of the death of a friend of his, a pathologist, who had pricked his finger during an autopsy and died – with symptoms similar to that of childbed fever. While midwives purely looked after the women under their care, doctors also performed autopsies. And those doctors frequently went from an autopsy to the maternity ward.

So Semmelweis instituted a practice of washing hands in chlorine to remove the cadaverous particles he thought was being transferred from the dead body to the women in childbirth. This produced a fall in the death rate of women in childbirth.

Unfortunately this wasn’t to last, as Doctors did not like being accused of killing their patients, and refused to continue washing their hands. Despite his best efforts Semmelweis could not convince Doctors at other hospitals to take to his hand washing practice either.

Interestingly Samuel Hahnemann (founder of Homeopathy) when writing about malignant typhus said that nurses need to avoid having their face next to the patient’s mouth and if they touch the patient they should wash their hands with vinegar and water. This was published in his Lesser Writings in 1852, and considering Hahnemann died in 1843 his suggestion of hand washing predated Ignaz Semmelweis by years. Just another example that Hahnemann was ahead of his time.

Fast forward nearly 10 years and Florence Nightingale was in charge of the nurses in Scutari. Many more soldiers died of typhus, typhoid, cholera and dysentery than of their wounds. She organised the Sanitary Comission to come out and sort the drains and sewers and ventilation, but also instituted hand washing practices. The death rate fell from 42% to 2%.

While hand washing was utilised after that period it was not widely promoted or mandated for until the 1980s. Since then the world health organisation, governments and aid agencies have all developed campaigns to promote hand washing. With handwashing rates of diarrhoea and communicable diseases fall.

So don’t underestimate the power of a little soap and water to prevent disease!

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