29 March-4 April 2013 #649

Alcohol to the rescue

Hand sanitisers will be useful and complement the use of soap and water in a country where the habit of washing hands is finally catching
Dhanvantari by Buddha Basnyat, MD

Washing hands with soap after every checkup is one of the simplest hygiene habits health workers need to follow to prevent the spread of diseases. But hundreds of Nepali doctors, nurses, and other healthcare providers who work in cities and villages face acute water shortage. At other places they may be using dirty towels to dry their hands which defeats the whole purpose or soaps may be missing.

Even in developed countries where there is no shortage of water (or soaps), many healthcare practitioners fail to wash their hands as regularly as they should because they don’t want their hands to ‘dry up’. A 50ml pocket-sized bottle of alcohol is the answer to boosting this appallingly low compliance rate.

Alcohol’s antiseptic properties have been known for thousands of years. The Egyptians used wine as a preservative for their mummies. Although surgeons began using alcohol from the early 1900s as hand disinfectant, it was replaced by antimicrobial soap in the 1950s. However, alcohol has managed to make an impressive comeback in the last five years.

Common hand sanitisers like Purell (one of the first American companies to produce alcohol-based hand antiseptic) contain about 60 to 70 per cent alcohol, which is counterintuitively more effective than pure alcohol. This concentration rapidly kills many kinds of bacteria and inactivates influenza and other viruses. These alcohol based hand rubs also have high moisture content which helps prevent dryness and irritation.

In 2002, the Centres for Disease Control and Prevention (CDC) in the USA, after reviewing accumulating scientific evidence rewrote its Hand Hygiene in Healthcare Settings guideline. The report stated that alcohol based products were better for standard hand washing than soap. Several years later, the World Health Organisation also reaffirmed this fact.

Small enough to carry in handbags or pockets, easy to use, and reasonably priced at Rs 350 for alarge 500ml bottle, this revolutionary disinfectant needs to be targeted not only towards health professionals but also the general public. In our country where the habit of washing hands with soap is finally catching up after years of awareness campaigns, hand sanitisers will be useful and complement the use of soap and water.