It's Sometimes Hard to Wash your Hands

There are contradictions in life that we see everyday.  Sometimes it takes something very small to make you become acutely aware of this.  Here is my little missive for the day.  It’s about hand hygiene.

The link between hand washing and the spread of disease was established about 200 years ago, almost simultaneously in a Vienna and Boston Hospital.  

Everyone knows it is important to wash your hands.  The WHO has put out a 216 page document on this subject.

Here in Addis we, and most other ferenji’s, walk around with little bottles of hand sanitizer in our back packs.  We spend a good part of the day whipping out our Purell bottles and madly sanitizing our hands at a moments notice (not sure what local people think of this slightly annoying habit of ours). 

In hospitals at home, we are informed that there are about 400 different hand washing points before, during and after a patient encounter.  There are now people employed to spy on us to make sure we perform adequate hand hygiene.  This is of course all good.

We have recently been attending inpatient rounds at Yekatit 12 hospitals.  The wards have between 6-8 patients in a room.  Patients have active TB, HIV, meningitis; they certainly don’t need any health care worker associated infections added to this.  Of course hand hygiene could be and easy part of the solution.  But it’s not so easy.

Same sink this morning

We saw there was a sink in the male inpatient ward.  Thought for starters we might bring in a bar of soap and we and the other healthcare workers could start washing our hands at the sink.  We were willing to forgo our hand sanitizer for a few hours. Seemed simple enough, except the next day there was no sink and I don’t think they have a maintenance department to come up and replace the sink.

Sink on the ward yesterday

Yet again, it’s not fair.  Overcrowding, under staffing and lack of funds make it extremely difficult for these types of preventive measures to be put in place. 

We continue to admire the work that everyone does here.