The WHO-UNICEF Joint Monitoring Reports released in 2023 revealed that at least 40% of government health facilities in India do not have basic hand hygiene equipment in locations of care, and a survey conducted by WaterAid India in 2022 showed that only 6 of 10 government urban toilets in India had functional handwashing facilities that provided water and soap.

What’s more? According to a report conducted by the Indian Council of Medical Research, only 1 out of 4 Indians wash their hands following loo visits with soap, irrespective of being aware of the dangers. It is ironic, but more painful than Dettol on a clean wound. In a nation where density and crowd overlap with each other every single day, it is not a health hiccup but a leading health disaster on the threshold.

Hand Hygiene: It is more than a habit, it is a Heroic act

It does not take long to become a clean freak, much less be a saint. Let us not beat around the bush; in India, we touch everything. The pani puri counter, the autorickshaw handle, the elevator button in a mall, the shared office mouse, all of them are the incubators of bacteria, viruses and anything that the day has decided to sling at us. Yet we do not wash up all the time before eating or after getting out of the door. You need good hand hygiene as the first defence mechanism to avoid getting the common cold, or even something more menacing like the norovirus, typhoid or Hepatitis A.

Clean hands = fewer germs = fewer infections. It is a matter of biology and not rocket science.

Public Areas are the New Germs Central

Well, why don't we have a stroll in some of the busiest open areas of India?

• Public Transport: Buses, Trains and the Great Metro Hustle : The transport systems in India are enormous and transport more than 23 million passengers on a single day, which is through trains alone. Think of how many people touch those chairs, railings, ticketing areas and handles. According to research published by the Indian Journal of Community Medicine in 2022, more than 60% of the swab samples collected by testing of E. Coli and Staphylococcus aureus found at the surface of the buses and the metro and trams were contaminated, which can be transferred to the hands and cause harm. And still… how many of us use a sanitiser or wash our hands when we have touched the same strap as 43 other people in the rush hour?
• Toilets and the Heel of Hygiene : Although the Swachh Bharat Abhiyan has contributed towards some improvements, 45% of the toilets in urban areas do not have fully functioning handwashes as well, and 27% of the ones with taps have soap at all times. It would be like a parachute without cords; you have the parachute, but when you need it the most, it is of no use. Specialists from the best medicine hospital in Delhi warn us that the toilet is a warzone when it comes to sanitation. And when our hands are not clean after we flush, we end out with more than we went in with.
• Markets, Malls and Food Stalls : The tempting fragrance of aloo tikki wafts to your nostrils, to the thrill of a Buy 1- Get 1 sale in the mall; these are sensory overload places, and bacteria cannot resist them. Add to that the receiving of currency notes (which by the way have more microbes than a dog's mouth), and you have the brew of potential sickness. And it is not the chaat that is a danger. It is eating it without cleaning the bhelpuri off the fingers.

Knowledge vs. Practice

This is where it gets crazy. Indians are aware that hygiene is significant. An after-pandemic Knowledge, Attitude & Practice (KAP) survey showed that 87% of Indians feel that washing their hands can help prevent the illness, but only 41% use soap to wash their hands in the presence of a crowd. What is the cause of this huge decline between intention and action?

• Inconvenience (There is no soap!)
• Overconfidence (Mere immunity strong hai!)
• Sluggardness (Enough with the work now, what has one gained?)
• Inability to access (No water or facilities close by)

The culture exists, we clean ourselves before pooja, after having food and on festivals. But out in the street? What we do is snooze hygiene.

Spread of Hand-to-mouth diseases

Dirty hand is the expressway towards:

• Diarrhoea diseases (Cholera, Typhoid, Dysentery)
• Respiratory infections ( Flu, Tuberculosis, COVID-19 )
• Worm infections/Intestinal worm infections (Worms)
• Infections on the skin and eye (Scabies, Conjunctivitis)
• Common cold, Influenza, Chicken Pox and Meningitis

Food Poisoning and Stomach Infections

And these not only directly affect health, but they also affect attendance at school, efficiency at work and healthcare costs. Simply, dirty hands are not cost-effective either.

COVID-19 made us his walking disinfectant machine. We disinfected phones, groceries, doorknobs, and our souls, why not! But post-2022? Again, we are falling. Sanitiser bottles, which used to dominate glove compartments, are now rolling under the car seat, long forgotten. We should not wait until the next outbreak and then put into practice what we have already learned. How can we do a clean-up of our act?

1.  Bring Your Hygiene Army

• Travel-sized sanitiser? Always.
• Wipes? Nice to have around when you need to get pani puri out.
• Where chlorinated water and soap are available, use them; do not depend on one splash and you are clean.

2.  Construct Hygiene Framework

• There should be an increase in the number of handwashing devices in public areas.
• Use of soap and water should be non-negotiable at the malls, metros, markets and schools.
• Hygiene hubs can be powered by CSR funds in busy places.

3.  Begin at the beginning: Start with Kids

• Schools have fun hand-washing songs.
• Reward or hygiene badges.
• Pay particular attention to encourage handwashing not only before meals but also after contacting the outside world.

4.  Behavioural Nudges Do Miracles

• Posters that remind us to wash hands, reading, Have you washed your hands today (The placement of such posters is outside toilets and food stalls).
• The behavioural science studies have shown that visual cues and reminders raise the level of compliance by over 50%.
• The pressure to do what the other kids do can be your own personal BFF, whereby when one friend washes his or her hands, the rest all do.

Government & Brands Need to Step Up

• The Swachh Bharat Mission 2.0 needs to spread itself to concentrate on workable cleanliness, rather than on infrastructure.
• The engagement can be implemented through a brand campaign such as the Hat Dhoye India or the Hygiene Heroes.
• Hospitals, bus stands, and Metro stations can be fitted with automated, touchless hand sanitiser dispensers, which may be sponsored by the private players as part of CSR.

Not only is Negligence dirty; it is Deadly

The lack of care when it comes to hand hygiene is not like a sneezing case or a stomach ache case here and there, but it is a complete health menace. The mysterious cause of thousands of hospitalisations annually in India is:

• Unwashed hands
• Infections due to unhygienic practices
• Cross-contamination in shared spaces like schools, markets, and offices
• Rise in antibiotic-resistant bacteria due to repeated, preventable infections
• Maternal and neonatal complications during delivery due to poor sanitation
• Waterborne diseases are spreading in communities because of poor hand hygiene after toilet use

Indeed, it is reported that some 525,000 children under the age of five lose their lives annually to diarrhoeal diseases, most of which can be prevented by washing hands.

One dirty hand can cause the domino effect, leading to gastroenteritis outbreaks among communities and causing antibiotic resistance and even maternal and neonatal infection during birth. Hepatitis A, hand-foot-mouth disease, and such infections are being passed along in the adult population the way gossip travels through a local commuter train. It is not only a hygiene flop, but also an epidemic boiling up on our fingertips.

Make hygiene a mandatory option, not a fuss. We live in a universe of beauty makers and skincare regimens, so why not begin praising clear hands as well? Hygiene is not dull. It’s powerful. It’s personal. And in India, where just a handful of grime can affect a hundred, it is a revolution. We are finding intelligent cities, launching treasure troves, and creating unicorn data sets. But when our citizens continue getting sick due to diseases that may be prevented with 20 seconds of soap, what is the purpose?

The revolution does not begin with plans by the government or viral movements. It begins when an individual makes a choice not to eat a golgappa without resorting to washing of hands. As a cleaner India begins not only at home, but on your fingertips. Swachh haath = swasth desh. If even after careful precautions, you are suffering from hygiene-related infections, feel free to consult a specialist and book an appointment at Sir Ganga Ram Hospital today.