Oxfam installed Contactless Handwashing Devices which are activated with a foot peddle to avoid transmission of the virus from touching the soap. Rohingya refugee camp, Cox's Bazar, Bangladesh. Credit: Fabeha Monir/Oxfam

12 tips to sustain hygiene practices now and post coronavirus in emergencies

Emergencies, Water, Sanitation and Hygiene (WASH)

Oxfam installed Contactless Handwashing Devices which are activated with a foot peddle to avoid transmission of the virus from touching the soap. Rohingya refugee camp, Cox's Bazar, Bangladesh. Credit: Fabeha Monir/Oxfam
Oxfam installed Contactless Handwashing Devices which are activated with a foot peddle to avoid transmission of the virus from touching the soap. Rohingya refugee camp, Cox’s Bazar, Bangladesh. Credit: Fabeha Monir/Oxfam

Over 20 years ago when I stopped seeking medicinal remedies to prevent and treat diarrhoea and other infectious diseases and moved to population enabling solutions, I have not had cause to look back. Today the coronavirus is having a huge impact, so now more than ever we have better hygiene practices in emergency that not only tackle it now but put in place long term solutions.

Handwashing practice with soap and water is a significant solution for reduction of diarrhoea related diseases and respiratory infections. In recent years these solutions have received increased attention globally. Oxfam and partners have made substantial investments  in handwashing research to identify enhanced and innovative approaches which facilitate handwashing, especially among vulnerable population groups affected by crisis (women, girls, men, boys, elderly and persons with different mobilities).

Today, we have a collection of robust handwashing options and a novel low-cost station with over 20 features to increase handwashing practice. There is also a novel promotion approach – “Mums Magic Hands”, which was co-created with Unilever to help increase and reinforce handwashing practice, not just amongst carers, but also with their immediate family and entire community.

Working with different partners, we have harnessed Oxfam’s people centred, gender and vulnerability sensitive experiences with a strong emphasis in different emergencies to develop products which are now needed in one of the biggest disasters of the century.

Since the onset of the outbreak, Oxfam has been working to prepare for the pandemic. In February 2020, the organization formed a taskforce, who pulled together lessons learnt from previous outbreaks (e.g. Ebola, Cholera, Zika) and developed guidelines to help ensure staff safety and implementation of quality responses.

Many countries are now responding to the outbreak with a focus on preventing and reducing the infection risks related to coronavirus. This entails the promotion of handwashing practice with soap and water alongside the training of community-based volunteers to motivate and support their peers in adapting safe behaviours and practices.

So how do we ensure that handwashing and other related hygiene practices are maintained and sustained when the coronavirus may continue for many years? To address the most vulnerable, more efforts will be needed to tackle inequalities. In particular prioritization of programme and policy which look at erasing disparities.

For sustained behaviour change, the following intersectoral recommendations will be crucial:

  1. Ensure access to practical attractive low cost, durable handwashing stations at household and communal levels. For example, Oxfam’s new handwashing station for rapid deployments and other locally made standardised solutions. Latest estimates by WHO/UNICEF show 2 in 5 people globally lack functioning handwashing facilities with soap and water in their home.  
  2. Instilling a sense of ownership and maintenance of WASH facilities amongst the target population.
  3. Provision of continuous access to soap or soapy water (which is cheaper and equally effective option).
  4. Provision of continuous access to safe water for personal, domestic and hand hygiene.
  5. Facilitate continuous well-planned and executed promotion and monitoring of handwashing using interactive activities to remind and reinforce handwashing practices.
  6. Community engagement to help the target population understand better the coronavirus means of transmission and how to prevent the spread. As well as how they can collectively work together to end it through:
    • dialogue
    • joint identification of key risks and debunking rumours
    • interactive age, gender and culturally appropriate communication
    • shielding most vulnerable
    • engaging in other effective action plans including physical distancing.
  7. Supporting government/local administration efforts in referrals, advising on tracing, tracking and WASH provision in treatment and isolation centres.
  8. Different stakeholders working together to ensure joined up efforts to reduce the spread and impact of the different measures introduced since the outbreak impacts on different spheres of life and all groups of people although in different ways.
  9. Sustained financing over time and investments through appropriate resources, new innovations/technologies and their scale up.
  10. Capacity building of different actors and facilitators especially on improved handwashing and hygiene promotion approaches.
  11. Government, NGO communities and others supporting different communities should also endeavour to apply key community engagement principles. These include:
    • building trust
    • collaboration
    • inclusion
    • coordination
    • context analysis
    • use of interactive information, education, communication (IEC) materials
    • accountability (including for service delivery)
    • monitoring and periodic reviews.
  12. Governments should aim to adequately pre-empt, access and address the impact of different preventive measures e.g. impact of lockdowns on access to food, health services for other non-coronavirus ailments including vaccination, gender-based violence, unemployment etc.

The above is all encompassing, however, to make handwashing and hygiene a lifestyle, the right enabling environment and adequate resources to fund it will be needed. Globally, only 9% of counties with costed hygiene plans reported are having enough financial resources to achieve national hygiene targets. Ultimately if we are all able to make proper frequent handwashing and always practice good hygiene (including respiratory and surface hygiene) a way of life, some of the losses to coronavirus may turn to gains through significant reduction in some of the other infectious diseases.

Author
Foyeke Tolani

Foyeke Tolani

Dr Foyeke Tolani has over 20 years of Public Health humanitarian and development experience, in more than 20 countries in the world. She is a Public Health Adviser and lead in handwashing research and innovation in Oxfam. She has been involved in six different multi-agency Water, Sanitation and Hygiene (WASH) projects, and is passionate about supporting women and different vulnerable groups in disaster-affected and vulnerable communities.