WATERAID: Small investment, big rewards: handwashing devices

Public health advice on handwashing during the COVID-19 pandemic is difficult for many living in rural communities to follow without a running water supply. Here, members of the WaterAid Bangladesh team introduce their manual of easy-to-use, context-based handwashing devices designed to overcome challenges of affordability and accessibility to include everyone. Since the onset of COVID-19 in Bangladesh, the country has been flooded with the primary public health message to ‘frequently wash hands for at least 20 seconds’, following advice from the World Health Organization (WHO). In theory, handwashing with soap is an easy, effective and affordable do-it-yourself preventive measure against COVID-19. The media have played a dynamic and vital role in promoting handwashing with soap and disseminating this core preventive message across the country. The Government has also highlighted handwashing with soap in its official COVID-19 messages, although these have been crowded out by other public health advice. Almost all local and multinational companies producing soap, hygiene and cleaning products have also tailored their advertising in line with COVID-19 messaging. Running water excludes many communities But, while appreciating these correct and whole-hearted efforts from all corners, a critical observation is that most of the promotional materials show running water. This can leave the more than 63% of people in Bangladesh who live in rural areas feeling excluded, because most of the rural population uses one of various types of hand-powered tubewells or another kind of community-managed waterpoint. Rural communities often carry water from waterpoints or nearby sources such as ponds to latrines for washing their hands after defecation. People store water in their kitchens or other suitable places in their households for washing hands before or after eating. The situation is similar in slums and low-income communities in urban areas; water is available only at community-managed waterpoints, having extended connection from water utilities or typical tubewells, depending on the context. In densely populated urban slums, people require handwashing at entry and exit points to reduce spread of COVID-19. This is difficult due to a lack of adequate and appropriate facilities. Risk of contamination from waterpoints COVID-19 has changed the whole notion of handwashing. People have started washing their hands even at rural markets, health complexes, local government office premises and after returning home. This is definitely a positive development, but we need to be cautious about the risk of transmission via the waterpoints people have to use. The virus can spread from person to person through high-contact points such as handpump handles or mugs used to draw water from buckets. For example, use of tubewells or mugs requires one hand to pour the water. This is not only inconvenient but also the cleaned hand is then used to pour water on the other by touching the handpump or another surface, which could be contaminated. Our manual of affordable handwashing devices To address these challenges, we have designed simple, context-specific and affordable handwashing devices with running water for both public places and households, with support from our partner NGOs, enthusiastic social workers and local entrepreneurs. We have promoted a wide variety of handwashing devices during COVID-19 for both rural and urban contexts, to enable even the most marginalised communities to wash their hands easily with running water. In our work promoting handwashing devices over many years, several innovative and low-cost models have been developed, such as the Tippy Tap, a tap attached with a barrel or clay pot and many others. Many of the low-cost models were created by local inventors, together with WaterAid and our partner NGOs. We have compiled 22 different types of handwashing devices in an easy-to-use manual, including descriptions and cost estimations so people can identify the most appropriate device for a particular context and set it up. The devices mostly require locally available materials, which increases their affordability. Contactless handwashing devices for COVID-19 and accessibility One of the best innovations introduced during the coronavirus pandemic and included in the manual is the contactless pedal type handwashing device, which enables people to wash their hands without touching the tap. This minimises the risk of the spread of COVID-19 and other communicable diseases, while also reducing wastage of water. The manual also includes handwashing devices that enable children and people with disabilities to access and use the facilities easily. And there are guides to enable people in hard-to-reach rural areas to make their own handwashing devices in their yards using a tap attached to a mini drum, earthen pot or plastic bowl to collect used water, fixing this simple system using mud. Tippy Taps are another very simple handwashing device included that are also useful in rural Bangladesh. Our manual is publicly available and we are sharing it widely with water, sanitation and hygiene (WASH) sector actors. Several organisations and individuals have already reached out and proactively started using the suggested designs for developing handwashing devices using their own resources. We have also developed a design specification for public handwashing stations, to encourage best practices in handwashing design. Video: A paddle-operated handwashing device in use in Bangladesh. https://youtu.be/Nj4kQ0mjk0g Handwashing is a cost-effective intervention COVID-19 has shaken the world with fear and uncertainty. But a very basic and simple strategy of frequently washing hands with soap and water can challenge the devastation of this pandemic. Handwashing with soap has been recognised as one of the most cost-effective inventions in public health. According to WHO, an investment of just US$3.35 in handwashing promotion is estimated to deliver the same amount of health benefits as does an $11 investment in latrine construction, or a $200 investment in household water supply. These figures show how small investments in hygiene equal big changes, yet hygiene remains neglected by individuals, communities, institutions and policy makers. Handwashing with soap should not be continued solely because of COVID-19 fears; rather, it should be developed as a lifelong habit. Good handwashing practices are estimated to reduce incidences of diarrhoea and respiratory illnesses by up to 40% and 21% respectively, leading to huge economic benefits. The COVID-19 pandemic offers an opportunity to change hygiene behaviours for good and reap the long-term health benefits. And it is an opportunity to ensure everyone has the facilities they need to maintain these new behaviours. The time has come to redefine the investment paradigm at individual, community and even the national level, to make sustainable changes for humanity part of the ‘new normal’. Hasin Jahan is Country Director, Golam Muktadir is Technical Adviser for WASH and Zarif Ifthekhar Rasul is Strategic Support Officer, all at WaterAid Bangladesh. Original article: https://washmatters.wateraid.org/blog/small-investment-big-rewards-handwashing-devices-for-every-context