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    One of the simplest ways to maintain good health is washing your hands. You may feel that hand washing doesn’t merit mention in a survival medicine article, but an austere medic’s encouragement of frequent hand-washing in a group can prevent many health issues off-the-grid. Once the power is down, you may not have hot water for showers, but there is still water for hand-washing.

    A number of diseases are related to germs that somehow make their way onto your hands. Many of these, like Salmonella or E. coli, exist in feces. There’s always a risk of microbes in excrement contaminating your hands. You probably wouldn’t be surprised if the contamination came from a dirty diaper, but it can also occur from touching soil or after handling raw meats that may have miniscule amounts of manure on them. Just one gram (1/454th of a pound) of human feces contains up to one trillion bacteria.

    Germs can also get on your hands if people touch contaminated surfaces and then touch their faces, a very common occurrence. This leads to respiratory infections and may be a factor in the spread of COVID-19. Diarrheal disease, skin, and eye infections may be caused from microbes passed from hand to mouth, eyes, or small open wounds.

    There are significant health improvements seen in areas that received education on proper hand washing with soap and water. Diarrheal infections were reduced by 23-40 percent. Respiratory illnesses dropped by 16-21 percent. In areas of the world where diarrheal disease and pneumonia are common, 1.8 million children under 5 years old die annually from these two illnesses. It may be inferred that a prolonged disaster setting may place a developed nation into similar circumstances.

    Here’s how to wash your hands properly, according to the Centers for Disease Control and Prevention (CDC):

    •             Wet your hands with clean water (temperature doesn’t matter)

    •             Lather your hands by rubbing them together with soap (bar or liquid). Be sure to apply soap to the backs of your hands, between your fingers, and under your nails.

    •             Scrub your hands for at least 20 seconds.

    •             Rinse your hands well with clean (preferably running) water.

    •             Dry your hands using a clean towel or air dry.

    Soap and water is much better than just using water. A good lather forms pockets called micellesthat trap and remove germs, harmful chemicals, and dirt from your hands as you rinse. Running water is best for rinsing organisms off but may not be available in survival scenarios.

    Not everyone agrees that cold water works as well as warm. A chemist and associate professor at Emory University who studies disinfectants says: “Cold water will work, but you have to make sure you work really vigorously to get a lather and get everything soapy and bubbly…Warm water with soap gets a much better lather, more bubbles. It’s an indication that the soap is trying to encapsulate the dirt and the bacteria and the viruses in them.”

    Antibacterial soap has not been shown to be superior to regular soap for proper hand-washing; indeed, some chemicals (Triclosan) in antibacterial soaps have been banned.

    When To Wash Your Hands

    You are most likely to spread disease-causing organisms at certain times. The CDC counsels you to wash your hands:

    •             Before, during, and after preparing food

    •             Before eating

    •             Before and after caring for someone at home who is sick with vomiting or diarrhea

    •             Before and after treating an open wound

    •             After using the toilet

    •             After changing diapers or cleaning a child who has used the toilet

    •             After blowing your nose, coughing, or sneezing

    •             After touching an animal, animal feed, or animal waste

    •             After handling pet food or pet treats

    •             After touching garbage

    Recommendations are even stricter during infectious disease outbreaks. In the current pandemic, the CDC advises washing hands after being in public places and having touched door handles, tables, counter, gas pumps, shopping carts, and ATMs.

    Hand sanitizer is useful for when soap and clean running water isn’t an option. It should contain at least 60% alcohol to kill germs.

    Proper use involves applying the product to the palm of your hand and rubbing your hands together.  Cover the back of your hands and between the fingers until dry. Be certain to use enough to completely cover the area.

    You should be aware that sanitizers can’t kill every type of microbe. Some that cause diarrhea like Norovirus, Cryptosporidium, and Clostridioides difficile are resistant. Hand sanitizers also aren’t effective on visibly dirty or greasy hands and don’t remove harmful chemicals.

    Hand washing should be instilled as part of a culture of good hygiene in good times or bad. Wash your hands as an activity with your kids often (and don’t forget a step stool so they can reach the sink!)

    Bonus: Here’s a previously-released video about a time when hand washing was considered, well, weird, by the medical community….

    Joe Alton MD

    Dr. Joe Alton

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    The Survival medicine handbook Third Edition 2016
    The Survival Medicine Handbook Third Edition

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