As a mother of two children, making sure that my children are healthy is the number one priority. The phrase “prevention is better than a cure” has far more meaning to us post our experience with Covid. Covid-19 reminded us that despite technological advancements, the key to a healthy life still starts with personal hygiene or Handwashing. Research conducted in 14 different countries by BMC Public Health later concluded that higher handwashing adherence was associated with lower levels of Covid-19 morbidity since the beginning of the pandemic. So, we already have the superpower to ensure hygiene to prevent illness, which is soap and water.
This innovation is the most impactful breakthrough in public health, as this simple behaviour can save millions of lives. Identified in the 1850s, Handwashing has been vital to fighting germs, diseases and illness worldwide. It became more evident in the 1920s during the Spanish flu pandemic when brands like Lifebuoy started to make people aware of the importance of Handwashing to fight illness and disease. Even a century later, this is still relevant today as it is estimated that 1.4 million people, including nearly 400,000 children under five, die each year from diseases that can be prevented through the simple act of Handwashing. According to UNICEF, unsafe hand hygiene alone is responsible for 394,000 deaths from diarrhoea and 356,000 deaths from ARIs like pneumonia. Despite all the economic and technological advancements, even today, 3 out of 10 people globally still need adequate access to Handwashing. However, the simple concoction of only soap and water to wash hands can reduce the chance of diarrheal disease in our children by 45% and pneumonia by 23%.
Coming to our part of the world, even in the 1990s, the infant mortality rate in South Asia was near 100 children per 1000 births (99.4 in Bangladesh, 88.7 in India, 106.4 in Pakistan). Handwashing was not part of people's daily life and was often neglected. Awareness regarding handwashing with soap was also low. The situation demanded intervention from the government and the private sector's contribution to ensure product availability, affordability and awareness creation. For example, Unilever's soap brand Lifebuoy is sold in more than 100 countries and is on a mission to improve people's hand hygiene and advocate for better hygiene habits.
Apart from ensuring product availability, Lifebuoy, which takes its purpose very seriously, has also contributed to creating awareness and habituating handwashing behaviour among people, especially children. Upon my arrival to Bangladesh, I learnt about the inspiring story of the Lifebuoy School Program. Handwashing behaviour change has been a significant work area of Lifebuoy in Bangladesh since the 1990s. Lifebuoy school program has been teaching students the right way of Handwashing and forming habits in many schools across the country. This is not a typical marketing campaign to promote the brand; instead, this is a research-backed program that teaches children the right way of handwashing and forming habits through a 21-day cycle within schools. This initiative has directly engaged over 11 million school children since 2011. This initiative is one key example of how a purpose-led brand can contribute to the WASH agenda and save lives.
According to the recent WHO-UNICEF joint report, Bangladesh has increased Handwashing Coverage by 17 percentage points in just 5 years (2015- 2020), the highest in the world. According to the National Hygiene Survey 2018 by BBS, over 60% of toilets had a hand washing station with soap and water within 30 feet. These behaviour changes have reduced the infant mortality rate to 21.5 children per 1000 births in 2023, and the awareness creation contributed to this progress. In their recent publication, the importance of this initiative is acknowledged by UNICEF, which mentioned that sustaining a behaviour-change program is necessary to continue good handwashing practices. Experts also commented that if students habitually wash their hands, there would be less disease, and they can spend more time studying.
With the onset of the COVID-19 pandemic, we collaborated with BRAC, the world's largest NGO, as a part of our Hygiene & Behaviour Change Coalition (HBCC) and the collaborative effort ensured information dissemination and public awareness creation, product availability, emergency support for the front-line workers, hard-to-reach community engagement and out-of-home handwashing facility deployment. However, it came to our realization that we still have a lot more to accomplish. Handwashing is not a "When needs to be Protected" task but a habit of being "Always Protected". While COVID-19 has been a powerful reminder to practice washing hands, many of us did not adopt handwashing as the first defense against infectious diseases in our daily lives.
At the University of Chicago Medical Center, a recent study revealed that before the pandemic in September 2019, hand hygiene compliance was at 54.5%; it peaked at 92.8% in March 2020 but declined to 51.5% by August 2020. This showcases a diminishing rate of hand hygiene practices, and this decline is seen across all socio-economic landscapes. A similar trend was also experienced in Bangladesh, which reminded us that the milestone is yet to be reached. Realising the need, we re-initiated our “Lifebuoy School of 5” program when the schools reopened in collaboration with BRAC.
Along with our school visits, we started an advocacy program to include Handwashing in the school curriculum as the "H for Handwashing" movement in 2020. The foundation of this campaign is rooted in the belief that the children of today will be the torchbearers of tomorrow. As they stand poised to inherit this world, it becomes imperative to instill in them the values and practices to ensure a healthier, safer future for all. Hand hygiene, being a foundation of this vision, needs to be more than just a practice; it should be a way of life.
In the long journey of educating children on hand hygiene, Lifebuoy also realised that the best way to adopt a good habit within a child is by making the learning process more enjoyable and engaging, not by only inducing fears of germs and diseases. In a recent study to gauge the appeal, relevance, and understanding of digital games among internet-accessible families, children were encouraged to play each of the four digital games at least once over two weeks. The results were promising as 82% noted their children emulated handwashing skills from the games, and over 90% reported sustained good handwashing practices post-study. Encouraged by this learning, we have revised and updated our approach. On the occasion of Global Handwashing Day 2023, recognising the power of play in learning and behaviour change, Lifebuoy evolved the H for Handwashing campaign into the "Play and Learn" methodology. This strategy seamlessly blends the joy of games with essential hand hygiene lessons.
Along with BRAC, Lifebuoy is teaching proper handwashing behaviour to 730,000 schoolchildren with the innovative "Play and Learn" approach this year. These innovative approaches aim to teach and instill Handwashing as a cherished lifelong habit while making the process fun and engaging for future generations. Investing in handwashing is considered the smartest investment to improve public health as handwashing reduces the risk of illness among people and is a preventive measure. Preventive measures always bring in better results as this reduces the risks and costs associated with major diseases. Investing in Handwashing Awareness and Behaviour Change will reduce the infrastructure burden and ensure better utilisation of the government funds. The Government of Bangladesh is already aware of the importance of this action as it, as the first country in the world, has formulated a National Hygiene Policy to achieve Universal Health Coverage by 2030 as a Vision 2041 goal and SDG Target 6.
So, this Global Handwashing Day, let's take a moment to think about the profound impact of this simple act of Handwashing. Let us all come together and take an oath to have a playful learning approach to demonstrate and instill the proper hand hygiene habits amongst our children. Let's have safer hands for our children to build a safer nation together.
Nilushi Jayatileke is the personal care head and marketing director of Unilever Bangladesh Ltd
