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From: Hygiene and sanitation – Footsteps 97

How behaviour change happens, the importance of handwashing and how to make soap

Even if our hands look clean, they can still be covered with millions of germs. Germs are microbes that are invisible to the naked eye. Germs on unwashed hands cause illnesses, for example pneumonia and diarrhoeal diseases. Washing hands with soap is one of the most important ways to keep ourselves healthy and stop these germs from spreading from one person to another.


When to wash hands


Using soap

Many people wash their hands with water alone. However, this is not enough to remove germs. Using soap breaks down the grease and oils on our hands that carry the most germs.

Problems with soap use

Soap left near hand washing facilities often goes missing. It is too valuable a resource to leave around, yet it needs to be available wherever hand washing takes place, in the home or in public places such as schools. Soap on a rope is often the best option.

However, it is not enough to have soap in the home. We need to wash our hands with soap at important moments to prevent germs spreading (see box above).

A household bar soap can be used on the hands. A special type of soap for washing hands is pleasant but not essential. If soap isn’t available, then ashes or an abrasive agent such as sand can help cleanse hands.

When washing hands, use the number five to help you do it really well.

Five fingers – count to five

When washing hands, use the number five to help you do it really well.


How to wash hands

1. Hand washing does not depend on having a tap with running water. Improvisation is the key! A tippy tap, a bowl and jug, and a bore hole are all good options. Running water is best but not essential.

2. The temperature of the water is not important.

3. Wash all hand surfaces: palms, backs, wrists, finger tips and between fingers. The order does not matter.

4. Keep fingernails short so they are easier to keep clean.

5. It is important to dry hands properly before touching anything. Use a clean cloth or shake them in the air. Damp hands pick up more germs than dry hands.

6. If water is difficult to come by, wash hands whenever the opportunity arises.


Illustration: Rod Shaw WEDC Loughborough University

Illustration: Rod Shaw WEDC Loughborough University


Tippy Tap

Building low-cost or no cost hand washing stations can help people take the step from simply understanding the importance of hand washing to actually practising hand washing with soap. The Tippy Tap is widely promoted and used for hand washing around the world. It’s simple, cheap, and allows hand washing with only a little water. It is also easily adaptable to suit local situations and preferences.

Other types of hand washing stations are being developed in a number of countries. The design stage is very important.



Children’s activity

You will need paper and pencils or pens 

Ask the children to draw round their hands, one hand with the palm down and one hand with the palm facing up. Once they have an outline, they should remove their hands from the paper and draw on fingernails and any lines and creases they see on their hands.

  1. Explain how sickness spreads through unseen germs on our hands.
  2. Ask the children to look closely at their hands.
  3. Ask them ‘where might the germs be hiding?’
  4. Ask them to imagine they have put their hands in some soil. Ask them ‘where does the soil stick?’ The answer will be under the fingernails and in the creases of the hands. You could demonstrate this on your own hands with soil, and follow it by washing your own hands with soap so the children can see how it should be done.

On the pictures of their hands, the children should draw where the germs might be hiding. It doesn’t matter how they choose to draw the germs.

Use this activity to help children think about when to wash their hands. Help them understand that their hands need washing when they look dirty and sometimes when they look clean but may have germs on them. Emphasise the importance of washing hands thoroughly with soap to get the germs out of the creases and from under the fingernails.



Ideas for using this article


Compiled and edited by Helen Gaw, with contributions from Zoe Burden, Barbara Almond and Paul Dean. Children’s activity adapted from a WaterAid lesson plan, with thanks for permission. Recommendations on designing hand washing stations taken from a study in Vietnam by the Water and Sanitation Program.


To read this article as a pdf click here (PDF 394 KB). 

Provide a safe and clean way of disposing of the wastewater - for example, between stones (see picture), or in a bucket that is regularly emptied - so that the ground does not become muddy and insects and animals are not attracted.

Provide a safe and clean way of disposing of the wastewater - for example, between stones, or in a bucket that is regularly emptied - so that the ground does not become muddy and insects and animals are not attracted.

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Cover of Footsteps 112: Communicable diseases

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