Hand hygiene.pdf

and (wash) your feet up to the ankles … then make ablution at the time of each prayer”
(chapter 6, Almaidah, verse 6).
Apart from the Qu’ran, other references also exist to guide Muslims. The way in which the
Prophet Mohammed conducted his life is documented in a body of literature, the Hadith
and the Sunna, and provide additional observations regarding both the emphasis given to
personal hygiene within Islam, and the specific prominence of hand hygiene. The Prophet
Mohammed always urged Muslims to wash hands frequently and especially after some
clearly defined tasks (Table I.15.1) 549 . Hence, from the dawn of Islam, strict observation of
hand hygiene with freely running water has been advocated for all Muslims, whatever their
occupation.
Unfortunately, the above-mentioned hypothesis that community behaviour influences
HCWs’ professional behaviour has been corroborated by scanty scientific evidence until
now (see also Part I, Section 16). In particular, no data are available on the impact of religious
norms on hand hygiene compliance in health-care settings where religion is very
deep-seated. This is a very interesting area for research in a global perspective, because this
kind of information could be very useful in identifying the best components of a programme
for hand hygiene promotion. It could be established that in some contexts emphasizing the
link between religious and health issues may be very advantageous. An assessment survey,
moreover, may also show that in populations with a high religious observance of hand
hygiene, compliance with hand hygiene in health care will be higher than in other settings
and, therefore, does not need to be further strengthened or, at least, education strategies
should be oriented towards different aspects of hand hygiene and patient care.
With the exceptions of ritual hand aspersion before the consecration of bread and wine,
and of the cleansing of hands after touching the holy oil (the latter only in the Catholic
Church), the Christian faith seems to belong to the third category of the above classification
regarding hand hygiene behaviour. It must be highlighted that there are some episodes of
Christ’s life where the act of hand cleansing apparently had negative connotations. Jesus
criticized the Pharisees and scribes for their strict compliance with the ritual of washing
hands before meals (Matthew 15:2, 20). It is important to understand that this is a symbolic
criticism, in order to refer to the priority given to interior purity as opposed to exterior
appearance. Similarly, the negative meaning given to Pilate’s act of washing hands to refer to
his innocence has to be interpreted in a symbolic manner (Matthew 27:24). In general, the
indications given by Christ’s example refer more to behaviour in a Christian’s spiritual life
than in everyday life and are aimed to free believers from those formal and repetitive acts
that do not always reflect interior purity. The emphasis on this specific point of view does
not imply, though, that personal hygiene and body care are not important in the Christian
way of life.
Similarly, specific indications regarding hand hygiene are nonexistent in the Buddhist
faith. No mention is made of hand cleansing in everyday life, nor during ritual occasions.
According to Buddhist habits, only two examples of pouring water over hands can be given,
both with symbolic meaning. The first is the act of pouring water on the hands of the dead
before cremation in order to demonstrate forgiveness to each other, between the dead and
the living. The second, on the occasion of the New Year, is the young person’s gesture of
pouring some water over the hands of elders to wish them good health and a long life.
In some African countries (e.g. Ghana and some other West African countries) hand
hygiene is commonly practised in specific situations of daily life according to some ancient
traditions. For instance, hands must always be washed before raising anything to one’s lips.
In this regard, there is a local proverb: “when a young person washes well his hands, he eats
with the elders”. Furthermore, it is customary to provide facilities for hand aspersion (a bowl