Handwashing has often been seen as the poor relation of public health. Not as tangible as mosquito nets, not as sexy as vaccines. But it is – as public health experts will tell you – just about the most cost-effective health intervention in the world.
It doesn’t look like the poor relation at the moment though, with governments and health professionals speaking with one voice about the importance of all of us washing our hands regularly while we sing Happy Birthday twice. Experts, like the team at the London School of Hygiene under Peter Piot, are being lauded and listened to, and handwashing talked about as the number one weapon in the fight to prevent or at least delay the spread of Coronavirus. This message has landed, with shops selling out of anti-bacterial wash and many now introducing rationing to prevent stock-piling. No-one is underestimating handwashing now.
We have worked as part of Unilever’s Lifebuoy soap team to promote the life-saving habit of handwashing since 2006, primarily in areas where child mortality is high and regular handwashing with soap can reduce the risk of diarrhoeal diseases by nearly 50%. Here are five things we’ve learned in that time:
1. Handwashing is undervalued because of its familiarity. Because we’re so familiar with it, we struggle to value its importance. In the absence of a new virus leading the global news agenda, public health professionals have to find new ways to break through familiarity and ingrained habits;
2. Changing handwashing habits is hard. In our work with Lifebuoy soap, we applied Unilever’s Five Levers of Change to the problem: Make it Understood, Make it Easy, Make it Desirable, Make it Rewarding, Make it a Habit. Coronavirus has certainly raised Awareness of the power of this behaviour, and the fear of the disease is making the practice Desirable. The opportunity now is to apply the theories of behaviour change to embed the habit for good, once this particular emergency fades;
3. Behaviour change needs institutional support. We lobbied at the United Nations for handwashing with soap to be included in the Sustainable Development Goals in 2015. Its subsequent inclusion makes it easier for national public health experts to argue for handwashing facilities and programmes to be supported by their governments.
4. Be open to others if you want to make change at scale. When we helped create Global Handwashing Day in 2008, we designed it to be inclusive for all parties, including Unilever’s competitors. The event is now recognised by the United Nations and celebrated in more than 70 countries every October 15;
5. Creativity matters. Dull handwashing posters in toilets are unlikely to help embed good habits once an extreme situation passes. This is where the power of positive creativity can play an important role, especially for something so simple in today’s often complex and expensive world. Not every piece of communication will be as magical as this award-winning film, but even the most humble bathroom poster should aspire to be memorable. Making the complex simple and the simple compelling lies at the heart of good communication.
We’ve known how important handwashing could be to public health and saving lives since a Hungarian doctor, Ignaz Semmelweiss, published his research in 1846 and it was there in the early days of the Unilever business, when Lever Brothers introduced the Lifebuoy brand in 1895. But it’s not been a straightforward story and handwashing has come in and out of fashion. Maybe the spotlight handwashing is finding itself under in this time of uncertainty can be a signal for long-term support.