B1 - Washing People

Poor hygiene increases the transmission of diseases, including diarrhoeal disease, respiratory disease, hepatitis and infections. The rates of these diseases in some developed world indigenous communities are as high as in many developing countries and are many times higher than for non-indigenous children.

Diarrhoeal and respiratory diseases, in particular, are the major causes of illness among indigenous children and also play a major role in malnutrition in the first three years of life. Skin infection is one of the most common problems of Indigenous children and causes chronic illness and discomfort. Re current or persistent skin infection is known to increase the risk of developing kidney disease and rheumatic fever. All these illnesses are commonly linked to poverty.

Washing children daily is likely to reduce the frequency and spread of these diseases.

• Having functional washing facilities in the house will reduce diarrhoeal disease because organisms are less likely to be transmitted between people, particularly between children and adults.

• Respiratory disease is primarily spread by aerosol droplet transmission. However, it has been shown in Papua New Guinea that a micro-organism that causes pneumonia was found on the hands of mothers who had been handling children. This type of transmission is likely to be even more common in Australian Indigenous children, who have higher rates of nasal discharge and face secretions than children in Papua New Guinea. Other studies have also demonstrated strong evidence for ‘secretion swapping’ as a method of spreading the micro-organisms responsible for respiratory infections. Washing will reduce the amount of infected secretions on people’s faces and hands, and may reduce transmission both by aerosol and by direct contact.

• Persistent scabies infections can lead to an increased risk of infection by other bacteria, especially Group A streptococci associated with impetigo. These infections are most effectively treated by frequent washing and removing the crusting around weeping sores that protects and encourages organism growth. Washing skin sores will not only reduce discomfort and frequency, but will also help to reduce the consequent high rates of renal disease, rheumatic fever and rheumatic heart disease.¹

• In many regions, Indigenous children have high rates of trachoma and bacterial eye infections. Trachoma is known to be associated with poverty and poor living conditions. Studies have shown regular face washing can reduce the amount of eye infection.

• Washing hands after using the toilet can significantly reduce the transmission of hepatitis.
• The facilities used for hand washing can also assist in the carrying out of dental hygiene and tooth brushing, leading to reduced dental disease.

The health hardware required to support the first Healthy Living Practice: the ability to wash people, particularly children includes a private, functional wet area with hot and cold water supply, shower, a bath or tub for washing children, a hand basin, and working drainage.