Risk of more COVID-19 as use of handwashing stations declines in Nairobi, Kenya

By Sharon Atieno

At the onset of the global COVID-19 outbreak, studies showed that the virus is transmitted through respiratory droplets or contact. Contact transmission occurs when contaminated hands touch the mouth, nose, or eyes as well as surfaces, thus enabling the virus to be transferred to the surface.

It is for this reason that hand hygiene – especially washing hands with soap and water or with alcohol-based hand rub – was promoted as a means of preventing the spread of the coronavirus. 

In Kenya, like other countries, the message was loud and clear. So clear that even small business enterprises set up their own handwashing stations near their businesses.

The stations range from simple innovations such as raised buckets/containers with a simple tap or water outlet, suspended containers with outlet or tap, foot pump sink to free-standing water tanks with taps or outlets.

Hand-washing station in Nairobi

83.9 percent of handwashing stations installed as an emergency measure in various business premises in Kenya were fully functional six months post-installation. In addition, 85 percent of observed users washed hands with soap as recommended before getting into the business premises.

Amref Health Africa

Fast forward, it is now more than a year since the pandemic hit the country, and the level of adherence to handwashing and sanitizing, especially in these business premises, is declining.  

Walking along business premises in Nairobi, one cannot fail to notice that some have either removed their handwashing stations or they are lying idle as customers no longer use them.

Elizabeth Njoki is a tailor and an owner of a boutique shop in Dandora estate. Outside the boutique shop, she has set up a small handwashing station, which includes a 10 litre jerrican fitted with a tap on its side and tightly tied to a post outside. 

Elizabeth Njoki outside her clothes boutique shop

She says that initially, she would fill the jerrican twice a day with water. Her customers could not come in without first washing their hands. Even passers-by would request to use the handwashing station. 

“That practice ended. Almost all customers walk in to the shop without washing their hands. This jerrican can stay there for even up to three days until I use the water to clean the shop,” says Njoki.

“People are not taking this disease seriously. Some people are saying that the disease exists, others are saying that the disease is not there and others just shrug it off, saying that even if they get the disease, they will still recover.”

She is not alone. Lydia Makena, a shopkeeper and M-PESA agent in the same estate, also attests to this.

“People are no longer washing their hands. They think that this virus is a scam and they have grown comfortable. I am the only one using this handwashing station unlike during the first wave, when people would wash their hands so much that I would fill this jerrican every day, sometimes even twice,” she says, referring to her black 20-litre container positioned near her metallic makeshift shop.

Maria Mueni, a shopkeeper, decided to remove the handwashing station completely. 

“I would set it up in the morning and remove it in the evening, but this got tiring because people stopped using it and now small children would take advantage to play with the water,” says Mueni.

The owners of the small business enterprises say laxity crept in after the passing of the first wave, which was marred with strict measures such as restriction of movement, curfews, closure of schools, and ban of social gatherings, among others.

According to Patrick Kariuki, a resident of Umoja Three estate, the onset of COVID-19 in Kenya came with a lot of fear, so people would regularly and consistently wash their hands even when just going to the shop but that changed. 

“I hardly sanitize or wash my hands when I visit the shop or some small business enterprise. It’s not that I have refused to do it but even the places that I go to, they have removed those handwashing stations. The situation is the same even in the neighbouring businesses,” he admits.

“That strict enforcement that those things have to be there declined. They would serve as a reminder for me to wash my hands frequently.”

But for Lucy Mugo, the case is different. She stopped washing her hands regularly because constant washing with different soaps at different places resulted in her hands becoming dry and chapped.

According to Martin Muchangi, Programme Director for Water and Sanitation Hygiene (WASH) & Neglected Tropical Diseases (NTDs), Amref Health Africa, regular handwashing in the continent is low at only 67 percent, despite handwashing with soap and water having a proven efficacy of reducing 16-30 percent of respiratory diseases.

“Since COVID-19 is a respiratory infection and is easily transmissible through contact with respiratory secretions, frequent washing of hands with soap and clean running water in addition to other public health measures is of critical importance,” says Muchangi, adding that utilisation of public handwashing stations has reduced over time since the onset of the pandemic.

“Until everyone is vaccinated, and herd immunity is attained, frequent handwashing remains one of the most important tools for preventing the spread of the pandemic.”

Muchangi says handwashing promotion is needed, with a focus on social, financial, technical, and social sustainability.

To ensure utilisation of handwashing stations in the small business enterprises, he advised that the stations should be strategically placed in locations that are easily accessible to all: young children, the elderly, and those with limited mobility.

“Embedded communication materials and reminders should be distributed liberally to cue individuals to wash their hands,” Muchangi said.

He notes that frequent handwashing with soap has additional benefits, including a 40 percent reduction in people who get diarrhea, preventing one in every five pneumonia cases in children, and contributing to an increase in school attendance by preventing six out of every 10 children from missing school due to gastrointestinal illness. 

“It also helps prevents the overuse of antibiotics—the single most important factor leading to antibiotic resistance around the world. Handwashing can also prevent illnesses attributed to antibiotic resistance, which can be difficult to treat,” Muchangi added.

This story was produced by MESHA

The Media for Environment, Science, Health and Agriculture (MESHA) is a Kenya-based and registered association of science journalists and communicators, whose membership includes journalists, editors, scientists and communicators.

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