The spread of covid-19 will soon be under control all over the world and economies will open up fully for social and business interactions. It has been predicted by World Health Organization (WHO) that the disease will become endemic which means that Infection Prevention and Control (IPC) measures must become a continuous process to prevent recurrence or outbreaks. Measures already in place have resulted in lifestyle changes which are being described as the ‘New normal’ and it is generally anticipated that some of these new lifestyles will become entrenched moving forward.
The key features of IPC are likely to remain: Hand hygiene, cough and sneeze etiquette, wearing of face masks and social distancing. Observing good hand hygiene and social distancing include avoidance of getting very close to other people, refraining from hand shaking, washing hands frequently or sanitizing with 70% alcohol solution or gel. Sensitization efforts in Kenya prior to Covid-19 pandemic concerning the danger posed by handshaking practice were frowned on and deemed difficult to implement as it is an established cultural practice in many parts of not only Kenya but the world. There was however abrupt cessation of handshaking countrywide after it was advocated as one of the measures for controlling Covid-19 pandemic along with social distancing rules. In his article World After Corona Virus in the Financial Times, historian Yuval Noah Harari observed that pandemics have the power of fast forwarding historical processes and bringing about changes previously perceived as difficult to achieve.
A handshake is used worldwide for/as; greeting, a friendship or peace gesture, bidding each other farewell, expressing gratitude, a sign of reaching an agreement or sign of good sportsmanship. Some cultures and religions have protocols governing the practice but in Kenya it is probably only among the maasai and some religious communities that some handshaking protocol is observed. Handshaking as generally practiced appears not to have been part of African culture and perhaps it is time we brainstormed about it and decided exactly how it ought to be done. For instance, a handshake should be initiated by the more senior or older person and it should be executed with decorum and it should not be with such a firm grip as to almost cause an injury to the weaker person. Women especially when accompanied should not shake hands but they can initiate it if they so wish and shaking the hands of everyone on arrival at a meeting should be avoided as it causes disruption and wastes time.
That handshakes spread germs is indisputable and this is especially the case in poor resource settings such as prevails in Africa including Kenya. There is no way hands can stay clean as desired if there is inadequate water supply and if the resources to buy ablution requirements are also inadequate. Some public places may sometimes sell small sheets of toilet paper but they oftentimes will not have running tap water whereas others might have neither paper nor water. Many germs consequently remain on people’s hands every time they visit toilets and these germs are exchanged freely when people shake hands as many are wont to do. This poses a health hazard to small children especially when we shake hands with them because they frequently put their fingers in their mouths. Handshaking should therefore be avoided as much as possible and we must not shake hands with children for they either have not yet learnt how to properly wash hands or they often forget to do so. We should generally be very cautious about hand shaking and we must remember that it is an integral part of hand hygiene. It is pointless to wash hands and immediately thereafter shake hands with someone whose habits you do not know about or have no control over. Covid-19 pandemic advisories have minimized handshaking and we should all work on making it part of the new normal that is now so much being talked about. You will stay safer if you not only wash your hands with soap and water or sanitize but also avoid handshaking as much as possible.
Joseph Kimani Wanjeri, MB ChB, MMed (Surgery), MPH, IPTM (Tel Aviv)
Lecturer, UoN Dept of Surgery (surgery.uonbi.ac.ke)
Acknowledgement: Dennis Ochande of UoN CHS IT Department for his assistance.
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