The 20-second rule is the new diktat. Wash your hands for 20 seconds. Do not have a clock? Just hum Happy Birthday twice. That’s sufficient time for hand cleaning. If you want to make hand washing more groovy, use Wash Your Lyrics, a tool that automatically pairs your favourite song with hand-washing instructions. There’s a TikTok handwashing dance challenge, Mayo Clinic has issued a definite dos and don’ts of handwashing, Mariah Carey is singing along with her kids about handwashing and there’s The Handwashing Liaison Group that has relentlessly propounded the importance of handwashing in reducing hospital-acquired infections.
A copper engraving portrait of Ignaz Philipp Semmelweis by Jenő Doby © Eugen Doby.
Hand-wash is the new chorus but did you know that the theory of hand hygiene arose in Vienna? Pause for 20 seconds and memorise a name: Ignaz Philipp Semmelweis. A Hungarian-born physician who started the hand-wash revolution. In the middle of the 19th century, the young Hungarian doctor came to Vienna to work at the city’s General Hospital. Semmelweis quickly noticed that women delivered by physicians and medical students had a much higher mortality rate than women delivered by midwives. Women were so afraid, many said they would rather give birth alone on the streets than risk being admitted to the ward. Hot on the trail of the phenomenon, Semmelweis spotted that there were links between the lack of hygiene of the doctors and the mortality rate of the mothers. Midwives weren’t but physicians were handling corpses during autopsies before attending to pregnant women and not washing hands between the two jobs. Semmelweis was certain that hand washing would prevent physicians from passing on illness to the patients.
After Semmelweis initiated a mandatory hand-washing policy, the mortality rate for women delivered by doctors fell from 18 percent to 2 percent and when he began sterilising medical instruments, it fell to 1 percent. But in 1847, not many were convinced. His seniors defied Semmelweis’ hand-washing idea and attributed lower death rate to the hospital’s new ventilation system.
According to an article by Mark Best and Duncan Neuhauser in Quality and Safety in Health Care, “Physicians resisted these changes for several reasons. Washing of hands before treating each patient would be too much work. In the long run, solving this problem would require rebuilding hospitals so that sinks and running water were within reach. The profession of being a physician was divinely blessed, so it would be unreasonable to think they could cause disease. Semmelweis was saying that doctors were the cause of death. Egos were often inversely proportional to the evidence, and the scientific evidence was very scant at this time”.
Two years later, an academic axe fell on Semmelweis - his assistant professorship was not renewed and he was offered a clinical faculty appointment without permission to teach from cadavers. A dejected Semmelweis left Vienna to join as head of obstetrics at St Rochus Hospital, Budapest. Here, he publicly harangued doctors and nurses about handwashing and reduced maternal mortality.
Postage stamp of Ignaz Philipp Semmelweis, 1818–1865. Issued in Austria in 1965 on the 100th anniversary of his death.
Dr Semmelweis died in Lower Austrian state mental hospital in Döbling, Vienna. He was 47.
Though Dr Semmelweis was right, hand washing did not become a norm until two decades later when research by Louis Pasteur, Robert Koch and Joseph Lister produced more evidence for germ theory and antiseptic techniques. The world now believes in what Semmelweis had said in 1847 and he is still called ‘the saviour of mothers’. In the English-speaking world, Semmelweis has not only made it into the history books but also into the dictionary - ‘Semmelweis reflex’, a term describing the immediate rejection of a scientific finding or information without conducting one’s own deliberations or verifications.
So, next time you wash your hands, do not hum Happy Birthday twice. Thank Dr Ignaz Philipp Semmelweis. At least once.Preeti Verma Lal is a Goa-based freelance writer/photographer. Photo credit: Preeti Verma Lal.