Wash hands

Best way to choke disease flows. Wash your hands. Do doctors and nurses wash hands, not maybe with Dettol or chlorine but at least with water? Most of India today has not water to drink; a wash of hands is out. At blood testing labs, none washes his or her hands; or at least, me has not seen it happen. Each year, according to the US Centers for Disease Control, two million Americans acquire an infection while they are in the hospital. 90,000 die of that infection. The hardest part of the infection-control team's job, Yokoe says, is not coping with a variety of contagions they encounter or the panic that sometimes occurs among patients and staff. Instead, their greatest difficulty is getting clinicians like me to do the one thing that consistently halts the spread of infections: wash our hands. Writes Atul Gawande, a US surgeon in his book - Better; Malcolm Gladwell says: A gorgeous writer and storyteller. In 1847, at 28, the Viennese obstetrician, Ignac Semmelweis said doctors were to blame for childbed fever 'by not washing their hands consistently or well enough.' Doctors did not like the suggestion. 'Far from being hailed, Semmelweiss was ultimately dismissed from his job,' mentions Atul Gawande. Never thought washing hands is best. Atul Gawande comes from Uti, four hundred miles east of Mumbai. Dr. Ashish Motewar at the Nanded hospital, serving 1,400 villages including Uti, is ever under stress of ailing patients; on one day morning he saw 36 patients in three hours. 'With no time for a complete exam, a good history, or explanations, Dr. Motewar relied mainly on a quick, finely honed clinical judgement;.... at least 50 of the 250-some patients seen by the surgeons in Nanded that morning turned out to need an operation. The hospital had operating rooms and staff, however, for only 15 such operations per day. Everyone else had to wait,' flows on Gawande. At All-India Institute of Medical Sciences, Delhi it is no better. A senior resident was queuing patients six months ahead with cancers first priority; the queue can be jumped, broken or avoided by the rich - ministers and other assorted power points. 'By necessity, he accomodated them -- and pushed the least connected ever further back in the queue' owns up Atul. Increasing private medicine and medical treatment will keep the rich in, poor out; in terms of power and cost. Then Atul Gawande, who should know, winds down: ' New laboratory science is not the key to saving lives. The infant science of improving performance --- of implementing our existing knowhow --- is. Nowhere though the government has recognised this....These realities are without question demoralising. ...All the surgical residents I met hoped to go into the cash-only private sector (where patients with the means increasingly seek care, given the failure of the public system) or abroad when they finished their training -- as I think I would in their shoes. Many attending surgeons were plotting their escape, too. Meanwhile, all live with compromises in the care they give that they cannot bear to tolerate.' Atul Gawande, me has always gone to private hospitals; never public hospitals; had cash; most of India prefer to breathe their ailments on the streets. Off hand picked up the book at Oxford Book Stall. Atul Gawande is worth it.