The first time I learned to wash my hands “properly” was nearly seven years ago: I was twenty-six.1 It was in an NGO in Delhi, India, one of the organizations in which I was conducting my doctoral fieldwork into slum children’s lived experiences of development. Sitting on the floor with a group of children, I watched as the NGO worker—a visitor from a specialist WASH (Water, Sanitation, and Hygiene) organization—demonstrated how dirty our hands could be. She asked the gathered children in Hindi: “Who has very clean hands?” Nearly all their hands shot up. “Really, really clean?” she said. The children nodded, and she selected two particularly eager boys. These boys were asked to wash their hands thoroughly over a bucket. She then picked up a clear glass tumbler. Presenting this to the children like a magician, she asked them to look at the glass very carefully to determine if it was clean. They all nodded. She then took the bucket from the first boy, carefully pouring some of the water into the glass and holding it aloft for all to see. It was murky and grey. She offered it to one of the boys to drink. He shook his head, backing away. Seizing her moment, she declared: “if you don’t wash your hands properly, you will be having this ‘Coca Cola’ with each of your meals.” Later in the class the solution to avoiding this “Coca Cola” was revealed: an eighteen-step handwashing program, drilled until the children could remember it unassisted.
Two months later I was in another slum community, teaching this eighteen-step sequence—which had been transformed by another NGO into a dance—to a group of assembled slum children, all of whom appeared far cleaner than me. Poorly adapted to Delhi summers, and unused to hand washing my own clothes, I was already dirty, dusty, and sweaty before even arriving in this community for another day of fieldwork in 45°C. Despite this I joined the NGO worker at the front of the group of children to demonstrate the dance, counting the steps aloud in Hindi. In doing this I play a role in a biopolitical project more than three centuries old. This project discursively constructs me—despite my dishevelled appearance—as “clean,” and the slum children in front of me “ignorant” and “dirty.” Intertwined with racial ideas of purity, discourses of dirt and hygiene have long produced and perpetuated social hierarchies that distribute mortality and morality unevenly throughout the population. However, like the nineteenth-century doctors who rejected Ignaz Semmelweis’ hypothesis that it was their “dirty hands” that were causing childbed fever, some people have always been able to claim that “dirt” is incompatible with their social position.
As I demonstrate the dance steps to the gathered children, I do not remove their dirt—this NGO cannot provide fresh water or even soap to these communities, and this dance is just a dance. Instead I make claims to remove their “ignorance.” The simplicity of handwashing education programs is one of the reasons why they have been described in one contemporary public health study as “one of the most cost-effective of all public health interventions” (Greenland et al. 2013, 246). Cost-effective. While several other studies—many of these funded by soap manufacturers—suggest that handwashing could save up to a million lives each year. It is the could that is worth emphasizing here, given that many studies of handwashing promotion attest to both the complexities of behavior change and entrenched structural problems—in particular, access to resources such as clean water.
In late 2019, a virus—perhaps moving from bats, via pangolins, into human bodies—quickly spread. By February 2020, it acquired the official name Covid-19, and by March it was declared a pandemic. Mirroring the spread of the virus, handwashing dances, songs, and memes began spreading online with viral intensity. Videos from the likes of Chinese actress Fan Bingbing, Vietnamese record producer Khac Hung, the Bangkok Overground Train Service, Singaporean comedian Gurmit Singh, Mexican singer Mister Cumbia, and, in our own country (Australia), Indigenous rapper Baker Boy circulated online. Yet beyond the world of YouTube stars and Instagram influencers, information around handwashing moved through the most mundane and everyday institutional networks. The day before the pandemic was declared, I received an email from the dean sent to our entire faculty. In it he reminds staff to wash their hands regularly, including a suggestion of some songs to hum to ensure the wash goes for the required duration. The next time I come into campus there are signs everywhere demonstrating the appropriate handwashing method and duration. The Australian government soon begins circulating handwashing messages on television, social media, and the radio. Knowledge about appropriate handwashing, that thing that the development workers “had” and the slum children we worked with were presumed to lack in deadly quantities, now appears to be lacking in the general population of the global North. And now here too the consequences are deadly.
So now we are all small children, learning how to wash our hands properly, humming happy birthday twice, borrowing mimetic devices from YouTube influencers, shaking our hips as we wash. Yet as we sing and scrub, perhaps for the first time learning how to be clean enough to save our lives, we must also remember that what kills people is microbes, bacteria, viruses, large single-stranded RNA genomes surrounded by a fatty outer layer adorned with club-shaped spikes. But it is also stigma, poverty, racism, the ongoing effects of colonization, and state neglect. Now that we have all been shown up as ignorant of proper handwashing protocols, perhaps we can look beyond a simplistic narrative of “ignorance” and recognize all the things that, despite our ignorance, have long protected some of us from from the deadly effects of “dirt”: clean water, sewerage, sanitation systems, and privilege.
1. The “I” refers to the first author, Annie McCarthy.
Greenland, Katie, Sandy Cairncross, Oliver Cumming, and Valerie Curtis. 2013. "Editorial: Can We Afford to Overlook Hand Hygiene Again?" Tropical Medicine and International Health 18, no. 3: 246–49.