Out of the darkness, a ray of hope. The coronavirus pandemic, though potentially serious, brings me hope that perhaps humanity may discard two archaic habits that cause me personal pain.
First, the handshake. Dirty. Dangerous. For the most part, unnecessary. Supposedly a ritual signifying peace but rendered meaningless by human duplicity. Mortal enemies shake hands, then resume their plots for mutual destruction.
The handshake dates back to ancient Europe when people carried arms. It was a means of affirming that the other person’s hands were not concealing a weapon. Why it was assumed that the person could not conceal the weapon in the other hand is a puzzle.
Over time, the handshake became a universal gesture of peace and friendliness, a silent message of trust, respect and equality. That is why we celebrated the great handshake between Kenya’s Uhuru Kenyatta and Raila Odinga, scions of their country’s two royal families, for it gave a reprieve to their combustible land. Hopefully the bloodletting will forever be trapped inside that handshake.
I do not know whether or not my ancestors engaged in handshakes. Their greeting, passed down to us, consisted of hugs, accompanied by repetitive deep squeezing of each other’s arms, an act that sought assurances that the other person was fit and healthy.
We continue that tradition, one of the few to have survived the advent of our pseudo-Anglicisation. The embrace is accompanied by a simultaneous verbal greeting, a long conversation in itself, a rapid fire of kaije, kaije, kaije, kaije, buhooro, buhooro, buhooro, buhooro, buhoorogye, obayo, ogumire, ogumiregye, followed by all manner of queries asking basically the same question: “How are you?”
Each of those questions elicits the response “hmm,” meaning “yes” even when one’s bones are aching after a 30 kilometre walk from Kahondo ka Byamarembo. At the end of the long greeting, the two let go of each other, their hands never having touched.
The problem with hugs is that they bring a dangerous closeness that encourages airborne and droplet transmission of diseases. Not recommended for general use. To be reserved for the closest relatives and friends, as long as they are free of contagious disease.
On the surface, a handshake and a brief declaration of “welcome!” followed by “how are you” would be a more efficient substitute for our traditional greeting. However, it is a dirty substitute to which I have become increasingly averse over the years.
Too many people do not wash their hands when they should. My anecdotal observations suggest that more than half the men I have seen in shared public washrooms at airports and in shopping centres in the developed world walk out without washing their hands.
Many walk out of the toilet stalls after evacuating their bowels and stroll out the door without washing their hands. Then there are people, mostly in the developing world, who empty their bladders by the roadside or behind a tree and offer you their hand with smile. One pities the politicians who must shake such hands, dozens daily, in search of votes.
Sadly, the healthcare community is not free from this malady of filthiness. Multiple studies in hospital settings have shown low rates of hand hygiene adherence by healthcare workers.
Worldwide, the hand hygiene adherence rates among healthcare workers are between 40 per cent and 60 per cent. In other words, up to 60 per cent of healthcare workers do not practice proper hand washing.
Some country-specific figures for hand hygiene adherence among healthcare workers are: Canada, 78.3 per cent; Turkey, 63 per cent; China, 51.5 per cent; Vietnam, 47 per cent; India 36.4 per cent; and Brazil, 27 per cent.
A recent analysis of 27 studies on hand hygiene in sub-Saharan Africa, published in 2018 in the American Journal of Infection Control, found that the compliance rate among health care workers there was about 21.1 percent. Whereas doctors had higher compliance rates than other healthcare workers, this figure was not reassuring.
These studies, among them two from Uganda, identified the main barriers in sub-Saharan Africa to be the heavy workload for the staff, staff attitude and inadequate knowledge, time constraints, infrastructural deficit (lack of water, soap, hand sanitisers and blocked or leaking sinks) and poorly positioned facilities.
The problem, of course, is that hand hygiene habits are acquired very early in life, beginning during the toilet learning stage. Human behavioural studies suggest that our hand-hygiene habits are set by 9 to 10 years of age. To change this behaviour, even among health care professionals, is an uphill task that demands patience, repetitive teaching and reinforcement.
One thing I pray we abandon is the handshake. In addition to getting used to keeping at least one metre (three feet) between two people, we should adopt non-touch greeting options like (1) placing one’s hand on one’s heart; (2) bringing hands together to the face or chest, as though in prayer, accompanied by a slight bow (the Indian Namaste greeting); (3) a smile with hands slightly raised with the palms facing forward as though offering a blessing; or (4) thumbs up.
Whereas the hi-five and the fist bump have been shown to spread fewer germs than the handshake, they still do. I discourage them.
If I dislike handshakes, I hate the use of handkerchiefs to clean one’s nose. This ancient relic, reportedly invented or popularised by King Richard II of England more than 600 years ago, still enjoys residence in many people’s pockets or handbags.
Perfect gentlemen blow into them, then use them to scoop any remaining mucus from their noses, rub the stuff into the fabric and return the soiled hankies into their pockets, to await retrieval for use when the need arises again. Then they offer their contaminated hands to their companions!
Clean handkerchiefs are fine as pocket squares or puffs. Zambia’s Kenneth Kaunda found political use for a white hankie. They are also useful accessories in various dances.
However, they should be retired from humanity’s hygiene kits.
Better to use facial tissues (Kleenex), as long as they are also safely disposed of immediately after single use, followed by thorough handwashing. If you pee or sneeze, please do not offer me your germs.
If you must shake a hand, grab your other one and please yourself. The times are changing. Tradition must bow to science – and to basic social etiquette. That’s what education is about.