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An easily preventable health problem, or not?

How something as simple as washing hands time and time again reduces proven risks but still isn't always enforced.

In 1846, Ignaz Semmelweis started a new job in the maternity ward of the Algemeines Krankenhaus in Vienna, Austria. There were two wards, and Semmelweis soon discovered a dramatic difference between him and the other ward. In his ward, the average death rate was one in ten young mothers who died from pregnancy fever. For a few months, this was even 30%! In the other department, the mortality is much lower, on average 4%.

He opts for a systematic approach. He tries out various possible resolutions and closely follows the results. In 1847 he started to experiment with washing hands. He suspects that students who autopsy in the morgue and then help in his maternity ward are putting toxic particles on their hands. The students only work in his department and not in the other. Semmelweis requires all employees to wash their hands in a chlorine solution before entering the department. The results were astonishing.

Within a few weeks, mortality will drop from - at that time - 18% to less than 2%. Within a few months, the figure will fall below 0.2%!

Despite evidence that the numbers were correct and that he sought publicity for his findings, most doctors do not adopt handwashing. Worse still, the idea that doctors and nurses themselves spread disease throughout the hospital was ridiculed by many colleagues.


It took more than 15 years for the French chemist and biologist Louis Pasteur to discover that many diseases are caused by microorganisms that are not visible to the naked eye. Step by step, doctors are accepting that it is a good idea to wash hands before and after contact with patients, and they establish guidelines.

We are now 170 years later. Every doctor and nurse know when to wash their hands, but do they? Or, to be more precise: are employees in an average hospital able to observe the hygiene rules themselves based on the medical status?

You guessed it: NO!

Research from 2012 showed that average compliance to the standard for handwashing is 20% (note: a more recent study in Sweden also found <20%). Every year there are more victims due to poor hand hygiene compared to road accidents in the Netherlands. Isn't that something crazy, because - apparently - it's easy to prevent?

This story is from the book "The Ladder" by Ben Tiggelaar, and he shows how difficult it is to change habits, but he also offers useful solutions for changing (bad) habits.


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