Poonam Sandhu & Jennifer Goodnight Win Award for Handwashing Ladder

In an award-winning presentation at the George Mason University's Graduate Student Research Conference, EOH MPH students Jennifer Goodnight and Poonam Sandhu got audience members involved in a hands-on activity. For their "Social Handwashing Ladder: A Practitioner's Tool for Initiating a Handwashing Intervention" session, Goodnight and Sandhu divided the audience into three groups with high, medium, and low resources and asked them to choose which handwashing guidelines they would use. For groups with fewer resources -- less water to go around and limited or nonexistent soap and paper towels -- it quickly became apparent that following handwashing guidelines from the World Health Organization (WHO) or Centers for Disease Control and Prevention (CDC) wouldn't be feasible. So, Goodnight and Sandhu demonstrated a "Handwashing Ladder" they created to help communities figure out the best handwashing methods based on their resources.

Using soap, plentiful running water, and paper towels to wash and dry hands may be the best practices for preventing the spread of disease, but they aren't always feasible. "I decided to work on this problem because I showed some of my friends the current handwashing recommendations and asked if they thought I could implement them in Haiti, or Tanzania, or East Timor – and all of them said no," explains Goodnight. "How can you use a sink to wash your hands if you don't even have running water? How can you buy soap if you don't even have enough money to feed your family?"

Goodnight and Sandhu reviewed the literature and found that practices short of the ideal – using mud or ash instead of soap, using less-clean water or rinsing for less time, and using air rather than paper towels to dry hands – could still reduce disease transmission compared to foregoing handwashing altogether. Then, they created a 

Chart describing the hand washing ladder

"Handwashing Ladder" to allow communities to figure out the most effective handwashing practices they could use based on the resources they have available.

The students tested out their presentation on classmates in Dr. Carol Henry's Environmental Policy, Politics, and Programs class (shown in the photo) before delivering it at the research conference. "Actually getting current and future policymakers to go through the exercise of trying to implement handwashing recommendations can make more of an impression," Sandhu says. She thinks the interactive nature of their presentation helped them win a place as one of the Top Three presentations at the conference.

For Goodnight and Sandhu, the conference presentation was a first step toward spreading their handwashing intervention to a global audience. "Now we can get communities thinking about increasing handwashing within the context of the resources available to them," says Sandhu. "That's one step closer to getting the world to wash their hands more efficiently."