Hesperian Health Guides
Clean your hands and wear protective clothing
HealthWiki > A Book for Midwives > Chapter 5: Preventing Infection > Clean your hands and wear protective clothing
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Wash your hands often
Washing your hands is one of the most important things you can do to prevent infection. It prevents you from spreading germs to another person, and it helps protect you from germs, too. If you can do nothing else to prevent infection, you must wash your hands.
Wash your hands with soap and clean water. If you do not have soap, you can use ash (but not dirt!). Be sure to rinse all the soap or ash off. When you wash your hands, and especially when you rinse them, use clean water that is flowing, not water sitting in a bowl. When you wash your hands in a bowl, the germs that come off into the water will get back onto your hands again.
Each time you care for a woman, wash your hands before you touch her body, after you touch her body, and after you touch anything that has her blood or fluid on it (like the placenta). Wash before you put on gloves and after you take gloves off. If you are helping more than one woman at once, like at a hospital, it is very important to wash between helping each person.
Normal hand washing removes most germs. But sometimes to remove more germs, you should wash your hands for a full 3 minutes, and scrub under your fingernails.
How to do a 3-minute hand wash
| Before you start, take off rings, bracelets, and other jewelry. | ||
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| Wash your hands and arms with soap and clean water — all the way up to your elbows. | Make sure to scrub in between your fingers. | If you have a clean brush, scrub your fingernails. |
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| Keep scrubbing, brushing, and washing your hands and arms for 3 minutes! Spend most of this time on your hands. | Rinse with clean, running water. | Dry your hands in the air instead of using a towel. Do not touch anything until your hands are dry. |
Always do a 3-minute hand wash
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Alcohol and glycerine hand cleaner
You can make a simple hand cleaner to use if you do not have water to wash your hands. When used correctly, this cleaner will kill most of the germs on your hands.
Mix 2 milliliters glycerine with 100 milliliters of ethyl or isopropyl alcohol 60% to 90%.
To clean your hands, rub about 5 milliliters (1 teaspoon) of the hand cleaner into your skin. Be sure to clean between your fingers and under your nails. Keep rubbing until your hands are dry. Do not rinse your hands or wipe them with a cloth.
Wear gloves
If you are doing invasive procedures, or if you are touching any tools that have been sterilized, you must wear sterile gloves.
How to put on sterile gloves
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| Open the package without touching the gloves. Do not touch the outside of a sterile glove with your hand or it will not be sterile anymore. | Carefully wash your hands. Let them dry in the air. | The gloves should be folded out at the cuff. Pick up one glove under the cuff on the inside of the glove and slip your hand into it. Do not touch the outside of the glove. |
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| Wiggle your hand in while you pull with your finger tucked inside the glove. | Pick up the second glove by slipping your gloved fingers into the fold of the cuff. Slide your hand into the glove. | Once the gloves are on, do not touch anything that is not sterile — or the gloves will not be sterile anymore either! |
| Practice with the same pair of gloves over and over again until it feels easy. | ||
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| If you carefully wash your hands . . . | and put on sterile gloves . . . | and then scratch your head . . . | your glove is not sterile anymore |
Of course, when you touch a woman you will get germs on your gloves, but do not move germs from one part of her body to another. For example, if you touch a woman’s anus where there are many germs, do not put your fingers inside the vagina with the same gloves. Germs from the anus can make a woman sick if they get into the vagina or womb.
After you use a pair of gloves one time, throw them away, or sterilize them before you use them again.
Protect yourself from infection
Midwives must protect themselves from germs and infection. You will not be able to help women if you are sick. And if you are infected with dangerous germs, you can easily spread them to the women you are trying to help.
Some germs that cause serious illnesses, like AIDS and hepatitis B, only live in blood, urine, stool, the bag of waters, and other body fluids. That means you do not get these illnesses just by touching someone’s skin. But the germs that cause AIDS and hepatitis B can infect you if an infected person’s blood gets into a cut or opening in your skin — even a cut so small that you cannot see it (see all the ways HIV can spread). Keep blood and other body fluids off your clothing and skin, and if they do get onto you, wash them off right away with soap and water.
Wear protective clothing
You do not need expensive equipment to keep body fluids off your skin, out of cuts, and out of your mouth and eyes. You can wear an apron or an extra shirt to keep fluid off your body. Protect your eyes with eyeglasses or plastic goggles. Cover your feet so that you do not step into blood or other fluids.
Wash all your clothing after any blood, waters, or other body fluids gets on it. If you get body fluids in your eyes or mouth, rinse them for several minutes with clean water or saline (water with a little salt added).
Be careful with needles
If a syringe is used to give an injection, or a needle was used for sewing a vaginal tear, the needle has blood on it. If you accidentally stick yourself with that used needle, you will be exposed to germs. Carry needles carefully with the point away from your body. Do not leave needles lying around.
Use each needle only once and then throw it away in a disposal box. You may be able to get needles that can only be used once and do not need a cap. If you must reuse a needle, put the cap on very carefully and then put the needle in a bucket filled with bleach solution until you are ready to clean and sterilize it.
How to avoid puncturing your skin with a needle
| Do not use your hand to put the cap on the needle. | Instead, use the needle to pick up the cap. | Then close the cap all the way. |  |
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