Hesperian Health Guides

Preventing Infection

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HealthWiki > Where Women Have No Doctor > Health Care Skills > Preventing Infection

Infections cause many kinds of sickness. People who are already sick or hurt are often more at risk for getting an infection, and getting one can make them much sicker. So it is important to do everything you can to keep infections from developing. It is also important to protect yourself from getting an infection from those you care for.

Infections are caused by germs, such as bacteria and viruses, that are too small to see. Every person carries bacteria on her skin, and in her mouth, intestines, and genitals all the time. These germs do not usually cause problems, but they can cause infections if passed to sick people. Germs also live on the equipment and tools used when caring for a sick person and can easily be passed to others you help.
a woman looking at a syringe and other tools near a steaming bucket of water

You can prevent infection by following the guidelines in this chapter. For other ways to prevent infection, see the chapter on "Staying Healthy".

IMPORTANT! You must follow these guidelines every time you help someone, whether you use your hands, tools, or special equipment. If you do not, you may get a dangerous infection, or pass an infection to the people you are helping.

Washing your hands

a woman shaking water from her hands
Let your hands dry in the air instead of using a towel. Do not touch anything until your hands are dry.
Wash your hands before and after caring for another person. It is the most important way to kill germs living on your skin. You need to wash your hands even more thoroughly and for a longer time:
  • before and after helping someone give birth.
  • before and after touching a wound or broken skin.
  • before and after giving an injection, or cutting or piercing a body part.
  • after touching blood, urine, stool, mucus, or fluid from the vagina.
a bucket with a water tap on the side
Use water
that flows.
  • after removing gloves.

Use soap to remove dirt and germs. Count to 30 as you scrub your hands all over with the soapy lather. Use a brush or soft stick to clean under your nails. Then rinse. Use water that flows. Do not reuse water if your hands must be very clean.

Try making a Tippy Tap. It will save water and will make it easy to keep a supply of clean water for washing hands.
Use a large, clean plastic bottle with a handle.
1. Pinch the handle together here with a pair of hot pliers or a hot knife. an arrow pointing to the bottom of the handle where it joins the bottle 2. Make a small hole in the handle, just above where you sealed it. WWHND ChSk Page 526-4.png 3. To hang the tippy tap, make 2 more holes in the other side of the bottle and pass a string through them. Now you can hang it on a peg or tree branch.
4. Fill the bottle with clean water and replace the lid. 5. When you tip the bottle forward, the water will flow out, so you can wash your hands. Do not make the hole too large or it will waste water.
WWHND ChSk Page 526-5.png
You can also hang a bar of soap from the string.

How to disinfect equipment and tools

a razor blade, a syringe, and two knives

Cleaning tools and equipment to get rid of nearly all the germs is called high-level disinfection.

Tools must first be washed and then disinfected if they are used to:

  • cut, pierce, or tattoo skin.
  • give an injection.
  • cut the cord during childbirth.
  • examine the vagina, especially during or after childbirth, a miscarriage, or an abortion.
  • when giving fluids in the rectum.

High-level disinfection: 3 steps

a razor blade and a syringe in a jar filled with liquid

Steps 1 and 2 should be done right after using your tools. Try not to let blood and mucus dry on them. Step 3 should be done right before you use the tools again. All the steps can be done together if you can store your tools so they will stay disinfected.

  1. Soaking: Soak your tools for 10 minutes. If possible, use a 0.5% solution of bleach (chlorine). Soaking your tools in bleach solution first will help protect you from infection when cleaning the tools. If you do not have bleach, soak your tools in water.

How to make a disinfecting solution of 0.5% bleach:

If your bleach says: Use:
2% available chlorine........................................1 part bleach to 3 parts water
5% available chlorine........................................1 part bleach to 9 parts water
10% available chlorine......................................1 part bleach to 19 parts water
15% available chlorine......................................1 part bleach to 29 parts water
For example:
If your bleach says 5% available chlorine, use this much bleach: 1 cup and this much water: 9 cups
Mix just enough solution for one day. Do not use it again the next day. It will not be strong enough to kill germs anymore.

gloved hands washing tools in a basin
  1. Washing: Wash all tools with soapy water and a brush until each one looks very clean, and rinse them with clean water. Be careful not to cut yourself on sharp edges or points. If possible, use heavy gloves, or any gloves you may have.
  2. Disinfecting: Steam or boil the tools for 20 minutes (as long as it takes to cook rice).
    a pair of gloves in a steamer

    To steam them, you need a pot with a lid. The water does not need to cover the tools, but use enough water to keep steam coming out the sides of the lid for 20 minutes.

    scissors and a syringe in a pot of boiling water

    To boil them, you do not need to fill the whole pot with water. But you should make sure water covers everything in the pot the entire time. If possible, put a lid on the pot.

    For both steaming and boiling, start to count the 20 minutes after the water is fully boiling. Do not add anything new to the pot once you begin to count.

WWHND ChSk Page 527-6.png
IMPORTANT! Never use a tool on more than one person without washing and disinfecting all the parts between each use.

Disinfecting needles and syringes, gloves, and bandages

illustration of the below: a hand pushing in the plunger of a syringe

Needles and syringes. If a needle and syringe can be used more than once (reusable), squirt bleach or soapy water through the syringe 3 times right after using it. Then take everything apart and follow Step 2 and then Step 3. Carefully store the syringe until the next use. Be sure not to touch the needle or the plunger.

If you are not able to store things in a clean and dry place, boil or steam them again before use.

If a needle and syringe can be used one time only (disposable), carefully put them in a covered container that cannot be pierced by the needle, and bury the container deeply. If you cannot dispose of the needle safely, squirt bleach solution through it 3 times.


WWHND ChSk Page 529-1.png
If you do not have gloves, you can use clean plastic bags to cover your hands.

Gloves protect both you and the people you help against the spread of infection. If you do not have gloves, use clean plastic bags to cover your hands.

Sometimes it is OK to use gloves that are clean but not disinfected—as long as you are not reusing them. But you should always use high-level disinfected gloves when:

  • putting your hand inside the vagina during an emergency exam before or after childbirth or abortion.
  • touching broken skin.

If you use gloves more than one time, they should be cleaned, disinfected, and stored following the instructions. Always check washed gloves for holes, and throw away any that are torn.

If possible, it is best to steam gloves rather than boil them because they can stay in the pot they were steamed in until they are dry. If you are unable to steam gloves and must boil them, try to dry them in the sun. You will probably have to touch them to do this, so they will no longer be disinfected, but they will be clean. Keep them in a clean, dry place.

Cloth dressings

If you do not have sterile gauze, use cloth dressings. Follow the instructions for disinfection and storage. Dry the dressings in the sun, but be sure to keep them off the ground, and to protect them from dust, flies, and other insects.

This page was updated:17 Apr 2019