October 8, 2019

By: Torben Holm Larsen, Real Relief

Global Handwashing Day is all about promoting handwashing with soap – of course! However, it is easy to forget that for many people handwashing with soap is not easy to practice. This year’s theme ‘Clean Hands for All’ draws attention to these handwashing inequalities.

One such example is when a humanitarian crisis occurs. Populations are at higher risk of diarrhoeal disease and yet handwashing in such circumstances is harder to practice. In crises, both soap and water are scarce and valued commodities. If people are displaced, they frequently share handwashing facilities. Sharing can cause people to worry about soap being stolen or wasted, which often results in people keeping their soap inside the house, creating a barrier to good behaviour. The soap distributed to crisis-affected populations is often poor quality or not designed for handwashing. This means that populations tend to prioritize it for other tasks such as laundry and bathing rather than handwashing.

In 2016, the Humanitarian Innovation Fund (HIF) created a challenge called #Reimagine Soap. The purpose of this challenge was to address the scarcity of soap in emergency settings and address barriers to good behaviour and identify possible alternatives to soap.

Real Relief responded to the challenge by suggesting a textile cloth with an antimicrobial treatment that could be used for handwashing without soap and while only using a small quantity of water. We developed a prototype of this cloth and presented this to HIF at an innovation event in London in June 2016. Following this event, Real Relief went into a partnership with London School of Hygiene and Tropical Medicine (LSHTM) and developed a two phased, iterative project to test the idea. The first phase of the project was a laboratory study which aimed to investigate whether the product could actually remove bacteria from human hands as efficaciously as water and soap.

The original prototype failed this test! But we didn’t give up. The project team involved designers and design students from the Royal College of Art. During an innovation workshop we came up with a range of ideas to improve the products efficacy. The outcome of this workshop let to the development of the product that is today known as the Supertowel™.

We ran the same laboratory test again with this new version of the Supertowel™ and this time we passed the test with flying colours! Not only did the Supertowel™ display the desired proof of concept, it actually outperformed handwashing with water and soap by a factor 10 in terms of bacteria removal from hands.

Now that we knew it worked, we needed to find out whether people would actually want to clean their hands with the Supertowel™. Phase 2 of our work was a user acceptability study under real life conditions in an Eritrean refugee camp in Northern Ethiopia. The study involved distribution of 120 Supertowel™ to more than 20 households evenly distributed over the demographics of the camp. The conclusion of the study was that users willingly accepted the Supertowel™, they used it for multiple purposes, and it seemed to increase the frequency of handwashing.

The laboratory study and the field study are both published as peer reviewed articles that can be found here and here.

Real Relief and LSHTM has just received additional funding from USAID OFDA to continue the research. We are going to test how Supertowel™ performs if submitted to conditions mimicking real life settings. This means testing with less water, less time, contaminated water and using the towel when it is visibly dirty or oily. We are also going to be developing an interpersonal communication package that could help hygiene promotors explain the product to populations so that they trust it from the outset.

The Supertowel™ has been developed to overcome a real handwashing inequity which poses challenges for both the humanitarian sector and crisis affected populations. This Global Handwashing Day, the Supertowel-team is calling on humanitarian actors involved in WASH activities to contact us to discuss ways of safely distributing the Supertowel™ in crisis affected settings.

This plea does not just concern the Supertowel™, it addresses a much more general issue. The humanitarian sector is crying for innovation and new tools. When new tools are developed however, these tools are often met with reluctance and a reliance on “how things are normally done”. It is important that new tools are given the chance to prove themselves in real life settings, in order to create evidence and develop new best practices.

Photo Credit: Torben Holm Larsen, Real Relief

Category: Community Forum