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 Dr. Nisha Thampi and colleagues adapted the tune of the song Brother
John, also known as Frere Jacques, replacing its lyrics with a
six-step handwash practice prescribed by World Health Organization.
"As a mother of two school-going children, I think a lot about germs
at work and home," said Thampi, medical director of the Infection
Prevention and Control Program at Children’s Hospital of Eastern
Ontario, in Ottawa.
"People may be surprised there's an issue with how we wash our
hands," Thampi said in an email. "While there have been public
health campaigns about when to wash our hands, that is, the right
moments, there has been relatively little focus on how to wash our
hands, the right technique, particularly among children."
Because there didn't seem to be an existing musical video targeted
at children showing the six-step technique using the recommended
handwash duration of 20 to 30 seconds, Thampi and colleagues decided
to develop their own musical mnemonic. They wrote the lyrics with
the help of schoolchildren.
"To get my own children to wash their hands with the proper
technique, I played with each step until it fell into a song pattern
that flowed nicely to the tune of Brother John," Thampi said.
The Brother John lyrics:
"Are you sleeping, are you sleeping,
Brother John, Brother John,
Morning bells are ringing, morning bells are ringing,
Ding, ding, dong; ding, ding, dong"
. . . were replaced with:
"Scrub your palms, between the fingers
Wash the back (one hand), wash the back (other hand)
Twirl the tips (one hand) around (other hand)
Scrub them upside down
Thumb attack (one thumb)! Thumb attack (other thumb)!"
Thampi then used her 8-year-old daughter as a test case.
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"She heard the first version of the song and helped revise it to
have better flow. She demonstrated it to her friends and
classmates," Thampi said.
To test whether the routine would be effective in removing germs,
the researchers applied fluorescent markings on the hands of the
children, who were between 6 and 9 years old, before they washed
with soap and water while singing the song. After the routine, there
was a significant reduction in the markings, according to a report
in The BMJ.
"This song is a fun way to teach children how to wash their hands
and has the potential to decrease the burden of germs on hands, a
very common way of catching an infection," Thampi told Reuters
Health.
She said her daughter also taught the song and technique to Thampi's
4-year-old son.
To be effective, the technique should ideally be implemented early
in life, used regularly and embedded into the national curriculum in
schools, said Nicky Milner, director of medical education at the
School of Medicine, Anglia Ruskin University, in Chelmsford, UK.
Involving schoolchildren in the design of actions and choice of song
was also key to the technique's effectiveness, she added.
"We know children enjoy learning through the use of songs that are
easily remembered and accompanied by simple actions," Milner said in
an email.
There is potential for the technique to be used internationally, if
the song choice reflects local songs in different countries, she
noted.
"This approach may help reduce the global burden of infections that
are spread by poor hand hygiene," she said.
Thampi's team hopes to validate their findings in larger school
settings and demonstrate that the song is effective in reducing
respiratory and gastrointestinal illnesses, and school absenteeism.
"We are also in the process of translating the mnemonic into other
languages so the song and video can be easily adopted across the
globe," she said.
SOURCE: https://bit.ly/354AcZi The BMJ, online December 16, 2019.
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