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The only study I have come across on the literature was in a paper by Sandy Cairncross, which suggested that abrasion & friction were the mechanisms responsible for killing bacteria during hand washing. This would partially explain why there is little evidence for anti-bacterial soap or gels being superior to ordinary soaps in preventing diseases

Credible quantitative evidence for the benefits of using ash or sand, is likely to be difficult to obtain, as there is limited scope for providing a placebo for soap or Ash in a control group situation. I guess from a WASH perspective, promotion of the act of handwashing has the potential to build positive hygiene behaviours, the practice of which reinforces hygiene education messages and awareness of "F" diagram transmission paths within communities. Consequently rubbing hands with ash or sand as an alternative to soap at key times can be viewed as a positive hygiene behaviour, when the later is unavailable. According to the Cairncross paper it will have some beneficial impact. In most humanitarian contexts soap should be provided as a standard item in distributions (explicitly mentioned in the relevant sphere indicators and guidelines I seem to recall). With this in mind promotion of hand washing with materials other than soap should be seen as a stop gap measure while supply chains are established. I believe Ash has been used as toothpaste and for other hygiene uses, so it's promotion is better than nothing at least.

The risk from heavy metal contamination is likely to be low relative to consumption via foods, and the alkalinity of ash would tend to mitigate risks from contamination. In the context of setting post 2015 development Goals, surely access to soap and secure running water at the household level should be a minimum from the perspective of equity. I recognise that this is a question on belief's in response to your question on science, but the " soap or ash" element of your suggested wording strikes me as a serious lack of ambition in the post 2015 vision, surely we should be aiming for a world where everyone can maintain health and dignity?

Regards

Cody

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The only study I have come across on the literature was in a paper by Sandy Cairncross, which suggested that abrasion & friction were the mechanisms responsible for killing bacteria during hand washing. This would partially explain why there is little evidence for anti-bacterial soap or gels being superior to ordinary soaps in preventing diseases

Credible quantitative evidence for the benefits of using ash or sand, is likely to be difficult to obtain, as there is limited scope for providing a placebo for soap or Ash in a control group situation. I guess from a WASH perspective, promotion of the act of handwashing has the potential to build positive hygiene behaviours, the practice of which reinforces hygiene education messages and awareness of "F" diagram transmission paths within communities. Consequently rubbing hands with ash or sand as an alternative to soap at key times can be viewed as a positive hygiene behaviour, when the later is unavailable. According to the Cairncross paper it will have some beneficial impact. In most humanitarian contexts soap should be provided as a standard item in distributions (explicitly mentioned in the relevant sphere indicators and guidelines I seem to recall). With this in mind promotion of hand washing with materials other than soap should be seen as a stop gap measure while supply chains are established. I believe Ash has been used as toothpaste and for other hygiene uses, so it's promotion is better than nothing at least.

The risk from heavy metal contamination is likely to be low relative to consumption via foods, and the alkalinity of ash would tend to mitigate risks from contamination. In the context of setting post 2015 development Goals, surely access to soap and secure running water at the household level should be a minimum from the perspective of equity. I recognise that this is a question on belief's in response to your question on science, but the " soap or ash" element of your suggested wording strikes me as a serious lack of ambition in the post 2015 vision, surely we should be aiming for a world where everyone can maintain health and dignity?

Regards

Cody