Wednesday, March 19, 2014

Strategies to Keeping Clean and Avoiding Illness During Protracted Emergencies

These are compressible plastic peri bottles which can be helpful in a variety of hygiene situations for general or special needs.

        Most of us know how to maintain personal hygiene normally, although standards of cleanliness do differ in the world.  The American habit of the daily shower is considered a bit obsessive in many parts of the world.   There are other hygiene taboos in many parts of the world of which Americans might not be aware.  One of them is that in Russia, placing a lady's purse on a dining table at a restaurant is considered to be quite a violation of hygiene, as such a bag has likely been to a ladies room and near a toilet. Failing to remove ones shoes while entering homes in Russia is also considered poor breeding, if not certainly poor hygiene.  (Think about it. People spit in the street, and if you enter their home with the shoes you wore in the street, the highly durable acid fast bacillus which causes tuberculosis, might then inhabit their carpets)

                Sometimes, during natural or man-made emergencies, we don't have unimpeded access to enough water in which to shower. Sometimes, it's simply too cold to remove our clothing and bathe, and we might not only not be able to take a daily shower, but we might have trouble receiving a weekly one !
                 In such emergencies there are some strategies that may help you keep clean, maintain some level of personal hygiene and therefore help to avoid disease.

Strategies to Disaster Personal Cleanliness:

               Suppose you found yourself in a post disaster area in hot weather.  Excesses of perspiration might make you wish to shower more often, but clean water availability might make this less possible.  In such circumstances, you may be able to locate a clean basin of some type. You can place plain water in it.  You can add a little liquid soap or use a small bar of soap.  Use paper towels or a clean cloth like a washcloth.  Daily, you should wash your face without soap.  Then, using soap wash your chest, under your arms, your feet, your legs, any skin folds, and very last, your genital region.  Then rinse out the basin, place to bar soap to dry, and soak your washcloth in either your laundry soap to wash it, and dry for a time in a couple of days, or place a capful of bleach in the washcloth soak water.  Then rinse it with plain water, and hang it to dry for use either tomorrow or the next day.  It works best to have two washcloths to alternate.   Later in the day you can wash face and hands a couple more times with either a paper towel or cloth at bedtime.  Your back can be washed at the weekly bath. Dry carefully anywhere that there are skin folds. Certainly, if you have it, using deodorant daily is more comfortable and more pleasant.
             Certainly you can wash obviously soiled areas at other times of the day as needed.

These are hospital style wash basins.  These are available inexpensively from the Claflin Medical Supply Co. at

              Women, those with diarrhea, women who are menstruating, babies, incontinent family members,
those with diarrhea, and anyone with a special medical need, especially diabetics, should use a perianal cleaning bottle filled with water to gently rinse their perianal region.  Plain water will work.  Very soiled areas can be squirted with a tiny amount of mild liquid soap and water,  and then rinsed just after with plain water.   Rinsing using the peri bottle is very important, particularly for the aforementioned groups because it helps to decrease skin bacteria that can lead to boils, particularly among diabetics.  Rinsing the peri region is essential because it can help to prevent everything from urinary tract infections to yeast infections.  Women who have given birth recently must use a peri bottle for at least daily cleansing in order to avoid potential internal infections. In general, a woman who still has post partum discharge is recommended to use a peri bottle with plain water in it as a rinse to the perianal region each time she uses the toilet.  She can pat dry with toilet paper afterward.  This is probably a good plan also for menstruating women in emergencies when they can't shower daily.

You can add commercial products such as these, or even ordinary lotion to your washbasin and do an excellent job keeping clean.

               Another strategy that will help women in particular, keep cleaner when they might not be able to change underwear as often as normal, is to use sanitary napkins or panty liners in their underwear, even when not menstruating.  It is important that these be the normal variety and NOT the deodorant variety which can cause some allergic reactions and irritation.  Also in emergencies, the pads can be changed a couple of times daily if needed, and the underwear can be rinsed every couple of days unless obviously soiled.


This is one brand of liquid castille soap.   It does a lovely job in hair.

           Those of us who wash our hair daily aren't thrilled at the prospect of having the water out, or the hot water out.  However, if this is the case, most people can wash their hair weekly without developing infections or boils from not doing so.    A bottle of plain castille soap  (used for simple washing or as enema soap) makes a fabulous shampoo.   Wet hair, lather, and then wait five or ten minutes for the lather to dissipate, and then the hair can be rinsed with much less water than you would normally.  The hair can be rinsed using a jug or a peri bottle refilled three times.   My daughter and I both have very long hair and we washed one another's hair during a two week power outage during Hurricane Isabelle.  Most of the time, you can place the persons head over a sink or tub.  If this is not possible, a child's swimming pool catches the water well.  In hot weather, washing hair outside is a good idea.

             Sometimes the water is available, but it isn't hot, or your home or where you are staying is not warm enough to safely disrobe completely without potential for chill or for actual hypothermia. (Think of those polar bear clubs and their annual frosty dips.)   Many of us, especially the young, can handle cold water upon us without dire consequences.  However, this is not true of babies, the elderly, or those who take cardiac or blood pressure medications.   A rapid chilling for many of these groups can result in some degree of shock, activation of the dive reflex, or a drop in blood pressure or pulse which could result in a loss of consciousness.

            For those people, you should heat some water on the stove and add it to cold water. I do not recommend microwaved water for bathing especially in peri bottles because I have seen a number of people burned by the practice as it is not always possible to determine exactly how hot all the water is, because microwave ovens do not always heat uniformly throughout the food or the fluid.  (I also don't recommend microwaving dialysis solution for peritoneal dialysis.)

Special Cleanliness Needs:


Incontinent Family Members

Menstruating Women or Those who have recently given birth

Those with ostomies or urostomies

Those using insulin pumps need to keep their abdominal areas clean.

So long as you don't plan contact with an open flame or you are not smoking, a gauze pad saturated with alcohol can also do a good job for spot skin cleaning when water is not available.  I have used a gentle alcohol wipe on backs and abdomens of those who can't shower, on occasion.  Be careful near mucus membranes, eyes, or abrasions.

Zodi Extreme Shower:    is another way people can obtain hot water for showers in extreme conditions.
This is a prior post here discussing this:

You can obtain perianal bottles at the following locations:
I stock a number of them which I occasionally use for clean water rinses of animals or other purposes.
Every family should have some.

 The least expensive quality source for perineal irrigation bottles.

 To purchase hospital styled wash basins, one for each family member for about a dollar each plus postage:
 You may wish to have extras for foot soaking.

Claflin Medical Inexpensive Wash Basins 

A source for inexpensive liquid castille soap

A source for unscented liquid castille soap

I will discuss oral hygiene in emergencies and doing laundry with restricted water and without electricity in  upcoming posts.