Hi Elisabeth,

sodium hydroxide is caustic soda or lye. Lye dissolves greases. White wood ash contains potassium carbonate, or potash, along with calcium hydroxide, but very little if any sodium hydroxide. By adding water to white wood ash, the calcium hydroxide and potassium carbonate react, forming caustic potash (ash lye, potassium hydroxide) and calcium carbonate (please somebody correct me if I'm wrong, I'm not a chemist!).

On this basis I have always assumed that handwashing with ash and water means handwashing with ash lye. I wash my hands with wood ash, which is particularly effective at removing greases and hard-to-remove dirt. Ash will remove just about anything from hands, and it certainly is not painful to use and it doesn't burn skin. Well, not mine anyway...

I'm asking whether it's appropriate for people from the developed world who like the smell and feel of soap to impose their paradigms on those with different practices...  Habits are also influenced by tradition and availability. If someone washes their hands effectively with wood ash and has always done so, because they are happy with that practice and use their own resources, is it right for someone to come along and say "you should use soap, it will feel nice on your skin and make you smell nice."?

cheers
Dean

Hi,

The statement in our post that says 'Be aware that handwashing with ash does not feel very nice and does not leave hands feeling and smelling nice in the way that soap does, as such promoting ash may actually discourage people from practicing handwashing' is based on research that I and others have done in several countries exploring soap products and ash. This includes work done in DRC, Ethiopia, and Nigeria - all settings where ash is commonly promoted by NGOs and quite widely used in some regions. This sentiment reflects the sentiment of populations who, across these countries, consistently rank ash as the least desirable option for handwashing. The fact that it continues to be used widely is much more a factor of poverty and inequality. In fact people often directly said that ash is perceived as something only poor people would use - a label that understandably they did not wanted to be associated with.

In general I am not familiar with organisations promoting the use of soap and discouraging the use of ash. In most cases handwashing with soap is promoted and organisations explain that if soap is scarce ash can be used instead. However at the moment I think this is an imperative to actively encourage people to use soap where possible because we know that it can effectively destroy and remove SARS-CoV-2 from hands. While it is plausible that ash may be able to do the same we have no evidence to suggest this at the current time.

I hope that helps

Sian White

Research Fellow
Environmental Health Group - Faculty of Infectious and Tropical Diseases London School of Hygiene and Tropical Medicine

Find out more about the Environmental Health Group at: ehg.lshtm.ac.uk Find out more about the Health in Humanitarian Crises Centre at: crises.lshtm.ac.uk

This has been an interesting thread to read.

Allow me to add that quite a good number of people in urban communities use soap either in its liquid or solid form, However, many communities in rural areas can not access or afford soap. The SAGE journal documents some research on handwashing practices in Bangladesh and elsewhere have actually shown that ash can be a low-cost alternative to soap. Bangladeshi fieldwork carried out in 2007 found that 13% of people in the sample used ash or soil (which brings about a whole other discussion) to wash their hands after defecating, compared to 19% who used soap. Organizations like UNICEF have recommended that people without soap wash their hands with ash. The Cochrane Library early this year in April did a study to know whether people who use ash for hand cleaning were more or unlikely to catch infections than people who use soap. The study investigated children who had been to the hospital with diarrhoea compared with children who had not. The study focused on handwashing in children. Most families that used ash for hand cleaning made a similar number of hospital visits for children with diarrhoea as those families that used soap. 

Traditionally within the African setting, soil, ash, and salt have been used as both mechanical and chemical forms of neutralizing contaminants on dirty hands and surfaces.   The premise of the effectiveness of such materials assumes that households will obtain the soil, ash, and salt from uncontaminated sources.  The availability of these alternative methods may be limited to people living in informal urban settlements areas but not in rural areas.

Regards,
Chaiwe

I am glad to see this topic come up. I conducted the research in a paper cited earlier in this thread where we examined whether the likelihood of diarrhea was different for households relying on soap versus ash:

Title: Association between Moderate-to-Severe Diarrhea in Young Children in the Global Enteric Multicenter Study (GEMS) and Types of
Handwashing Materials Used by Caretakers in Mirzapur, Bangladesh. 
Authors: Baker, K.K., Dil Farzana, F., Ferdous, F., Ahmed, S., Kumar Das, S., Faruque, A.S.G., Nasrin, D., Kotloff, K.L., Nataro, J.P., Kolappaswamy, K., Levine, M.M.,
Year: 2014.
Am. J. Trop. Med. Hyg. 91, 181–189.  https://doi.org/10.4269/ajtmh.13-0509

One piece of data that gets overlooked in that paper is that the epi data was followed up with environmental microbiology bench experiments where i prepared an ash and water suspension as described by Bangladeshi women and then spiked it with different types of bacterial pathogens, like Shigella, Vibrio cholera, and ETEC. I was able to isolate a handful of pathogenic bacteria in high dose bacteria concentrations out to 15 or 20 seconds, but nothing (including high pH loving vibrios!) survived for longer time points. As proposed earlier, the pH 9-10 of such a solution is so caustic that bacteria generally cannot survive. It destroys the lipid structure in the cell wall.

Given what we know about the survival of many viruses in the environment, it is reasonable to hypothesize that yes ash is fairly effective at destroying viruses or the molecular binding structures on their surfaces as well. Maybe I can motivate a student to repeat some of those experiments with the viruses we have in house...

That does not make it pleasant or ideal to wash with, or mitigate the chemical exposure issues, so I endorse the strategies that recommend it in situations where washing might not happen at all, or with water only.

Post-comment edit
To my knowledge the majority of ash users are rural, as noted by a previous author, and the sources are wood, brush, and cow dung. Exposure to man-made chemicals, lead, etc from such burn sources seems very unlikely.

washing with ash removes dirt, oil, and grease which removes almost 90% of bacteria. moreover, it would be useful if you are not dealing in an area full of harmful bacteria and viruses as it doesn't pollute water as much as soap does. 

You can use ash to wash hands whenever you don't have soap - Sylvia Masebo (Zambia's Minister of Health on the Main News on 15th February 2023.

Zambia, like all countries, is promoting accessing to basic hygiene service ie availability of a handwashing facility on premises with soap and water. This is also buttressed in the country's National ODF 2030 Strategy. 

However,  World Health Organization  like the minister, did provide seemingly contradictory guidance in 2020 at the advent of  #covid19pandemic  - that ash should be considered as an alternative to soap in low low income settings since it raises the pH which inactivate pathogens. Article here  https://lnkd.in/dyrZDTes . Compounding to this, ash isn't only known to be used for handwashing in poor settings but also dishwashing, teeth brushing and cooking (to reduce cooking time in beans and okra). This is an immemorial custom common in most African settings.

1. Arising from this seemingly contradictions, doesn't it then mean that there's a lot and urgent need to harmonize the guidance given to end users?
2. If ash can be used in dishwashing, teeth brushing, cooking etc, are there conclusive researches not only is ash's efficacy in handwashing but also in all those other areas?

Thanks

Dear SuSanA Member 
Mr Chaingaa: 
It's true we can use wood Ash for hand-wash and many other cleaning, cooking eating utensils.
Even cow-dung cakes when used as cooking fuel, generate Ash, this too can be used.
This has been a standard practice,  in many rural homes.
In order the utensil are not scratched while washing, can use a fine sieve, and the coarse material mixed with cow-dung is used for coating floors in front of hut- homes
Well wishes 

Prof Ajit Seshadri
Vels University Chennai India and
Head Environment,  www.vigyanvijay.org  

Hi,

It is worth remembering that all soap used to be made with wood ash, which has always been the source of lye. The main difference is that soap includes animal fat.

Many of the relevant papers talk about washing with "soil", but I think the key substance here is pure clay, which is dug out of the subsoil and is free from biological or chemical contamination. I am certain that there are scientific papers on this, but I did not have time to find them just now.

I like to mix ash and clay, roughly half and half (plus the amount of water necessary to make a paste), which is very pleasant for hand-washing.

One other substance to keep in mind is the same person's urine, with the key ingredient being urea.
link.springer.com/article/10.1007/s13555-021-00611-y
The person can urinate into a receptacle, introduce their hands into the liquid, and rub the hands together for an adequate amount of time. Then they can rinse with water. 

Some good relevant links that I found:
www.engineeringforchange.org/news/places...ve-prevent-covid-19/
www.ircwash.org/sites/default/files/ash_...for_hand_washing.pdf

We also need to be aware that companies that make soap spend large amounts of resources to lobby for its use, so we also need to sort out the science from the lobbying.

Best wishes,
Chris Canaday