Clean care is safe care, says the World Health Organisation and follows it with a campaign on washing hands towards cleaner living and working conditions across the globe. And Dr. Pawan did his part too. By creating a hand-washing device that costs less than 50 cents, roping in children to keep the initiative going, and relying on elders for the device to adapted and adopted into the community.

In 2008, Dr. Pawan was one of the seven students selected for a two-year fellowship programme at Nirman’s SEARCH (Society for Education, Action and Research in Community Health), in Gadchiroli district, Maharashtra, India. The programme encourages students to work in areas affecting rural communities like water management and NRGA schemes, and being a physician, Dr. Pawan chose to work in the health sector. Living in the community, he realised that there were several diseases persisting in the village, those that could be prevented by merely drinking clean water or paying more attention to cleanliness. He promptly did a study that revealed that of the 64 families living in the village, only six families used soap for washing hands.

The fact that diarrhea was the second largest contributor to infant mortality got him thinking. Here was a disease that could be easily diagnosed, prevented and treated; yet so many children were dying from it. An act as simple as washing hands could save so many lives! It was at this juncture, he heard about the Tippy Tap concept introduced in New Zealand. The idea simply involved a few sticks, a string and a soap to set up a low-cost hand-washing device.

For Dr. Pawan, the first challenge came in the design itself. When he first installed the device, goats would eat the soap or birds would mess it up, the thread was constantly rubbing against the soap and wasting it, kids were getting their pants soiled and so on. For six months, he solved the design issues one by one (he worked as a physician in the local hospital and took time in the evenings to work with this pet project). And then, Nirmal, the robust Indian washing device, was born.

The next bigger challenge lay in getting the villagers to actually use this device. He smiles, “If you tell them their clean-looking hands actually have germs in them and that the research on diarrhea shows that it could be prevented by hand-washing, they won’t bother. So instead of using the typical health communication model, I thought why not give them something they can relate to.”

He took up his Nirmal device and with the help of school children set it up in the primary school of Kudakwahi village. This ensured that the kids had a sense of ownership towards the device. In a way, he says the kids co-developed the device as they kept giving suggestions to improve its design. At a cost of 35 rupees, Pawan set up the community’s first hand washing device (with soap being the only recurrent cost). But this would not suffice. For sustained usage of the device, he knew that behavioral change was necessary

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