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Women were dying from childbirth at hospitals. This 19th-century doctor figured out why.

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March of Dimes

Today, we know that washing our hands is one of the most important steps we can take to avoid getting sick and spreading germs.

But how we came to know that is pretty fascinating.

Image via iStock.


Handwashing is actually a relatively new practice ā€” even for doctors.

In fact, one of the first doctors to realize how important handwashing could be ā€” Ignaz Semmelweis ā€” didnā€™t discover this fact until 1847. And even after he did realize it, the battle to convince the rest of the medical community wasnā€™t easy.

The 19th century has been described by some historians as ā€œa golden age of the physician and scientistā€ because for the first time, doctors were expected to have scientific training.

They were also expected to use symptom-based diagnoses to solve medical ailments. And to do this, of course, medicine relied on understanding what was happening inside the human body to get at the root of disease.

So, autopsies became all the rage.

Not only did they form a critical part of a doctorā€™s training, but the doctors who regularly performed them were the most respected in the medical community. An unfortunate byproduct of this, though, was the erroneous belief that the dirtier the doctor, the better the doctor.

In fact, there are accounts of doctors going directly from their last autopsy to deliver a baby or treat a patient without changing their clothes.

Enter Hungarian doctor Ignaz Semmelweis.

A portrait of Ignaz Phillip Semmelweis. Image via JeƱo Doby/Wikimedia Commons.

In 1846, Semmelweis had just started his new job at the maternity clinic at Vienna General Hospital.

At that time, women were dying at staggering rates in hospitals shortly after giving birth from ā€œchildbed fever,ā€ a disease also called puerperal fever. It was a cruel infection, causing raging fevers, painful abscesses, an infection in the uterus and birth canal, sepsis, and then finally, death ā€” all within about three days of the babyā€™s delivery. And it was the single most common cause of maternal death at the time.

Being a man of science, Semmelweis wanted to understand why so many women were dying in his clinic. So he studied two maternity wards in the hospital ā€” one staffed by doctors and medical students, the other by midwives ā€” and recorded the number of deaths in each ward.

Vienna General Hospital, where Semmelweis worked. Image via Josef & Peter Schafer/Wikimedia Commons.

His results showed that women died at a rate nearly five times higher in the ward staffed by doctors and medical students.

But it wasnā€™t until one of his colleagues, a pathologist, got sick and died after pricking his finger in an autopsy of someone who had died from childbed fever that Semmelweis realized that anyone, not just mothers, could get sick from puerperal fever, and the reason the midwives' ward had fewer deaths was because they didn't do autopsies.

He theorized that there must be some ā€œcadaverous particlesā€ or ā€œmorbid poisonā€ that doctors were getting on their hands during autopsies. And the doctors in the ward were then transferring these particles inside the women when they delivered the baby, which then made the women sick.

Today, these ā€œcadaverous particlesā€ are known as bacteria, such as streptococcus pyogenes.

A photomicrograph of streptococcus pyogenes bacteria, which causes puerperal fever. Ā Image via the Centers for Disease Control and Prevention/Wikimedia Commons.

Semmelweis immediately ordered the medical staff to start cleaning their hands and instruments before delivering babies.

They were told to use a chlorine lime solution, not soap, until they could no longer smell the bodies they had dissected.

And it worked ā€” chlorine is actually a great disinfectant. The rate of puerperal fever fell drastically in the doctorā€™s ward.

The first edition of Semmelweis' published findings. Image via IstvƔn Benedek/Wikimedia Commons.

Unfortunately, the Semmelweis' colleagues did not embrace his findings ā€” they were outraged at the suggestion that they were the cause of their patients' deaths. Semmelweis was fired from the hospital and eventually committed to an asylum. He died at the asylum two weeks later. (Several historians believe that he died, after being beaten at the asylum, from sepsis ā€” an infection in the bloodstream caused by germs.)

It would take about 20 years before his ideas would start to be accepted by the medical community. And even then, it was "germ theory" ā€” and the work of Louis Pasteur in the late-1860s ā€” that really convinced anyone of the importance of hygiene and handwashing.

Over a 150 years later, though, Semmelweis is finally getting the recognition he deserves because the simple act of handwashing is one of the most important tools we have in public health.

And its benefits extend well beyond the hospital. Washing your hands reduces the chances of getting diarrheal illnesses by 31%, according to the Centers for Disease Control and Prevention (CDC). It also reduces the occurrence of respiratory illnesses ā€” including colds ā€” by 16 to 21%.

Thatā€™s why in the 1980s, the first nationally endorsed hand hygiene guidelines were released by the CDC, after a series of outbreaks of food-borne and health care-associated infections. And over the next few decades, a number of other guidelines have followed to stress the importance to the general public.

Image via iStock.

Today, the battle to promote this public health tool is still not over.

Diarrhea and respiratory infections remain leading causes of death in the developing world ā€” claiming about 3.5 million children every year ā€” because people either don't know how important handwashing is or don't have access to a reliable, clean water source. There are also still over 1.4 million cases of health care-associated infections around the world. But through education initiatives, NGOs all over the world are hoping to bring about change with this one simple habit.

Proper hand hygiene is still one of the best ways to fight these infections and diseases ā€” and we have Dr. Semmelweis to thank.

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Identity

Celebrate International Women's Day with these stunning photos of female leaders changing the world

The portraits, taken by acclaimed photographer Nigel Barker, are part of CARE's "She Leads the World" campaign.

Images provided by CARE

Kadiatu (left), Zainab (right)

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Women are breaking down barriers every day. They are transforming the world into a more equitable place with every scientific discovery, athletic feat, social justice reform, artistic endeavor, leadership role, and community outreach project.

And while these breakthroughs are happening all the time, International Womenā€™s Day (Mar 8) is when we can all take time to acknowledge the collective progress, and celebrate how ā€œShe Leads the World.ā€

This year, CARE, a leading global humanitarian organization dedicated to empowering women and girls, is celebrating International Womenā€™s Day through the power of portraiture. CARE partnered with high-profile photographer Nigel Barker, best known for his work on ā€œAmericaā€™s Next Top Model,ā€ to capture breathtaking images of seven remarkable women who have prevailed over countless obstacles to become leaders within their communities.

ā€œMabinty, Isatu, Adama, and Kadiatu represent so many women around the world overcoming incredible obstacles to lead their communities,ā€ said Michelle Nunn, President and CEO of CARE USA.

Barkerā€™s bold portraits, as part of CAREā€™s ā€œShe Leads The Worldā€ campaign, not only elevate each womanā€™s story, but also shine a spotlight on how CARE programs helped them get to where they are today.

About the women:

Mabinty

international womens day, care.org

Mabinty is a businesswoman and a member of a CARE savings circle along with a group of other women. She buys and sells groundnuts, rice, and fuel. She and her husband have created such a successful enterprise that Mabinty volunteers her time as a teacher in the local school. She was the first woman to teach there, prompting a second woman to do so. Her fellow teachers and students look up to Mabinty as the leader and educator she is.

Kadiatu

international womens day, care.org

Kadiatu supports herself through a small business selling food. She also volunteers at a health clinic in the neighboring village where she is a nursing student. She tests for malaria, works with infants, and joins her fellow staff in dancing and singing with the women who visit the clinic. She aspires to become a full-time nurse so she can treat and cure people. Today, she leads by example and with ambition.

Isatu

international womens day, care.org

When Isatu was three months pregnant, her husband left her, seeking his fortune in the gold mines. Now Isatu makes her own way, buying and selling food to support her four children. It is a struggle, but Isatu is determined to be a part of her community and a provider for her kids. A single mother of four is nothing if not a leader.

Zainab

international womens day, care.org

Zainab is the Nurse in Charge at the Maternal Child Health Outpost in her community. She is the only nurse in the surrounding area, and so she is responsible for the pre-natal health of the communityā€™s mothers-to-be and for the safe delivery of their babies. In a country with one of the worldā€™s worst maternal death rates, Zainab has not lost a single mother. The community rallies around Zainab and the work she does. She describes the women who visit the clinic as sisters. That feeling is clearly mutual.

Adama

international womens day, care.org

Adama is something few women are - a kehkeh driver. A kehkeh is a three-wheeled motorcycle taxi, known elsewhere as a tuktuk. Working in the Kissy neighborhood of Freetown, Adama is the primary breadwinner for her family, including her son. She keeps her riders safe in other ways, too, by selling condoms. With HIV threatening to increase its spread, this is a vital service to the community.

Ya Yaebo

international womens day, care.org

ā€œYaā€ is a term of respect for older, accomplished women. Ya Yaebo has earned that title as head of her local farmers group. But there is much more than that. She started as a Village Savings and Loan Association member and began putting money into her business. There is the groundnut farm, her team buys and sells rice, and own their own oil processing machine. They even supply seeds to the Ministry of Agriculture. She has used her success to the benefit of people in need in her community and is a vocal advocate for educating girls, not having gone beyond grade seven herself.

On Monday, March 4, CARE will host an exhibition of photography in New York City featuring these portraits, kicking off the multi-day ā€œShe Leads the World Campaign.

Learn more, view the portraits, and join CAREā€™s International Women's Day "She Leads the World" celebration at CARE.org/sheleads.


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Over or under? Surprisingly, there actually is a 'correct' way to hang a toilet paper roll.

Let's settle this silly-but-surprisingly-heated debate once and for all.

Elya/Wikimedia Commons

Should you hang the toilet paper roll over or under?


Humans have debated things large and small over the millennia, from the democracy to breastfeeding in public to how often people ought to wash their sheets.

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Olivia Munn at the 2018 MTV Movie & TV Awards

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The 43-year-old, who has a 2-year-old son with comedian John Mulvaney, shared her experience with photos, video and a written statement shared on Instagram.

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