His autopsy showed a pathological condition similar to that of women drying from puerperal fever. The puzzled Semmelweis got a breakthrough in 1847, following the death of colleague Jokob Kolletschka, who had been accidentally got a cut by a student's scalpel while performing an autopsy. The second clinic, attended by midwives had a maternal mortality of only 2 per cent. The first clinic was attended by medical students, who moved straight from autopsy rooms to the delivery suite and had an average maternal mortality rate due to puerperal fever of about 10 per cent. There were two maternity clinics in the hospital, with alternate day admission policy. Semmelweis 7 worked in the Great hospital in Vienna in the 1840s. Labarraque 6 provided the first evidence that hand decontamination can markedly reduce the incidence of puerperal fever and maternal mortality. The significance of hand washing in patient care was conceptualized in the early 19 th century 6 – 8. This review focuses on one of the simplest, low cost but least accepted from infection prevention: hand hygiene. With “Clean Care is Safer Care” as a prime agenda of the global initiative of WHO on patient safety programmes, it is time for developing countries to formulate the much-needed policies for implementation of basic infection prevention practices in health care set-ups. There is now undisputed evidence that strict adherence to hand hygiene reduces the risk of cross-transmission of infections. These factors, compounded by the paucity of availability of new antimicrobials have necessitated a re-look into the role of basic practices of infection prevention in modern day health care. The medical community is witnessing in tandem unprecedented advancements in the understanding of pathophysiology of infectious diseases and the global spread of multi-drug resistant infections in health care set-ups. This is not only because of the magnitude of the problem in terms of the associated morbidity, mortality and cost of treatment, but also due to the growing recognition that most of these are preventable. Health care associated infections are drawing increasing attention from patients, insurers, governments and regulatory bodies.
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