Greeting gestures, a language of paying honour, respect, love, adoration, graciousness, empathy towards each other. It is a global custom and has multiple variations. Each country has its own customized version and ritual. The most popular version i.e. hand-shake probably has its roots in Great Britain. Men in the United States will usually shake hands when greeting each other, but it’s not usual for them to kiss when greeting. Americans in addition to handshaking also do a fist bump, wave and hug.

For English people, the handshake is the formal way of greeting when meeting someone new. In informal situations, both men and women use a quick kiss on the cheek, and for women who know each other well. Handshake works universally as a professional way to greet. It is a little firm in Germany, more extended (3-step handshake) in Botswana and for Malays, it extends to touching each other’s fingertip followed by their hearts. Filipinos take a hand of their elders and press it to their foreheads called as ‘Mano’.

One of the major health and environmental challenge we face today is rapid emergence of novel pathogens. The spread of these pathogens, especially of nosocomial origin (hospital based), is often linked to cross-contamination by healthcare workers and ways of greeting gestures while meeting each other. An idea of handshake-free zones in hospitals have encouraged awareness. But also questioned how a doctor will take the physical examination without touching a patient. On the other hand, we cannot ignore the fact that microbes like Acinetobacter calcoaceticus, Enterococcus faecalis, E. faecium, and Shigella dysenteriae type 1 can sustain on hand surface upto one hour while Pseudomonas aeruginosa and Burkholderia cepacia survive up to 30 minutes. Rotavirus might survive for 20 min while the viability of human parainfluenza virus is nearly 60 min.

Studies indicate that a contaminated hand can transfer its viable contamination to seven different subjects or surfaces. One of two common items is a clean paper towel and soap dispenser with average transfer rate ranges between 0.01% to 0.64% and 12.4% to 13.1% respectively. We touch our face nearly 2-5 times a minute i.e., 2000 to 3000 times a day. In fact, whatever contamination we have on our hands is also getting transferred to our face. We may wonder whether our hand soap is capable of killing all the potentially pathogenic microbes. Are we washing our hands correctly and does it really help? We often use hand wash, sanitizers without giving attention to their content and standards. Do they qualify for antimicrobial purpose? Moreover, our greeting gestures further contribute to the spread of the germs.

For healthcare workers, the protected physical contact is a non-avoidable choice. Healthcare workers and doctors should change their gloves while switching from one patient to another. Avoiding greetings which involve physical contacts especially during outbreaks can provide a preventive approach to managing outbreaks. Hospitals need to improve compliance with hand hygiene. Handshake free zone can be one alternative in hospitals. But they aren’t designed to replace hand washing but to complement it. Creating handshake free zone will also bring attention to the hands as vectors for disease. It will also improve compliance with hand hygiene and an easy and inexpensive way to reduce infections.

It is rude to not to shake a hand if a person extends its hand towards you in the name of trust and honour. We can’t be rude to others but why not to adopt ‘Anjali Mudra’, Wai, Namasté, Wave, Bowing or Adaab to greet. This respectable way of greeting with no physical contact should be adopted in the healthcare settings. In India, by adopting our age-old greeting method especially in a healthcare setting can shield us from many invisible microbial infections. We just need to adopt, practice and re-practice these gestures to decrease the spread of infections.

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Time seemed to be flying, when I was in conversation with a very jovial person Dr David Kirkpatrick, a General Practitioner at Al Zahra (Pvt.) Medical Centre. His take on life is truly an admirable one and he makes you feel that life is all about exploring opportunities in the right way and with the right attitude it can be never too late to build on a dream and acquire it.

He came to UK when he was five years old, and completed his entire schooling there. For three months thereafter, he was clueless about the direction he would be taking in life. Medicine was not at all in the radar for him, not until he had worked in a hospital environment. Today, he has been a practising GP for about 30 years.

His mother one day remarked,“ You have gone through a very expensive education and you cannot stay like this Ð doing nothing”. He gave an interview for a job with the London Police and the Navy and finally found a job at Radcliffe Hospital, Oxford in U.K. where he worked for about a year as a potter in an X-ray dept.

Dr Kirkpatrick said, “When I went home returning from my job Ð one night, my mother said ‘Have you had any more thought about what you want to do?’ I replied, “You know mother, I wish I had done medicine, I really love that hospital environment.” Immediately his mother said that his grandfather had left some money in a trust and the trustees would be happy to know that he wanted to get back to school to study science.

Without wasting any more time, Dr Kirkpatrick decided to go to St. Edwards School in Oxford for 12 months to do ‘A’ levels in physics, chemistry and biology. He had done English, history and French. He joined the Middlesex Medical School and Hospital in London for further training and then went on with his further education in the field of medicine. By then he was already focused on becoming a General Practitioner.

He got married in 1976 and then they travelled to New Zealand, where his wife was offered a job. He says, “We had planned to stay in New Zealand for a year or two but we stayed there for 26 years. I had my own practice for 23 years in New Zealand but wanted a change from the same atmosphere. We had good friends, a nice lifestyle and house but when our boys left university and were independent, my wife wanted to travel again.”

“In May 2002, we stopped in UAE on our way back to England that time I gave a couple of interviews in a few hospitals in the UAE. On 2nd November 2002, we arrived in the UAE to settle here and I started my job with Al Zahra Hospital on 9th November 2002.”

He says, “It has been a good experience at Al Zahra, as I get to see an extraordinary range of cultures and nationalities walking into my room for consultation here in Dubai, which I did not see in New Zealand. I am happy to be working with nice people and in good surroundings.”

“Another good thing about being in Dubai is travel,” he says. “Travelling back home and visiting other places in the world from UAE is very convenient compared to New Zealand.” He has been to Africa, Morocco, Petra, Thailand etc…, but finds the Fiji Island the best travel destination. He wants to see the TajMahal and visit Bhutan and many other places across the globe.

He is also a passionate photographer, who likes to capture candid pictures of people and beautiful places on film. He has gathered thousands of photos in his computer. He states, “I disappear in my study area for hours to play around with my collection in Photoshop.” However, he admits it to be a very time consuming hobby.

He finds great delight in practicing his cooking skills on a regular basis. “I feel cooking is a great way to relax. When you get back home after a busy day at work, just put on an apron and get into the kitchen to try out some delicious recipes. It is a nice way to stay away from stress. I love playing golf, squash and tennis but don’t get much of a chance to play,” he discloses speaking about his pastime activities.

“I like to do some form of exercise every day. We have a gym and pool in our building; I manage to go for a workout 2-3 times a week. I feel exercising and walking helps me think better. I often find myself composing e-mails and narrating new ideas well while I am exercising.”

Talking about his philosophy as a doctor he reveals, “I feel that doctors should be teachers. When patients walk out of their room, they should have an idea of what is wrong with them. You have to set aside more time for each patient to explain to them what is going on with them. You have to simplify, a complicated matter to explain it to your patients.”

“I follow a simple rule, I limit myself to giving three bits of information to each patient and I repeat the information twice for my patient to understand it thoroughly and this works. The formula is simple distil down a complex matter into something that you can describe in a few minutes and hope your patient will absorb it and remember.”

“Another important thing to remember to be a good GP, is that it is important that you have to know what you do not know and you should be prepared to admit the same. In addition, you should have some idea of what is wrong with your patient and whom to refer to for further consultation.”

He concluded with his thoughts about being positive, “I feel good about what I do if a patient leaves my room happy and satisfied with my service. I am a positive person and I am positive about people and I think most people are good people.”

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Read all the issues of InnoHEALTH magazine:
InnoHEALTH Volume 1 Issue 1 (July to September 2016) – https://goo.gl/iWAwN2 
InnoHEALTH Volume 1 Issue 2 (October to December 2016) – https://goo.gl/4GGMJz 
InnoHEALTH Volume 2 Issue 1 (January to March 2017) – https://goo.gl/DEyKnw 
InnoHEALTH Volume 2 Issue 2 (April to June 2017) – https://goo.gl/Nv3eev
InnoHEALTH Volume 2 Issue 3 (July to September 2017) – https://goo.gl/MCVjd6

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