PostScript Emerg Med J: first published as 10.1136/emermed-2020-210121 on 3 July 2020. Downloaded from LETTER catering to a population of 12 million. screening zones and ED. MG and SK were responsible Daily flow is approximately 1500 patients for reinforcement visits and feedback collection after at outpatient and 200 at Emergency the campaign. The manuscript draft was written by ‘Greet with NAMASTE, bye-bye SK and MG. It was reviewed critically for content and Department (ED). The ‘NAMASTE edited by GKB, MKG and SM. All authors read and handshake’: a behavioural CAMPAIGN’, which began in the ED, was approved the final manuscript. change campaign for infection committed to achieving a HANDSHAKE- Funding The authors have not declared a specific FREE hospital. The campaign included a grant for this research from any funding agency in the prevention in the Emergency document highlighting the importance of public, commercial or not-for -profit sectors. Department from Jodhpur, India hand hygiene and benefits of NAMASTE, Competing interests None declared. awareness meeting for HCWs and display Patient and public involvement Patients and/ of posters at prominent sites of the or the public were involved in the design, conduct, To the Editor, hospital (figure 1). The general population reporting or dissemination plans of this research. Refer Cross-infection by healthcare workers and patients were involved by using print, to the Methods section for further details. (HCWs) with contaminated hands social media and banners in the hospital. Patient consent for publication Obtained. is a major source of spread of infec- Their behaviour was further reinforced Provenance and peer review Not commissioned; tion. Transmission or prevention, it all by welcoming them with a NAMASTE at internally peer reviewed. remains in the hands. In this COVID-19 hospital premises. This article is made freely available for use in pandemic, greeting with a handshake All this was in place before the very accordance with BMJ’s website terms and conditions is no longer acceptable socially or first case of COVID-19 in India. Thir- for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download medically. In February 2020, we initi- teen weeks after the campaign, we have ated the ‘NAMASTE CAMPAIGN’. and print the article for any lawful, non-commercial managed 176 patients with COVID-19 purpose (including text and data mining) provided ‘NAMASTE’—greeting with folded hands, and had a single case of COVID-19 in that all copyright notices and trade marks are an ancient Indian cultural practice means HCWs. Namaste has fit well into our retained. ‘The divine in me bows to the divine in hospital’s culture. A survey among HCWs © Author(s) (or their employer(s)) 2020. No commercial you’. It spreads positivity but not infec- in the ED conducted 11 weeks after the re-use . See rights and permissions. Published by BMJ. tion, which is essential for mental fitness campaign revealed 91% followed hand Handling editor Ellen J Weber of emotionally strained HCWs in the 1 hygiene measures according to protocol pandemic. Our centre is an 800 bedded while 52% were practising ‘Namaste’. tertiary care hospital in Rajasthan, India, Those following Namaste agreed that it resulted in a positive experience. To cite Khichar S, Gopalakrishnan M, Bohra GK, et al. Greeting, an essential part of commu- Emerg Med J Epub ahead of print: [please include Day Month Year]. doi:10.1136/emermed-2020-210121 nication should not be avoided during COVID-19 era. The end of handshakes Accepted 19 June 2020 should not mean an end of greeting. Social Emerg Med J 2020;0:1. doi:10.1136/ distancing is reported to have an adverse emermed-2020-210121 impact on mental well-being. 2 Namaste ORCID iDs http://emj.bmj.com/ maintains the physical distancing but helps Satyendra Khichar http://orcid. org/0000- 0003-1355- to prevent social distancing.3 3766 Maya Gopalakrishnan http://orcid. org/0000- 0002- Satyendra Khichar , Maya Gopalakrishnan , 0661-9854 Gopal Krishana Bohra, Mahendra Kumar Garg, Sanjeev Misra REFERENCES All India Institute of Medical Sciences, Jodhpur, 1 Ayanian JZ. Mental health needs of health care workers
Rajasthan, India providing frontline COVID-19 care. JAMA Health Forum on September 24, 2021 by guest. Protected copyright. 2020;1:e200397. Correspondence to Professor Mahendra Kumar Garg, 2 Galea S, Merchant RM, Lurie N. The mental health Department of Medicine, All India Institute of Medical consequences of COVID-19 and physical distancing: the Sciences Jodphur, Jodhpur, Rajasthan, India; need for prevention and early intervention. JAMA Intern Figure 1 (A) Poster displayed for the mkgargs@ gmail.com Med 2020. doi:10.1001/jamainternmed.2020.1562 Namaste campaign. (B) Healthcare worker Contributors SM and MKG designed the campaign. 3 Aminnejad R, Alikhani R. Physical distancing or social in personal protective equipment performing GKB, MG and SK were responsible for implementation distancing: that is the question. Can J Anesth/J Can namaste gesture. of infection control and hand hygiene at the COVID-19 Anesth 2020:1–2.
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