Although people constantly hear about the importance of washing hands, they may not understand how crucial this action is in controlling the spread of microorganisms. This emphasis on hand sanitation can be traced back to 1847 when Semmelweis noticed the higher death rate of women from puerperal fever following labor on the ward handled by the medical students when compared to the significantly lower death rates on the ward run by midwifery students and a similar maternity hospital in Dublin, Ireland (Pommerville, 2014, p. 13). This lead Semmelweis to the suggestion that medical students must be transmitting the disease and the source of the harmful microorganisms was from the cadavers the students were handling before coming to the ward. As a result, Semmelweis made his staff wash their hands in chlorine water before entering the maternity ward, thereby cleansing their hands of harmful microorganisms and the deaths from puerperal fever immediately dropped on the ward. This first case demonstrates how the washing of hands helps control diseases through the scrubbing of harmful microorganisms off of the hands as well as the use of chemicals (in this case chlorine) to kill the microorganisms. However, because this process is done on a daily basis in our present time, it has become more automatic, resulting in people putting less thought into how well they wash their hands. This is the problem that is discussed in Gawande’s article, On Washing Hands. This reading highlighted Gawande’s experience of touring his hospital from the perspective of the infection-control unit. During this experience, Gawande focused on one of the infection control unit’s greatest difficulties: getting employees to wash their hands. By walking with people who are constantly trying to stop the spread of infection in the hospital, Gawande was able to gain a better understanding of how significant hand washing is in controlling the spread of infection as well as become aware of how little emphasis most employees have on the subject (Gawande, 2007). However, even if everyone regularly cleansed their hands, there are still several other challenges that the infection control unit faces on a daily basis. Some of these difficulties include how all parts of the human skin are contaminated with bacteria and how difficult bacteria are to remove even with scrubbing. Thus, sterilization is impossible and there is no way for the infection control unit to completely control the spread of infection in the hospital. Furthermore, proper hand washing regimens are strict and time consuming. According to the reading, proper hand washing includes: using the right antibacterial soap, removing any jewelry, wetting the hands in warm water, lathering the soap over all surfaces, including the lower one third of the arms, for fifteen to thirty seconds, rinsing off for thirty seconds, completely drying with a clean, towel, and using the towel to turn the tap off (Gawande, 2007, p. 1284). These strict procedures led to the other challenges the control unit faced, including complaints from staff, inefficient use of time, and inability to check that all staff is properly washing their hands on all floors of the hospital. Even after incorporating the use of the gel and increasing sanitation compliance, the infection rates in the hospital did not decreased at all (Gawande, 2007, p. 1285). This emphasizes why good hand washing is as important today as it was in Semmelweis’s day. The statistics presented of how the use of gel did not decrease the infection rates supports how even though we do have alternatives, nothing is as effective in preventing the spread of microorganisms as the hand washing first emphasized in Semmelweis’s days.