We arrived at Courtyard School in the California state capital of Sacramento at the end of the school day. Some children had gone home, others were doing homework or playing outside on the playground. A small group of seven-to-ten year olds was ushered into a classroom for a health lesson as part of the after school program.
Anne Judson of AWARE, the Alliance Working for Antibiotic Resistance Education, was teaching a lesson developed by her organization to show school-age kids how infection spreads.
"What we are going to talk to you about today is hand washing, to prove to you how important it is that all the germs get off your hands, so that you and your families and your friends don't get sick," she began. "So first we are going to start off and we are going to play a game, and we are going to see how germs get spread."
She explained that germs are tiny, and they can make you sick. She handed out packets of trading cards with cartoon pictures of common bacterial infections on them, and instructed the children to keep the card with a sticker on the back, but to give all the other cards away to their friends to simulate the spread of germs in the community.
The kids get the idea that one person can spread a lot of germs. But it is not until Anne pulls out a can of fake germ powder, only visible under a special light, that they begin to understand that germs are everywhere. She sprinkles the magic powder on the children's hands and then turns on the lamp.
"Everybody look at their germs. They are glowing in the black light," she said. "Now, what we are going to do is that, everybody is going to wash their hands one-by-one, and we will see how the 'bugs' come off your hands."
"When you wash your hands, it is important how you wash them," Ms. Judson continued. "Have you ever gone to a bathroom and seen someone turn on the water and put their hand under and say, 'Oh, I've washed my hands?'" One boy admitted he did that. "I bet you did," she replied. "Then you do that, and you touch a doorknob or touch a friend - that is how you get people sick; because just as you traded the bugs around, that's what you are doing all the time when you don't wash your hands.
"So what we are going to talk about next is how long you wash your hands for," she continued. "It has to be for at least 20 seconds, and that is as long as it takes to sing this song." Ms. Judson handed out a sheet with new words to a popular children's tune.
"Wash, wash, wash your hands, wash the germs away. Scrub my hands with soap and water. Germs go down the drain. Bubbles, Bubbles, a million bubbles carry the germs away. I won't let germs get me sick. I hope you do the same. (Sung to the tune of Row, Row, Row Your Boat)
One by one, the kids head to the sink in the back of the room for timed practice. Hands clean and dripping, the children seem to have learned the lesson.
"I will just make sure that I wash them good," said one girl. "Maybe you could time yourself on a watch or sing a song that is only 20 seconds or count 20 seconds," suggested a boy.
The children left the classroom with more than clean hands. As she gathered up the song sheets, Anne Judson observed that the students carry away with them a valuable lesson that can keep them healthy.
"The purpose [of this exercise] is prevention of infection," she said. "If the children know now how to wash their hands, how to wash their hands properly and have fun with it at the same time, they will continue that process of not passing on infection. They will be aware for the rest of their lives, and will prevent infection in the community on a very practical level."
This is part three of VOA's five-part series on Curbing Abuse of Antibiotics.