In 2007 the British Medical Journal polled doctors about what they considered to be the most important medical advance in modern history. While not necessarily a medical advance, clean water and sanitation—the number one answer in the survey—have undoubtedly prevented more early deaths than any other single advancement. The question for us is: What do we do to ensure we have clean water and to promote sanitation when TEOTWAWKI  hits?
The black plague killed over 75 million Europeans. Why? Rats and their fleas were the major source of spreading Yersinia Pestis– the cause of the black plague. Why were rats crowding around European cities? It was due to the utter lack of sanitation and cleanliness. That, combined with the high population density, produced the perfect storm of death.
Unfortunately, we live in a society where proper hand and bathroom hygiene is disregarded by many and where even food service industry workers have to be threatened with job loss for failing to wash their hands after using the restroom at work. Ready access to medical care and medications has protected us in the past, but these modern blessings may not be available in the future. We have to recognize that we will be surrounded with others who may not share our views on sanitation. We need to be able to educate them and protect ourselves at the same time.
Boiling water has been the method of choice for purification throughout history, and according to the CDC, “[e]xcept for boiling, few of the water treatment methods are 100% effective in removing all pathogens.” So while bleach, filters, and purification tablets may be used, boiling is best.
To kill pathogens (bacteria, parasites), bring water to a hard rolling boil for one minute, plus an extra minute for each 1,000 feet above sea level. A major disadvantage of boiling is the energy required. It may be wise to consider having a Kelly Kettle  or rocket stove  available.
Just a little searching on the Internet will yield a wide variety of plans for DIY solar stills; it won’t be long before you find one that will fit your situation and skill set. While every bit as effective as boiling at killing pathogens (and with the advantage of removing heavy metals and radiation), the major drawback is that most DIY and personal-size stills do not produce enough water for a family.
Data strongly suggest that iodine disinfection is not 100% effective in inactivating Cryptosporidium, an organism commonly found in surface waters.
When boiling water is not an option, water can be treated with bleach. First, if your water is not clear, pour it through a coffee filter  or let the water sit until the particles settle at the bottom and then pour off the clear water into a clean container. Add two drops of non-scented bleach  per quart of water (eight drops per gallon). For cloudy water, use three drops per quart of water or twelve drops per gallon. Let water stand for 30 minutes. There should still remain a slight odor of bleach; if not, let stand an additional 15 minutes. To eliminate some of the off taste, pour this water between clean containers several times.
While most of us understand the need for treating drinking and cooking water, what many people fail to understand is that all wash water must also be clean. We absolutely cannot wash our hands or rinse out some dishes in what appears to be a clean, clear mountain stream without the risk of picking up giardia or cryptosporidium. We can’t use that same stream to wash off some dirt or clean a wound. All water coming into contact with our hands and with any wounds, even scratches or scrapes, must be treated.
Ounce of Prevention
It is much easier to purify water than to suffer the consequences of parasites, cysts, dysentery, typhoid, and more, all of which will require medication to treat and which will have the potential to spread and expose and/or harm others. We will not live long without clean drinking water.
Effective hand washing prevents the spread of germs. A quick rinse is not enough! It is the combination of soap, clean water, and friction that rids our skin of germs. Having a small brush  near the sink to use under fingernails is also critical. Antibacterial soap is not necessary and, in fact, can prevent our immune systems from building up the antibodies we need to fight germs.
Hand sanitizer disinfects when soap and water are not an option. It has a three-year shelf life from time of manufacture. Keep some bottles on hand as a backup when soap and water are not available.
To make DIY hand sanitizer, combine ½ cup 100% aloe vera gel  with ¼ cup witch hazel  and stir until the lumps are gone. Then, add ¾ cup 70% isopropyl alcohol . You can choose, as an option, to add 10 drops of lemon  or orange essential oil  for a scent. Shake and pour your DIY hand sanitizer into bottles.
Latex exam gloves and N-95 masks  should be used in caring for the ill. The gentle care of cleaning fluids from a sick person’s face is all well and good, but using the same water and washcloth over and over only spreads disease. Contaminants will get onto the caregiver’s hands, if he/she doesn’t use latex gloves. Exam gloves offer protection when dealing with an open wound and can also protect you from any pathogens that may be infecting your patient’s blood. Wear these gloves only once and be careful about cuts or holes that can contaminate your hands or the individual you are assisting.
In addition to the wearing of latex gloves, an N-95 mask, which can be purchased at hardware stores, helps protect the caregiver from bacterial or viral infections. When the H1N1 flu erupted a few years ago, those who wore masks and gloves were less likely to get sick.
Daily care helps you keep your teeth. If bacteria linger in the mouth, gums can develop abscesses. A soft bristle brush  is gentle on the gums and enamel. Hard bristles hurt the gums and enamel and can actually foster cavities or other dental problems.
Toothpaste manufacturers advertise the bristles of the toothbrush need to be filled from one end to the other with toothpaste. This is not necessary. Just a little dab is all that is needed. (While fluoride is promoted as preventing tooth decay by strengthening the teeth, it is actually the brushing that is most essential.) I was curious to see how many months I could get out of a 5.6-ounce tube of toothpaste . Still brushing morning and night and being stingy with the toothpaste, my tube lasted between five and six months.
Alternatives to using toothpaste include wet brushing (just putting water on the toothbrush) or using salt or baking soda, like my mother’s family used during the Depression.
It is wise to store floss , as it not only gets the foreign matter from between teeth, but it also stimulates and strengthens the gums. (Floss can also serve as suturing thread if it is not waxed and is thin enough.)
Gargling with mouthwash  also aids in oral care. If manufactured mouthwash isn’t available, you can gargle with diluted apple cider vinegar  and water. This solution helps to eliminate bad breath and whiten teeth. Bear in mind that apple cider vinegar is highly acidic and quite harsh, so it needs to be diluted with water before gargling. Straight apple cider vinegar could damage the enamel on your teeth or the tissues in your mouth and throat.
The skin is the most important organ, in protecting the body from disease. We need to clean it properly and keep it clean. Our bodies accumulate foreign matter and can develop sores if we don’t cleanse ourselves. Bathing removes dead skin and germs and helps prevent irritations and rashes that could otherwise lead to infection.
For times when normal showering isn’t available, there are solar showers  made for camping. Simply fill the bag with water and set it in the sun to warm.
Baby wipes  are not just for babies; they can be a godsend to the rest of us as well. They were very highly prized by our military in the Middle East to be able to clean up on the go. A few baby wipes can substitute for a shower, which is what many do while camping. Baby wipes are also easier to use when giving sponge baths to the elderly and disabled/injured.
Commercial baby wipes store for at least six to twelve months. Some may find it is better to store the supplies to make DIY wipes when they are needed. Bear in mind that the DIY wipes lack preservatives and thus do not have the shelf life of commercially produced wipes.
Recipe #1 (all-natural ingredients)
- 1 roll of heavy duty paper towels, like Bounty , cut in half and inner cardboard tube removed
- Plastic container  with tight-fitting lid
- 1 3/4 cups boiled water (or distilled), cooled but still warm
- 1 tablespoon of pure aloe vera 
- 1 tablespoon of pure witch hazel extract 
- 1 tablespoon liquid castile soap 
- 10 drops grapefruit seed extract  or 2 capsules of Vitamin E (optional)
- 1 teaspoon of olive  or almond oil  (optional)
- Essential oils of choice (optional, such as six drops each of orange  and lavender )
Mix all the liquid ingredients in a bowl. Put the paper towels in the container and pour wipe solution over the towels. Let it absorb; this takes about 5-10 minutes. Flip the container over to make sure wipes are well soaked. Use as you would regular wipes.
- 1 roll of heavy duty paper towels, like Bounty , cut in half, and inner cardboard tube removed
- Plastic container with tight-fitting lid
Put one half roll of towels in the plastic container. Set the other half aside for the next time.
Mix solution well and then pour solution over paper towels. Let absorb for 10-15 minutes. Invert container to soak other end as well.
Store bar soap  instead of liquid. Bar soap weighs less and takes less space. In addition, store two to three different brands  of bar soap that you and your family already use to make sure you do not have any sensitivities and so that you have another option in case sensitivities develop later.
To make your soap last longer, unwrap the soap and set it aside for six to eight weeks. This “cures” the soap, and it will be less likely to turn to mush when used. To make it last even longer, keep soap in a soap dish . Finally, if the bar is allowed to dry completely before being used again, it will last much longer.
Our bodies are designed to keep us cool so we won’t overheat, but we don’t need to stink. How much deodorant  you store depends on how much you use. The purpose of deodorants prevents us from smelling. If store bought isn’t available, apple cider vinegar can help kill odor-causing bacteria, so dab a bit under your arms for a natural deodorant.
Hands must be especially protected and pampered. The skin is the first line of defense against infection. Once our society collapses, our hands are going to be a whole lot busier and subject to cuts and scrapes. We can reduce the likelihood of some minor damage to the skin by keeping it moisturized. I live in a dry climate and my fingers crack and bleed if I don’t take care. Knowing I’m susceptible to infection, I have finally found a lotion that works for my hands. Avoid lotions that contain alcohol—it dries out skin.
To remove odor-causing bacteria from your feet, wipe them with apple cider vinegar.
Ounce of Prevention
Good personal hygiene will help protect the body from infection.