Gombe Hospital is a 100-bed rural General public hospital situated 70 km west of Kampala, Butambala district in Uganda. Its catchment area is 300,000 people. The hospital staffing is 55% of the recommended. The hospital is facing a problem of inadequate water supply. This therefore made the observation of hand hygiene (HH) as recommended by WHO very difficult for both healthcare workers (HCW) and patients leading to high rates of healthcare-associated infections (HAI). Therefore a HH project was launched.