Imagine a doctor’s surgery with gallons of water lined up in jerry cans, purchased because the taps are dry. Lab technicians washing out excrement samples in hand basins without running water. As many as 40 patients a day with only one fetid, backed-up toilet in which to relieve themselves. Nigeria boasts the fastest-growing economy on the African continent. Yet one-third of its population of 174 million do not have access to clean water, two-thirds do not have access to basic, private toilets, and one in three healthcare facilities in Nigeria do not have access to water. This new photo series, released to mark Universal Health Coverage Day 2016, reveals this silent emergency of erratic or non-existent water supply, broken toilets and poor hygiene, which puts the health of patients, staff and surrounding communities at risk. Overuse of antibiotics in healthcare settings to treat or protect against infections is a major driver of the growing threat of antimicrobial resistance. Of the 10 million deaths from antimicrobial resistant infections predicted by 2050, an estimated 4.1 million would likely be in sub-Saharan Africa, where clean water, good sanitation and rigorous hygiene practices, which might prevent infections in the first place, are often lacking. In Zuba Primary Health Centre, Abuja, healthcare staff report that there is no water supply; even the water they buy each day is not safe to drink. Martina Ohaegbulem, 56, the deputy nurse in charge of the Zuba Primary Health Centre, said: “We need a borehole, or a well if one can be dug in the compound. We need more toilets for both the staff and patients. We need running taps and other things, too. We need improvement in handling those things -- handwashing basins and similar things. We buy the soap we use from the little money we are paid for deliveries [of babies]. It's the money for deliveries we use in paying some of our workers, the volunteers, but we also buy the soap from that same money. “We need improvement as we are not functioning efficiently. But we are trying our best with what we have." Yael Velleman, WaterAid senior policy analyst on health and hygiene, said: “All too often, healthcare conditions in many low- and middle-income countries are characterised by unreliable or non-existent water supplies, inadequate sanitation, and unsafe medical waste disposal. This situation leaves healthcare professionals unable to properly care for patients, and leaves doctors, midwives, nurses, cleaners and patients alike at serious risk of infection and illness.” “Good health, dignified and clean healthcare, and effectively combatting the rise of antimicrobial resistance requires clean water, good sanitation and good hygiene practice in homes, in schools and in hospitals and health centres, all around the world.” The staff and patients in Zuba Primary Health Centre in Abuja are not alone: A WaterAid Nigeria study of 242 healthcare facilities across six states – Bauchi, Benue, Enugu, Ekiti, Jigawa and Plateau – found 21% did not have at least one toilet facility, and only 27% had access to a motorised water borehole. Only 20% of healthcare centres had handwashing facilities alongside their toilets. Across the developing world, 38% of healthcare facilities do not have access to water. On Universal Health Coverage Day, 12 December, WaterAid is calling for healthcare professionals to join our global petition to ask national governments to accelerate their plans for safe, reliable access to water, sanitation and hygiene in all health facilities. Universal Health Coverage Day is intended to highlight the need for all to achieve good health and access to quality healthcare without incurring financial hardship. An essential element to good health and effective healthcare is access to clean, safe water to drink, a decent private toilet and the ability to practice good hygiene, including handwashing with soap. For more information about our International Healthy Start campaign, or to sign our global petition, please see www.wateraid.org/healthprofessionals ENDS To see further images of clinics please click here. For more information or to arrange interviews please contact: Lisa Martin, senior media officer, [email protected] / +44 (0)20 7793 4524, or Carolynne Wheeler, news manager, [email protected] / +44 (0)207 793 4485. Or call our after-hours press line on +44 (0)7887 521 552 / [email protected] Notes to Editors: WaterAid WaterAid’s vision is of a world where everyone has access to safe water and sanitation. The international organisation works in 37 countries across Africa, Asia, Latin America and the Pacific Region to transform lives by improving access to safe water, hygiene and sanitation in some of the world’s poorest communities. Since 1981, WaterAid has reached 25 million people with safe water and, since 2004, 24 million people with sanitation. For more information, visit www.wateraid.org, follow @WaterAid or @WaterAidPress on Twitter, or visit us on Facebook at www.facebook.com/wateraid. Around 315,000 children die each year from diarrhoeal diseases caused by dirty water and poor sanitation. That’s almost 900 children each day, or one child every two minutes. An estimated 663 million people (around one in ten) are without safe water Nearly 2.4 billion people (around one in three) live without improved sanitation For every £1 invested in water and sanitation, an average of £4 is returned in increased productivity. Just £15 can help provide one person with access to safe water. For details on how individual countries are keeping their promises on water and sanitation, please see our online database, WASHWatch.org.