Putting the health into healthcare with clean water

3 min read
Image: WaterAid/ Guilhem Alandry

The health consequences of poor water, sanitation and hygiene services are enormous. I can think of no other environmental determinant that causes such profound, debilitating, and dehumanizing misery… I am deeply concerned that many healthcare facilities still lack access to even basic water, sanitation, and hand-washing facilities.

Back in 2015, the world agreed to achieve universal healthcare by 2030 as part of the Sustainable Development Goals (SDGs) (Goal 3). WaterAid highlighted that water, sanitation and hygiene (Goal 6) would be essential to meet this ambition.

Earlier that year, we contributed to a report publishing the first global data on water, sanitation and hygiene (WASH) in healthcare facilities – it's this report that Margaret Chan, Director General of the World Health Organisation (WHO), is responding to in the quote above. The findings – that in low- and middle-income countries, 38% of health centres had no access to water, 19% lacked sanitation, and 35% didn’t even provide water and soap for staff and patients to wash their hands and maintain basic hygiene – were described as an embarrassment.

The report also showed that Mali was suffering the most, with just 20% of health facilities providing clean water. This prompted The Guardian to find out more. Mamadou Diarafa Diallo, WaterAid’s country representative in Mali, was interviewed about the situation. You can listen to the discussion or find a transcript here.

Three years on, the UN Secretary General Antonio Guterres launched the Water Action Decade by calling for water, sanitation and hygiene in all healthcare facilities.

We must work to prevent the spread of disease. Improved water, sanitation and hygiene in health facilities is critical to this effort.

Today it’s the UN’s Universal Health Coverage day and once again decision-makers are talking about the importance of WASH, which is great.

But talk doesn’t always translate into action. The WHO’s Dr Maria Neira, is frustrated by the lack of progress over the last 20 years and at the World Health Assembly earlier this year warned:

We are accepting the unacceptable – we simply shouldn’t call it a healthcare facility if there is no water, sanitation and a piece of soap. It is time to stop accepting it.

At WaterAid we don’t accept it. We’ve been working hard to improve WASH in healthcare facilities in Mali. Since 2015, we've provided 23 health centres with clean water, sanitation and hygiene, and trained health workers to make sure the changes are sustainable.

Oumou Traore, Matron, during an antenatal consultation with Fatoumata Sogoba. Oumou helped deliver Fatoumata as well as all her children, at Diaramana Health Centre, Cercle de Bla, Segou Region, Mali. April 2018.
"The arrival of clean water has drastically reduced water-related diseases." Oumou Traore, Matron, Diaramana, Mali.
Image: WaterAid/Guilhem Alandry

One of these centres is Diaramana. As well as building a water tower, accessible toilets, showers and washing areas for women who have just given birth, we also tiled the consulting and delivery rooms so they can be wiped clean, built a wall around the centre to keep animals out, and installed an incinerator so that medical waste can be safely destroyed. Mariam Traore from WaterAid Mali explains more about this pilot project:

As well as building new facilities, we also trained health workers in hygiene promotion and waste management. We wrote standards and worked with the governing board of the health centres to design improvement plans. It was a long journey, but we learnt a lot.

You can see more of what's going on behind the scenes at Diaramana by clicking on the different buildings in the image below to meet the patients and find out more about the technology that has transformed this healthcare centre:

We're now using the lessons from our pilot at Diaramana to design a new intervention package for the healthcare centre of nearby Talo. Talo will be a model that can be replicated across the region and then across the country. You can find out more about Talo, meet some of the staff and patients and find out how you can support the project though our Water Effect appeal here.

This is how we'll reach the ambitions of the SDGs. By not accepting, by striving, by learning, by striving some more. Health centre by health centre, village by village, country by country.