Around 1.8 billion people are at heightened risk of COVID-19 and other diseases because they use or work in health care facilities without basic water services, warn the World Health Organisation and the United Nations Children’s Fund.
The report, Global Progress Report on Water, Sanitation and Hygiene in Healthcare Facilities: Fundamentals First, comes as COVID-19 exposes key vulnerabilities within health systems, including inadequate infection prevention and control.
The report noted that WASH is vital to the safety of health workers and patients, yet provision of these services is not prioritised.
“Worldwide, one in four healthcare facilities has no water services, one in three does not have access to hand hygiene where care is provided, one in 10 has no sanitation services, and one in three does not segregate waste safely,” it said.
WHO Director-General, Dr. Tedros Adhanom Ghebreyesus, said, “Working in a healthcare facility without water, sanitation and hygiene is akin to sending nurses and doctors to work without personal protective equipment.
“Water supply, sanitation and hygiene in healthcare facilities are fundamental to stopping COVID-19. But there are still major gaps to overcome, particularly in least developed countries.”
In the same vein, UNICEF Executive Director Henrietta Fore, noted that, “Sending healthcare workers and people in need of treatment to facilities without clean water, safe toilets, or even soap puts their lives at risk.”
Continuing, she said, “This was certainly true before the COVID-19 pandemic, but this year has made these disparities impossible to ignore.
“As we reimagine and shape a post-COVID world, making sure we are sending children and mothers to places of care equipped with adequate water, sanitation and hygiene services is not merely something we can and should do. It is an absolute must.”
The agencies said the situation is worst in the world’s 47 Least Developed Countries where one in two healthcare facilities does not have basic drinking water, one in four healthcare facilities has no hand hygiene facilities at points of care; and three in five lack basic sanitation services.
“But this can be fixed. Preliminary estimates indicate that it would cost roughly one dollar per capita to enable all 47 LDCs to establish basic water service in health facilities,” it said.
“On average, 20 cents per capita is needed each year to operate and maintain services,” the report said, noting that immediate, incremental investments in WASH have big returns: improving hygiene in healthcare facilities is a best buy for tackling antimicrobial resistance.
“It reduces health care costs because it reduces healthcare-associated infections (which are costly to treat).
“It saves time, as health workers do not have to search for water for hand hygiene. Better hygiene also increases uptake of services. This all adds up to a return of $1.5 for every dollar invested.
“These services are especially critical for vulnerable populations, including pregnant mothers, newborns and children.
“Improving WASH services in healthcare facilities is particularly important around childbirth when far too many mothers and newborns suffer and die, including from preventable conditions like sepsis.
“Better WASH services could save a million pregnant women and newborns’ lives and reduce stillbirths,” the report added.
The report recommended the implementation of costed national roadmaps with appropriate financing; monitoring and regularly reviewing progress in improving WASH services, practices and the enabling environment.
Other recommendations include developing capacities of health workforce to sustain WASH services and promote and practice good hygiene; and integrating WASH into regular health sector planning, budgeting, and programming, including COVID-19 response and recovery efforts to deliver quality services.
“For millions of healthcare workers across the world, water is PPE”, said Jennifer Sara, Global Director for Water at the World Bank Group.
“It is essential that financing keeps flowing to bring water and sanitation services to those battling the COVID crisis on the frontlines. Funding WASH in healthcare facilities is among the most cost-effective investments that governments can make.”
Data published by WHO in October indicates that COVID-19 infections among health care workers are far greater than those in the general population: Health care workers represent less than three percent of the population, but account for 14 per cent of global COVID-19 cases reported to WHO.
Responding, Chief Executive at international charity, WaterAid, Tim Wainwright, said, “Ensuring that healthcare workers have the basic WASH necessities to keep themselves, their patients, their families and children safe is imperative.
“Millions have no option but to seek care from the 50 percent of healthcare facilities in the developing world which don’t have clean water on their premises.
“This cannot continue. Every day, both healthcare workers’ and patients’ lives are being put at risk.”
“Without frontline health workers being able to wash their hands, provide their patients with clean water, or have somewhere decent to go to the toilet, a hospital is not a hospital at all — it’s a breeding ground for disease,” Wainwright added.
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