Wash in Health Care Facilities

WASH is critical in health care facilities where the risk of patients contracting infections is high. As a public health-focused organization, our goal is to improve WASH services systematically at health care facilities, to protect patients, care-givers and staff from nosocomial (hospital-acquired) infections and ensure quality care.

In low and middle income countries over 15.5% of patients contract nosocomial infections, with up to a quarter of patients affected in some developing countries. Such infections can prolong hospital stays, increase resistance to medication, escalate costs for patients and result in long-term disability or death.

WHO identified alarming gaps in the supply of WASH to health care facilities (HCF) in low and middle income countries: 38% lacked an adequate water supply (this rose to 50% when factors such as reliability and functionality were included), 19% did not have adequate sanitation and 35% had no water or soap for handwashing. Inadequate access to WASH in health care facilities means health care workers cannot ensure quality care, and therefore frequently put themselves, their patients and surrounding communities at risk of infection and even death. Without sufficient WASH facilities and infrastructure in hospitals, preventing or containing disease outbreaks such as Ebola or Cholera becomes a major challenge.

There is considerable evidence to suggest that hand-washing is the most effective single measure to reduce cross-infections. Health facilities can encourage behaviour change by informing visitors about WASH and providing a hygienic environment model. WASH in health care facilities has the following additional benefits:

Source: WHO and UNICEF, 2015 http://wsscc.org/wp-content/uploads/2015/11/WASHinHCFGlobalActionPlanOct20151.pdf

International Medical Corps promotes WASH as a mainstream activity at health facilities to capture these benefits and ensure safe health care delivery and effective infection control.

Our Response

Providing WASH in healthcare facilities is a core component of International Medical Corps’ work. Our WASH priorities focus on strengthening health care service delivery at the facility level by establishing safe water supplies, adequate sanitation infrastructure, accessible handwashing facilities and rigorous training of healthcare staff in infection prevention and control.

Most of our country projects include interventions to strengthen basic WASH facilities in health care centers. We currently operate programs in both Africa and Asia that include WASH in health care facilities activitiesOur interventions incorporate assessing, planning, building and monitoring WASH improvements for new, temporary or existing health facilities and assuring the provision of critical WASH supplies such as detergents, disinfecting solutions, soaps and cleaning materials, as well as protective clothing.

Examples of our work:

In Yemen, conditions have deteriorated at an alarming rate since armed conflict broke out in March 2015 and well over half the country’s population struggles daily to find—or buy–enough clean water to drink or grow food. International Medical Corps provides hospitals in Sana’a, the capital, with thousands of liters of water daily. At one hospital in the capital we provide 24,000 liters of water/day—enough to support 600 patients.

International Medical Corps has also provided WASH services to health care facilities located in refugee camps in Ethiopia. We have constructed latrines and incinerators at health centers and installed roof rain water harvesting systems. We supply water storage containers and water purification materials to households and health posts; we have rehabilitated water boreholes, shallow hand dug wells and springs that improve water supply systems. We have also trained health workers and community volunteers on appropriate sanitation and hygiene practices.
In Kenya, International Medical Corps has installed rainwater harvesting systems at health care facilities and trained health facility staff and community health workers on basic care and hygiene practices as well as how to maintain sanitation facilities.

During outbreaks of infectious diseases like Cholera and Ebola, where WASH is a critical component in any successful response, International Medical Corps has also been instrumental in providing adequate water, safe sanitation and imposing strict hygiene practices in treatment centers.

In West Africa, WASH in Ebola Treatment Units.
International Medical Corps was one of the few international NGOs to treat patients infected with the Ebola virus at the source of West Africa’s 2014 outbreak, the world’s largest to date. Before it was over, more than 28,000 confirmed cases and over 11,000 deaths were recorded. During the outbreak our experts were on the ground in Guinea-Bissau, Guinea, Liberia, Mali, and Sierra Leone.

The outbreak placed a significant strain on the region, which already lacked robust public health infrastructure, possessed little capacity for appropriate infection prevention or control measures and had few acute care facilities and providers. Because of the highly contagious nature of the Ebola virus, significant WASH infection prevention and control measures were essential to maintain in an Ebola Treatment Unit (ETU) to ensure the safety of suspected patients and staff.

Diarrhea is common among Ebola patients, hence a system was critical to manage, dispose of and treat human waste. Much as other infectious disease interventions, Ebola outbreaks require well designed treatment centers to reduce risk. These centers must enforce strict infection control practices and have WASH facilities that are well setup and require minimal to no maintenance.

International Medical Corps led a well-trained response team and designed and monitored WASH activities in the ETUs to ensure infection prevention control. After the outbreak ended, International Medical Corps continued to provide health care and psychosocial support to Ebola survivors and work to strengthen local health care systems as part of longer term preparedness and response measures to prevent future outbreaks of Ebola and other infectious disease with epidemic potential.

WASH in Haiti’s Cholera Treatment Centers.
During the response to Haiti’s massive earthquake in 2010, cholera was brought into the country for the first time. By early 2013, over half a million people in Haiti had been affected by Cholera – a WASH-related and easily treatable disease. International Medical Corps quickly became one of the main providers of cholera treatment and management in Haiti, bringing lifesaving and life-changing help to communities hit by this disease. Our focus on WASH has helped lay the necessary foundation for Haiti to eradicate cholera in the long term, through critical health care and the construction of latrines, hand-washing stations, and waste disposal systems in both urban and rural locations. International Medical Corps took over operation of the two largest Cholera Treatment Centers in Haiti’s South Department, quickly improving WASH facilities and treatment practices, resulting on a sharp drop in the fatality rate among cholera patients at the clinic from 14% to 0.5% within eight weeks.