“Most primary health centers in Nigeria lack good washing facilities. At the Lugbe PHC, there is no washing sink in the labor room, so water has to be fetched from the tap outside and brought to the mother. A health worker who wants to wash her hands will have to fetch a bucket. It is not possible for us to do our jobs as midwives without access to water, sanitation, and handwashing stations.”
-Rita Momoh, WBFA Midwife

Rita lives the everyday challenges caused by the absence of one of the most fundamental requirements for basic health care: access to safe drinking water, sanitation, and hygiene in health care facilities round the world. Hundreds of thousands of midwives and other health care professionals work in similar conditions.

Rita’s experience is backed up with startling data from the Water Institute at the University of North Carolina. In an analysis of 129,000 health care facilities in the developing world, researchers found more than 65 percent of facilities lack both running water and soap for handwashing. Data from a subset of six countries — Bangladesh, Haiti, Malawi, Nepal, Senegal, and Tanzania — revealed that only 2 percent of their health care facilities have concurrent access to water, sanitation, hygiene, and waste management services.

This on-the-ground reality results in the inability to implement the most basic infection control measures, a situation that not only endangers patients and staff, but also presents a danger to all of us. Health facilities are the epicenters for pandemic containment, but the lack of WASH can contribute to further spread of disease.

When it comes to patients, among the most vulnerable are pregnant women and newborns, both at great risk of sepsis — a leading cause of death in hospitals. WaterAid found that half of the primary health care facilities it surveyed in Nigeria did not even have handwashing facilities in delivery rooms.  The scope of this problem extends far beyond Nigeria, of course, to a majority of health care facilities in developing countries throughout Africa, Asia, Latin America, and the Middle East.

We know that access to WASH in health care facilities is a major global problem, one that is readily solvable, but largely ignored by the international community — until recently. In March 2018, United Nations Secretary-General António Guterres recognized the need to address this urgent health concern with the launch of the Water Action Decade and his call to action in which he specifically challenged the global community to achieve universal WASH access in all health care facilities by 2030. The World Health Organization and UNICEF will lead the global charge.

We in the global health and development communities cannot allow mothers and newborns to die from preventable and unnecessary complications, simply because the most basic of WASH services are not available. The Wellbeing Foundation Africa has committed to work with its partners around the world to ensure that all countries implement the 2017 World Health Assembly Sepsis Resolution. Hand hygiene must be a quality indicator in every facility and a national marker of health care quality, with access to soap and water monitored and assessed.