It is all or nothing with health if doesn’t concern WASH

Water, sanitation and hygiene (WASH) are an indispensable tri­partite elements for the lives of all creature on earth.

Water, which for the largest per­cent complements other twin com­ponents, remains to be crucial for any economic development.

The level of development of any society is measured against the availability of sufficient water and the required quality.

In its nature, water is part of the environment, and its quantity and quality help in determining how water will be used.

Access to clean and safe water for domestic use and sanitation is important in protecting the health of citizens.

Unsafe water use and water short­ages contribute to the outbreaks of diseases such as diarrhea and chol­era.

One of the areas that are most affected by the lack of clean water and sanitation are healthcare facil­ities.

The lack of clean water in health­care facilities, including hand wash­ing services, is one of the biggest challenges developing countries face up to.

It is laid down that in many devel­oping countries in the world, almost half of the healthcare facilities do not have basic clean water services.

Tanzania, being one of the devel­oping countries, is never spared from the onslaught, especially in healthcare facilities at the council level.

The challenge affects the patients as well as the nurses who are the main service providers at those facil­ities.

The President of the Tanzania Nurses Association (TANNA), Alex­ander Baluhya says that the availa­bility of clean water, sanitation and hygiene in healthcare facilities in the country is currently not satisfactory, especially at the council level.

He says that clean and safe water at healthcare facilities should be available 24 hours a day bearing in mind that water can be a good cure against several disease with these medical services are up and running all the time.

“According to our service delivery directives, as a nurse, I am not sup­posed to touch anyone before I wash my hands, that is to say, when I finish providing care to one patient, I must wash it off before serving another, however, the infrastructure neces­sary to implement such directives are still not satisfactory,” says Bal­uhya.

According to him, regional and referral level hospitals are in a good shape, triggered by proper infra­structure installed for WASH ser­vices but the situation takes a turn for the worse at council level, forc­ing nurses sometimes to resort for water sources outside the facility.

“This puts both healthcare pro­viders and patients’ health at stake due to the reported higher risk of disease prevalence,” adds up Balu­hya.

According to the National Guide­lines for WASH Services in Health Care Facilities in Tanzania, inade­quate provision of WASH services, patients can be susceptible to devel­oping healthcare-associated infec­tions with a greatest risk posed to newborns.

Apart from that the shortage of such resource may lead to some complications to expectant mothers during birth.

Another challenge, according to Baluhya, is the poor water infra­structure where he has claimed that there are some councils whose water infrastructure are dilapidated and therefore found unable to meet the current needs.

“Some councils are using dilapi­dated infrastructure that are not in line with current needs because the needs have increased. Many health­care facilities have been built within the last five years, but they lack clean WASH services due to poor infra­structure,” says Baluhya.

Explaining the increase in health­care facilities in the country and access to clean water, Baluhya says that the increase has not taken into account the issues of WASH servic­es.

“The government has made an effort to build many healthcare facil­ities in the council to facilitate access to these services for citizens, but a large percentage of these facilities are facing the challenge of access to clean and safe water,” says Baluhya.

He reveals that the investment made by the Government in the health sector is not compatible with the issue of improving the infra­structure of clean and safe water in those facilities. This causes the Gov­ernment to incur additional costs due to the treatment of epidemic diseases caused by the lack of clean water.

He ascribes the challenge to the differences in priorities spotted between ministries and Govern­ment institutions. For example, the priority of TAMISEMI ministry is to build as many healthcare facilities as possible throughout the country, but the issue of access to clean water and sanitation at those facilities rests with the Ministry of Health.

Baluhya says that what needs to be done is the proper alignment between these twins ministries so that when the budget is tabled, WASH services at those facilities can be taken into account.

He also says that MPs should raise their voices regarding this matter, especially through their committees to make sure that the construction of healthcare facilities is compati­ble with the availability of WASH services.

They also encourage the Gov­ernment to allocate an exponential budget to the Ministry of Health to provide education to all depart­ments and institutions in the coun­try about the importance and effects of the lack of WASH services at healthcare facilities, especially at the council level.

Baluhya says that TANNA has been emphasizing and reminding the Government about improving the health services infrastructure, especially WASH services at the healthcare facilities.

“We, as nurses, often through our association internal meetings, have been emphasizing this matter by advising the Government to address the challenge. We recently had a meeting with the Minister of Health and insisted on the matter, and as ministry, they agreed to reallocate some funds to improve the infra­structure to provide health servic­es,” says Baluhya.

The Health Officer of Temeke Dis­trict, Juhudi Nyamuka admits the existence of a challenge of access to WASH services at the health­care facilities at the council level and explains that the Government has been making various efforts to ensure that these services are avail­able starting with districts, regions and referral hospitals including Temeke.

“At the district, regional and referral hospitals, including Teme­ke hospital, the condition is good because we have good systems to execute WASH services. Here, every building has clean water and sew­age systems, hand washing facilities, water storage tanks, waste storage facilities, etc.,” says Juhudi.

At Temeke Referral Hospital, people are instructed to wash their hands every time they enter and dispose of waste into colored dust­bins according to the type of waste labelled; For example, the red dust­bin is for hazardous waste and this is due to the existence of great under­standing among nurses and other health practitioners.

She opens up that the Temeke District has set up its own municipal waste disposal cages used by other healthcare centres with awareness on which type of waste to be burned or disposed of remains a vexed ques­tion.

WaterAid Tanzania Country Director, Anna Mzinga recommend­ed that as the world faces climate change, epidemics and the ongoing COVID-19 pandemic, inclusive, sus­tainable and climate-resilient water, sanitation and hygiene (WASH) ser­vices are more important than ever.

The need is more urgent in health­care facilities (HCF), where a lack of access to these services has for long undermined the quality and safety of healthcare and set back progress on achieving universal health cov­erage.

This can be achieved by encour­aging cross-sectorial working and strengthen national and sub-nation­al coordination between ministries responsible for health, finance and WASH, to ensure there is adequate finance to support the sustainable and inclusive delivery of all aspects of WASH across the health system.

Also, tracking progress against national standards on WASH in HCF within routine health moni­toring systems and responsive citi­zen-led accountability mechanisms.