Upwards of 50% of healthcare facilities are operated by faith-based organizations in some countries. No where could we have a greater impact on human health and suffering than here.
During the Middle Ages, life-expectancy was measured in the teens, not decades, because much of the world lived in filth: poor hygiene, practically no sanitation and unsafe water. Epidemics and diseases like bubonic plague, typhus, smallpox and tuberculosis (“consumption”) took a massive toll on humanity.
Little improvement was made until the 19th Century when the Industrial Revolution, germ theory of disease, and a nurse named Florence Nightingale became the driving force for hospital reform. She convinced the world that improving hygiene and sanitation, as well as having trained professional nurses tend to the sick, were necessities.
Ebola and COVID-19 have re-enforced this lesson still not learned, when all around the world healthcare staff and patients cannot wash their hands.
WASH is Water, Sanitation & Hygiene
Assuring access to sustainable clean water, toilets, soap, basic sanitation and hygiene practices inside hospitals and health clinics is the foundation for safe and dignified healthcare everywhere.
Maternal, newborn and child health, pandemic prevention, antibiotic resistance, Infection Prevention and Control (IPC), and the call for Universal Health Coverage (UHC) all require WASH in healthcare.
Multiple Sustainable Development Goals (SDGs) cannot be achieved without it.
Well into the 21st century, hospitals and healthcare facilities look like something from the 1800s. As medicine travels across bionics and gene therapy into string theory and nanotechnology, the most important discovery that can save millions of lives is left behind.
Here's the data you need to know:
Every year, 17 million women in developing countries give birth in healthcare facilities without adequate water, sanitation and hygiene. One million newborn deaths annually are associated with unclean births, with infections accounting for 26% of neonatal deaths, and 11% of maternal deaths.
In 2019, WHO/UNICEF issued the first baseline global assessment of Water, Sanitation, Hygiene (WASH) in healthcare facilities (HCFs). (JMP, 2019). Data from 560,000 HCFs revealed devastating conditions:
At this main referral facility mothers give birth, side-by-side, sometimes three at a time. With no working water tap, when very busy, the mothers clean up their blood and bodily fluids with their own clothes and rags to make way for the next women about to give birth. Mothers are afraid to deliver here but they are also afraid to die in labor at home.
At one health center serving some 53,000 people, there is just one latrine, no shower and two donkeys make 20 trips a day to transport water from a nearby, dirty river. It’s clear the donkeys cannot meet the facility’s needs, but the staff does much with little. The place is clean and organized.
“Ethiopians work very hard to solve their issues. They are also deeply ashamed of the level of poverty and won’t talk about sanitation for fear outsiders will react with judgment. I have anything but judgment. I have hope. Though one of the most desperate places in terms of maternal and child health, mortality rates are dropping in areas where international assistance and the Ethiopian government have reach. And we’re learning that local commitment is vital to creating sustainable health systems. But it seems to me that we shouldn’t have to learn that water is, too.”
- Dr. Margaret “Migs” Muldrow
"A darling, petite young woman with a beautiful smile on the outside, Mecca’s reality is a daily onslaught of pain and shame due to a completely preventable injury of pregnancy, afflicting a million women and resulting in untold stillbirths.
I was in Ethiopia with a project focused on the appalling absence of Water/Sanitation/Hygiene (WASH) in health-care facilities. It’s a global health scandal impacting hundreds of thousands of clinics and hospitals around the world. But I hadn’t anticipated Meeting Mecca..."
But what about the antibiotics of tomorrow?
Pharmaceutical companies have continually withdrawn from developing new antibiotics. In 1990, there were at least 18 large pharmaceutical companies actively developing antibiotics. Today, there are four.
Concern has led England’s chief medical officer to recently add antimicrobial resistance to the UK’s national risk register of civil emergencies. Five years ago, Dame Sally Davies warned of an “apocalyptic scenario” where people die of common infections and simple operations because antibiotics no longer work. Davies recently told The Guardian, “The importance of clean water, sanitation and vaccination must not be forgotten to avoid infections occurring in the first place.” More in The Guardian.
Resistance can also spread between microorganisms. Using antimicrobials in any one sector (human health, aquaculture, agriculture or on crops) can result in unintended exposure in other sectors. AMR can undermine not only human health, but also animal health, crop health and ecosystem health.
Every infection prevented is one that needs no treatment. We must prevent infections and better manage antibiotics: