By Rebecca Root
The Roman Catholic Church is the largest non-governmental provider of healthcare in the world, yet many of its hospitals and clinics lack basic facilities for water, sanitation and hygiene, known by the acronym WASH.
There is a global problem with the lack of clean water in health care centres, with one in ten not having a toilet and one in four without handwashing facilities, increasing the risk of infection and sepsis
The Vatican’s Dicastery for Promoting Integral Human Development, created by Pope Francis in 2017, is determined to improve conditions in its own centres.
In 2021, alongside Caritas, Catholic Relief Services, and Global Water 2020, the dicastery — a Vatican department – committed to supporting 150 Catholic healthcare centres. “So far, 51 facilities in 14 countries have received in total, or partially, the funds they need for improvement for building, for training, for education, for maintenance,” said Tebaldo Vinciguerra, a dicastery official.
But there is more work to be done to reach the remaining 99, which health consultant Lindsay Denny said, represents only the “very tip of the iceberg and an initial understanding of the need”. To reach those, she said, an estimated $12m (£9.3m) was needed but so far only $1.5m had been raised. The dicastery called for others to join its efforts.
Sister Mary Louise Stubbs, who is on the dicastery’s WASH committee, said: “Life in a cesspool of preventable sickness and hardship is not only a waste of human potential, it also breeds despair, hostility, rebellion and all of their debilitating results. However, if enough people of good will work together to galvanise a response to this disaster, the core issue can be addressed in a sustainable way.”
The church is among several groups addressing the hygiene challenge. Globally, one in four health centres have no handwashing facilities on site, according to the World Health Organisation. One in 10 also have no lavatory, and in the lowest-income countries, almost half of health workers are forced to deliver care without clean water.
“This means that each year 16.6 million women in least-developed countries give birth in healthcare facilities with inadequate WASH, leaving both mother and child at risk of infections, including sepsis,” said Sue Coates, deputy executive director of the United Nations’ Sanitation and Hygiene Fund.
“This is but one example of how the lack of investment toward sanitation and hygiene in healthcare facilities has resulted in the most basic infection control measures collapsing.”
More than a million deaths annually are associated with unclean births while 15 per cent of patients in acute-care hospitals in low and middle-income countries will acquire at least one infection associated to healthcare. At the same time, doctors and nurses are unable to keep their own hands clean and must work long hours without access to a lavatory.
“In countries where it’s not a problem it’s something we take for granted, but about four billion people across the world lack basic hygiene services,” said Helen Hamilton, a senior policy analyst at WaterAid, adding that the problem went beyond healthcare facilities.
Globally, almost 1.7 billion people have no access to a lavatory and 2.3 billion have no handwashing facilities with water and soap available at home. Such gaps became clearer amid the Covid-19 pandemic when handwashing acted as a critical preventative measure.
“If we can’t make sure healthcare facilities are safe and have the fundamentals we all expect — that a baby can be delivered with a clean pair of hands, that a nurse or doctor is able to wash their hands in between patients, that there’s running water — we can’t say healthcare systems and related services are future-proofed or resilient to future pandemics,” Ms Hamilton added.
Others agencies, such as the Aga Khan Development Network, are working to improve WASH services in Tajikistan, Afghanistan, and Pakistan.
Islamic Relief builds new hospitals complete with all basic services across Africa, Asia, the Middle East and Europe; and in 2019, more than 25 faith agencies, including Faiths for Safe Water, Water Mission and IsraAID made commitments to WASH in health centres.
This followed the call in 2018 by António Guterres, secretary-general of the United Nations, to achieve WASH in all healthcare facilities and the signing of a resolution by ministers at the 2019 World Health Assembly.
“We need a strong combination of different types of leadership on this issue,” Ms Hamilton said.
Outside the faith communities, other organisations are also championing this issue. WaterAid, for example, works to install water tanks and lavatories in health centres in Ghana, Mali, and Zambia. Freshwater Project International replaces water pumps and sinks in Malawi.
Ms Coates said: “A thriving sanitation economy, where people, including the most marginalised, have access to toilets, handwashing facilities and menstrual products and the goods and services needed to safely use, dispose, treat and reuse waste along the entire value chain, is fundamental for public health. Safe healthcare facilities cannot exist in a vacuum.”
Rebecca Root is a Bangkok-based journalist covering global health and climate issues