WATERAID: Healthcare facilities in Tanzania

Globally, 1.8 billion people are at risk of infectious diseases because they use or work in a health facility that doesn’t have water. Such infections can lead to prolonged hospital stays, long-term disability and spiraling healthcare costs. High infection rates and poor water, sanitation and hygiene can damage trust in health systems and make patients less likely to seek care when they are sick. In the district of Geita, northwestern Tanzania, some healthcare facilities that don’t have water ask pregnant women to bring it with them when they give birth. If the nearest water source to the hospital is unsafe, or patients are unable to bring water with them, they must buy it from commercial vendors at inflated prices. Kalunde Rashid gave birth to her second child at Chikobe Health Center in Tanzania. “Mum is here taking care of me. She is old and could not go to collect water down the valley, so we had to buy two buckets,” says Kalunde. During delivery, Kalunde bled so much that all the water was used for cleaning the delivery room. There was no water left for bathing. In training, nurses and midwives are told that the minimum amount of water they should use during childbirth is 100 liters. At Chikobe Health Center, because of acute water shortages, staff can only use 40 liters. “Bacterial infections and sepsis are common in babies and mothers,” says Dolgan Joseph, a nurse who has worked at Chikobe for six years. “If we can get water and electricity here, my work will be easy. Once the hospital environment is clean, it minimizes the rates of infection.” WaterAid brought clean water and infection control measures to hospitals throughout Geita district. Today, the number of women choosing to give birth at health centers has doubled. Zero cases of maternal sepsis were reported after these interventions, compared to 19 cases before the arrival of clean water. At Kakora Dispensary in Tanzania, the clinic had sinks but no water supply, so the staff had to depend on unprotected sources or buy water from vendors, which then had to be purified with chlorine. Once, the clinic endured three months without a working toilet when their latrine became full, and nobody came to empty it. “The working conditions were so bad, I felt like resigning,” says Jacob Busumba, clinical officer in charge at Kakora Dispensary. People visiting the hospital used to look for latrines in neighboring homes or wait until they got back to their home. When the staff couldn’t wait any longer, they decided to take matters into their own hands. With the help of community members, and without any money, they built a new pit latrine using an old rainwater harvesting tank. Since then, WaterAid has worked with local partners to build toilets and medical waste disposal facilities at Kakora and construct a solar-powered water system. The system not only supplies water to the health center but also serves the primary and secondary schools, and the rest of Kakora village – reaching more than 3,000 people. The changes have come as a great relief to Jacob. “I am very happy today,” he says. “My work is more enjoyable.”