Sustainable water, sanitation and hygiene (WASH) services in health care facilities (HCF) are critical for providing quality, safe health care. There is increasing recognition that many health care facilities, especially in low- and middle-income countries, lack even the most basic water, sanitation and hygiene services. The #COVID19 pandemic has further exposed these inadequacies in health centres, which in addition to jeopardizing the health of workers and patients, is also a clear violation of their basic human rights. 

This lack of WASH services in HCFs compromises the ability to provide basic, routine services and the ability to prevent and control infectious diseases such as COVID, Lassa fever, Zika Virus, ebola, etc. 

Water Rights in HCFs: Why does it matter?

Healthcare workers are usually at the frontline to save lives but working in an HCF without access to water, not only limits their ability to save lives, but it also limits their rights and lives. People go to healthcare facilities to get better but end up compounding their sickness when they visit HCFs without water, sanitation and hygiene (WASH) facilities. The situation is more severe with the prevalence of highly infectious disease agents that thrive in unsanitary conditions. Despite these glaring facts, it is disturbing that about 896 million people, globally, still use health facilities that lack water for basic hand hygiene with increased risk of infection while “One out of six health care facilities (16%) globally have no hygiene service, meaning they lacked hand hygiene facilities at points of care, as well as soap and water at toilets”. 

For healthcare workers to save their lives and that of the patients, especially in times of pandemic such as COVID19, respecting their rights to water is non-negotiable

Reality Check: Fighting COVID19 with Nigeria’s health system

Nigeria’s healthcare system is plagued with chronic underfunding and limited infrastructure and the government has repeatedly fallen short on its 2001 commitment under the Abuja Declaration to spend at least 15 percent of its budget on health. In 2018, only 3.9 per cent was allocated, and in 2020, this marginally increased to 4.5 per cent.

The outbreak of Coronavirus has exposed and drawn the government’s attention to the gross inadequacy in the health sector. The premise on which the federal government provided NGN 102.5 billion for direct interventions in the healthcare sector. Also, the upgrade of healthcare facilities has been identified as a major component of the NGN500 billion COVID-19 Crisis Intervention Fund, provided by the federal government. 

Since it took the pandemic to draw government’s attention to the debacle in the health sector, this is the right time to address pertinent questions about WASH in Nigeria’s healthcare facilities: Is there provision for WASH in Healthcare facilities in the COVID19 crisis intervention funds? What is the status of the WASH in HCFs in Nigeria, at the moment? What improvement is expected as an outcome of the intervention? Are workers and patients aware that their rights are been violated when they lack access to WASH in HCFs?

Remote Intervention amid lockdown

Enugu state is one of the focal states where Hope Spring Water Charity Foundation, in collaboration with other partners, have made tremendous progress in mobilizing rights-holders and duty-bearers to demand and respect human rights to water, respectively. Building on the success of the Claim-Your-Water-Rights campaign in the state, the team is focusing on mobilizing healthcare workers and patients to know and demand their rights to safe water in HCFs. One of the objectives of this renewed campaign is to leverage on the increased interest in HCFs to mobilize political will and direct resources to address WASH needs in HCFs. 

Considering the present lockdown in the state, the team is utilizing its network of members located in various parts of the state to gather case study of HCFs in the 17 (seventeen) Local Government Areas of the state, with major emphasis placed on at least one General Hospital in each Local Government. An online Qualitative assessment/Questionnaire has been provided for healthcare workers who have access to the internet to complete, while those who are offline will be reached through community contact persons in the various LGAs. 

Health workers and patients whose rights are violated and would like complaints are provided with an online link to the Complaint form of National Human Rights Commission. The links are included in the online questionnaire provided by the team while team members assigned to every LGA remotely guides complainants on steps to filling the form. 

In addition, key contacts of water service providers were included in the questionnaire. 

Feedbacks from this study, which serves as an accountability tool, are not only publicized to draw government’s attention to the status of WASH in the state’s health care facilities; it also serves as a guide for respective authorities to know where and how to direct resources for WASH interventions.

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