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Many developing countries have no running water in hospitals

New Delhi : Urging governments and non-governmental organizations to increase efforts to improve water infrastructure at hospitals in a bid to ensure provision of safe essential surgical care, a new research study has said more than one-third of hospitals in developing countries lacked running water.

The unavailability of water at many hospitals in low- and middle-income countries (LMICs) could pose a serious health concern.

Many people in the world – an estimated 700 million – live without access to water; half of those without water live in sub-Saharan Africa. Lack of access to water and sanitation has a significant negative impact on health care provision, including surgical care, the study from the Johns Hopkins Bloomberg School of Public Health noted.

The study - 'Water Accessibility at Hospitals in Low- and Middle-Income Countries: Implications for Improving Access to Safe Surgical Care' was published in the June issue of the Journal of Surgical Research. It focussed on water availability in 430 hospitals in 19 countries but did not look at access to drinking water.

Researchers found that 147 of the hospitals -- 34 per cent -- lacked continuous running water. Availability of running water at hospitals ranged from less than 20 per cent in Liberia to more than 90 per cent in Bangladesh and Ghana.

"Running water is something we so take for granted and it doesn't exist in a third of hospitals in these countries," said Dr Adam L Kushner, an adjunct professor at the Bloomberg School and one of the study’s lead authors. "Instead of water just being there, some hospitals truck in water or collect it in rain barrels, with no guarantee of its cleanliness."

"Without clean water, there is no way to clean surgeons’ hands or instruments, wash gowns and sheets or clean wounds to prevent or reduce infections.”

Hospitals without running water often truck in water – at great expense – or use rainwater. While helpful in the rainy season, rain barrels often run dry during the dry season. This water is not only needed for surgery, it is needed to keep patients and rooms clean during other parts of their hospital stays. The study didn’t address access to drinking water.

Without water, hospitals cannot conduct surgery, despite the large unmet surgical needs in these poor nations, said Kushner.

“Hopefully, people aren’t operating in those conditions, but what do you do if a woman shows up in obstructed labour and needs an emergency C-section and it’s the dry season and the rain barrel is empty,” Kushner says. “You can’t operate with dirty instruments, but if you don’t she’s going to die. This is the sort of dilemma that surgeons in these hospitals face.”

The researchers said there needs to be a greater push for improving water access for people globally. Countries whose hospitals often lack access to running water – such as Burundi with just under 32 per cent – might be able to learn from strategies used by their neighbours, such as Rwanda with more than 83 per cent, to build water infrastructure.

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