Global Handwashing Day – improving handwashing on Cambodia’s healthcare frontlines
On Global Handwashing Day, we turn the spotlight on rural health centres, which UNICEF supports to play a crucial role in promoting good hygiene and handwashing to disadvantaged communities.
Above photo: Pov Orng holds her infant son, who was delivered and immunized in the hygienically improved facilities of Krasaing Health Centre, Svay Rieng.
Svay Rieng, October 2020 - “We have always worked hard to keep this health centre clean and hygienic,” says Ma Sarom, the head of Krasaing Health Centre in Svay Rieng, Cambodia’s far flung south-eastern province. “Unfortunately, the water from the well came out dirty and red, because of iron in the soil. Imagine trying to wash your hands in that! So for years we collected rainwater, but this was difficult when it was dry season. It was our biggest headache.”
Today is Global Handwashing Day, a day with even greater significance this year than usual given the ongoing COVID-19 pandemic. This year is an opportunity to celebrate the power of handwashing in preventing diseases while particularly highlighting Cambodia’s health centres and their role in promoting good hygiene and handwashing in some of Cambodia’s most economically disadvantaged and remote areas. Global evidence has shown how such measures lead to improved health and nutrition, which is essential to the growth and development of children.
UNICEF has worked over many years with the Royal Government of Cambodia to develop and promote better water, sanitation and hygiene (WASH) practices in the nation’s health services in order to curb the spread of diseases and improve health outcomes. Since 2018, UNICEF and the Ministry of Health identified 15 health centres that would benefit from support in improving their WASH infrastructure and facilities. Staff in all the centers received training including WASH facility improvement tool (WASH FIT), Infection Prevention and Control (IPC) and health care waste management. Each health centre was also required to set up a WASH committee responsible for identifying needs and developing an action plan for improvements.
Krasaing Health Centre was one of 15 health centres where UNICEF supported the implementation of the improvement plan funded by UK AID’s Accelerating Sanitation and Water for All (ASWA) Programme. The centre first opened in 1997 with funding from UNICEF, and now covers 21 villages and 12,654 people. Mr Sarom has been with the centre since day one, when the only way to reach it was a dirt road. He is proud of its lynchpin role in helping vaccinate local children, treat illnesses, and deliver more than 300 babies annually. “When we started this place, we started from zero,” he says. “There were a lot of people who were sick or dying who didn’t need to be. My goal has been to keep improving, but sanitation and hygiene problems have held us back.”
His team of 11 agreed this was a big problem. Samedy Oum, 28, moved to Svay Rieng to work as a nurse at the centre five years earlier, believing she could make a greater difference to people’s lives in rural areas than in her more prosperous home city of Kampong Cham. “In my home city there are many choices, but here we are the only option for most people. Their lives depend on us. So we really have to be hygienic for them. But it was so hard to keep things clean with the water problem we had!”
When the health centre developed its WASH action plan, under Mr Sarom’s leadership, improved water supply and infrastructure were the top priorities, unsurprisingly. “UNICEF helped us a lot, including funding a new water filtering system, four new handwashing stations, renovated toilets and even facilities for patients with limited mobility. But we also had to play our part. We fundraised from the community for one of the handwashing stations. We also built some of the infrastructure ourselves, and even designed the new toilet block.”
The new facilities were completed just before the COVID-19 pandemic, when the importance of hygiene and sanitation was amplified. The health centre has played a crucial role in providing information on safety measures to the local population, often using materials produced by the Government with UNICEF support. The health centre has also supported the Government more directly by monitoring the health of returning migrant workers and staying alert for COVID-19 symptoms.
Even though there have been no cases so far, the centre has observed changes because of the virus. Many people take handwashing more seriously, with all the resulting benefits of reducing disease and improving food hygiene. As a result, diarrhoea cases are down. “Most people used to wash their hands quite badly and briefly, but they’ve improved a lot. They’ve got the right information from TV and social media,” Ms Samedy says. “Before, I’d have scored them 1 out of 10, but now they are at 7. Sometimes they’re as good as us nurses!”
The improved facilities have certainly been noticed by the centre’s users. Pov Orng, a 34-year-old mother of four sons, arrived to get her 3-month-old vaccinated. She explained that all of her children had been delivered there. “I mostly came because I trust the staff,” she says, while soothing her baby after his injection. “But I could see problems. It’s good to see the improvements, especially the handwashing and the toilets, and the amazing clean new delivery room. It makes me happy to see the centre getting the support they deserve. I feel even more confident to come back in the future.”