Parents are choosing to give birth safely and comfortably in Dar Health Clinic
When health care centres lack proper sanitation facilities it puts pregnant mothers and new babies at significant risk of preventable infections.
In light of the upcoming 30th Anniversary of the Convention on the Rights of the Child, UNICEF Cambodia emphasises every child’s right to the enjoyment of the highest standard of health.
Chitborie district, Kratie Province, August 2019 - The director of the Dar Health Clinic Sem Chanthou, describes the impact of the UNICEF-BORDA project as a great improvement for the health of the new babies, parents and the health staff working at the clinic. “Now more clients believe in this centre,” she explains, “and infections are better controlled. Before, we did not feel confident for either clients or nurses since we did not have access to safe tap water. We didn’t have enough hand washing facilities available or enough toilets. We couldn’t separate sharp and infectious waste. Clients were nervous about coming here.”
Chanthou still remembers the risks the patients took before the intervention. “One mother was in so much pain, she had rashes all over her skin, headaches and a sore throat. She had to shower with a bucket and her husband had to help her. It was so hard,” she recalls. “Before I felt uncomfortable telling patients to take a shower regularly because the patients had to pump water by themselves. But not anymore.”
UNICEF Cambodia in partnership with BORDA has been working to improve water, sanitation and hygiene (WASH) in health care facilities. The project provides safe and sustainable water sources, piped supply systems, water storage tanks, sex segregated toilets and accessible toilets for people with limited mobility as well as handwashing facilities, placenta pits, medical incinerators and wastewater treatment facilities. Staff members are also trained on operations and maintenance. There are seven health centres being supported in Kratie in partnership with BORDA. Most births in Cambodia happen in health care facilities, so ensuring healthcare facilities have clean water, accessible toilets and handwashing stations are crucial. Beyond improving the quality of care, these facilities can also improve patient outcomes, saving the lives of mothers and babies.
One new mother, Sreymom, brought her three-month-old baby daughter to Dar health centre to get her vaccinations. “I came here for the birth of both my children, my check-ups and now for vaccines. I will keep coming back,” explained Sreymom. Before the UNICEF-BORDA project here, there was only a working toilet downstairs, but the medical rooms for women in labour are upstairs. She describes the challenging birth of her first child here, “I hurt so bad someone had to carry me down to the bathroom. I was worried I would give birth on the way.” But for the baby girl on her lap, “it was so much easier. I got all the water I need from the tap and the toilet is just outside. My baby will be healthier because I’ve got safe water.”
The training delivered to staff has improved the quality of service they are able to give, “we’ve gone from treating 260 clients a month to around 1,000. The women giving birth benefit the most, they can shower here and easily access the toilets. Even the nurses don’t have to go back home,” said Chanthou. “I’m proud that I was awarded the funding to improve this place. I hope UNICEF and BORDA can provide this support to other health care facilities.”
One couple we met explained that they came here instead of Kratie hospital, where they had their first two children, because “since the UNICEF-BORDA project, it’s clean and quiet here. There is a toilet right outside this room, it has a shower and a disabled toilet so it’s easy. My wife is healthy, and my baby will have a better start,” explained the very proud and happy father.
This new mother, Sreymom, brought her three-month-old baby daughter to get her vaccinations. “I came here for the birth of both my children, my check-ups and now for vaccines. I will keep coming back,” explained Sreymom. Before the UNICEF-BORDA project here, there was only a working toilet downstairs. Women in labour must be seen in the medical rooms upstairs. She describes the birth of her first child, “I hurt so bad someone had to carry me down to the bathroom. I was worried I would give birth on the way.” She compares this to the birth of her new baby, “it was so much easier. Before, I had to pump water by hand. Now I get everything I need from the tap. My baby will be healthier because I’ve got safe water.”
Sreykhouch, 23 years old, is six months pregnant with her second child. She comes to discuss her health and have a check-up with Sem Chanthou, the director of Dar Health Clinic. “I choose to come here because it’s close to my house. It’s my second time here, it’s clean and easy to use the toilets since they renovated them upstairs,” Sreykhouch explained.
In December 2018, national guidelines to support basic WASH services in health care facilities in Cambodia were formally endorsed. This guides leaders like Chanthou to improve the infrastructure, operations and behaviour at the health centre beyond the minimum requirements. To guide these improvements and their maintenance, the WHO and UNICEF have developed the WASH FIT tool which has been adopted by the Ministry of Health (MoH). The seven health centres supported in Kratie province have received training on this tool.