Water makes COVID-19 treatment sites safe

Providing good sanitation and hygiene in health centres

By James Chavula
Cleaner Rose Kajawo carrying buckets of water as she prepares to start cleaning. Behind her are the toilet blocks constructed by UNICEF with support from UK Aid
UNICEF Malawi/2021/Chikondi
12 February 2021

Blantyre is one of the worst-affected hotspots of Malawi’s second wave of COVID-19. At the city’s Emergency Treatment Unit (ETU), doctors, clinicians, nurses and laboratory technicians witness winding queues of up to 300 people, anxiously waiting to be swabbed for signs of COVID-19. The situation is overwhelming and was even worse when the ETU did not have an adequate water supply.

For the 15 health workers and support staff deployed to the emergency centre, there is no time to rest. Forty-two-year-old Rose Kajawo is a cleaner and one of the unsung heroes at this high-risk centre, located nearly three kilometres from her home. She cleans one room after another, arriving at around 7am, almost three hours before health workers check in, and usually knocking off at around 5pm, almost half an hour later than most civil servants across Malawi.

“After dusting and mopping the rooms, corridors and open spaces, I disinfect chairs, doors, walls and places where people who cannot stand in the sun sit while awaiting coronavirus testing. All this requires water,” says Rose.

12-year-old Ana Kanyoza washes her hands at the ETU where she went for a COVID-19 test
UNICEF Malawi/2021/Chikondi
12-year-old Ana Kanyoza washes her hands at the ETU where she went for a COVID-19 test

Until recently, the ETU’s water and electricity supply were constantly being disrupted and preventing the spread of infection was extremely difficult. But thanks to UNICEF, with funding from UK Aid, the ETU’s facilities have been upgraded, making Rose’s work a little easier. The refurbishment included the construction of two flush toilet blocks and a solar-powered water system complete with three handwashing stands with liquid soap dispensers.

“Water, sanitation and hygiene have become trusted weapons in the war on COVID-19,” she explains. “Frontline workers like myself and our clients are able to wash our hands regularly with soap so we don't contaminate any frequently touched surfaces such as walls, doors, doorknobs, chairs and beds.”

Rose is certain that hand hygiene and sanitary settings help to disrupt the transmission of COVID-19, ensuring that people who visit the centre get medical tests, not infections.

“When I leave the centre, the health workers, our clients and I rest assured that we have practised the necessary measures to prevent contracting coronavirus, which has disrupted every aspect of life.  We go home happy, certain that we won’t infect our beloved families, including children, or leave them without a breadwinner,” she says.

Rose has five children who she calls “almost everything” to her. “When I think about them, I feel duty-bound to take all necessary steps to stay safe. They need my support to achieve their dreams,” she says.

However, Rose, like frontline health workers, is constantly exposed to COVID-19 as the centre is often congested with people who might test positive for the virus. “I take a swab test every 14 days. When I knock off, I remove my personal protective clothing and put on the clothes I wore on arrival. When I get home, I immediately wash my clothes with soap before taking a bath,” she says.

Penjani Chunda in front of the solar powered water system at the ETU
UNICEF Malawi/2021/Chikondi
Penjani Chunda in front of the solar powered water system at the ETU

Rose’s colleague, Penjani Chunda, who is managing the COVID-19 response at the ETU, says that without adequate water, sanitation and hygiene, health workers used to work in fear.

“Previously, we had an intermittent water and electricity supply, which was a huge challenge. The solar-powered water supply system has given us constant water and electricity both indoors and outdoors. It has enhanced sanitation and hand hygiene, which are pivotal to COVID-19 prevention. Since the start of the pandemic, no health workers at this isolation centre have been diagnosed with COVID-19,” he says.

The solar panels convert sunlight into electricity which pumps groundwater into four 5,000-litre tanks, as well as providing reliable, clean energy to light the centre amid the frequent blackouts that plague Malawi's power grid. With uninterrupted water and electricity in the isolation rooms as well as the toilet blocks and shower rooms, critical patients can be admitted to the 10 rooms without any sanitation and hygiene concerns.

“The dedication of frontline health workers personifies our calling to save lives, but we also have to protect ourselves. If we protect ourselves, we protect our nation, our spouses, our children and everyone who depends on us,” he explains. “Every day, we risk getting COVID-19 infections from the people we serve. Inwardly, we tell ourselves that we could be next on the death list as we have already lost our fellow health workers in Blantyre and beyond, but this does not deter us from working hard to save lives. Basics like water, sanitation and hygiene make our job easier and safe for everyone.”