Enabling good hygiene practices in health facilities in Sierra Leone
Water, Sanitation and Hygiene: The essentials of infection prevention and control
Gbalamuya – Memunatu Bangura, a Community Health Officer (CHO) at the Gbalamuya Community Health Centre has just finished administering medication to a female patient and heads to a sink to wash her hands. Clean water gushes out as she opens the tap.
The availability of running water is taken for granted in health facilities in many parts of the world, but a year ago, in this health centre, it was a pipe dream.
The lack of running water is bad news for infection prevention and control. Providing access to adequate amounts of clean and safe water; waste management facilities for the sanitary disposal of medical and other waste; and infection prevention materials for sound hygiene behaviours are vital to reduce the spread of infectious diseases.
The Gbalamuya Community Health Centre, where CHO Memunatu works, serves a population of more than 3,968 people across 16 villages (including from neighboring Guinea). The Health Centre attends to an average of 239 people a month (over 60 per cent of whom are children under the age of five).
In the maternity block, Nurse Isatu Kamara, a Maternal and Child Health Aide at the Centre assesses a pregnant woman who is in labour and has just been admitted to the facility’s labour room.
“We had a well but fetching water from it was very strenuous, especially when the water level was down,” says Isatu. “During some dry seasons, we could not use the well because it dried up. We [staff and patients] had to find other wells and streams outside the facility to get water. When pregnant women came to deliver, we had to go and fetch water to wash the equipment, clean the delivery room and they or their relatives had to go and fetch water to launder their clothes,” she adds.
As part of the Emergency COVID-19 Relief Assistance for Water, Sanitation and Hygiene (WASH) Improvement Programme funded by the African Development Bank (AfDB), UNICEF worked with implementing partners, Community Empowerment and Development Agency (CEDA) and Community Organization for Development and Empowerment (CODE-SL) to construct over 55 modern toilets, 33 showers, 11 laundries, and 11 waste management facilities, including incinerators for burning waste in 11 Peripheral Health Units (PHUs) across eight districts in the country, including at the Gbalamuya Community Health Centre. The partnership also installed water supply systems in the 11 PHUs and distributed Infection Prevention and Control (IPC) materials through the District Health Management Teams (DHMTs) covering the eight districts.
It is in this improved condition that Kadiatu Turay delivered her third child, a baby boy, about one hour after arriving at the Centre. A total of 200 deliveries were done at the Centre between January and December 2022. Kadiatu was able to easily get water to freshen up after delivery. “The improvement in the water and sanitation facilities at the centre really inspires us to come here when we need to,” says Kadiatu. “I had a better experience this time than I did when I delivered my two older children. My relatives had enough water and space to launder my clothes,” she says with a smile.
The new water, sanitation, and hygiene facilities installed through AfDB support are well appreciated. “Now we can wash all our equipment at the Centre each time we use them. Our new mothers have easy access to water to freshen up after delivery,” says Memunatu. “Other patients do not need to be reminded to wash their hands when they come here because they always meet soap and a bucket of water at each entrance of the Centre,” she adds.
“We believe that providing easy access to such facilities is vital to encourage good hygiene behaviours,” says Bishnu Timilsina, UNICEF Chief of Water, Sanitation, and Hygiene (WASH). “This will in turn help to reduce the risk of the spread of infectious diseases among patients and health workers,” he adds.
Nurse Memunatu is also positive. “Now my motivation for the job has increased. I can even concentrate more on the job because I don’t have to worry about or spend time trying to fetch water for use at the facility,” she says.
Given the limited numbers of trained health personnel stationed in communities, this support will go a long way in boosting efforts to mitigate human-to-human transmission, including reducing secondary infections among close contacts and health care workers, and to prevent transmission amplification events through access to and effective use of Water, Sanitation and Hygiene and Infection Prevention and Control (WASH/IPC) services in health care facilities. It will also contribute to keeping available personnel satisfied and motivated to stay on the job to keep fighting to reduce the high rates of maternal and infant deaths.