Beyond medicine, water is the greatest need at a Health Centre

UNICEF’s motorised, solar powered WASH facilities are keeping health centres operational and in good standing with community members

By Hope M. E. Muzungu
water, sanitation, hygiene, WASH, WASH in health facilities, Uganda, Iceland Government, West Nile, health facilities, health centre, infection prevention and control, IPC, refugees, host communities
UNICEF Uganda/2022/Mugisha
25 March 2022

40 litres of water per day. That’s the minimum amount of water that each pregnant woman needed for delivery at Dramba Health Centre III in Inia Village, Arafa Sub County, Yumbe District. The water would be used for washing, bathing, the delivery process, the cleaning up after and even for cooking. 

“We would give new mothers a rest period of 24 hours after which they or their attendants would have to go and fetch water,” Angaika Kalsum, the midwife at Dramba Health Centre reveals. 

Less than three minutes at a water tap would yield the 60 litres, however, because the nearest water source was a borehole shared with the community, long queues and occasional breakdowns meant that pregnant women, some of them in labour, and new mothers would often spend hours on end just waiting to fill their jerrycans with water. It wasn’t just the mothers; the hospital staff were affected too.

water, sanitation, hygiene, WASH, WASH in health facilities, Uganda, Iceland Government, West Nile, health facilities, health centre, infection prevention and control, IPC, refugees, host communities
UNICEF Uganda/2022/Mugisha

“ We provided health services, but the quality of our work wasn’t good as we used water very sparingly. We also would wash our uniforms only once a week, as we could not take a break from work to queue at the borehole, wash the uniforms and return to work,”

Angaika highlights. 

As the midwife speaks, a woman in active labour slowly walks to a set of taps in the middle of the facility compound. She opens the taps, fills her 10 litre jerrycan, lifts it up and shuffles back to the labour suite less than 15 metres away.

“This new water system has made us a real health centre,” the midwife says, “We can effectively treat, as well as prevent and control infections. 

In 2019, UNICEF, with funding from the Government of the Republic of Iceland, partnered with the Government of Uganda to install comprehensive WASH facilities at six health centres in West Nile sub region, host to the highest refugee population in the country. The objective is to increase sustained access to, and use of safe drinking water, and improve sanitation and environmental hygiene practices in schools and health facilities, with a focus on learners and pregnant women in refugee and host communities.

The facilities include a motorised, solar-powered water supply system that pumps water to the hospital wards; two drainable pit latrine blocks, one for men and another for women; and the staff quarters. Next to the women’s latrine are a brick and concrete placenta pit with a metallic lid, and an incinerator with an oblong vent. William Enzama, the Head of Dramba Health Centre, notes that the incinerator and placenta pit are critical to continued operation as proper medical waste disposal is a fixed standard for every health centre.

Ever since the WASH facilities were installed, the number of outpatient visits to the centre has increased by over 500,000 per month, including over 100 antenatal visits and 50 deliveries. 

At the labour ward, 25-year-old Janet Avaku is one of 12 women who have reported for a monthly antenatal visit. She plans to deliver her second child at Dramba though she has to walk a total of two hours to and from her home. She says water is critical for a woman in labour for washing, bathing, and also for preparing hot tea that can be taken to hasten the contractions.  

Nearly 80 miles away at    Arinyapi Health Centre III, Arinyapi Sub County in Adjumani District, 20-year-old Betty Drinza expresses similar sentiment. She is in active labour and has already used 15 litres of water for washing and making tea. 

“ Water is a priority in every hospital.” Angaika the midwife says. “With a direct water supply to the maternity unit, I no longer have to worry about where and how to get water. After each delivery, I simply go to the sink, turn on the taps, wash my hands, clean up the equipment and the delivery room, then help the next pregnant mother.”

water, sanitation, hygiene, WASH, WASH in health facilities, Uganda, Iceland Government, West Nile, health facilities, health centre, infection prevention and control, IPC, refugees, host communities
UNICEF Uganda/2022/Mugisha
water, sanitation, hygiene, WASH, WASH in health facilities, Uganda, Iceland Government, West Nile, health facilities, health centre, infection prevention and control, IPC, refugees, host communities
UNICEF Uganda/2022/Mugisha

A core part of the WASH facilities is the extension of water supply to the community. Just across the road from the hospital are two water taps powered by the motorised water system, which provide a constant water supply to the community. To ensure sustainability, the community has appointed a water user committee whose first action was to set up a community fund for maintenance of the facilities if required, utilising specially trained mechanics. At the health centre, a separate health unit management committee comprising hospital staff was set up and trained on proper operation and maintenance of the WASH facilities. 

By end of 2021, the WASH services installed in four out of six targeted health facilities in West Nile were already benefiting over 20,000 people.
The WASH Specialist at UNICEF Uganda’s Gulu Zonal Office, Paul Semakula explains that this project fits well within UNICEF’s greater strategy to enhance access to clean water and reliable sanitation, and promote good hygiene practices, to ensure that every child grows up in a clean and safe environment.