WASH in Healthcare Facilities

Contact details

Submitted by: Rod Beadle, Senior WASH and Response Advisor, Food for the Hungry

Email: [email protected] 

Introduction to the project

Country

Bangladesh - Kutupalong Refugee Camp

Duration

Started October 2018 and is ongoing.

Description

The project includes construction and operation of water, sanitation, and hygiene facilities at five healthcare facilities in the Kutupalong Refugee Camp.

Project Aims

The project sought to provide clean water, safe sanitation, and effective hygiene provisions conforming to SPHERE standards for five healthcare facilities serving Rohingya refugees in the Kutupalong Refugee Camp near Cox’s Bazar, Bangladesh. The improvements were intended to serve the healthcare facilities and the surrounding refugee community and to serve as examples of good WASH practices. Further, they were designed to be operational without being dependent upon other infrastructure systems or the unreliable electrical grid.

Resources used 

The projects were funded and supported by UNHCR and UNICEF grants. The WASH improvements were designed and constructed in accordance with the WASH Cluster guidelines, details, and standards. The work was also coordinated with and approved by the Government of Bangladesh refugee agency authority.

Partners

• ADRA 
• UNHCR 
• UNICEF 
• GoB 
• Medical Teams International 
• Water Mission 

Challenges and how they were overcome

Challenges

1. The only reliable source of water was from deep groundwater (approximately 200m). 

2. In spite of its depth, the groundwater was highly contaminated with microbial pathogens.

3. Poor quality and unsafe latrines were prolific throughout the camps, potentially adding further contamination to the groundwater supplies. 

4. Latrines needed to be safe, gender separated, and with separate latrines for staff and patients despite limited space. 

5. Access to each site was very difficult due to congested conditions and poor transportation within the camp, making it difficult to deliver materials and to get well drilling equipment in. 

6. The electrical grid was being installed so power was unavailable or unreliable. 

7. Refugees around the sites were drawing water from shallow wells with handpumps or from surface sources. Both were highly contaminated with microbial pathogens, contributing to the spread of waterborne diseases.

How they were overcome

1. Deep wells were drilled using hand-drilling equipment and methods in collaboration with drillers from the surrounding communities. 

2. Automatic chlorination systems were installed at all wells and staff was trained to test chlorine levels regularly to ensure safe water supplies. 

3. Latrines for the healthcare facilities included good quality slabs and pits lined with concrete rings to prevent collapse. Staff was trained to ensure that the latrines were regularly cleaned and monitored. 

4. Latrines were carefully sited to provide gender separated facilities for staff and for patients conforming to SPHERE standards. 

5. Day laborers were engaged to carry supplies to the sites and local well drillers were retained to drill deeps wells using hand-drilling equipment. 

6. Solar panels and solar pumps were installed with the ability to switch to grid power when available. 

7. Water distribution points were installed around the perimeter of each site to provide clean water sources for the wider refugee communities.

Results of the Good Practice

• Clean water, sanitation, and hygiene improvements at the healthcare facilities ensure that they remain places where patients can go without fear of contracting waterborne or other disease. 

• Clean water supplies are now available for the surrounding refugee communities. 

• Improved latrines at the healthcare facilities provide an example of how effective and safe latrines can and should be constructed.

How the project meets the GCR Objectives

Objective 1: Ease the pressures on host countries

This project helps reduce the demands on the host government to provide services to the refugee population by ensuring clean, potable water at the health clinics that provide medical services. 

Next steps

The healthcare facilities and their WASH improvements continue to be operational and are intended to be so as long as the refugee camps are needed.