Need to Know: WASH

Posted on Apr 21, 2020

a girl washes her hands with soap and water at a school in Mirebalais, Haiti
A girl washes her hands with soap and clean water at an elementary school in Mirebalais, Haiti.
Photo by Aliesha J. Porcena / Partners In Health

The world is seeing now more than ever, how washing hands with soap and water has become one of the most important ways to prevent the spread of infections leading to illness. However, in lower-income countries, access to clean water is a luxury that most cannot afford. This is an incredible shame, because when people have regular access to potable water, it can lead to increased productivity, healthier communities, and decreased spread of water-borne and diarrheal diseases. That is why WASH—or water, sanitation, and hygiene—is such a vital part of improving people’s quality of life.  

For more than three decades, Zanmi Lasante (ZL), as Partners In Health is known in Haiti, has worked in close collaboration with the Haitian Ministry of Health to improve the lives of the less fortunate in the Central Plateau and lower Artibonite regions. In addition to clinical care, ZL started a WASH program to educate the public, provide clean water treatment, and conduct a variety of community projects to improve water and sanitation.

doctor provides care to cholera patient in Mirebalais, Haiti
A doctor provides patients with care in a cholera treatment center in Mirebalais, Haiti, in 2012. Photo by Rebecca E. Rollins / Partners In Health

Since the cholera epidemic began in October 2010, ZL established 12 cholera treatment centers to care for the sick and help stop the spread of the bacterial infection. Staff also disinfected homes, distributed hygiene kits, which included soap and water purification tablets, and made patient referrals to local cholera treatment centers. ZL trained teachers and community health workers on how to communicate about and encourage proper hygiene. And ZL staff led the construction or rehabilitation of dozens of public water sources, including protecting natural springs, covering wells, and repairing pumps.

At University Hospital in Mirebalais, ZL built a sanitation block—called Kay Liz—where an average of 500 people each day access bathrooms and showers, where this a regular stock of clean water and soap. This was key considering many patients arrive with family members or friends, who sometimes travel from far away to stay and accompany their loved ones through care. The sanitation block ensures they will remain healthy themselves throughout their stay.

Below, Saskya Vitiello, ZL's partnership relations officer, provides a definition of WASH, explains its importance in quality health care, and talks about its link to climate change:

community education on proper handwashing outside Mirebalais, Haiti
Rose Marie Renati (center), a local PIH health agent, teaches children at an orphanage in Fond Michel about the importance of handwashing to prevent illness. Photo by Cecille Joan Avila / Partners In Health
  1. What is WASH exactly?

WASH is the intersection of access to water, sanitation, and hygiene. A complete WASH program ensures individuals have access to safe water to drink, bathe in, wash clothing, and perform all bodily care. It means people have access to a toilet, where fecal waste is properly disposed of and cannot contaminate individuals or water sources.  In addition, it means that everyone has basic hygiene knowledge, including the importance of washing hands thoroughly with soap and water.

  1. Why is WASH important in places like health care facilities?

Just as there is an intersection among the three components of WASH, there is an intersection between WASH and health care. According to the British Medical Journal, the invention of sanitation is the greatest medical advancement in 150 years, surpassing the inventions of antibiotics and anesthesia.

Health facilities should exist in an environment that helps individuals recover from illness not makes individuals sicker. As such, a health facility cannot properly function if infection is not controlled. Health care professionals cannot control the spread of infection without clean water to wash their hands and clean surfaces, nor without toilets for proper disposal of human waste. Moreover, when health facilities do exist in the absence of good WASH, patients and health care workers suffer.

  1. What are the positive impacts of strong WASH programs in health facilities?

Having access to adequate WASH services in a hospital creates environments that are safer for both health care workers and the patients who visit facilities. This includes reduced risk of infection in surgical spaces, safer labor and deliveries—including cesarean sections, and reduced transmission of infectious diseases among patients.

  1. When WASH is not in place properly, what are the negative impacts?

Infection can spread among health care workers and patients. Patients can spread disease to other patients. Surgery cannot take place safely. In addition, labor and delivery can lead to complications for the woman and child, even leading to higher mortality rates from uncontrolled infections.

  1. How is WASH linked to environmental and climate change issues?

A poorly planned or executed WASH project can negatively impact communities and ecosystems when, for example, improperly collecting and disposing human waste—especially when that waste contaminates public water sources. This is most important in countries where open defecation due to lack of sanitation facilities is the highest.

Water-related climate change, such as more severe and frequent droughts or floods, will have the greatest impact on the most vulnerable. During those droughts and floods, the lack of water and sanitation in emergencies leads to increases in diarrheal diseases, such as cholera, and other health problems.