Sanitation At Healthcare Centres – AM Show on JoyNews (13-5-19)



[Applause] [Applause] [Applause] [Applause] [Applause] can you imagine that that's the rather sorry state of water and sanitation in some of our healthcare facilities here in Ghana let's learn a little bit more about it the coalition of NGOs in water and sanitation has done some work let's let's learn a bit about it from our two guests in the studio now from water aid Ghana I say good morning to George Coburn at New York he is head of policy advocacy and campaigns hello miss New York and we also have with us Patrick apoyo up there he's a member of corny wasps and of course he's a water and sanitation water sanitation and hygiene expert it's good to meet you both thank you for making the time now this is this is truly troubling that there are hospitals here in Ghana or healthcare facilities here in Ghana that have no water source tell us about those first that's like the worst situation tell us about those and then we'll talk about the rest afterwards mr. poo yeah okay sometimes when you begin to talk these things people think you're over stretching and that people have lived with the situation for a long time and they're used to it but some of the stories and things we have saluted eyes are very troubling imagine woman don't look don't look at the urban area just good it really area where there's no hard connection nobody is really a goal for them a human is going to deliver a human it's expected to carry on water on the head to go and have to deliver that's what you use to wash whatever she has to wash or when you deliver they pop all your bloody chlorine and everything for you you carry back home to man wash now it is only not the human aspect of it but is also directly related to it so the reasons why we are stagnating when it comes to maternal mortality Ghana has regulated for a long time we are making so much progress in reducing infant and child mortality in fact we have had infant mortality by between 1988 and now for materia metalli the reduction is just insignificant it was in the health care sector it was one of the MDA MDGs yes that was not met in the health sector after 310 women out of hundred thousand men who go to deliver do not gamble and infection accounts for up to 15% of this group and infection is related to how clean your operation or your delivery wouldn't have been undertaken so clearly effects of this lack of water sources yes now for you George at water aid it might not be a surprise to people that there are some communities that can't access water but the fact that a healthcare facility and that the management of government would be placed in such a community and that facility also cannot access I mean it beggars believe how health care can be delivered without water but for that to be happening I mean how widespread is it first of all how many parts of the country will we find this sort of problem you know thank you very much I just want to really touch on the some of the global commitment as a country with really ratified a lot of global commitment we've signed to the SDG and especially CDC that's really looking at access to water sanitation hygiene for everyone everywhere by 2030 what we've been signed to the the ratio commitment resolution of really ensuring investor watch coverage abide by the same period and Ghana has ratified that particular solution but the the situation is so pathetic the recent GMP report that came out just in the last month indicated that we have about 35 percent of her care facilities in the least developmental including Ghana without water in her care facilities and for me that that that shouldn't be the case yeah but beyond that we have any another problem which is the quality of water in the facilities that can access it you know and I'm hearing that actually the one of the most important things is checking the quality of the water is something that almost never happens what they're just grateful to be getting water so they don't really bother checking the quality of it but what are the implications of not checking the quality of videos I used in healthcare yeah when you look at water we did a research in Upper East into the streets and in terms of water assess it was a bit higher because different partners like water aid and UNICEF are all providing water fast in that region so it was over 90 percent but in terms of water quality when we checked on water quality we realized that less than 35 percent really have been water quality in the past year and that's supposed to be done at least every six months so the people are drinking what I do the quality and that is also an area where fluoride is endemic so what we have she replied drinking Freret water they don't know so they think they are getting water but the natural sense they are drinking to their grave what is so sad so the water quality issues are really serious issue as a country people drink from rainwater harvest but they haven't done any water quality test so what's the guarantee that the water that they are drinking is ozone from it that is one particular thing that we have to also look at it as a country let's talk about toilets and you know toilet facilities again there are some facilities that some health care facilities that don't have it beggars belief once more but over there it would seem that the problem is well it's twofold its first of all perhaps a lack of access to water which might lead to that here but there are also facilities where they have access to water but their toilet facilities have been left in a state of disrepair that is just shameful yeah let me tell us a bit about that well I think I like that that part if we're looking for me if you look at what is the best situation in the West situation I was in the West Twiggy is the one who stole it has been left at the state of disrepair in actual fact the study that Congress was involved in by use of what to eat actually found out that a more than half of heme facilities in a certain district which are not mentioned here oh why the facilities we want to know over half of okay plan that district right good because they are going out to the facilities where described as death traps outside the district capital if you were to discover the facilities they said excellent excellent excellent you move on to the district after everything else was in the state of disrepair we were described as death traps now the implications of deaths if you look at it is so imagine a health worker who agrees to accept posters to such a rural area most doctors would not do you say I can't work here they sacrifice the actually education they sacrifice the comfort of live with their husbands and everything they gather maybe people have never traveled to that side of the country and we don't know what open defecation is negative for the first three days they can even go to toilet because when they enter and this what you see they can even manage so they cope with it after three days trying to fall back to the purification I prefer to do it in open Strether than go into such a controller if you look at the one which is later to water ninety percent of it would later today because in those places you can even think of a flush toilet here so they're all VIPs VIP the maintenance is also an issue it's not like you just and go in that's a way you have to maintain the toilet and because the toilets are not provided according to the number or they delete there's overcrowding and when you have overcrowding the VIP concept to no work optimally so the faeces just accumulate and sort of actually getting composted and reducing food or it just it just it rots and sort of decomposing it rots I had smells it stinks so these are the challenges it was also recorded were no guidelines in the past fortunately UNICEF and other development partners are facilitated a process and we are hoping that this thing we are seeing the death drop that you just shoot here people now will be able to put their minds on it they gonna have service the Minister of Health of Sanitation water resources and the NGOs and development partners with Minister of Finance backing unless you pull all this work together to appreciate what our health workers are going through the prolines not going to be solved right now has there been any work George to help us understand what the cost will be of bringing all of these facilities to us at or to a human reusable standard yeah thank you very much I I think when you look at that one we even invest $1.00 in wash or less the quantity in Wars we are likely to really get gain for cities more so that had been declined so we got because we are not improving our wash facilities in her care facility we are really incurring more more cost in terms of the drugs in terms of employing more lessees doctors and others in to provide a facility to provide a service to the people in the in the in the area but I just want to also touch on the issue of investment probation control aporia really indicated that there are guidelines but the intersection is that the guideline normally UNICEF and development will support and develop the guideline and they would train some core people will be at a regional level and that is the end of it in that one is the actual people who really need the training other people who are in the district and the community they are not trained so until other different partners coming to really provide a support to trade the nurses on how to even to clean their environment and also really bring those volunteers or on board is always a bigger a bigger issue so there's a need for us really not just have the policy developed and trained core staff but how do we ensure that will cascaded to the people who really who need that service to ensure that they use it and practice it the most of the facilities are being managed by volunteers they they clean this bill done by volunteers I mean in a cracker you can go to a facility most of the forces are crying here you have to pay to use a service yeah in Accra here I want to just Hospital you have to pay to use a service to use the toilet what regarded the issue is that they do have cleanness government employee cleanness so they're cleaner that you volunteer that is they should be paid and as I really have to pay for that service to help them really pay for that particular volunteer dereliction of duty on the part of government I mean yes we have conflicting priorities we prioritize but I mean our health is there something more important than that really should should then should what is water AIDS assessment of the the prioritization government of Ghana gives to wash you know particularly in health care yeah i for for what eight routine they still need to be more to be done because wash is integrated into other interventions we talk of washing school we talk of washing her care facility talk of washing community so whatever intervention that you're doing actually look at the component of wars and there's a that need for government to play that coordination role to ensure that all the players within the sector their interests are well coordinated by the Ministry of Sanitation water resources because look at urban ministry is doing aspect gonna have is also doing aspect but if it's not well coordinated this is scattered all over and this really not happiness as a country but there's also a need for us to ensure that when we develop policies with Rob guidelines we have to implement them governor has service a Minister of Health is been supported by himself to develop a guideline to really ensure that all her care facilities that we have really have words water sanitation hygiene as a component but what what happens as a develop can live well they just sit in a class or who is going to ensure that that guideline is being financed to ensure that we provide adequate or basic at least basic words in her care facility we don't have to really build a hospital or Chiefs compound with at worst and who is even checking to ensure that that is not supposed to be done that is they also do of the civil society we need also to monitor to ensure that whatever interventional government is providing so the hospitals and the clinic really have component of Wars if that is done then they would govern accountable is there a quick fix Patrick is there something as some low-hanging fruit that government could do that would make a massive impact on this sorry situation yes there are some low-hanging fruits the first step is to have all health facilities who cannot be connected to a pipe network give them a very simple mechanised babul we call it limited mechanization we're not even talking about pipe into the entire whatever limited mechanised bogles that at least you can have water pumped from the underground to your storage tank that can serve the three categories of people were talking about any health facilities that is the patients who are on admission people who just come to help facilities to visit OPD and they go home and then the people who are visiting or caring for the in addition to that the staff so even if you can target the staff and the impatient and the outpatients to start with those ones are we did a health facilities in sirs but you also need to also think about the people who are caring for them they can use the same toilets are the pigeons and those ones that are located outside can all be served by the mechanized systems let me also be honest to say that the commercial or government houses mixed in some way to demonstrate that they are very committed of course the president has done it beyond what any president can do that I can see but when cost implementation finance minister is opposite they don't even see that it's a priority and nobody's even thinking about what a health facility so if you cannot speak for yourself they are finished nobody would think of you that's how we have that kind of financing for development we have in Ghana it's only those who can speak who get it the minister of special initiatives especially pessimist special initiatives actually have a big program since last year they are they awarded over 200 of such health facilities with mechanized googles and very beautiful things we are still tracking but what is lucky – I don't want to preempt by it as being become political political contractors who have no accountability to whatever monies they are getting and who and not actually input I won't pretend the report but it is not going to be good so that is the kind of mix attrition that we have and on good at the policy level but when it comes to actually rolling out a different a different picture that appears to be our problem in almost every every sector of our existence so let's look to the future I mean this report it's probably going to highlight a problem even more you know you talk about how there is some commitment but implementation is not so let me ask this you know from the position of water aid if this is all we can reasonably expect from government how do we make up the shortfall where will the rest come from who will come to our aid I really think that the the hope has to be led by the government for me that that is key and we should also look for internal resources normally most of the Doudna interventions are on pilot basis and they dealt with the pilot so if we like what I do I've done a lot of work in in in Appa Appa Appa now we are in a place to bomb Western Canada Street with ready we are using a technology that is environmentally appropriate because one of the challenges also pain of the water bras there are situations where the water where the heffa sylheti has no money to pay for the water bill and as a result of that they are not getting water for the facility so what we are doing now is what we are introducing so it's all a mechanised limited water systems where they don't really have to rely on Honda City right so they so those are the technology we have to really look at as a country because we keep on doing the same thing when you look at any resource so we lessen it for us to bring innovation whatever we do organize the water aid and other side really bring innovation but how I wished killing abuse integration for me is a credit card in because we document will share when that is the end of it because it's also getting money from donor so if we are working in we have about 200 district so yeah just working include the street and make an impact what about Eric the street we the concern on kannababu recorded zero maternal death because of the improvement in dia water sanitation hygiene horror facilities but what about the other areas so if we are able to do that also the involved local people involved this assembly to make commitment for me that is very very important when they are at the abandoned budget for the year they have to really make that commitment to ensure that at least what do they need basic change that they need never have as little this table which will provide a facility support today to the chips compound the hospitals and clinics in the area so that we can address the washing needs in her care facilities by 2030 George come cope New York thank you so much for your time George of course the head of policy advocacy and campaigns at water aid Ghana and joining us from Coney was Patrick aporia who is a wash expert you really paint a picture there and it's not it's not a pretty one I think it's a call to arms we all need to do something about this health care is a priority thank you thank you very much for so every 90 smoke you Wow well there's more to come on the air should stay where you are we're back after these

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