Clean water, decent toilets, hygiene challenge for the southern African community – Global issues

A garbage collection bin awaiting collection from the town hall. Markets are one of the places targeted by the SADC hygiene strategy. The photo was taken around 5 a.m. as people gathered for market day. It is a stone’s throw from the health center featured in the story. “Credit: Charles Mpaka? / IPS? “
  • by Charles Mpaka (blantyre, malawi)
  • Inter Press Service

Failed facilities also serve as bathrooms.

Visiting bathrooms and toilets is an act of courage, says Thokozani Paulo, who spent four days at the center in November 2021, when his first child was born.

“When you want to take a bath or relieve yourself, the picture is awful because half the time there is a mess, and the stench is terrible,” she told IPS.

At night there is no light and the rooms are swarming with mosquitoes.

Moreover, there is also not much dignity and privacy for the users. There are no doors, so the women improvise using their slings for more privacy.

“So, you bathe, and someone comes to seek relief,” said the 23-year-old in an interview with IPS at her home. Her one month old baby girl sleeps peacefully on her lap. Workers at the facility clean both toilets, but without detergent and only once a day in the morning. One day, the women in the ward and their guardians begged the workers to clean the toilets at least twice a day. “They yelled at us saying that we were not the ones paying their salaries and that we had to focus only on what we had gone to the health center for,” says Paulo.

The only hand washing basin in the ward was never supplied with soap during the four days she was at the health center.

In November, this experience and the experiences of many others like Paulo were high on the agenda of a meeting of health ministers of the Southern African Development Community (SADC) in the capital of South Africa. Malawi, Lilongwe. At this and other meeting, ministers approved the SADC Hygiene Strategy (2021-2025).

According to the strategy developed by the SADC Secretariat, the analysis of national plans in the region on health, water, sanitation, environmental health and nutrition indicates that there is an “enabling environment” for the region. implementation of hygiene practices.

However, considerable gaps remain in most of the 16 Member States.

“There is still a need to mainstream and mainstream hygiene into most national policies in order to broaden the basis of an enabling environment for effective and sustainable promotion of hygiene practices,” it read.

The framework, therefore, challenges SADC governments to increase hygiene coverage and behavior change in all settings. These settings include health care facilities, schools and daycares, workplaces and commercial buildings, prisons, markets and food establishments, transportation hubs and places of worship.

Key hygiene behaviors include washing hands with soap, managing drinking water, disposing of feces, food hygiene, menstrual hygiene, and waste management.

In the case of health centers, these should have a safe and accessible water supply, clean and safe sanitation facilities, hand hygiene facilities at health points and toilets, waste disposal systems appropriate and environmental cleaning.

According to the strategy, infrastructure that supports hygiene and medical waste management practices help prevent the spread of disease in health facilities and the surrounding community. The strategy was developed with the support of UNICEF and WaterAid Southern Africa.

Maureen Nkandu, Regional Director of Communications for WaterAid Southern Africa, says the policy emphasizes the need for leadership, commitment and accountability “to create a culture of hygienic behavior and practices at all levels of society and to enable people to hygiene services, behavior change and promoting sanitation ”.

“For these goals to be effective, strong planning, financial resources, implementation, monitoring and evaluation systems will be needed in each of the SADC countries,” Nkandu told IPS.

She says WaterAid has rallied key partners, including civil society and WASH-focused development agencies, to demand adequate resources to effectively implement the strategy.

In addition, achieving sustainable hygiene behavior across generations requires innovative large-scale behavior change programs. This can be achieved through adequate funding, coordination of relevant sectors and political leadership, Nkandu said.

For Malawi, the strategy offers the country the opportunity to intensify its efforts to achieve the hygiene-related Sustainable Development Goals (SDGs), said Maziko Matemba, community health ambassador appointed by the Ministry of Health. .

Matemba corroborates Paulo’s experience, observing that many health facilities in Malawi are a source of infection for patients, guardians and visitors due to poor hygiene.

“Sanitation and hygiene in most of our public health facilities is a serious concern. People go to the hospital for treatment, but we have cases where patients and caregivers have returned home with new health conditions contracted due to poor hygiene, ”he said, citing the toilet. as hot spots.

Matemba argues that health facilities could promote good hygiene in Malawi and SADC.

“People gather in these establishments to ask for services. It is a huge advantage to spread awareness messages at home and demonstrate by your own standards how people can promote good hygiene in their homes, ”says Matemba, who is also executive director of the health education program and to rights (HREP), a local organization. But in all of this, funding is a major factor, he observes.

“Hospital administrators tell us that if they don’t have the money for a basic commodity like drugs, hence these continuing drug shortages that we see, how mops, hand washing products and can chemicals for cleaning toilets become a priority? ”

Matemba told IPS that although civil society organizations have campaigned for ages for the government to address the critical lack of funding for hospitals, little has changed.

“The development budget is still insufficient. Recurring expenses, already below requirements, are further reduced, and the little that remains barely goes to facilities on time. The Treasury always says that the resource envelope is limited, ”explains Matemba.

He said the strategy challenges Malawi as SADC President to lead the way for member states to improve the hygiene situation in the region by fixing theirs.

A spokesperson for the Ministry of Health, Adrian Chikumbe, told IPS that the SADC strategy is an important approach to minimize the transmission of infection in health facilities and communities.

According to Chikumbe, a recent ministry assessment found that nearly a third of health facilities in Malawi lack running water and that 80 percent of patient latrines did not have an associated handwashing facility.

The assessment also found that the cleanliness of the environment was generally below average, characterized by poor waste management practices.

He says most of the lower-level facilities in the country lack the resources to maintain a functioning WASH infrastructure.

“The government recognizes that it cannot do everything alone. He therefore plans to mobilize the support of partners led by the district authorities to plan and prioritize water supply, sanitation and hygiene infrastructure in all health facilities, ”he said.

© Inter Press Service (2022) – All rights reservedOriginal source: Inter Press Service

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