Delivering maternal health requires water and sanitation

Wednesday, 18 May 2016 09:29 GMT

A handwashing point that only works during the rainy season in Bugasera district, Rwanda. WaterAid/Behailu Shiferaw

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* Any views expressed in this opinion piece are those of the author and not of Thomson Reuters Foundation.

By most measures, my country of Rwanda has made incredible progress in the last 20 years: we reduced maternal mortality by 77% between 2000 and 2013, and under-5 child mortality is down nearly 70%.

Our government’s focus on healthcare has helped accomplish this. But while many of our hospitals look fine on the outside – many are spacious and well-maintained – there remains a serious health crisis lurking inside, in the form of overflowing toilets and waste disposal pits, and water taps that are dry.

We still have an enormous task ahead. Some 290 women will die for every 100,000 live births; 20 newborn babies out of every 1,000 will not survive their first month.

Delivering a baby in these hospitals is a nightmare. When I visit some of these healthcare facilities, I ask myself how it works out for these mothers. The waiting rooms where the mothers labour are a few minutes’ walk from any toilet or latrine. And when the mother gets there, it is a pit latrine, so she has to squat, whether she is there for a short call or a long one. The midwife or nurse managing her care is in the same situation.

And there is no access to water in the labour or delivery room – it is outside the premises, if it is there at all. So water is being stored in jerrycans and basins and is at risk of contamination, and clinics are forced to purchase clean drinking water at great expense, taking away from precious resources for operating the hospital and caring for patients.

Around the world, a newborn baby dies every minute from sepsis or infection, many of which can be prevented with clean water, good sanitation and rigorous hygiene practices. This means a midwife who has the ability to wash her hands with soap, a clean razor to cut the cord, a clean sheet to deliver the baby on, and clean water and soap to wash mother and baby before and after birth.

Despite all our country’s progress, when I speak with the mothers in the communities in which we work, I still hear these tragic stories often – they gave birth six, eight, 10 times, but only have four children surviving. And most of them say I lost my baby after just a few days.

Water, sanitation and hygiene are essential for health, whether at home or in hospital. According to monitoring by the World Health Organization and Unicef, some 38% of Rwandans still do not have access to a safe, private toilet, and 24% do not have access to clean drinking water.

In Rwanda, WaterAid is working on a programme where we ensure high-quality water, sanitation and hygiene delivery in a few hospitals to demonstrate how it can be done, with the important caveat of working with the duty-bearers -- the authorities whose job it is to provide these services. Our role is not to tell governments and local partners to do what we think is right, but to demonstrate what can be done, and how we can do it together.

At the Women Deliver conference in Copenhagen, thousands of delegates representing civil society, NGOs and governments from all around the world will gather to share experiences and seek out new and innovative solutions to the challenges of ensuring the human rights, good health and progress of women and girls.

Water and sanitation are essential to all of these. Girls cannot grow up healthy if they do not have clean water to drink, a safe toilet to use and the ability to wash with soap. They cannot complete their education and reach their potential if they are hiking miles to find water each day, or constantly ill from diarrhoea, or unable to manage their periods in a hygienic way at school. And they cannot expect to have healthy, happy children themselves if the place where life begins is not itself clean and hygienic.

It will take effort on a grander scale to resolve this crisis. Providing water, sanitation and hygiene in healthcare is a cause that needs to be taken up on a global scale. When donors and civil society organisations call for it, national governments will follow suit. This injustice requires action.