WASH IN HEALTH FACILITIES

PROGRAM
Water in Health Facilities

2016
 WATER DEFINITION AND ITS
IMPORTANCE IN OUR LIFE

 Water Definition: Water is a chemical compound

consisting of two hydrogen atoms and one oxygen
atom (one water molecule).

 Water is the source of life for all life being on earth.

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 WATER CONTAMINATION

 Practical work

 What could contaminate water?

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 WATER CONTAMINATION

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 RISKS RELATED TO INADEQUATE WATER
SUPPLY (QUALITY & QUANTITY)

 Insufficient water quantity leads directly to a lack of

hygiene and thus increases the risks of:
• Fecal-oral diseases (diarrhea, dysentery, cholera,
hepatitis A, poliomyelitis, typhoid, giardia, etc.)
• Skin and eye diseases (scabies, trachoma,
conjunctivitis, etc.)
• Nosocomial infections (surgical site infections,
urinary infections, etc.)

Access to water in quality and quantity is a priority in any

health structure.

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 RISKS RELATED TO INADEQUATE WATER
SUPPLY (QUALITY & QUANTITY)

 Poor water quality increases the risk of:

• Water-borne diseases by ingestion of water
containing pathogenic micro-organisms (all fecal-oral
diseases mentioned above, leptospirosis, Guinea
worm)
• Certain diseases by direct contact with water infested
by larvae (schistosomiasis, leptospirosis, etc.)

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 RISKS RELATED TO INADEQUATE WATER
SUPPLY (QUALITY & QUANTITY)

 Inadequate water supply may prevent staff from

performing certain activities correctly:
• Hand-washing (and standard precautions)

• Cleaning and sterilization/disinfection of medical

devices and linen
• Housekeeping of rooms and furniture

• Preparation of antiseptic and disinfectant solutions

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 INFRASTRUCTURE, EQUIPMENT, AND BASIC
MAINTENANCE OF A WATER SUPPLY SYSTEM

 Water needs:

Practical work

 How many liters of water we need to have in the HFs

in 24 hours?

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 INFRASTRUCTURE, EQUIPMENT, AND BASIC
MAINTENANCE OF A WATER SUPPLY SYSTEM

 Water needsdepend on:

• Water needs the climate
• the habits of the population
• the type of activities performed (e.g. amount of
material to be cleaned and sterilized, laundry, etc.).

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 TYPES OF WATER

 Always use the least contaminated water possible, in

order of preference:
• Groundwater (boreholes, springs, deep wells):
generally clear and of good bacteriological quality
• Rainwater: can be consumed without treatment if
collected on a clean surface (tin roof, tent, plastic
sheeting, plastic containers),
• Surface water (streams, rivers, lakes, ponds, dams):
water generally polluted and requires treatment
before consumption.

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 INFRASTRUCTURE, EQUIPMENT, AND BASIC
MAINTENANCE OF A WATER SUPPLY SYSTEM

 Water needs:
• Minimum requirements :

Min storage
Max distance
Health structure/activity Liters/person/day capacity in
to Source
closable reservoir
Outpatient Department 5
Inpatient Department 40-60
Operating theatre/maternity 100 /intervention
0.5 (5 L if long
Dry Supp. Feeding Centre 100 M 2 Days
waiting time)
Wet Su. Feeding Centre 15
Therapeutic Feeding Centre 30

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 TREATMENT OF WATER

 Treating water before use is not always systematic. It will depend on:
• the quality of the water available
• its destination (what it will be used for?)

 Minimum requirements of:

• Drinking water: absence of pathogenic organisms, low turbidity,
low toxic concentrations of certain chemicals, no color, no taste or
odor, non-salty.
• Clean water (used for health care activities other than drinking
water or preparation of food): filtered water non-salty, low or not
chlorinated and preferably with low mineral content.

 No direct relation between the appearance of a sample of water and its

potability (a cloudy sample may be safe, whereas a clear sample may
be both chemically and biologically dangerous).

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 TREATMENT OF WATER
 Methods of water treatment:
• Boiling

• Chlorination

 The main objective of water treatment is the removal of microbiological pathogens.

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 TREATMENT OF WATER

 BOILING
• Boiling clear water for 20 minutes (from the moment the water
starts to boil) allows the destruction of all microorganisms
• Method used for the disinfection of small quantities of water BUT
without any remnant effect (water must be used immediately!)

 CHLORINATION
• Chlorination results in the destruction of all viral and bacterial
pathogens in water
• Essential to remove suspended particles either by sedimentation or
by rapid sand filtration before disinfecting water with chlorine
• HTH is preferred for disinfection of large quantities of water (e.g.
cholera epidemics)

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 THANKS FOR YOUR ATTENTION

QUESTIONS?

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