In Nepal 52% of people do not have handwashing facilities with soap and water at home (JMP 2017), despite this being one of the key ways to prevent the spread of infectious diseases, such as COVID-19. Ahead of World Health Assembly next week, WaterAid Nepal is urging our Health Minister to make hygiene a key part of our country’s plan to respond to the COVID-19 pandemic.

Healthcare facilities are becoming the epicentres of the disease putting the lives of doctors, nurses and midwives at risk while saving others. There are currently no approved treatments or vaccines for COVID-19 and everyone is reliant on good hygiene and infection prevention and control to help stop the spread.

Whilst vaccines and therapeutics are urgently needed, lives are being put at risk every day because the very basics of disease prevention are being ignored. Last year, the world’s Health Ministers committed to ensuring clean water was available in every hospital and healthcare facility but there has been woefully little progress.

Despite the dire statistics, the importance of access to hygiene and clean water has been appallingly overlooked by world leaders in the current crisis. Governments have been quick to promote handwashing, but without acknowledging that this is shockingly still impossible for the three billion people around the world who lack clean water and soap in their homes, and for millions of frontline health workers and their patients in clinics and hospitals.

The draft World Health Assembly (WHA) resolution on COVID-19, which will be discussed at a virtual WHA next week, has no mention of water and hygiene access as fundamental preventative and protective measures, and fails to put in a place any sort of plan to tackle the huge gaps in access to this first line of defence.

WaterAid believes this is a dereliction of duty from both donor countries and national governments of countries where access is low, and flies in the face of WHO’s advice to Member States which calls for urgent provision of hygiene services in communities and health centres.

This follows similar exclusions of water and hygiene from almost all of the COVID- 19 emergency funding released by Governments and donor agencies over the past two months. Of 51 major announcements of financial support from donor agencies to developing countries only six have included any mention of hygiene*.

Tripti Rai, Country Director-WaterAid Nepal has said “the Constitution of Nepal 2015, includes access to safe water and sanitation as fundamental right of people. The Global Goals, or SDGs, have a dedicated Goal 6 to achieve universal and equitable WASH, to which the Nepal Government has responded with national priorities and commitments for improved water and sanitation services. Universal includes households, schools, health facilities, public places, and such. Access to WASH in healthcare facilities is essential for the provision of quality of care, however 54% of Healthcare Facilities in Nepal do not have handwashing facilities available at point of care, accordingly to the WASH in health care facilities: Global Baseline Report 2019. An assessment done by WaterAid Nepal in 3 districts in Sindhuli, Siraha and Makwanpur, 55% of the healthcare facilities had any provision for drinking water treatment, none had any mechanisms in place for monitoring the quality of drinking water. Hand washing stations were available in 75% of the total toilets observed yet out of
this number only 55% of hand washing stations had soap and water.”

WASH extends beyond health impacts to issues of dignity and respect, and health care workers morale and safety. If ever there was an urgent time to learn fast and act faster, that time is right now. WaterAid calls on all decision makers and leaders to ensure peoples access to safe water, sanitation and hygiene in all Healthcare facilities where people seek quality health services, Right to Health Care is a fundamental right.

Professor Wendy Graham from London School of Hygiene & Tropical Medicine (LSHTM), said: “A year ago, the World Health Assembly Resolution on water, toilets and hygiene in healthcare facilities offered such promise to tackle the obstacles to providing clean, safe care. Dr Tedros himself held up a mop to reinforce the clear commitments that were made to ensure all facilities have reliable water supplies to enable cleaning both of hands and of the care environment. Sadly, too little progress has been made in meeting those commitments. COVID-19 is a stark reminder that we ignore these basics of hygiene at the peril of humanity.”