Water and Sanitation in Hospitals and Healthcare: A South African and International perspective Mudau LS. Tshwane University of Technology

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1 Corporate Affairs and Marketing (CA&M) Brand and Event Management Water and Sanitation in Hospitals and Healthcare: A South African and International perspective Mudau LS Tshwane University of Technology

2 OUTLINE Wash issues in health care facilities Overview of WASH in health care facilities International perspectives WASH in developing countries South African perspectives Issues of concern Pseudomonas Mycobacterium Avium Legionella Prevention Take home message 2

3 WASH ISSUES IN HEALTH CARE FACILITIES 3

4 OVERVIEW OF WATER, SANITATION AND HYGIENE IN HEALTH CARE FACILITIES WASH is essentials in provision of basic health care service. Provision of WASH programmes in Hospital prevent infections and spread of diseases Worldwide 15% of patients develop other illnesses during hospital stay and account to 430 death annually (Oza et al. 2015) Improved WASH Facilities encourage mothers to use health care facilities for their reproductive and maternal care. The challenge is that WASH services in most health care facilities are low. This enhance the growth of anti-microbial resistance due to nosocomial infections. 4

5 INTERNATIONAL PERSPECTIVES Hospital outbreaks caused by nosocomial infections are still common in most of the Developed countries. E,g. Pseudonymous outbreak in Northern Ireland that killed prematured babies in maternity ward where taps were found contaminated (McCrekan, 2013). Tap survey done by walker et al (2014) showed high contamination of sensor taps as compared to ordinary tap. In London teaching hospitals sinks were found contaminated by E. meningoseptica isolated from 30 patients. In Brazil microcystins were found during renal dialysis treatment (Azevedo et al. 2012) 5

6 ISSUES WITH WASH IN HEALTH CARE FACILITIES DEVELOPING COUNTRIES Faculty of Science

7 SOUTH AFRICAN PERSPECTIVES One out of 5 patients admitted in hospital is affected by nosocomial infections such as Superbug in South Africa. The most reason being poor hand washing. Michelle (2010) indicated that most of antimicrobial resistance bacteria in South African hospital is caused by poor hand washing. Wastewater from hospital also carry mycobacterium or enterococcus antimicrobial resistance. 7

8 ISSUES OF CONCERN IN HOSPITAL Pseudomonas-found in toilets, sink drainage and shower cabin, taps, hands etc. 8

9 PSEUDOMONAS Design of sinks, toilets, shower cabin as well as their piosition should not be next to bedside or high risk area. 9

10 BIOFILM IN WATER( LEGIONELLA AND MYCOBACTERIUM AVIUM) It encourages suitable growth media for mycobacterium aviaum and legionella. Mycobacterium in drinking water cause problems in patients affected by HIV/AIDS Mycobacterium is found in wastewater from hospital and can be transported with drinking water from the hospital. In USA Mycobacteria causes > hospital stay per annum Legionella can be carried to hospital through drinking water distribution pipes where pipes are exposed to a temperature of above 25 C to 42 C. It can be unhailed through shower heads, hot water systems, plumbing systems and majority found in sinks as well as respiratory equipment's. Can cause obstruction of respiratory system and Pneumonia Both require amoebae to grow in numbers. 10

11 PREVENTION Strengthen environmental monitoring Risk assessment of drinking water especially is obtained outside hospital facilities Good WASH programmes Good handwashing habit Proper wastewater management Training of health staff Development of WASH policy in health care facilities 11

12 TAKE HOME MESSAGE More research are needed to address WASH in health facilities Multi-disciplinary approach is recommended Addressing Health facilities issues through HACCP is essential 12

13 Corporate Faculty of Science Affairs and Marketing (CA&M) Brand Department and Event of Environmental Management Health THANK YOU 13