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Supporting safe water, sanitation, and hygiene in health facilities

A man in a white coat standing in front of a white tank

48-year-old Saleh Ali, a doctor in one of the targeted health centres in Al Dhale governorate

48-year-old Saleh Ali, a doctor in one of the targeted health centres in Al Dhale governorate

After more than six years of relentless armed conflict, Yemen is facing a crisis on multiple fronts: looming famine, economic crisis, and outbreaks of diseases such as dengue, acute diarrhea, cholera, and COVID-19. A total of 15.4 million Yemeni people lack access to safe water and sanitation, while 20.7 million people lack access to adequate healthcare.

Decades of underdevelopment and years of intense fighting have left only half of all health facilities fully functional. The disruption of public services, especially in the health, water, and sanitation sectors, large-scale displacement, and the widespread of deadly diseases, such as cholera, dengue, and malaria, have made Yemenis even more vulnerable. The lack of supplies, as well as equipment, operational costs, and irregular payment salaries, hinders health staff’s ability to provide proper health care and puts the lives of millions at risk. COVID-19 pandemic has aggravated the situation further, with roughly 15 percent of the functioning health systems repurposed for COVID-19 treatment.

In many areas of Al Dhale governorate in southern Yemen, health facilities that still operate can barely meet the dire need for health services due to the lack of essential facilities, medical supplies, and equipment.

Mohammad Saeed, a resident from Al Dhale governorate, says: “We have suffered from the spread of diseases and epidemics for long years as a result of the prolonged conflict and its impact on the health sector. You can imagine how the situation is now with the spread of the new COVID-19 pandemic.”

To provide quality care, health facilities need to have a safe and accessible water supply and clean and safe sanitation facilities. Infrastructure that supports water, sanitation, and hygiene (WASH) in health facilities helps in preventing the spread of diseases within the health facility and to the surrounding community.

A man carrying a box from a small truck
Provision of much-needed personal protective equipment (PPE) and hygiene supplies to a COVID isolation centre in Aden governorate

“Patients, including children, women, and elderlies, need to wash their hands and use the toilets for different reasons,” says 48-year-old Saleh, a doctor in one of the targeted health centres in Al Dhale governorate. “As toilets were often crowded and not clean, patients had to go out of the centre to relieve themselves in their homes or in the open.”

With funding from USAID, CARE works to improve access to safe WASH services and contain the spread of the COVID pandemic in Aden, Lahj, and Al Dhale governorates through improving access to safe water supply and sanitation services in health facilities, as well as supporting COVID isolation centres and raising communities’ awareness about the transmission and prevention of COVID-19.

A white small building with orange trim
The newly constructed toilet in Bir Ahmed health centre

Through the intervention, nine (9) health facilities have benefited from rehabilitating sanitation facilities and constructing water tanks. In addition, seven (7) health centres were provided with personal protective equipment (PPE) and hygiene supplies, and thirty-five (35) were supported with much-needed hand-washing facilities.

Bir Ahmed centre, one of the targeted health facilities in Al Buriqa district of Aden governorate, had only two toilets, which were used by both centre staff and patients. Overcrowding and a lack of clean water made it difficult to maintain good hygiene practices in the centre. Through the intervention, the centre was supported with new toilets, a sewage network, and clean water tanks.

“The situation in the centre has improved a lot since the construction of four additional toilets, including two disability-friendly toilets,” says Abeer, a nurse in Bir Ahmed health centre. “Proper water and sanitation infrastructure in health facilities ensure patients’ safety and dignity.”

“Patients can use toilets safely now,” says doctor Saleh. “Improved water and sanitation services are crucial to ensure the quality of the provided health care,” he concludes.

Safe water, sanitation, and hygiene services are an essential part of preventing and protecting human health during infectious disease outbreaks, including the current COVID-19 pandemic. One of the most effective long-term strategies for increasing pandemic preparedness, especially in settings with limited resources, is supporting water and sanitation infrastructure in health facilities.


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