(Photo credits: WaterAid India) (Feature image)

The doctor who decided it was time.

By N. Sudhakar/WAI

Not all doctors walk the extra mile to improve health care systems, but one doctor in the tribal-dominated district of Baswada in Telangana did. Dr. Srinivas Prasad, Superintendent of Baswada’s area hospital decided it was time, the healthcare facility stopped being a hub for hospital-borne infections and started being the institution it was meant to be.

Banswada, a small town located in the tribal pockets of Kamareddy district in Telangana has only one hospital catering to its vast population. This lone hospital attends to almost all essential medical needs required by the majority of the tribal communities in the district.

But with an increasing number of cases being reported on hospital-acquired infections, morbidity, and bacterial sepsis, Dr. Srinivas Prasad, Superintendent of the area hospital, took the onus upon himself to do something about the grave situation.

Armed with a firm mindset to rectify the situation, Dr. Srinivas joined hands with WaterAid India and its partner organization forming a core team. Together, they identified various gaps in the maintenance of water, sanitation, and hygiene systems in the hospital, as well as observed a lack of basic hygiene practices by the hospital staff.

While the hospital was visibly unclean and unhygienic, what also came as a shock was the lack of knowledge among the junior staff members about management of crucial aspects, such as handling biomedical waste and being unaware of Bio-medical rules (1998). To add to it, the WASH (water, sanitation, and hygiene) infrastructure of the hospital, including handwashing stations, water storage tanks, toilets, water quality treatment units and sewage pipelines were not functional.

Also, the lack of understanding by the hospital staff about important tasks related to water, sanitation, and hygiene like safe disposal of human waste, water quality, faecal-oral transition, and safe handling and disposal of hazardous waste was evidently visible. The wastewater generated from laboratories and surgical areas appallingly overflowed into the hospital premises, increasing the risk of infections for the patients.

As a first step to change the situation, Dr. Prasad deputed the entire staff for a training on WASH sensitization. The project team additionally sensitized the senior hospital officials on WASH components and Kayakalp guidelines, part of the Government of India’s Swachh Bharat Abhiyan. He ensured that all team members participated in the monthly hospital meetings and reviews structured as well as played active roles in the Hospital Development Society to identify WASH gaps and take corrective measures. The ultimate objective was to make the hospital an inspiration for others; a model area hospital.

Post training sessions, the doctors and health care professionals began practicing good hygiene habits (Photo credits: WaterAid India)

Additionally, IEC (information, education, and communication) material was developed and displayed so that both service providers and patients have a better understanding of appropriate WASH practices.

Dr. Prasad also initiated the formation of a Hospital Infection Control Committee (HICC), to closely review the status of various infectious diseases with in-depth discussions to reduce it with regular follow-ups.

And, the results were remarkable!

While clean drinking water was made available to the patients and staff, handwashing stations and sanitizers were introduced in the hospital premises. The toilets not only underwent renovation but were thoughtfully designed to make them inclusive and accessible for the differently abled, the elderly, pregnant women, and those with certain health conditions. Other issues, such as a drinking water treatment unit, closed drainage systems and pipeline leakages were also renovated, along with the construction of new rooms for bio-medical waste segregation. It was also decided that the drinking water quality would be tested twice a year – pre and post monsoons to further lower the risk of infections.

Solid waste segregation in progress (Photo credits: WaterAid India)

Based on Kayakalp guidelines, the hospital staff started assessing standards on a monthly basis as per the Kayakalp checklist, while the Infection Control Committee actively monitored the practices adopted along with the services offered to the patients and their families. The Hospital Development Society members were thoroughly oriented on water, sanitation, and hygiene issues, and it was decided to allocate a certain budget for WASH prioritized issues and activities.

In order to sustain the remarkable change taking place, a 32 member core group team was trained on crucial aspects related to water, sanitation and hygiene standards at health care centres.

Soon, the overall impact of the systematic and sustainable efforts was evidently visible – the cases of bacterial sepsis and severe infections reduced considerably.

From being a hub for hospital-acquired infections to being a model area hospital adhering to Kayakalp Guidelines serving tribal dominated communities, the health facility of Baswada reinforces the fact that WASH is a critical component for health care facilities and hospitals.

It also is an example that all it takes is one individual, who believes and pursues that change for the better like Dr. Prasad did for Baswada’s people.

Glossary

HCF

Health Care Facilities

WASH

Water, Sanitation, and Hygiene

Kayakalp Guidelines

A government initiative that encourages every public health facility in the country to work towards standards of excellence to help them stay clean and hygienic.

Bacterial sepsis

A clinical term used to describe symptomatic bacteraemia, with or without organ dysfunction.