Only 33% toilets of Dhaka's govt hospitals clean, 32% non functional: icddr,b survey

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Dhaka hospitals have poor toilet access and hygiene conditions, according to a recent study conducted by the icddr,b. 

What's wrong: Dr Md Nuhu Amin, icddr,b's associate scientist and principal investigator of the study, said, "The actual sanitation conditions in Dhaka hospitals may be worse than what we found as our study was conducted in the aftermath of the Covid-19 pandemic when many hospitals were shifting from mainly treating Covid-19 patients to general medical care. This could have led to reduced patient flow and toilet usage." 

• He directed an increase in resources allocated for maintaining clean and working toilets in hospitals, with a particular focus on meeting gendered needs and those of disabled persons.

Poor toilet access and hygiene pose significant health risks, potentially spreading diseases like cholera and typhoid, the study says. Photo: Courtesy

By the numbers: The study looked into 12 government and private hospitals in Dhaka. 

• Only 68% of government hospital toilets were functional 
• Only 33% were clean 
• 92% of toilets in private hospitals were functional 
• But only 56% were clean
• Both government and private hospitals failed to meet the criterion of one toilet per six inpatient beds by the Bangladesh national WASH standard and implementation guidelines from 2021. 
• There were 17 users for each toilet in government hospitals and 19 users per toilet in private hospitals. 
• Less than 1% of toilets had facilities for disabled people 
• Only 3% of toilets had a trash bin for menstrual pad and solid disposal, according to the study.

Who conducted the survey? The icddr,b scientists, in collaboration with partners at the University of Technology Sydney, Australia, and the Directorate General of Health Services (DGHS) at the Ministry of Health and Family Welfare Bangladesh, recently published the study in the journal PLOS ONE.

• The study evaluated 2,459 toilets in Dhaka's healthcare facilities to assess the availability, functionality, and cleanliness of toilets
• It further said high user-to-toilet ratios were observed in outpatient facilities, with one toilet for every 214 users in government hospitals and 94 users in private hospitals, significantly below the recommended standards set by WaterAid. 
• According to their guidelines, there should be one toilet for every 20–25 patients or carers, up to the first 100 individuals, with an additional toilet for every additional 50 patients or carers.

Why it matters: Poor toilet access and hygiene pose significant health risks, potentially spreading diseases like cholera and typhoid. Proper sanitation and its accessibility are particularly crucial in hospitals, where disease-causing pathogens are expected to commonly circulate, the study says.