Patients suffer from safe water crisis at coastal hospitals

Dhamrai Upazila Health Complex, located on the capital's outskirts, has a reliable source of water for its patients. A deep tube well, equipped with a motor, fulfills all water requirements, and the electricity bill is covered by the facility's annual budget.

In contrast, the Paikgacha Upazila Health Complex in Khulna faces a major challenge when it comes to meeting the water needs of its patients. Due to a lack of underground water and high levels of salinity in the area, the hospital cannot rely on a similar method used by the Dhamrai facility. Unfortunately, there is no allocation or arrangement by the health directorate to ensure drinking water or other water needs for patients at the facility.

Some 15 other upazila health complexes in coastal areas such as Mongla, Sarankhola, and Dakop, also have a severe shortage of drinking water. These facilities arrange water through local municipalities or NGOs and they cover the cost from patients. In some hospitals, patients have to buy water from outside.

To make matters worse, the health directorate does not provide any financial support for buying water from municipal sources or for the repair and maintenance of the reverse osmosis machines in the event of the devices going out of order at different coastal area hospitals.

Experts have recommended separate planning for hospitals in coastal areas, where patients and health workers are facing an acute shortage of water. 

The Paikgacha Health Complex is a major health care facility for people from all 10 unions under the upazila. Every day, more than 150 outdoor patients visit the complex to get medical services at low costs. As there are no drinking water facilities, patients have to buy drinking water from outside which adds to their cost. Meanwhile, many municipalities and individuals in coastal areas sell water by installing water treatment plants. 

Sources say, the Paikgacha Upazila Health Complex around 2014 started buying water from the Paikgacha Municipality. After a few months, when the complex wrote to the health directorate seeking funds to pay the bill, the directorate replied that there is no separate allocation for water purchase. Water management is completely on the hospital to manage. The hospital then discontinued the water line.

In 2019, local NGO Nabolok, with financial and technical support from WaterAid Bangladesh, installed a proper rainwater harvesting system with a drinking water vending machine inside the health complex. This rainwater harvesting system has a capacity of 39,000 litres to ensure the availability of safe water throughout the year.

"There is a severe crisis of drinking water here. Deep tube wells are useless here while Shallow tube well water is filled with iron. Pond water is used in the hospital through pumps. And the patients take water from the vending machine with Tk2 and Tk5 coins -- per litre costing Tk1. Every month some Tk2,000 is deposited from the sales, which is used for the vending machine's maintenance," Dr Nitish Chandra Golder, upazila health and family planning officer at Paikgacha, told The Business Standard.

"We feel bad taking money from patients for water in government hospitals, but there is no other way. There is no allocation for us from the directorate for water," he added.

Dr Golder further said during the months of Chaitra-Baishakh-Jaisthya, there is a water shortage in the upazila health complex, like other areas of Mongla. The water from the pond is pumped for use in the hospital, and the water purchased from the municipality is used by the patients.  

Dr Mohammad Shahin, upazila health and family planning officer at Mongla Upazila Health Complex, told TBS, "A service charge is paid annually to the municipality from the hospital budget where the water bill is covered. It would be better if the health ministry had a separate plan for water for coastal hospitals."

Waterborne diseases are more prevalent in coastal areas due to the shortage of clean water. Due to salinity, hypertension, pre-eclampsia, eclampsia, and skin diseases are increasing in coastal areas, said doctors.

Patients, doctors and health workers at the Dakop Upazila Health Complex buy drinking water from outside for Tk1 per litre. The filter machine provided by the public health engineering department has not been functioning for a long time. In addition, reverse osmosis machines were installed in collaboration with WaterAid and Transformation, but the machines mostly remain out of order due to salinity.

Dr Mosammel Haque Nizami, the immediate past health and family planning officer of Dakop Upazila Health Complex, said even after writing to the directorate, they failed to get any funds to fix the machines.

Public health expert Dr Abu Jamil Foisal said it is the responsibility of the health ministry to provide water to all hospitals.

"Appropriate arrangements should be made where there is a water crisis," he said, adding that the government can surely adopt similar ways the NGOs are using to provide water.