Improving the sanitation facilities at the Manambaro Hospital by providing hygienic and sustainable latrines.
Madagascar is considered one of the most biodiverse countries in the world, but it is also one of the most impoverished and least developed. With 92% of the population living below the international poverty line of $2 a day, the population is struggling with high rates of child and maternal mortality, chronic malnutrition and insufficient infrastructure (UNICEF, 2016; UNDP, 2016). Considered a national emergency, Madagascar falls far below global sanitation standards; just 12-14% of the population have access to improved sanitation facilities (WHO, 2014; World Bank, 2017). As such, open defecation is commonly practiced, which alongside traditionally poor hand hygiene, accelerates the risk of waterborne illnesses. This has secured diarrhoeal diseases as the primary cause of early and preventable mortality for the past decade. Clinical environments and healthcare facilities present even more challenges as the safe disposal of human waste and advanced handwashing practices can reduce the incidence of diarrhoeal diseases by one third (WHO, 2015). But, the hospital in Manambaro fails to meet the acceptable level of improved sanitation required to ensure patient safety and staff hygiene.
The Manambaro Hospital is attempting to alter the chain of events that starts at preventable illness and leads to premature mortality. Once a renowned and distinguished regional medical facility, decades of underfunding have led to its decay, near-bankruptcy and the cessation of major services. While the new Medical Director has managed to restore many of the hospital's previous activities, the 50-year-old latrine block does not meet even the basic needs of the patients, staff or visitors due to disrepair and waste overflow. Inevitably, open defecation within the hospital grounds is prevalent, leading to flies and vectors, and urine seeping into the surrounding soil. The Manambaro Hospital Latrines Project will construct a new ventilated improved pit (VIP) latrine block for patients and visitors, flushing toilets with a septic tank for staff, and repair an existing septic tank within the hospital compound. Alongside water, sanitation and hygiene (WASH) training for staff, these provisions will decrease the incidence and impacts of diarrhoeal diseases and provide the community of Manambaro with a dignified and hygienic facility.