WASHINTON: More than one-third hospitals in the developing world lack running water, a deficiency that can lead to unsanitary and dangerous conditions for patients who need surgery, scientists, including those of Indian origin, have found.
The research points to larger deficiencies in the health care systems in many of the world's low- and middle-income countries and the need to focus on basic infrastructure in order to prevent the spread of disease and improve health outcomes.
"Running water is something we so take for granted and it doesn't exist in a third of hospitals in these countries," said Adam L Kushner, from the the Johns Hopkins Bloomberg School of Public Health in the US.
"Instead of water just being there, some hospitals truck in water or collect it in rain barrels, with no guarantee of its cleanliness," said Kushner.
"Without clean water, there is no way to clean surgeons' hands or instruments, wash gowns and sheets or clean wounds to prevent or reduce infections," he said.
The researchers, including Sagar S Chawla from Mayo Medical School and Shailvi Gupta from University of California, San Diego, analysed previous research related to surgical capacity in low- and middle-income countries.
They identified 19 surgical capacity studies undertaken between 2009 and 2015 that included information on water availability covering 430 hospitals in 19 nations.
They found that 147 of the 430 hospitals lacked continuous running water (34 per cent). These ranged from less than 20 per cent with running water in Liberia to more than 90 per cent in Bangladesh and Ghana.
Hospitals without running water often truck in water - at great expense - or use rainwater. While helpful in the rainy season, rain barrels often run dry during the dry season.
This water is not only needed for surgery, it is needed to keep patients and rooms clean during other parts of their hospital stays. The study did not address access to drinking water.
Without water, hospitals cannot conduct surgery, despite the large unmet surgical needs in these poor nations, Kushner said.
"Hopefully, people aren't operating in those conditions, but what do you do if a woman shows up in obstructed labour and needs an emergency C-section and it's the dry season and the rain barrel is empty," Kushner said.
"You can't operate with dirty instruments, but if you don't she's going to die. This is the sort of dilemma that surgeons in these hospitals face," he said.
Kushner said there needs to be a greater push for improving water access for people globally.
The study was published in the Journal of Surgical Research.