The government hospitals in the city have only 68 per cent functional toilets, of which 33 per cent are clean. The private sector hospitals have 92 per cent functional toilets, but only 56 per cent of these are clean, according to a recent study.
The International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b) scientists, in collaboration with partners at the University of Technology Sydney, Australia, and the Directorate General of Health Services (DGHS), conducted the study and recently published in the PLOS ONE journal.
The study evaluated 2,459 toilets in Dhaka's healthcare facilities to assess their availability, functionality, and cleanliness. It was conducted in 12 government and private hospitals in the capital.
Poor toilet access and hygiene pose significant health risks, potentially spreading diseases like cholera and typhoid.
High user-to-toilet ratios were observed in outpatient facilities, with one toilet for every 214 users in the government hospitals and 94 users in the private hospitals, significantly lower than the standards recommended by WaterAid.
According to their guidelines for construction of institutional toilets in outpatient facilities, 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, said the study.
Additionally, both the government and private hospitals failed to meet the criterion of one toilet per six inpatient beds, as set by the Bangladesh national WASH standard and implementation guidelines in 2021.
There were 17 users for each toilet in the government hospitals and 19 users per toilet in the private hospitals. Beyond basic functionality, hygiene and availability, less than 1.0 per cent of toilets had facilities for disabled people, and only 3.0 per cent of toilets had a trash bin for menstrual pad and solid disposal.
The researchers defined toilet functionality according to criteria, used by the World Health Organisation (WHO) and UNICEF, and assessed toilet cleanliness based on the presence of visible faeces on any surface, strong faecal odour, flies, sputum, insects, rodents, and solid waste.
"The actual sanitation condition 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," icddr,b's Associate Scientist and principal investigator of the study, Dr Md. Nuhu Amin, was quoted in a statement of icddr,b.
"This could have led to reduced patient flow and toilet usage," he added.
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