When Hospitals Themselves Become a Health Risk

A hospital is meant to be a place of safety. People go there to be treated, to recover, and to return home healthier than when they arrived. But what happens when a hospital lacks safe water, adequate sanitation, hand-hygiene facilities, environmental cleanliness and proper medical-waste management? Under such conditions, the very institution meant to heal can become a source of infection and a threat to patient safety.

The latest global monitoring data from the World Health Organization and UNICEF make this hard to ignore. In 2025, among healthcare facilities with sufficient data, 85 per cent had basic water services, but only 40 per cent had basic sanitation services. Basic hygiene services were available in 72 per cent, environmental cleaning in 59 per cent, and healthcare waste management in 71 per cent. The pattern is unmistakable: having water on the premises is not enough. Safe healthcare demands a clean, properly managed environment throughout.

Globally, 11 per cent of healthcare facilities had no sanitation service at all in 2025, affecting an estimated 936 million people. Even where toilets existed, many were unsuitable for healthcare workers, women, people with disabilities, or those with limited mobility. Only 40 per cent of facilities worldwide met all requirements for basic sanitation.

For Bangladesh, this deserves close attention. According to the 2025 data, 27 per cent of healthcare facilities in the country had no basic hygiene service - meaning effective handwashing facilities were absent at critical points of care or near toilets.

According to the 2025 data, 27 per cent of healthcare facilities in the country had no basic hygiene service - meaning effective handwashing facilities were absent at critical points of care or near toilets.

The problem is compounded in Bangladesh, where public hospitals and health centres - particularly at the upazila level - already strain under patient overcrowding, staff shortages, insufficient cleaning personnel and ageing infrastructure. Add inadequate water and sanitation to this mix, and the risk of infection rises sharply.

Water supply itself needs closer scrutiny. Bangladesh was among the countries where at least 10 per cent of healthcare facilities had no water service in 2025. But a water connection alone does not guarantee a safe, reliable supply. Is there enough water throughout the day? Is the flow continuous? Is it stored safely? Is it fit to drink? These questions matter as much as the presence of a tap.

This distinction matters for hospital management. A tap that works only intermittently cannot be called an adequate water service if patients and staff cannot depend on it when needed. Likewise, a toilet that is dirty, waterless, or inaccessible to certain groups cannot be considered functional sanitation.
The same logic applies to hygiene. A single handwashing point somewhere in the building does not ensure hygiene across the facility. Hand-cleaning stations must be available precisely where they are needed - at points of care - so that healthcare workers, patients and attendants can clean their hands before and after essential contact.

Environmental cleanliness matters equally. Floors, beds, surfaces and equipment require regular, proper cleaning; without it, harmful microorganisms spread easily within healthcare settings. Improper handling of used syringes, sharp instruments and infectious waste poses further danger - not only to patients and staff, but to cleaners, waste collectors and communities living near these facilities.

Yet hospital cleanliness is too often treated as peripheral to healthcare itself. Doctors treat, nurses administer medicine, and cleaning is seen as a mere support function. This mindset must change. Cleanliness is not an optional add-on; it is central to patient safety and infection prevention.

Water, sanitation, hygiene, environmental cleaning and waste management should be treated as core components of healthcare infrastructure - not afterthoughts. A modern hospital cannot be judged only by its number of doctors, nurses, beds or advanced machines. Its capacity to provide a genuinely safe environment matters as much.

There is also a real accountability problem. Hospital management may fall under health authorities, while water and sanitation involve local government, cleaning is often outsourced to contractors, and waste management may span several agencies. This fragmentation makes it unclear who bears responsibility when basic services fail - and allows problems to persist unaddressed.

Bangladesh needs clear, enforceable standards for water, sanitation, hygiene, environmental cleaning and medical waste management across both public and private healthcare facilities. More importantly, compliance must be monitored regularly. It is not enough to ask whether a hospital has toilets, taps or waste bins. Authorities must assess whether these facilities actually function, are maintained, and can be used safely by patients and staff alike.

Reliable data are essential to this effort. Every hospital and health centre should maintain updated records of daily water requirements and supply, functional toilets, hand-hygiene facilities, cleaning staff and waste-management practices. This information should be part of routine health-sector monitoring, not something gathered only during occasional inspections or special surveys.

Ultimately, this is a question of priorities. Bangladesh needs more hospitals, beds, equipment and trained health professionals - but expanding physical infrastructure alone will not guarantee better healthcare. A patient’s experience of the health system also depends on whether they can access safe water, use a clean toilet, wash their hands when necessary, and receive treatment in a hygienic environment.

Healthcare must therefore be understood more broadly than diagnosis and treatment alone. Protecting patients from preventable infection is itself part of healthcare. A hospital that cures one illness while exposing patients to another, because of poor sanitation or weak infection control, cannot be called a truly safe facility.

Bangladesh’s next health-sector priority should not simply be building more hospitals. It should be making existing hospitals genuinely safe, clean, humane and patient-friendly. When a sick person walks through a hospital’s doors, they expect not only treatment but protection. Ensuring that a hospital never becomes a source of disease itself should rank among the most basic responsibilities of the health 
system.