The schools where children can't wash their hands or use a toilet

ALICANTE, Spain — Hand-washing remains the first line of defense against COVID-19, yet new research reveals that 2 in 5 schools worldwide lacked basic hand-washing facilities prior to the outbreak. As children, young people, and teachers in many parts of the world prepare to go back to school, advocates are calling for action.

The report from the World Health Organization and UNICEF’s Joint Monitoring Programme for water supply, sanitation, and hygiene found that, globally, 37% of schools didn’t have a decent toilet on site and 43% had nowhere for their pupils to wash their hands with soap and water in 2019. That figure rose to 74% in sub-Saharan Africa.

“Access to WASH services is essential for effective infection prevention and control in all settings, including schools," said Dr. Tedros Adhanom Ghebreyesus, WHO director-general, in a statement. Without them, children and staff are at increased risk of contracting COVID-19 and other transmittable diseases.

Jean-Bosco Twizeyimana is a student at Groupe Scolaire Kibungo in Bugesera, Eastern Rwanda. The school has a basic water harvesting system, but it’s not enough to meet the needs of all the students. “There's no water to wash hands after using the toilet, so we don't wash them before coming out of class,” he said in a statement.

Jeri Stein, executive director of Watering Minds — a clean water charity that connects donors with schools — said she’s worried about children going back to schools without WASH services amid COVID-19. “We all know children may not be getting as sick but they’re the biggest [COVID-19] carriers,” she said.

COVID-19 aside, the absence of water and sanitation impacts school attendance, explained Richard Hall, chairman at Water for Kids. Young people often have to miss school because they need to collect water or, as a result of drinking water from unprotected water sources, become ill, he told Devex in an email. Girls also miss school days or drop out of education entirely because they are on their period and have no safe, private, and hygienic facilities to manage them.

Tedros called on governments to make the implementation of WASH services a major focus of strategies around the safe reopening and operation of schools during COVID-19.

Building on the guidelines for the safe reopening of schools, the report lists 10 actions needed when considering COVID-19 prevention and control in schools. These include several WASH-related protocols on hygiene measures, use of personal protective equipment, cleaning and disinfection, as well as providing access to clean water, hand-washing stations with soap, and safe toilets.

During the pandemic, Food for the Hungry and Engineers Without Borders USA rolled out a survey — designed for use on a smartphone or tablet by staff members — to help identify the WASH needs inside health facilities. This week marks the start of its roll out in schools. The data acquired can then be shared with ministries and nongovernmental organizations to take action.

For Ada Oko-Williams, senior WASH manager at WaterAid, the problem however is a lack of political will and investment in the issue, alongside poor coordination between ministries. Calling progress “achingly slow,” she said COVID-19 should be the catalyst to prioritizing better facilities. “If we’re to beat this pandemic, with schools reopening, we need enough resources to ensure we fight this battle on the school grounds and fight it effectively,” she said.

The difficulty is that, even if it has been recognized as an issue in a country, sometimes it’s not prioritized over other demands on finances, such as infrastructure projects, Hall said.

In general, there is a lack of national funding for WASH. In Uganda, just 3% of the national budget is allocated to water and environment, and that figure drops to 1.5% in Malawi.

Stein explained that the schools themselves also don’t have the budgets to pay the subsidies that usually come with community-level water access.

While there’s no one-size-fits-all solution, she recommended that schools work with local safe water enterprises that already have decentralized water filtration kiosks. “Working with an organization that is filtering on a larger scale to the community and delivers to the school makes sense,” she said, adding that water catchment could be another solution.

Donors and development agencies can help by committing to stop the building of schools without clean water and toilets, WaterAid said.

But Oko-Williams highlighted that even when there are adequate hand-washing facilities and toilets, there can be an issue with technical expertise and maintenance.

“In some countries, you go onto school premises and you see two, three, four blocks of broken down toilets funded by different funders and they’ve got all their logos on them ... It’s not just a case of providing money, but how do we ensure they are properly operated, maintained, and continually provide services they are designed for?” she asked.