Delia Jepson and Cheryl Stanley, midwives, Liverpool Women’s Hospital

We started this year by travelling to rural Tanzania with WaterAid to experience what daily life is like for the committed midwives working in a busy referral hospital where the taps only worked sporadically.

It is an experience that will never leave us—observing the caring and creative approach of these midwives, who try to provide high quality care in a place where, until the week before our arrival, running water was only available for one hour each day.

Delivering babies anywhere is full of joy and, sometimes, sorrow, but there—so far from the automated taps and sterile wrapped instruments we take for granted at Liverpool Women’s Hospital where we work—the emotions and risks ran so much higher.

One of the mothers we met had a 12 day old baby girl who was being treated for sepsis, which probably came from a cloth, known as a kanga, that swaddled her after birth.

In Tanzania relatives are expected to cook and wash for the mothers and their newborns, and we were horrified to visit the pond that water had been fetched from to wash the swaddling cloth of this baby girl. Although the relatives put great care into using soap powder and scrubbing the cloths clean, they were all rinsed in pond water and then often dried on the grass. When wrapped around a baby, those cloths could easily transmit infection through the unhealed umbilical cord wound.

Just as shocking was the old teapot that midwives used to trickle out a small stream of water to wash their hands in, so that they could eke out their water supply through the day. In Liverpool we have the luxury of being able wash our hands regularly and thoroughly, paying little heed to the amount of water we use. Our Tanzanian peers Ester, Juliana, and Daniel knew how important keeping hands, surroundings, and equipment clean was to infection control in their ward, but they lacked the water and resources.

Despite their best efforts, the maternity ward with its dry taps and unflushing toilets posed a real risk to mothers and babies.

Happily, thanks to WaterAid’s work, the midwives, doctors, and patients of Kiomboi Hospital now have a reliable supply of water; functioning toilets; and the ability to keep delivery rooms, instruments, and linens clean.

We were able to see the water supply increase even during our stay and the delighted reaction of midwives, who had gone from watching cases of sepsis soar at times when the water supply failed, to being able to follow their professional training for their patients—all because of a working tap

But while conditions at Kiomboi Hospital have improved, there are thousands more healthcare facilities where access to water remains a daily struggle. According to figures from the World Health Organization, 42% of healthcare facilities in sub-Saharan Africa do not have access to clean water. Worldwide, one neonatal baby dies every minute from infections linked to unhygienic conditions.

WaterAid’s Healthy Start campaign is designed to bring awareness to the need for clean water, good sanitation, and good hygiene in every hospital and healthcare centre around the world.

WaterAid is working with the Commonwealth Nurses and Midwives Federation to launch a new call to action for healthcare professionals, including a global petition, to make sure that every mother has the right to deliver her baby into a clean and hygienic environment and that every patient is protected from disease by clean water, safe sanitation, and rigorous hygiene and infection control

Every mother, everywhere, wants what is best for her child. And as midwives, wherever we are in the world, we are united in our desire to help mothers deliver their babies safely and to keep them healthy.

Competing interests for Cheryl Stanley: During my trip to Tanzania, WaterAid paid for my travel and accommodation only.

Competing interests for Delia Jepson: I received expenses towards inoculations that were recommended for my stay in Tanzania. My travel expenses and accommodation for travelling to Tanzania and the subsequent WaterAid Supporters Day were paid for by WaterAid. My employers, Liverpool Women’s Hospital, gave me paid leave.