Hospital is the byword for cleanliness and hygiene, or at least that is what you would think. Go to the toilets at the emergency block of Pangu Hospital and you would have your faith in hospital hygiene pretty much destroyed.

You would never want to go back in there.

The word unhygienic falls far short when you are trying to describe the toilet. It's dark, damp, filthy, and garbage is scattered everywhere.

A toilet floor under water at a ward in Pangu hospital. Photo: Rashed Shumon

And oh! the horrifying gut-wrenching stench from the toilets flooded with faeces.

Your inner organs would want to leap out with your vomit.

This is the state of the toilets The Daily Star correspondents found during a recent visit to National Institute of Traumatology and Orthopaedics Rehabilitation, popularly known as Pangu Hospital.

The state of toilets in other public hospitals was almost the same. The Daily Star correspondents visited five government hospitals on July 23, 24, 27 and August 1.

The toilets there are just left like that in utter negligence and experts said that this was a health hazard and could cause psychic complexities in patients and their attendants.

The Daily Star correspondents found no soaps there let alone toilet papers. All of them had squat toilets and no modern flush toilets.

The condition of the toilets at Dhaka Medical College Hospital (DMCH), Sir Salimullah Medical College Hospital and Mitford Hospital and National Institute of Kidney Diseases & Urology (NIKDU) was a bit better than that of Pangu Hospital's and Shaheed Suhrawardy Medical College Hospital (SSMCH).

However, the numbers of toilets in DMCH (main building), Mitford and SSMCH were inadequate, patients and their attendants alleged.

Mahmudur Rahman, director of Institute of Epidemiology, Disease Control and Research (IEDCR) said the unhygienic washrooms in hospitals were largely responsible for infectious hospital-acquired diseases, like hepatitis, typhoid, and diarrhoea.

Infectious diseases usually spread through stools, urine and bodily fluids. When patients carrying germs of infectious diseases use a washroom and the toilet is not cleaned properly, other patients or their attendants could be infected afterwards when they use the same toilet, he told The Daily Star.

PANGU HOSPITAL

The washroom across the emergency ward had no door. Inside, there were two large bins placed at a water tap.

One toilet stall was not useable, as the pan was full of excrements, and the other one had a broken door.

Someone had made a poor effort to make it useable by hanging a piece of polythene over the broken part of the door. The stench was horrible.

The washroom for "I" and "J" wards is used by males and females.

The wet, damp and poorly lit ablutions area of another toilet, in the hospital. Photo: Rashed Shumon

One toilet pan on the male end of the toilet was full of human waste while the floor of another toilet stall was under two inches of water.

Four bathrooms were not useable at all and the entire room lacked light.

Women were seen entering toilets covering their noses.

Doors of a toilet at the outdoor section were broken. Filth and insufficient light made the situation even worse.

The condition of toilets at other wards was relatively better than that of the outdoor but those toilets had dirty and damp floors.

All of them had squat toilets, which made it almost impossible for patients with fractured legs to use them.

Suchi Rani, a 50-year-old woman, went to the hospital from Narsingdi on July 23, with her right leg broken. She said, "Using the toilet is now my main worry."

Shah Mohammad Saiful Islam, administrative officer of the hospital, said there were only 40 janitors to clean the 500-bed hospital. The number of janitors was 71 in 2004 but no new appointments were made in the last 11 years, even though the number of beds have been increased, he added.

"However, we are trying to keep the hospital clean with the limited number of cleaners but sometimes, it is not possible," he added.

SUHRAWARDY HOSPITAL

The toilet situation in the SSMCH is as terrible.

At the outdoor section, there is just one washroom for males and females. Among the four toilet stalls, the door of one was broken.

One toilet did have a modern flush toilet but it was not useable.

The conditions of two others were appalling.

The floor was damp and it lacked light.

There was no toilet at the emergency department. People have to go to the wards to use the toilet. Both male and female were seen using the same washroom at a male ward.

Nazma Begum, wife of Safiullah, 60, a patient of the medicine ward (male), said, "Whenever I go to the washroom, I feel like throwing up."

They wash utensils next to the urinal, which was very worrying, she said.

Washrooms of four other wards, including a paying ward, were of almost the same state.

"We clean the washrooms thrice a day. This is a government hospital, how many times will we have to clean it?" said a cleaner.

Suhrawardy hospital administrative officer ABM Mustafa too said they have manpower shortage at the hospital and asked The Daily Star correspondents to talk to the director of the hospital.

The director could not be reached over the phone despite repeated attempts.

DMCH

The toilets of DMCH were a bit better than that of Pangu and Suhrawardy hospitals.

However, there were used bandages, women's sanitary napkins, and garbage inside the toilets on the ground and the first floors of the main building.

Floors were filthy and damp.

The toilets of the outdoor section were worse.

However, the main problem of the hospital's main building was that it had inadequate number of toilets.

There were only four toilets for outdoor patients but those serve more than 2,500 patients a day.

There were some 70 toilets inside the main part of the compound of the country's largest hospital. Patients and their attendants often compete to use those toilets in the mornings, sources said.

More than 2,000 patients have treatment at the main building every day. There are a huge number of attendants there too, sources said. 

Khawza Abdul Gafur, assistant director (administration) of DMCH, admitted the inadequacy of toilets. "Although there is a lack of manpower, we try our best to keep toilets clean," he added.

Mitford Hospital

The Daily Star correspondents found the washrooms at the medicine wards of the city's oldest hospital dirty. Several attendants complained of inadequate number of toilets and intermittent water crisis.

Toilets in other wards of the hospital were relatively clean.

NIKDU

At least 10 toilets were not clean at the NIKDU.

A nurse of the hospital said though cleaners clean the washrooms four times a day, they do not do their work properly.

AUTHORITIES' RESPONSE

Saidur Rahman, deputy director (hospitals) of health directorate, also admitted the poor condition of toilets in public hospitals.

He said higher number of patients than beds available, inadequate manpower, and users' callousness have contributed to this situation. "The hospitals' authorities were also responsible for this condition," he added.

"There is adequate budgetary allocation for cleaning materials like soaps and hand wash liquids, but we will look into the matter why those are not in the toilets," Saidur said.

He also felt the necessity of having proper modern flush toilets in hospitals.

"We will discuss the issue in our next meeting," he added.