Some patients used to avoid staying in Yen Thanh District General Hospital, in the central Viet Nam province of Nghe An.
The reason? Everyone knew that the hospital did not have a reliable supply of clean water. This was because the hospital was effectively competing for its water with the agricultural sector – so, twice a year during harvest season, the hospital’s water supply was cut off.
Dr Phan Thi Thuy, Head of the Department of Infection Control at Yen Thanh District Hospital said the lack of water compromised the safety of patients, staff and the community. Bacterial and other infections were common.
“In the past, the hospital mainly relied on tap water, and that source of water was often cut off, so it had to be used sparingly.
“There was not enough water for patients to brush their teeth, wash their faces, shower, do laundry or flush the toilet. So, they did not want to stay in Yen Thanh Hospital.”
But, averaging over 140 000 visits, and 16 000 inpatients every year, Yen Thanh Hospital plays a critical role in the health and well-being of its community.
Yen Thanh Hospital is not alone. Almost half of health-care facilities in Viet Nam do not have a reliable supply of clean water. Many lack secure and clean energy sources, and safe waste management, which are also essential for safe health care.
A reliable source of safe water is essential for effective infection prevention and control (IPC) in health-care facilities to prevent avoidable infections, including those caused by antimicrobial-resistant (AMR) pathogens.
Patients, health-careworkers and the community are at risk.
Storms, floods, drought and salt-water intrusion - made worse by climate change – are increasing the risks.
Health-care facilities are particularly vulnerable to climate change, as they often lack stable infrastructure, adequate sanitation, and reliable supplies of water and energy.
Disasters can disrupt health care – as with Typhoon Yagi, which damaged more than 800 health care facilities in September 2024.
But globally, the health sector also contributes nearly 5% of total greenhouse gas emissions – through energy consumption and health-care supply chains, as well as factors such as poor management of health-care waste, which can also pollute the environment.
Since 2021, the World Health Organization (WHO) has been working with the Ministry of Health’s Health Environment Management Agency (VIHEMA) to pilot tailored solutions to mitigate the risks at Yen Thanh and hospitals in Ben Tre and Lao Cai provinces..
The four components of the pilot model (known in Vietnamese as the 4Ns) are: 1. water, sanitation and hygiene (WASH), and health care waste management; 2. capacity building and awareness raising; 3. energy efficiency and green energy; and 4. improved infrastructure, technology and products.
Yen Thanh District Hospital Director Dr Luyen Van Trinh worked with Dr Thuy on all four components.
“We surveyed and built a raw water supply system, and a water treatment system. We also carried out other activities about the environment, such as communication, education and guidance to change behaviour to help us adapt to climate change,” he said.
Dr Thuy said the changes have made a huge difference to patient care.
“Now there is a new water system with a very high capacity of 200 cubic metres of water a day. It works very well.
“All of those things will help to reduce the risk of disease transmission in the hospital, and also improve treatment and help patients recover quickly. Patients are much happier now.”
The hospital is now able to perform significantly more medical procedures than before.
Yen Thanh and the other pilot hospitals are models for other health-care facilities across Viet Nam, so that they can keep serving their local communities safely – despite the climate change challenges – and contribute to Viet Nam’s climate commitments.
In November 2023, the Ministry of Health announced it had joined the Alliance for Transformative Action on Climate and Health (ATACH) to exchange experiences with other countries that have also committed to climate change and health initiatives. ATACH will help the health system contribute to the country’s target of achieving net-zero carbon emissions by 2050.
WHO Representative in Viet Nam Dr Angela Pratt said, “Yen Thanh has seen a great result from improving its climate-resilience and environmental sustainability, and so have the other two hospitals in the pilot programme.
"We believe many other health-care facilities around Viet Nam could reap similar benefits, once we can unlock the resources to scale up improvements like these nationwide.
“Bringing safe, climate-resilient, low-carbon health care near to where people live not only improves health outcomes and equity now, it also contributes to carbon reduction goals and is an investment in a safer and healthier future for Viet Nam in a changing climate.”