Priorities for hospital cleaning, disinfection, sterilisation, and control of infection.

Abstract

The continuing high prevalence of infectious diseases in develop? ing countries?in contrast to the dramatic decline of such diseases in the West?has been attributed to many factors, among which poor sanitation and hygiene, inadequate medical services, and malnutrition are foremost. In this article I con? sider what measures may be taken in a district hospital in the Third World, to help in controlling infection and achieving a reasonable standard of hygiene. In developing countries policies for the treatment and control of infectious disease need to be geared to the specific needs of the community and take into account the fact that many hospitals have no electricity, an inadequate water supply, and no reliable sewage facilities. Such circumstances necessitate a simplified and more fundamen? tal approach that is both economically viable and effective. Although direct comparison with standards feasible in the West may not always be appropriate, it may be beneficial in stimulating a re-examination of conventional and possibly wasteful practices. Limited resources and adverse geographical factors are im? portant considerations in formulating public health policies, but effective health measures also call for understanding the local cultural practices and religious beliefs. Various approaches have been made?for example, that put forward by the Environmental