(RNS) — I’m Jewish and an advocate for water and toilets. I never expected to speak in the shadow of the Vatican. But a few weeks ago I joined more than 100 experts and advocates in Rome for the largest-ever summit on the challenges to provide clean water, sanitation and hygiene (WASH) at hospitals and clinics around the world lacking these basic needs.

A big part of my message at the event, under the patronage of the Vatican, was this: Those closest to the frontlines need to be asked about WASH conditions, and those on the frontlines need to speak up and be heard. 

While it should be unimaginable that healthcare could lack these critical needs, the data says otherwise: In 60 fragile state countries, 37% of healthcare facilities did not have basic water services in 2023, according to a joint report by WHO and UNICEF. Eighty-one percent did not have basic sanitation services. Faith-run facilities are no exception. To be a patient in a facility without WASH is to be the most vulnerable of the most vulnerable. 

Solving the global WASH crisis would be cost-effective for global health, so the fact that it is so widespread is as nonsensical as it is dangerous. Some clinics receive pharmaceuticals but have no safe water to swallow a pill. They receive medical equipment that they can’t adequately clean. Women must bring their own water to give birth. Newborns die preventable deaths. 

Consider the current Ebola outbreak spreading in Africa, showing us once again, diseases know no borders. Detection alone does not stop an outbreak — infection control does. WASH is foundational to preventing and curtailing scores of illnesses and diseases. Clean conditions also curb the overuse of antibiotics, which has increased antibiotic-resistant infections that cause millions of deaths and make even routine care costlier and more dangerous everywhere. 

So why hasn’t the global aid community solved this crisis already? Part of the answer is that WASH suffers from a lack of prioritization and also a kind of invisibility. Those who don’t face healthcare without WASH are often the ones setting global health priorities. Those who do face healthcare without it, have accepted it. They do not see realistic alternatives.

Few know the challenges of working without WASH better than Catholic sisters. They have been the global backbone on the frontlines of healthcare for centuries. They’ve not only staffed healthcare facilities, they’ve founded them, professionalized them and built systems of care — especially in underserved and resource-scarce places. 

An informal survey of sisters is a real eye opener. Sisters Rising Worldwide supports Catholic sisters “responding to humanity’s greatest challenges” as they define them. Its founder and president, Sr. Irene O’Neill, hadn’t heard much about WASH in the healthcare setting, so in preparation for the Rome event, she asked a sample of sisters in 12 countries about WASH conditions. 

The result: 90% of sisters responding reported no regular access or unreliable access to clean water on-site; 80% reported insufficient or poor condition toilets for patients and staff; 75% reported there was “rarely/never” or only “sometimes” water available at points of care; 55% reported that medical waste is not safely managed or only partially managed. 

Had Sr. Irene not asked, she would not have known. 

In 2020, the Vatican’s Dicastery for Promoting Integral Human Development did ask, and the result is a pilot initiative to get WASH in 150 Catholic-run healthcare facilities in 23 countries. To date, 87 of the 150 facilities in 19 countries and across 44 dioceses have improved WASH. The price tag is $3.6 million in private funding so far. It’s a start. A good one. At the Rome summit, scores of leaders and technical partners across faiths, including Anglicans, Methodists, Adventists and evangelicals, committed to WASH improvements. 

In his statement, Pope Leo XIV said he was “pleased to see so many organizations of various faith backgrounds working together on this pressing issue and seeking to improve the living standards of our brothers and sisters” and extended “the assurance of his spiritual closeness” to those working on the challenges, from the frontlines to the funding. He also imparted his Apostolic Blessing. In September, he will dedicate his monthly prayer intentions to the theme of water. 

Archbishop of Canterbury Sarah Mullally also said in a video statement to the gathering that she was “encouraged by the work already underway to strengthen Anglican health facilities in several countries with more to come.” She encouraged all Anglicans to support “this vital work.” 

As Cardinal Michael F. Czerny, prefect of the Dicastery for Promoting Integral Human Development, said in 2023, “No one needs lofty theological concepts to justify proper WASH. Without it, healthcare cannot be healthy. No treatment, no surgery, no delivery can be safely performed without meeting basic WASH conditions. Providing them for all is an elementary step toward equal human dignity.”

What once felt like an orphan problem is growing into a global health movement. The question remains, will our political representatives, ministers of health and water, non-profits and private donors coordinate and direct funds to break through the wall of invisibility and give WASH in healthcare the home it deserves? What we do know is: They won’t if they aren’t asked.

(Susan K. Barnett is the founder of Faiths for Safe Water. A former investigative journalist with the network newsmagazines PrimeTime Live, 20/20 (ABC News) and Dateline NBC, she now leads Cause Communications. The opinions expressed in this commentary do not necessarily reflect those of Religion News Service.)