February 27, 2017

Water and Sanitation

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Our Water and Sanitation Department has worked hard over the years to ensure the Clinic has a clean water supply, and that all areas of the Clinic are kept as clean as possible. There have been many challenges faced by the Department, one of the most significant being difficulties with building permanent structures such as toilets on the rented Clinic grounds.


In the early years of Mae Tao Clinic, access to water was a major obstacle to the safe and efficient running of the clinic. In addition, there was often overflow of waste water from the toilets. In the rainy season, this overflow was particularly problematic as it contaminated fresh water sites. In the dry season, Mae Sot suffered severe water shortages and many households in the local population built water tanks in their homes to deal with this problem. The Clinic however, could not build  permanent structures on the site and thus had no water supply during the day. The Clinic water supply would flow only in the evenings so this was when clinic staff did all their cleaning; this included cleaning the medical instruments, having showers, and cleaning clothes. This was usually done around midnight.

As the number of staff, staff families, and patients attending the Clinic increased, the lack of toilet facilities became a major problem. The existing toilets were over-used and often would overflow. It was a health hazard, and there was a fear that the local authority would shut down the Clinic if the problem was not addressed.

An increase in awareness of water and sanitation issues lead to the establishment of the Water and Sanitation Department at MTC in 2000. Tin Htun, the department manager, has been in charge of the programme since its commencement.  Beginning with six staff members, the first major effort was to increase the fresh water supply to the Clinic. Even with rain water run-off, one deep water well and a Thai pipe-line, there was not enough water for the effective running of the Clinic. The Clinic, in conjunction with the its landlord, applied to the Thai government and was granted permission for a larger pipe-line to go through the Clinic. After the water supply issues had been addressed they began to work on drainage, cleaning and the toilets; these were the first priorities of the newly established department.

In 2002, it was identified that MTC needed to improve existing waste-water management systems. The local community had been complaining about the runoff from the Clinic, and MTC wanted to maintain a positive relationship with the local authorities and community. Therefore, the construction and stabilisation of ponds for waste water was undertaken. MTC also concentrated on the reduction of vectors (mosquitoes) and vector-borne diseases by introducing vector eating fish into the pond, thus decreasing contamination in local ponds. These improved methods of waste water disposal proved valuable in enhancing the relationship between the clinic and the local community.


Today, with the continuing expansion of the Clinic, the role of the department has grown, with responsibilities that include:

  • building maintenance (building and repairing)
  • cleaning and repairing drains
  • cleaning toilets
  • building additional toilets
  • sweeping and cleaning all outside areas
  • maintaining the horticultural aspects of the clinic
  • controlling the Clinic’s water supply
  • recycling waste water to use in the toilet and for cleaning Clinic vehicles


There have been many challenges involved in running the department. In the past it has been a problem to build permanent structures on land that is only rented by the Clinic. The departments’ staff is often faced with blockages in the toilets, as many of the Clinic’s patients are from rural areas, and have had no experience using toilets.  Sticks and plastic are often found blocking the toilets, and sometimes patients go to the toilet in the drains, thus, education is an important factor of the water and sanitation departments’ work.