Everyone seems to have a bug right now, but one hundred years ago the world was in the depths of the Spanish Flu outbreak, an event that would kill an extraordinary 100 million people — more than the combined number of WWII civilian and military fatalities. This event is personal to me. My great-grandfather Myron, and his brother Ernest, were both struck down in their prime from the outbreak and their Wisconsin dairy farm had to be sold, leaving my great-grandmother Minnie to live in poverty. I remember when I was very little, sitting on her lap and seeing the sadness in her eyes, as she told me stories of the hardship of living in the granary. She never remarried.

The global outbreak was aided by poor conditions inside overrun healthcare facilities where the lack of water, sanitation and hygiene — what we today call WASH — prevented important frontline infection prevention control measures, like handwashing and safe waste disposal. It would be nice to be able to say that things around the world have dramatically improved in the last 100 years, but they have not.

Twenty-six years ago, (ironically on “World Health Day”), the city of Milwaukee issued a “boil alert” in response to the largest documented waterborne disease outbreak in U.S. history; 403,000 people were sickened from a parasite called cryptosporidium, causing 93 deaths. As a young graduate engineer in Milwaukee, I was on the frontlines working day and night under the guidance of senior engineers to redesign and build temporary and long-term changes to water and wastewater treatment systems to remove this parasite. These designs still inform treatment standards used today.

But the most personal part for me was when I returned home late one night to find my young wife suffering terribly from this preventable illness. For three weeks the parasite ravaged her body and left her weak and dehydrated. While I did my best to help in the city’s response, all the while I couldn’t help but fear that she, too, might become a victim to the deadly epidemic.

Beyond Milwaukee, I have engineered projects on five continents as a volunteer in some of the world’s most challenging environments. I will never forget the day that I had to inform a hospital director in Guatemala that his wastewater treatment system was discharging waste into the river and was the cause of the typhoid outbreak he was desperately fighting. You cannot imagine the horror and agony on his face; this is a man who dedicated his entire life to the wellbeing of his people. He physically collapsed from the news. It is something I hope to never experience again.

Maybe it is for these very personal reasons that I took United Nations Secretary General Antonio Guterres’ global call to action for WASH in healthcare facilities last March so seriously. The lack of WASH in healthcare facilities is devastating and has gone unrecognized for far too long.

It sounds impossible to believe, but today, 50 percent of healthcare facilities lack piped water, 33 percent of healthcare facilities lack basic toilets, and nearly 40 percent of healthcare facilities lack soap. Those are key findings from a 2018 report by the prestigious University of North Carolina’s Water Institute, which analyzed World Health Organization data from 129,000 facilities in 78 low- and middle-income countries.

Healthcare facilities, meant to prevent and cure illnesses, instead leave staff at daily risk and patients to contract infections they didn’t have on arrival. Not surprising, among the biggest concerns is the lack of wastewater treatment in the facilities that do have water. This allows pathogens to be recycled into the environment to infect the next patient, an epidemic in the making.

Some wonder why we should care so much about a healthcare facility on another continent when our own infrastructure is in need of improvement. I quickly remind them that the world is a smaller place than ever. With our global economy and transportation network, epidemics can spread around the globe faster than ever before. The 2014 Ebola epidemic scare provided a taste of what could happen. And each year it’s a lesson we relearn during “flu season.” We need to understand that among our best defense against a worldwide epidemic such as the Spanish Flu might just be a healthcare facility in Africa or Asia with adequate WASH to contain an illness before it becomes an epidemic.

I, for one, give thanks for how my chosen profession dedicates itself to protecting the health, safety and welfare of the public. As priorities are drawn by the new Congress, it is my prayer that members of both houses — especially those who come from engineering and healthcare professions — prioritize working with other countries to support sustainable WASH infrastructure in healthcare facilities around the world, because tens of thousands of them still do not have the fundamentals of infection prevention.

We engineers, and an army of global health, development and humanitarian experts, know this problem is solvable, but it needs to be prioritized. Our nation’s health could well depend upon it.

Michael Paddock is chief engineer of Engineers Without Borders USA. A licensed civil engineer and surveyor, his professional career was spent managing teams of over 100 engineers designing infrastructure projects worth over $1 billion. Inspired by a near-death cancer experience, he began a pro bono engineering career that has delivered projects with Engineers Without Borders, Bridges to Prosperity, Rotary and others on five continents over the last 20 years.