In busy urban healthcare centers, safe water is as essential as medicine — yet it is often taken for granted until something fails. A leaking storage tank can shut down patient rooms; faulty water supply valves can compromise supply; clogged drains or inoperable toilets can reduce a clinic’s ability to serve its community.
In June 2024, an international coalition of plumbing and public health experts set out to address those risks directly. Over four intensive days in Manila, Philippines, the International Water, Sanitation and Hygiene Foundation (IWSH®), working with the World Health Organization (WHO), the World Plumbing Council (WPC), and Philippine industry partners, completed a pilot “Plumbing for Health” project aimed at improving water quality, reliability, and sanitation conditions across four healthcare facilities.
The effort combined technical assessment, hands-on repairs, and longterm planning, now serving as a model for expansion across the Western Pacific region and beyond.
A PARTNERSHIP FOCUSED ON WATER QUALITY AND ACCESS
The pilot marked the first practical, field-based collaboration under current official relations between WHO and WPC. Organized and facilitated by IWSH — the public charity of IAPMO — the project aligned with the WHO–UNICEF WASH in Healthcare Facilities program, which works to achieve universal access to water, sanitation, hygiene (WASH), and waste management services in all healthcare facilities by 2030.
Water, sanitation and hygiene systems are foundational infrastructure in any healthcare setting. When those systems fail or degrade, the impacts reach every patient and provider. Globally, WHO estimates that roughly one in five healthcare facilities lacks basic water services — a gap that increases infection risk and undermines patient care.
The Manila pilot applied WHO’s WASH FIT — Water and Sanitation for Health Facility Improvement Tool — a risk-based framework used to evaluate and improve facility conditions across water supply, sanitation, hygiene, waste management and environmental cleaning systems.
Monthly planning meetings, beginning in February 2024, brought together a technical working group that included IWSH representatives, WHO Philippines and Department of Health (DOH) officials, and leaders from the Philippine Society of Sanitary Engineers (PSSE) and the National Association of Master Plumbers of the Philippines (NAMPAP).
The DOH identified four Metro Manila sites for the pilot:
- San Lazaro Hospital
- Ospital ng Sampaloc
- Earnshaw Health Center
- Tondo Foreshore Health Center
FROM ASSESSMENT TO ACTION
Using WHO’s WASH FIT assessment tools, the IWSH team worked with fellow WPC member organizations PSSE and NAMPAP to evaluate and help identify long-term improvements for water systems at these four healthcare facilities in Manila. Unlike assessment-only programs, the Plumbing for Health pilot paired evaluation with immediate field repairs where possible. IWSH team leaders and volunteer plumbers worked side by side with Filipino counterparts — not only identifying deficiencies but correcting urgent failures on the spot.
More than 45 participants took part during the project week, including local operations and maintenance staff, city engineers, master plumbers, manufacturers and student representatives. San Lazaro Hospital served as the central hub for workshops, briefings and technical sessions. Manufacturing partners also engaged — product specialists representing LIXIL brands, such as American Standard, GROHE and INAX, participated in technical discussions and are expected to support future procurement guidance and product training.
At Ospital ng Sampaloc, inspectors traced persistent water leakage to a failing rooftop storage tank and faulty water supply float valves. The leak had rendered two hospital rooms unusable due to water damage from above. Teams isolated the compromised tank, modified pipework and repaired supply controls. A follow-up inspection the next day confirmed the leak had stopped and affected areas had begun drying.
At Earnshaw Health Center, crews repaired toilet cisterns and supply lines, replaced damaged toilet seats, and cleared blocked basins. By the end of the visit, the number of functional toilets increased from three to six — doubling restroom capacity for patients and staff. At Tondo Foreshore Health Center, where a WASH FIT assessment had not yet been completed, teams conducted the evaluation and performed immediate repairs on toilets and drainage systems while mapping needs for a new storage tank and pressure pump to stabilize supply and water quality. At San Lazaro Hospital, the group began comprehensive system mapping — documenting pipelines, tanks, wastewater systems and treatment components — and developed recommendations for pump replacement, fixture repairs and water quality testing protocols.
BUILDING LOCAL CAPACITY
While the visible outcomes included repaired fixtures and restored wastewater systems, capacity building was equally important. Through a collaborative, community-based approach, IWSH and IAPMO technical experts worked alongside local maintenance teams at each healthcare center to document systems, develop preventive maintenance protocols and prioritize future upgrades. Technical staff from the city of Manila, who oversee numerous neighborhood clinics, also joined project activities, broadening institutional knowledge transfer. Reliable local hardware suppliers were identified, helping ensure that future repair and upgrade phases can proceed efficiently using locally available materials. Two toolkits were also donated to support ongoing in-house maintenance and repair at San Lazaro Hospital and Ospital Ng Sampaloc, providing further resources to minimize future problems.
PSSE student chapters in Manila and other regions across the country participated throughout the week, with representatives from the National University in Manila expressing interest in supporting future WASH assessments nationwide. Student involvement is engaging the next generation of plumbing professionals and could help build a long-term workforce pipeline focused on healthcare plumbing and water safety.
Representatives from the Philippine Professional Regulation Commission are using this new collaboration to develop Plumbing for Health addendums for national standards, and PSSE and NAMPAP are coordinating with regulators to advance that work through a dedicated technical working group. WHO Philippines has committed to further expansion of the program in the future.
A MODEL FOR REGIONAL SCALE-UP
This Manila effort is a “regional model for scale-up” — a repeatable framework combining:
- Risk-based WASH assessments
- On-site plumbing inspections
- Immediate corrective repairs
- System mapping and documentation
- Local workforce training
- Standards and policy engagement
- Industry partnership
WHO’s Western Pacific Regional Office is positioned to help expand the model to other countries, with continued technical support from WPC and IWSH. Follow-up phases are already in planning, with the technical working group continuing monthly coordination meetings after the pilot’s completion.
PLUMBING AS PREVENTIVE MEDICINE
This Plumbing for Health pilot demonstrates how IWSH mobilizes the plumbing industry to transform communities.
Founded in 2016 as IAPMO’s public charity, IWSH focuses on water, sanitation and hygiene solutions worldwide by mobilizing skilled tradespeople, engineers, manufacturers and regulators. Its programs emphasize that safe plumbing systems directly support disease prevention, infection control, and community resilience.
The Manila pilot illustrated that connection clearly: restored water storage protected patient rooms; repaired toilets improved sanitation access; mapped systems reduced future failure risk; and upgraded maintenance capacity strengthened long-term water quality management.
This work also reinforces a broader message — technical trades play a central role in healthcare outcomes. Healthcare facilities may run on doctors and nurses, but they depend just as heavily on safe water systems behind the walls.
Through collaborative, field-based partnerships, the Plumbing for Health initiative aims to make those systems more reliable — and the care they support more secure — one facility at a time. Through partnerships, professional training, and scalable solutions, IWSH is creating a model that can improve WASH infrastructure in healthcare facilities, not just throughout the Philippines, but worldwide.
IWSH’S RECENT WORK
The 2024 Plumbing for Health pilot program is just one example of how IWSH changes lives through plumbing. In 2025, IWSH continued to quietly reshape daily life across communities worldwide. From restoring hot water at a community center in the Navajo Nation to improving sanitation infrastructure in Germany, Australia, and Zambia, IWSH delivered plumbing interventions that strengthened health, safety, and daily functioning, underscoring what targeted investments in skilled labor and quality plumbing can make possible.
Throughout 2025, IWSH focused on a small number of high-impact initiatives designed to be replicable and sustainable, including:
- Plumbing upgrades and repairs at community facilities serving Indigenous populations in North America.
- Workforce development and skills training initiatives supporting the next generation of plumbing professionals.
- Sanitation and hygiene improvements delivered through industry volunteerism in the U.S., Canada, Europe, Australia, and Africa.
- Education and engagement programs elevating future WASH and plumbing leaders worldwide.
Each project reflects IWSH’s commitment to applying plumbing expertise where it can deliver lasting public health benefits. See a full report of what IWSH accomplished last year in the 2025 IWSH Impact Report — iwsh.org/iwsh-news/iwsh-2025-impact-report. Each initiative featured in the Impact Report is part of IWSH’s broader effort to advance water, sanitation, and hygiene solutions while elevating the plumbing profession and strengthening communities worldwide.
