Indicator 9: Sitting, Light, Water, and Toilets: The Seven Comfort Facilities PHC Will Check

Series: Understanding MSDS | Post 12 of 52
Standard 3 (ROM-3) | Indicator 9 | Category: YELLOW (80% required)

The Clinic That Looked Perfect

Dr. Hira Qureshi opened her family medicine clinic in DHA Lahore after eight years abroad. It had Italian floor tiles, a leather sofa, a split air conditioner and a digital token display. Friends said it looked like a private hospital.

The PHC assessor arrived on a humid afternoon in August. He walked through the waiting area and asked the receptionist a question.

“When the electricity goes, what do you use for light?”

The receptionist looked at Dr. Hira. Dr. Hira looked at the UPS box under the reception desk. It powered the computer and the token display. It did not power a single light. There was no emergency light, no torch and no candle anywhere in the clinic.

Then the assessor stood beside the window in the consultation room and pointed at the frame. It had beautiful glass. It had no wire gauze. A mosquito was resting on the wall above the couch.

Indicator 9 was scored as not met.

“I spent more on this sofa than most clinics spend on everything,” she said later. “And I failed on a torch.”

What Indicator 9 Requires

The indicator reads: Clinic has adequate facilities for the comfort of the patients.

During the visit, the surveyor observes the presence of seven facilities:

• I. Sitting arrangement
• II. Alternate arrangements of electricity, at least an emergency light
• III. Waste container or receptacle
• IV. Proper ventilation
• V. Clean drinking water
• VI. Toilet available or accessible
• VII. Mosquito and fly proofing with wire gauze

None of these is expensive. The manual asks for basic conditions, not luxury.

What the Manual Says About Each Facility

For power outages, at the minimum an emergency light, torch or candles must be kept in a safe and easily accessible place. A dustbin or waste receptacle of metal or plastic should hold non-infectious waste, with further requirements following the Punjab Hospital Waste Management Rules 2014. Rooms should be airy, with windows or an exhaust system. Safe drinking water should be served in clean utensils.

A toilet should preferably be inside the premises. For single room clinics in markets, a toilet accessible in the closest proximity is acceptable, although in house availability is mandatory for polyclinics. Doors and windows should be fitted with wire gauze against mosquitoes and flies.

How It Is Scored

This is a YELLOW indicator with three possible outcomes.

Fully met: all seven facilities, I to VII, are present.

Partially met: facilities I to V are present.

Not met: any one of facilities I to V is missing.

The first five facilities carry the weight. Dr. Hira’s missing emergency light alone meant not met. The missing wire gauze would have held her at partially met even with the light in place.

Why It Matters

Load shedding is part of daily life in Punjab. In a region where dengue returns every monsoon, a clinic without mosquito proofing can expose the very patients who came for care. Water, a toilet and a waste bin are small safeguards of hygiene and dignity.

What Dr. Hira Changed

She bought two rechargeable emergency lights, one mounted near the reception and one in the consultation room, and placed a torch in the drawer of her desk. The receptionist now tests both lights every Monday.

A carpenter fitted wire gauze frames to every window and the back door.

She checked the rest of the list line by line. Covered pedal bins went into the waiting area and beside the couch, and clean cups were stocked beside the water dispenser.

At reassessment, the assessor switched off the main light, watched the emergency light come on, and scored Indicator 9 as fully met.

“I had built a clinic for how it looked,” she said. “The assessor checked how it worked.”

A Quick Self-Check

• Is there seating for at least three to five waiting patients?
• If the power fails right now, is there an emergency light, torch or candle within easy reach?
• Is there a waste bin in the waiting and consultation areas?
• Are the rooms airy, with windows or an exhaust system?
• Is clean drinking water with clean cups available for patients and staff?
• Is a toilet inside the clinic or accessible in the closest proximity?
• Are windows and doors fitted with wire gauze against mosquitoes and flies?

Series so far: Post 1, The Inspector | Post 2, 18 Standards, 47 Indicators | Post 3, Red, Yellow and the Score | Post 4, Signboard | Post 5, Easy Access | Post 6, PHC License | Post 7, Door Plate | Post 8, Consultation Hours | Post 9, Qualified Manager | Post 10, PMDC Certificate | Post 11, Minimum Premises | Post 12, Comfort Facilities

About this series: Educational content on MSDS compliance for clinics under the Punjab Healthcare Commission, based on the PHC MSDS Reference Manual 2017.