A Story from the Field: The Facilities Manager's First Walk Through the OPD

Khun Wichai, 50, is head of facilities at a community hospital in Chum Saeng. He has looked after its buildings, plumbing and electrical systems for more than twenty years. Before the water arrived, his team stacked sandbags across the entrances and moved equipment, medical records and medicines to the upper floor. In the end the water still found its way past the sandbags, rose more than 40 centimeters inside the ground-floor outpatient building and stayed there for several days.

On the morning the water had dropped enough to walk through, Khun Wichai led the head nurse of the outpatient department on an inspection. Their first stop was the registration desk and screening point. A thin film of mud covered the floor tiles, and the plywood counter had swollen with water. Next came the main waiting hall with its long rows of linked seats, every leg marked by the same tide line. Each time they opened the door of one of the general examination rooms lined up along the corridor, a wave of damp, stale air rolled out. The lower part of the gypsum walls was already speckled with black mold. The patient toilets in the middle of the building were sending sewer gas back up the drains, and several nurses hurried past holding their breath.

The head nurse explained what every day of closure was costing. Hundreds of patients with chronic conditions who were due to collect blood pressure, diabetes and asthma medication had to be rescheduled. At the same time, new patients with skin infections, diarrhea and post-flood fevers were arriving every day. For now the hospital had set up a temporary screening area on an upper floor. It was cramped, and elderly patients struggled with the stairs.

Both of them knew the ground-floor OPD had to reopen as soon as possible. They also knew that if it reopened while floodwater germs and airborne mold were still present, a patient who arrived with one illness might leave with another, and the hospital that the whole district depends on would lose the trust it had built over decades.

Khun Wichai's team began washing out the building the same afternoon. They worked late into the evening with hoses and squeegees, but the next morning the waiting hall still smelled stale and the mold on the walls had not gone anywhere. It was clear they needed a more complete approach.

Why Community Hospitals in the Nan River Basin Are So Exposed

Most community hospitals in Thailand were designed to put the outpatient department on the ground floor, close to the main entrance, the car park and the emergency room. That layout makes perfect sense for patients who are old, frail or arriving by motorcycle, but it also means the busiest part of the hospital is the first to flood. In Chum Saeng and neighboring districts, land is flat and low, drainage relies on the river and canals, and when the river is full, floodwater has nowhere to go. Modern OPD buildings use gypsum partition walls, suspended ceilings and ducted air conditioning, all of which absorb moisture and dry slowly. The waiting hall is a large, open space with hundreds of seats, counters and handrails. Put together, these features create exactly the conditions in which contamination spreads and mold grows unseen inside walls and ceilings.

The Hidden Risks in an Outpatient Building After the Flood

The outpatient building is the most heavily used part of any hospital. On a normal day hundreds or even thousands of patients and relatives pass through it. When this space is not properly decontaminated, risks multiply quickly.

1. Floodwater germs on shared surfaces

• Intestinal bacteria. Floodwater mixed with sewage from drains and septic tanks leaves E. coli and other pathogens on counters, handrails, waiting seats and door handles, the surfaces that thousands of hands touch every day.
• Leptospirosis. Staff who wash down the building, and patients with wounds on their feet or legs, are at risk of infection from residual mud.
• Healthcare-associated infection. Patients with weakened immunity, such as people with diabetes, chronic kidney disease or cancer, and pregnant women, may pick up infections simply by waiting in an area that still carries contamination.

2. Mold in walls, ceilings and air conditioning

Gypsum walls, ceiling panels and air ducts soak up moisture and dry slowly, so mold can grow inside them without being visible from the outside. When the air conditioning is turned on, spores can be blown across the waiting hall, triggering coughing, sneezing and asthma.

3. Pressure on services and staff

Moving services to a temporary area upstairs causes crowding and long waits, and makes staff work harder. Many staff members are also trying to rescue their own flooded homes at the same time. The longer the building recovery drags on, the heavier that burden becomes.

4. Public confidence

A patient who walks into the OPD and smells damp or drains, or sees mold on the walls, immediately loses confidence. People expect a hospital to be the cleanest place in town, and that impression shapes how they feel about the care they receive.

Why General Clean-Up Is Not Enough for a Hospital

• Hosing and scrubbing alone. This removes visible mud, but the wash water can carry germs into tile grout and along wall edges, and it does nothing for vertical surfaces or the undersides of furniture.
• Pouring on large amounts of bleach. In an enclosed building, the fumes are harsh and irritate staff airways, and bleach can corrode the metal frames of seating, beds and equipment.
• Running the air conditioning to dry the space. If the system has not been cleaned and checked after exposure to moisture, this can spread mold throughout the building.
• Using air fresheners. Fragrance only masks the smell for a while and is unsuitable in a hospital that serves allergy patients.
• Replacing ceiling panels or repainting immediately. If the structure behind is still damp and moldy, the problem returns before long.

An outpatient building needs disinfection that covers every surface and the entire volume of air, combined with step-by-step control of mold and odor.

The Solution: Disinfection Fogging Plus Ozone Treatment for Community Hospital OPDs

ULV fogging with Chemgene HLD4H

The WHD team uses CHEMGENE HLD4H, a high-level disinfectant for healthcare settings, applied with ULV equipment that breaks the solution into a very fine mist. The mist spreads through the waiting hall, examination rooms, registration area and corridors and settles on floors, walls, counters, seating, handrails and the undersides of furniture. Only a small volume of liquid is used, so floors do not become wet and slippery, which reduces the risk of falls for staff working in the area.

Ozone treatment to reduce mold and remove odors throughout the building

After fogging, the team closes off each zone and runs a high-output ozone treatment. Ozone penetrates ceiling voids, gypsum walls, bed curtains and seat upholstery, helping to destroy mold spores and airborne bacteria and breaking down the molecules behind musty and sewer odors. At the end of the treatment, ozone reverts to oxygen and leaves no chemical residue.

How the service works for community hospitals

1. Survey and planning with the facilities and infection control teams. The OPD is divided into zones such as registration, screening, waiting hall, examination rooms, dispensary and toilets, and the order of work is set to match the reopening plan.
2. Guidance on mud removal and sorting. The team advises on washing out mud, removing permanently damaged materials such as swollen plywood counters, and moving electronic equipment out first.
3. Fogging with Chemgene HLD4H. Every flooded zone is treated, with emphasis on shared touch surfaces and toilets.
4. Ozone shock treatment. Each zone is sealed and treated according to its size, one at a time, so ready zones can reopen first.
5. Ventilation. Doors, windows and ventilation systems are opened so ozone dissipates before staff and patients return.
6. Final check and handover. The team checks odor and conditions and advises on humidity control and cleaning frequency for shared touch surfaces.

A Phased Approach to Reopening the OPD

Most community hospitals cannot shut down completely, so recovery works best in phases. In phase one, staff and volunteers in proper protective gear remove mud, wash floors and sort materials. In phase two, disinfection fogging and ozone treatment are carried out zone by zone, starting with the most essential areas: registration, screening, the dispensary and patient toilets. In phase three, those zones reopen while humidity and mold are monitored, and the remaining zones follow until the whole OPD is back in service. This approach gets patients back sooner without compromising safety.

A few practical steps make each phase smoother. Keep a simple floor plan on which each zone is marked as "not started", "in treatment", "ventilating" or "open", and share it with the infection control nurse, the head of OPD and security staff so that patients are never directed into a zone that is closed. Put clear signs at every entrance explaining which services are available and where. Schedule ozone treatment in the evening or overnight where possible, so ventilation can be completed before the morning rush. And keep a short log of odor, visible mold and humidity readings for each zone over the following weeks, so that any area where problems return can be dealt with quickly.

Protecting Staff During the Recovery

Hospital staff are often the people doing the hardest physical work after a flood, and they are just as vulnerable to floodwater infections as anyone else. Everyone involved in clean-up should wear rubber boots, waterproof gloves and a mask, cover cuts with waterproof dressings and wash thoroughly with soap after each shift. Anyone who develops fever, muscle pain or headache after contact with floodwater should be assessed promptly for leptospirosis. Rotating teams, keeping drinking water and hand-washing points available, and making sure nobody works alone in a damaged building are simple measures that protect the people the hospital will rely on once services resume.

Areas That Need Extra Attention on the Ground Floor

Not every part of the outpatient building carries the same risk. During the site survey, the WHD team and the hospital usually agree on a few priority areas that deserve particular care.

• Registration and screening counters. These are the first surfaces every patient touches. Counters, card readers, queue ticket machines, pens and partition screens must be thoroughly disinfected, and swollen plywood or particleboard should be replaced rather than treated, because it will keep holding moisture.
• The dispensary. Shelving, drawers and dispensing counters need to be disinfected before new stock is placed on them. Cardboard boxes that got wet should be discarded, and humidity in the room should be kept under control in the weeks that follow.
• Patient toilets and hand-washing stations. These areas are often where sewer odors are strongest, because drains and floor traps were filled with floodwater. Drains should be flushed and traps refilled with clean water before fogging and ozone treatment, so the smell does not simply return from below.
• Medical records rooms. Paper files that got wet are very prone to mold. Records that can be dried and saved should be handled according to the hospital's own procedures, while the room itself is disinfected and ozone-treated before files are returned.
• Corridors linking to the emergency room. Where the OPD shares corridors with the emergency department, treatment needs to be coordinated carefully so emergency access is never blocked.

Communicating With Patients During the Recovery

Patients in a flood-hit district are anxious and often exhausted. Clear communication helps them and eases pressure on the hospital. Post simple notices at the entrance and on the hospital's social media pages explaining which services are open, where the temporary screening area is and when the ground-floor OPD is expected to reopen. Remind patients with chronic conditions how to collect their medication during the transition period. When a zone reopens after disinfection and ozone treatment, saying so openly reassures people that the hospital has taken their safety seriously. Staff at the front desk can also remind patients about basic post-flood precautions: wearing boots when cleaning, washing hands carefully, boiling or treating drinking water and seeing a doctor promptly if fever and muscle pain appear after contact with floodwater.

10 Reasons Community Hospitals in Chum Saeng Choose WHD

1. Healthcare-grade disinfectant. Chemgene HLD4H acts against bacteria, viruses and fungi.
2. Built for large spaces. Our ULV disinfection service suits wide waiting halls.
3. Floors stay dry. Lower risk of slips for staff and patients.
4. Fewer mold spores in ceilings and walls. Thanks to our ozone treatment service.
5. Musty and sewer odors removed at the source. No fragrances needed.
6. No ozone residue. Read more about ozone for odor and chemical residue removal.
7. Zone-based work. The rest of the hospital keeps running.
8. Works alongside your infection control team. Plans are tailored to each hospital.
9. Easy ongoing care. Use Chemgene HLD4H spray on shared touch surfaces every day.
10. Mosquito control on the grounds. Add our mosquito spraying service where water is still standing.

Before and After

In the Words of a Facilities Manager (Field Scenario)

"The OPD is huge, and our team simply didn't have enough people to wipe down every surface. Once we planned the work with WHD, split the building into zones and had each one fogged and then ozone-treated, we could reopen registration and the dispensary first. The musty smell that used to hang over the waiting hall dropped so much that patients stopped mentioning it, and our staff were relieved to be back working in their own space."
— Khun Wichai, head of facilities, community hospital in Chum Saeng (a composite persona based on real situations)

Frequently Asked Questions

Q: Can fogging and ozone treatment be done while other parts of the hospital stay open?
A: Yes. The team divides the building into zones, cordons off the area being treated and coordinates patient and staff routes with the hospital.

Q: Does the air conditioning need to be switched off during ozone treatment?
A: The team assesses each zone's air conditioning with your facilities staff. In most cases the system is switched off or isolated during treatment so ozone does not travel to occupied areas.

Q: Do medical devices and computers need to be moved out?
A: We recommend moving them out or covering them before fogging and ozone treatment. The team will help assess how to handle each item.

Q: How long before the area can be used again?
A: It depends on the size of the zone and the ventilation. The team always confirms when it is safe to re-enter.

Q: Does this service replace our infection control measures?
A: No. WHD's service complements and strengthens recovery. Hospitals should continue to follow their own infection control guidelines and those of their supervising authority.

Q: Can ozone remove the smell from wet medical records or cardboard?
A: Ozone can reduce musty odors on materials that have been properly dried, but it cannot reverse water damage. Paper and cardboard that stayed wet for days often carry mold deep inside and are usually better replaced or handled under the hospital's records procedures.

Q: What should we prepare before the team arrives?
A: Remove as much mud as possible, flush floor drains, move or cover electronics and sensitive equipment, and nominate one contact person from facilities and one from infection control. A floor plan of the ground floor helps the team divide the building into zones quickly and agree on the order of work with you.

Q: Do you serve Chum Saeng and the rest of Nakhon Sawan?
A: Call 065-556-6294 or message LINE @whd268 to check coverage and book a site survey.

Make Your OPD a Safe Place for Patients Again

Talk to WHD about a zone-by-zone disinfection fogging and ozone treatment plan for your outpatient building.

View Disinfection Service – Click Here

Book Ozone Treatment – Click Here

Call 065-556-6294 · LINE @whd268 · Email worldhealthdisinfection@gmail.com

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Reference: World Health Organization – Floods fact sheet and Department of Disease Control, Thailand