A Story From the Field: The Monday Morning Sunisa Unlocked the Exam Rooms

Sunisa is a registered nurse who runs a municipal public health service center in Mueang Nakhon Nayok district. For the neighborhoods around it, the center works like a warm, familiar community clinic. It is the first place people go when something is wrong. Parents bring babies for vaccinations, expectant mothers come for antenatal checkups, older residents have their blood pressure measured and collect refills for diabetes and hypertension medicine, and anyone with a cut or a wound comes in to have it cleaned and dressed. The staff know most patients by name, and many patients know the staff by nickname.

This year the rain did not stop for days. The Nakhon Nayok River and the canals that feed into it spilled over their banks and pushed water into the surrounding community. The ground floor of the health center flooded to roughly knee height. Staff moved what they could upstairs in the hours before the water arrived, but there was only so much time, and a building full of chairs, counters, cabinets and paperwork cannot be emptied in an afternoon.

Three days after the water receded, Sunisa and two colleagues came back and opened the front doors for the first time. The first thing they noticed was the smell: a heavy, damp, musty odor mixed with the earthy stink of river mud that rolled out of the building the moment the doors swung open. A thin film of dried mud coated the waiting room floor. The faux-leather seats of the long waiting benches had tide lines across them. The legs of the registration desk were stained dark. On the wall of the wound dressing room, a band of gray-green mold spots had already appeared, tracing the exact height the water had reached. In the lower cabinets where medical supplies were stored, cardboard boxes had gone soft and were starting to collapse.

At the same time, the center's phone kept ringing. Residents wanted to know when it would reopen. Some had cuts on their feet from wading through floodwater. Some had fevers and aching muscles. Others had simply run out of their blood pressure and diabetes medication and could not travel far to get more. Sunisa knew that every day the center stayed closed, the community would struggle more. But she also knew that if they reopened while the exam rooms still carried germs and mold, the place that was supposed to heal people could become a source of new problems. That was the challenge the WHD team was asked to solve: help the center reopen as quickly as possible without lowering the standard of safety.

Why a Health Center Needs More Care Than an Ordinary House After a Flood

Floodwater does not arrive clean. On its way into a building, it runs across roads, through storm drains and past septic tanks, and it carries many kinds of microorganisms with it. Among them are bacteria that cause diarrhea and the leptospira bacteria responsible for leptospirosis, which people in Thailand know as "rat urine disease." When the water drains away, these germs do not leave with it. They stay behind in the mud film, in tile grout, along the base of walls and under furniture. Meanwhile, moisture trapped inside walls and wooden fittings gives mold everything it needs to grow, often within just a few days.

What makes a health facility different from a typical home is who walks through the door:

• Patients with open wounds, especially on the feet and legs after wading through floodwater. If the dressing room is not clean, a wound that came in for treatment could pick up a second infection.
• Young children coming for vaccinations and pregnant women coming for antenatal care, whose bodies are more sensitive to germs and to irritating chemicals.
• Older adults and people with chronic illnesses such as diabetes, high blood pressure and lung disease, whose immune defenses may be weaker than average.
• People with allergies and asthma, whose symptoms can flare when they breathe in mold spores or sit in a room with a musty smell.
• Public health staff, who spend many hours a day inside the building. If several of them fall ill at once, the center simply cannot open.

Beyond health, there is the question of trust. A community clinic runs on the confidence of the people it serves. If residents walk in and notice a musty smell or see mold stains on the wall of an exam room, that confidence drops immediately. Some may decide not to come back, even when they genuinely need care, and that has consequences for the health of the whole community over time. A reopening that looks rushed or careless can undo years of goodwill.

There is also the cost of time. A municipal health center has limited staff and a limited budget. Every hour nurses spend scrubbing walls is an hour they are not spending with patients, following up on people with chronic illness, or visiting homes in flooded neighborhoods where residents may be too sick or too busy to come in. Getting the building safe quickly frees the team to do the work only they can do.

High-Risk Spots in a Health Center That Are Easy to Overlook

During site surveys, the WHD team often finds that the areas still carrying risk are not the ones staff forgot to clean. They are the ones that are simply very hard to clean properly by hand after a flood:

• The waiting room and long bench seating. These have many seams, joints and gaps where dried mud settles and stays out of sight.
• The wound dressing room and injection room. Sinks, drain pipes and low wall edges mean water lingers here longer than anywhere else.
• The medical records room. Paper soaks up moisture and gives mold a food source, so stacks of patient files can become a mold reservoir.
• Lower cabinets and shelves for medical supplies. Any medicine or supplies touched by floodwater must be handled according to the agency's own rules, but the cabinets themselves must also be disinfected before new stock goes in.
• Air conditioners and vents. Moisture caught in the coils and drain pans produces a musty smell every time the air conditioning switches on.
• Patient restrooms. Drains often push wastewater back up during a flood, leaving residue in places nobody wants to scrub.
• The parking area and front walkway. Everyone crosses these before entering, so mud and germs are tracked inside again every single day until the outside is dealt with too.

Mapping these spots before work begins is what allows the team to plan a reopening that is both fast and thorough, instead of having to choose between the two.

Why the Usual Cleaning Routine Is Not Enough This Time

Health center staff usually know infection prevention well, and they throw themselves into scrubbing. But a flood creates conditions that ordinary routines were never designed for:

• Wiping with bleach alone kills germs on the surfaces the cloth actually touches, but it does not reach the gaps in bench seating, the space under cabinets or the back of the counter. The strong chlorine smell also bothers patients with breathing problems, which is exactly the group a clinic most needs to protect.
• Running fans to dry the rooms dries the surface, but moisture deep inside the wall stays put. Worse, fans can blow mold spores around the room and into areas that were not contaminated before.
• Spraying air freshener only covers the smell. It does not remove the cause, and when the fragrance fades, the musty odor returns, sometimes mixed with a perfume that makes it even more unpleasant.
• Painting over mold stains makes the wall look clean for a while, but the mold underneath keeps growing. Within a few weeks it can push the paint into blisters or break through as new spots.
• Not enough people, not enough time. Staff are answering calls from patients and making home visits at the same time. A slow, room-by-room deep clean of the entire building is hard to achieve while also caring for the community.

What the center really needs is a system that deals with germs on surfaces thoroughly and deals with mold and musty odors in the air as well, without leaving behind a harsh chemical smell that would bother the very patients the building exists to serve.

The Solution: Chemgene HLD4H Fogging Plus Ozone Treatment, Planned Around Your Reopening Schedule

WHD combines two methods. The first is the disinfection fogging service using CHEMGENE HLD4H disinfectant delivered through ULV (ultra-low volume) foggers. The fogger turns the disinfectant into a fine mist that drifts across and settles on surfaces throughout the room, including the corners, seams and gaps a cloth cannot reach. The second is the ozone treatment service. Ozone gas spreads through the whole room, helping to deal with mold spores floating in the air and breaking down the molecules that cause musty odors at their source rather than masking them.

Step-by-Step Process for a Public Health Center

1. Survey and plan with the head of the center. The team walks through every room, notes which rooms flooded, which are damp and which must reopen first, such as the exam rooms and the dispensary, and sets the order of work accordingly.
2. Advice on removal and mud clean-up. The team advises which materials should be discarded, such as soaked cardboard and padding that has absorbed floodwater, and which can be kept after washing and disinfection. Medicines and medical supplies that touched floodwater are handled according to the agency's own regulations and the pharmacist's guidance.
3. Chemgene HLD4H fogging. A fine mist is applied across floors, walls, counters, seating, exam beds, cabinets and restrooms, with extra attention on high-touch points that patients handle most often.
4. Ozone shock treatment. Each room is sealed and treated with a dose matched to its size. No people, pets or plants are inside during treatment. Ozone-sensitive electronics, such as digital blood pressure monitors and computers, are covered or moved out on the team's advice, and treatment time is controlled.
5. Ventilation. After treatment, doors and windows are opened and exhaust fans are run until the ozone has broken down back into oxygen, and only then do staff go back in to work.
6. Follow-up check. The team returns to check odor and any mold spots. If some wall sections are still very damp, they recommend how to deal with the underlying moisture.

For a center that needs to reopen quickly, the work can be split into zones. The exam rooms and dispensary are treated first so basic services can resume, and the records room and meeting room follow in a later round. That way, residents are not left waiting for the entire building to be finished before they can see a nurse.

Ozone Safety in a Health Care Setting

Ozone is highly effective against odors and mold, but at the concentrations used for room treatment it irritates the airways. It must be used with a clear procedure. The team follows these principles every time:

• No patients, staff, animals or plants are in the area during treatment, and "do not enter" signs are posted on every door.
• Treatment is scheduled while the center is closed, such as in the evening or on a holiday, so services are not interrupted.
• Electronic medical devices, photographs and rubber components that are sensitive to ozone are covered or removed, and a controlled ozone dose is used.
• Rooms are ventilated thoroughly after treatment before anyone is allowed back in.
• Staff are briefed in advance about vaccine refrigerators, which must stay powered at all times. The team plans the work so that the fridge's power supply and temperature are not affected.

These steps are simple, but they matter. They are the difference between a treatment that quietly does its job overnight and one that causes headaches the next morning. Clear communication with the whole staff team is part of the service, not an afterthought.

10 Reasons Public Health Centers Choose WHD After a Flood

1. Disinfection fogging reaches seat gaps, the space under cabinets and the back of counters, where wiping by hand falls short.
2. CHEMGENE HLD4H does not leave the sharp smell of bleach, so it does not bother patients who are sensitive to odors.
3. Ozone treatment tackles musty odors and airborne mold spores instead of simply covering them up.
4. Zone-by-zone planning helps the center restart basic services sooner.
5. Work is done outside service hours, so patient queues are not disrupted.
6. Ozone safety steps are clear, from sealing off rooms to ventilating afterward.
7. The team gives advice on controlling the source of moisture, lowering the chance that mold comes back.
8. The Chemgene HLD4H 750 ml spray lets staff keep wiping high-touch points every day afterward.
9. A mosquito spraying service can be added around the building while standing water and mosquitoes remain a problem.
10. Easy to reach by phone and LINE, with quick answers and fast scheduling of site surveys.

Before and After Restoring the Health Center

A Customer's Perspective (Sample Scenario)

"At first we thought scrubbing it ourselves would be enough. But when we turned on the air conditioning in the exam room, the musty smell came straight back, so we decided to bring in a team. They split the work into zones for us, so we could open the exam room and the dispensary first and residents did not have to wait long. What I appreciated most was how clearly they explained ozone safety. Everyone on our staff understood exactly what to do and when they could go back in."
— Head nurse at a public health service center, Mueang Nakhon Nayok (scenario based on field experience)

Frequently Asked Questions

Q: Can we start seeing patients right after the fogging?
A: After fogging, wait for the mist to dry for the time the team recommends. Rooms that have been ozone-treated must be ventilated properly first. The team will give a suitable re-entry time for each room.

Q: Do we need to switch off the vaccine refrigerator during ozone treatment?
A: No, the vaccine refrigerator should never lose power. The team plans the work with your staff, for example by making sure the fridge door is closed tightly and that the ozone does not affect the unit, or by leaving the room with the fridge out of the treatment round.

Q: Can medicines and supplies that touched floodwater be used after disinfection?
A: Medicines and supplies that came into contact with floodwater should be handled according to your agency's regulations and the pharmacist's advice. Disinfection fogging is for surfaces and the environment. It is not a way to make damaged medicine usable again.

Q: Can it be finished in one day?
A: That depends on the size of the building and how badly it was damaged. A small center may be completed in a single round, while a larger building may be divided into zones. The team will give you an estimate after the site survey.

Q: Will the mold come back?
A: If walls are still damp inside, mold can return. That is why ongoing moisture control and a follow-up check are important. The team will point out the spots that need watching.

Q: What should we prepare before the team arrives?
A: Remove thick mud first, move important documents and portable electronics to a higher place, and assign a coordinator who knows the building layout and the order in which rooms need to reopen.

Q: Is the disinfectant safe around staff who return the next day?
A: The team applies the product according to its instructions and tells you how long to wait before re-entry. Once surfaces are dry and rooms are ventilated, staff can return to normal work.

Advice for Residents Before They Come Back to the Clinic

A safe reopening is a shared effort. Patients can lower the risk too. Wash your feet and change into dry shoes before entering the building. If you have a wound from wading through water, keep it covered and clean and tell the staff about it. If you develop a high fever and strong muscle pain, especially in the calves, after contact with floodwater, see a doctor promptly and mention that you were exposed to floodwater, because these can be signs of leptospirosis. For more on preventing disease after floods, see the Department of Disease Control and the World Health Organization's fact sheet on floods.

Staff can help residents by putting up simple signs at the entrance: a foot-washing point, a reminder to report flood wounds, and a note about which services are available in which rooms during the zone-by-zone reopening. Small steps like these keep the building cleaner for longer and make patients feel looked after from the moment they arrive.

A Simple Checklist for the First Week After Reopening

• Each morning, smell every room before switching on the air conditioning. A returning musty odor is the earliest warning sign.
• Check the lower edge of walls in the dressing room, restrooms and records room for new dark spots or bubbling paint.
• Wipe door handles, bench armrests, the registration counter and exam bed rails with disinfectant several times a day.
• Clean the air conditioner filters and make sure the drain pans are draining freely.
• Keep a dehumidifier or good cross-ventilation running in rooms that flooded the deepest.
• Note any spot that worries you and send a photo to the WHD team on LINE so they can advise whether a follow-up treatment is needed.

A short daily routine like this costs only a few minutes, yet it catches small problems before they turn into another closure.

Help Your Community Health Center Reopen Quickly and Safely

Talk to the WHD team to plan disinfection fogging and ozone treatment around your center's reopening schedule.

See Disinfection Service – Click Here

Book Ozone Treatment – Click Here

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

Related Links

• Ozone treatment for odors and chemical residue
• Master Ozone Generator
• CHEMGENE HLD4H disinfectant spray
• All articles

Health references: World Health Organization (WHO): Floods · Department of Disease Control, Thailand