Important note: This article is general information about cleaning and restoring a home after a flood. It is not medical advice. How to perform exchanges, how to care for the catheter and exit site, and whether any dialysis solution or piece of equipment is still safe to use are decisions for the patient's own nephrologist and peritoneal dialysis (PD) nurses. If the patient develops a fever, abdominal pain, or cloudy drained fluid, contact the PD unit or hospital straight away.

A Story From the Field: The Small Room Where Dad Does Four Exchanges a Day

Wanna is forty-five. She looks after her father, Prayoon, who is sixty-seven and has been on continuous ambulatory peritoneal dialysis, usually shortened to CAPD, for almost two years. The family lives in a two-storey townhouse down a side street off Rama 2 Road in Samae Dam, Bang Khun Thian district. When the PD nurse made her home visit at the start of treatment, she helped the family turn a small back room on the ground floor into a dedicated exchange room. It has a stainless-steel table, a hook for hanging the solution bags, a hand basin, and a shelf for the monthly cartons of solution that the supplier delivers. Everything was set up exactly as the nurse recommended, and for two years it worked.

During the 2026 floods, water from the canals and rain that could not drain away fast enough crept into the ground floor. It rose to roughly a hand-span above the floor and stayed for several days. The family managed to carry most of the cartons upstairs and moved Prayoon to his younger sister's house on higher ground. When the water finally went down, Wanna came back alone to open up the house.

The first thing she noticed was the smell: a heavy, damp mustiness mixed with the earthy stink of mud, rolling out the moment she opened the front door. In the exchange room, a clear tide line ran along the walls. A thin layer of silt had dried under the stainless table and around the shelf legs. The wooden door frame had swollen so the door no longer closed properly, and in one corner of the wall a cluster of small black dots had appeared, the unmistakable beginning of mold.

Her father wanted to come home immediately. Carrying several bags of solution a day to someone else's house, and doing exchanges in an unfamiliar space, was tiring and stressful for him. But Wanna remembered what the PD nurse had told them on the very first visit: the exchange room has to be clean, the fan has to be off, there should be no dust, because infection inside the abdomen is the thing everyone works hardest to prevent. That night she kept turning the same question over in her head: when can this room be used again, and what do we actually have to do to make sure it is ready?

Wanna's question is shared by many families in Bang Khun Thian, Chom Thong, Thung Khru and Bang Bon who have a peritoneal dialysis patient at home. This article will not teach anyone how to do an exchange. That is the job of the medical team, and they know the patient. Instead, it looks at the house itself: what risks a flooded room carries after the water recedes, why the usual quick fixes fall short, and how a structured combination of disinfection fogging and ozone treatment helps get the room ready for the family to set up again under the kidney team's guidance.

Why an Exchange Room Needs More Care Than Other Rooms After a Flood

Peritoneal dialysis means opening a connection into the abdomen several times a day. That is why PD teams are so insistent about hand washing, masks, closing windows and switching off fans during an exchange. All of those habits exist to reduce the chance that germs from the surrounding environment find their way into the system. When the room itself has just been underwater, that surrounding environment has changed, and not for the better. Several things need attention.

• Germs from floodwater and mud. Floodwater is rarely clean. It commonly mixes with sewage, drain water, animal waste and soil. That can carry a range of bacteria, including the organism behind leptospirosis (often called rat-urine fever in Thailand). The residue left on floors, under tables and around furniture legs is easy to overlook because it dries into a thin, dull film.
• Mold spores in the air. Plaster walls, ceiling boards, wooden door frames and damp cardboard begin growing mold within days. Mold releases microscopic spores that float in the air and settle on the very surfaces where a patient lays out supplies.
• Dust from dried mud. Once silt dries, it turns into a fine powder that lifts with every footstep and every breeze. Dust is precisely what an exchange room is supposed to avoid.
• Trapped humidity. Small back rooms often have little cross-ventilation. Moisture lingers in the walls long after the floor looks dry, and that keeps feeding mold growth.
• Musty and drain odors. Beyond being unpleasant, a persistent smell is a signal that moisture or contamination is still hiding somewhere, behind a shelf, inside a swollen door frame, or under the edge of the floor tiles.

From a community health point of view, the problems most often linked to flooding are leptospirosis, diarrheal illness, infected skin wounds, and allergy or breathing problems triggered by mold. International guidance, such as the World Health Organization's material on floods, highlights contaminated water and damp housing as key concerns in the recovery phase. For an individual dialysis patient, however, the people who can judge specific risk are the nephrologist and PD nurses who know their history. The most useful first step a family can take is simply to phone the PD unit, explain that the house flooded, and ask what extra precautions they want before the patient returns to using the same room.

There are practical costs too. Every extra day the exchange room is not ready means the patient stays somewhere else, relatives ferry heavy boxes of solution back and forth, and someone may need to take more leave from work. Planning the restoration in a clear sequence from the start saves energy, money and stress that families often underestimate.

Questions to Ask the PD Unit Before Any Cleaning Starts

Before inviting any contractor into the house, we recommend a conversation with the PD nurses. Some decisions are medical, and a cleaning company should never answer them on the team's behalf. Here are questions many families find helpful:

1. Some cartons of dialysis solution got wet or sat in a humid room. Can they still be used, or should we discard them and request replacements?
2. Equipment such as the bag hanger, the weighing scale or the bag warmer was on the ground floor. What should we do with it?
3. While the usual room is not ready, where should the patient do exchanges, and how should a temporary space be set up?
4. Once the room has been disinfected and aired out, are there any additional precautions you want us to follow for the first few weeks?
5. Which symptoms mean we should come straight back to the hospital?

Write the answers down and keep them somewhere visible. Once the medical side is settled, what remains is household work at a deeper level than everyday cleaning: removing mud, drying the structure, disinfecting surfaces and air, and eliminating the musty odor. That is the part where the World Health Disinfection (WHD) team can help.

It is also worth telling the WHD team what the PD unit said. If the nurses want the room to stay unused for a certain number of days after treatment, or want particular surfaces wiped in a particular way before the first exchange, the team can plan the visit around that timeline rather than the other way round.

Why the Usual Quick Fixes Are Not Enough for a Room Like This

When people come home to a flooded house, they reach for what is at hand. Each of these steps has some value, but none of them is enough on its own for a room that has to support daily dialysis.

• Bleach alone. Diluted bleach does kill germs on surfaces you can reach and wipe. It does nothing for spores floating in the air or hiding in joints, under door frames and behind furniture. In a small room, a strong chlorine smell can also bother a patient if the mix is too concentrated or the room is not aired out well. Bleach should never be mixed with other cleaners, either, because some combinations release harmful gases.
• Running fans to dry everything. Fans do reduce humidity, but they also blow spores and fine mud dust all over the house. Once the fans are switched off, any mold that survived simply starts growing again. And of course, fans are exactly what PD nurses ask patients to switch off during exchanges.
• Air fresheners and scented candles. These only mask the smell for a while. They do not remove its source, and strong fragrance is not a good fit for a room that is meant to be plain, simple and clean.
• Repainting over the stains. If the wall is still damp underneath, mold pushes back up through fresh paint within weeks. The family pays twice and loses time.
• Cleaning only the exchange table. The table may sparkle, but if the walls, the floor and the air around it still carry contamination, the room still has a source of germs a few centimetres away.

What an exchange room really needs is not one product or one trick. It needs the right sequence: remove mud and damaged materials, dry the structure, disinfect both the surfaces and the air, remove the odor at its source, and then check again.

The Solution: Chemgene HLD4H Disinfection Fogging Plus a Structured Ozone Treatment

WHD's disinfection service uses CHEMGENE HLD4H applied with an ultra-low-volume (ULV) fogger. The machine turns the disinfectant into a fine mist that drifts into corners, under tables, behind shelving and along wall joints that a cloth never really reaches. The ozone treatment service then fills the sealed room with ozone gas at a controlled concentration. Ozone is a strong oxidizer: it helps destroy mold spores suspended in the air and breaks down the odor molecules that soak into plaster, wooden frames and other porous materials. Because ozone naturally reverts to ordinary oxygen once the generator is switched off and the room is ventilated, it does not leave a perfume or chemical scent behind.

How the work is done in a home with a dialysis exchange room

1. Site survey. The team checks how high the water rose, where mold is visible, and how damp the walls still are. They ask which room is the exchange room, which is the patient's bedroom, where supplies are stored, and anything the PD unit has asked the family to observe.
2. Mud and debris advice. The team advises which materials should go, for example soaked cardboard, rugs and swollen particle-board furniture. They also ask the family to remove all dialysis solution and medical equipment from the work area before anything else happens. Nothing medical is treated or judged by the team.
3. Disinfection fogging with Chemgene HLD4H. The fog covers floors, walls up to and above the tide line, under the exchange table, shelf legs, the hand basin, the bathroom and the hallway the patient uses.
4. Ozone shock treatment. The room is closed and ozone is run for a period the team calculates from room size and odor level. No people, pets or plants are inside during treatment. Sensitive electronics and rubber items are removed or covered, and the dose is controlled to suit the space.
5. Ventilation. Doors and windows are opened so fresh air flows through until the ozone has broken down to oxygen. Nobody re-enters before the team says it is time.
6. Re-check. The team checks for remaining odor and mold spots. If walls are still damp, they will recommend waiting for further drying or scheduling a follow-up round rather than declaring the job finished too early.

After this, the daily routine of wiping the exchange table and preparing the room before each exchange goes back to exactly what the PD nurses taught. WHD's service restores the room after the flood. It does not replace any part of the patient's medical routine.

10 Reasons Dialysis Families in Bang Khun Thian Choose WHD

1. The team understands which rooms matter most. The exchange room and the patient's bedroom are treated as the top priority, not as an afterthought.
2. A fine mist reaches every corner. ULV fogging gets into gaps that wiping misses.
3. A high-standard disinfectant. CHEMGENE HLD4H is used across many kinds of disinfection work.
4. Airborne mold is addressed. Ozone treatment helps reduce spores floating in the room.
5. Odor is removed at the source. Ozone breaks down odor molecules instead of covering them up.
6. No heavy fragrance left behind. The room ends up plain and fresh, which suits a clinical-style space.
7. Clear safety steps. Nobody stays inside during ozone treatment, and the room is ventilated before anyone returns.
8. Respect for the medical team. WHD does not give medical advice and always points families to the PD unit for questions about solution and equipment.
9. Whole-home care when needed. The dust-mite removal service can follow up on mattresses that stayed dry but smell stale.
10. Close to Thonburi-side districts. Service covers Bang Khun Thian, Chom Thong, Thung Khru, Bang Bon and nearby areas.

A Family's Experience

"At first I was really worried about whether Dad's exchange room could ever be used again. The team asked a lot of careful questions about which room mattered most, told us to move the solution boxes out first, and were honest that anything to do with wet solution was a question for the PD nurse, not for them. When they finished, the musty smell that used to drift out of the back room was gone. We set the room up again the way the nurse showed us, and then we brought Dad home."

— A caregiver's story from the Rama 2 area of Bang Khun Thian (illustrative scenario)

Looking After the Exchange Room Once It Has Been Restored

The work does not stop when the treatment ends. A flooded building can stay damp inside its walls for weeks, and the first month is when mold is most likely to try to return. A few habits make a big difference:

• Control humidity. Open windows to air the room when no exchange is taking place, and close them during exchanges exactly as the PD nurse instructs.
• Store cartons off the floor. Keep solution boxes on a raised shelf, away from any wall that was wet.
• Watch the corners. Check the room's corners and the bottom of the walls every week during the first month. If new mold appears, call the team for a re-check rather than scrubbing it dry and spreading spores.
• Do not repaint too soon. If the wall is still damp, wait until it is completely dry before repainting.
• Everyday surface hygiene. For general household surfaces, the CHEMGENE HLD4H spray is convenient. For the exchange table itself, follow the cleaning method your PD unit taught you.
• Keep the drain trap filled. If the room's floor drain or basin smells of sewage, running water through it regularly keeps the trap sealed. A persistent sewage smell may need a plumber.

It also helps to keep a simple log for the first few weeks: date, any smell, any new spots, and whether the room felt damp. If anything changes, that record makes it easier for both the cleaning team and the medical team to understand what is going on.

Why Bang Khun Thian Homes Face a Particular Challenge

Bang Khun Thian sits at the very southern edge of Bangkok, between the Rama 2 corridor and the coast. Much of the district is low-lying, crossed by canals and old orchard channels, and close enough to the sea that high tides can slow how quickly rainwater drains away. When heavy rain coincides with high water, ground floors in townhouses and row houses can stay wet longer than in districts further north. That longer soak means more moisture is absorbed into walls and more time for mold to establish itself before families even get back inside.

Many households in Samae Dam, Tha Kham and the side roads off Rama 2 also live in compact townhouses where the ground floor is the only practical place for an exchange room, because elderly patients struggle with stairs. That is exactly the floor that floods first. For these families, a well-planned restoration of one small room can decide whether the patient can come home this week or must wait another month.

Frequently Asked Questions

Q: When can the patient go back into the room after ozone treatment?
A: After treatment the room must be ventilated until the ozone has broken down. The team tells you the right time on the day of service. As for when the patient is ready to do exchanges in that room again, please ask the PD unit as well.

Q: Some solution boxes got wet. Can your team disinfect them so we can keep using them?
A: No. The team does not make decisions about dialysis solution or medical equipment. Please ask your PD unit or the solution supplier, and remove those items from the work area before treatment begins.

Q: Will Chemgene leave residue on the exchange table?
A: After fogging and ventilation, the family can wipe the table according to the method the PD nurse taught before the first exchange.

Q: Should we treat the whole house or just the exchange room?
A: We recommend at least the exchange room, the patient's bedroom, the bathroom and shared hallways, because spores and odor travel across the whole ground floor.

Q: The walls are still damp. Should we wait before calling you?
A: You can book a survey now. The team will judge whether to fog immediately to stop mold spreading and run ozone once humidity drops, or do both in one visit.

Q: Can this article replace advice from the doctor?
A: No. It is general information about home restoration. If the patient has a fever, abdominal pain or cloudy fluid, contact the PD unit immediately.

Q: Which areas do you cover?
A: Bang Khun Thian, Chom Thong, Thung Khru, Bang Bon, Rat Burana and surrounding areas. Check availability on LINE @whd268.

Get the Room Ready Before Your Loved One Comes Home to Dialyze

Book a site survey for homes in Bang Khun Thian and nearby districts today.

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

Related Links

• Residential ozone disinfection
• CHEMGENE HLD4H disinfectant
• Dust-mite removal service
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Health information sources: World Health Organization (WHO): Floods · Department of Disease Control, Thailand