Sanitation and gender

I found myself losing concentration in the geography common room and ended up going through the haphazard collection of forgotten dissertations, journals and books that fill the shelves. Leading on from my last blog, I tried to find work by an African academic, and I came upon a book by A.Kalu, concerning narratives of women and development in Africa. It argues the status of women in much of Africa is key to understanding development issues. When considering sanitation this is especially true. I found studies showing- most of the unpaid daily tasks around sanitation and water are left to women, see figure 1, with harsh implications. In one study of 15 African countries, all had women and girls as the primary water collectors(Graham et al.,2016). It is mostly women who are responsible not just for drawing water from the well but for transportation, storage and cleaning public and private toilet facilities.(Caruso et al.,2022)

2/3^rds of the population in Africa must leave their home to get water. It's women and children who have to walk to the water with consequences for their health in far-reaching ways including Neck pain, spinal injury, and even spontaneous miscarriages from heavy workloads.

Figure 1 who fetches water by region :Source: United Nations, 2015. The World's Women 2015: Trends and Statistics. New York: United Nations, Department of Economic and Social Affairs, Statistics Division. Sales No. E.15.XVII.8, Statistical Annex.

Having to carry the water puts limits on the quantity available every day. This affects women most since they have have greater need for water sanitation services during pregnancy and because of their major role as carers for infants and the elderly. Moreover, with access to sanitation limited, women and girls have difficulty managing their menstruation. Poor menstrual hygiene management along with dangers to physical health has severe psychosocial impacts(Ray,2016). It affects education too, in rural Africa, there are poor attendance and high dropout rates for girls after puberty which can be partly linked to the fact 40% of schools there don’t have basic sanitation(Sommer,2015).

 

Source: world bank

Poor sanitation services also make women more vulnerable to sexual violence. Kayser's 2019 paper looks at refugee camps in Kenya, Ethiopia, and Guinea exposing a crisis of physical and sexual harassment. In the camps women either openly defecate or travel long distances to toilets. There, trauma from wars and collapsed social structures converge with inadequate sanitation facilitates creating epidemics of sexual violence that severely restrict freedom and opportunities for women(Miller,2017).

Clearly, inadequate sanitation is a women's issue and they are affected most by it. Thus, women must be included in water and sanitation decision-making, Malawi set up local water management committees in the 1980s and it was only when project leaders replaced men with women to head the committees did they start to be productive. Women were the ones using and dealing with water supplies day-to-day, they know what is needed when it comes to community water management.

 

 

 

 

Water and Sanitation in Africa, Introduction and Toilet Tech

“The hospitals refused to take in new patients, as they were already too full, even the verandas of the hospitals were filled with people. In some cases people burnt the dead with all their belongings, as they were afraid of the disease spreading” - recalled Father Joseph on Madagascar's Cholera epidemic

Cholera outbreaks like the one described above are facilitated by Inadequate sanitation. I chose to write about sanitation because it is fundamental to a healthy society, underpinning development(Tseole et al., 2022). Inadequate sanitation causes 115 deaths per hour in Africa, It is the main contributor to the crisis of diarrheal diseases- the leading factor in child mortality globally(Boschi-Pinto et al., 2006). 150,000 children die every year from such diseases in Nigeria alone(Jiwok et al., 2021). Africa has a sanitation crisis, a minority of people have access to adequate sanitation.

What is it? Sanitation pertains to those public health conditions concerning safe drinking water and the disposal of sewage. Good sanitation ensures a separation between human waste and water and food sources without which bacteria and viruses run rampant. There should be blocks to any faecal-oral route, see figure 1. Clearly, The importance of access to water, sanitation, and hygiene (WASH) cannot be underestimated. 

Figure 1: Fecal-oral transmission pathway. Based on Wagner & Lanoix, 1958

Figure 2: the percentage of people with access to improved sanitation, source

 Wainaina's scathingly satirical piece reminds us of the damaging narratives so common in western writing on Africa(Wainaina, 2005). Narratives that are rooted in neo-colonial imaginaries of the continent where white saviourism is predominant, portraying the continent in perpetual need for western intervention. In this blog, I will attempt to be cognizant of this neo-colonial perspective so common when looking at issues in Africa and utilise the work of African scholars.

Toilet tech 
Open defecation is the primary driver of sanitation related disease, toilets are key to separating the lived environment from faecal waste. 

Pit latrines reign supreme! or do they? They are a cheap and basic form of toilet, effectively an open hole in the ground. They can be vectors for dangerous flies called Chrysomya putoria-  the African latrine blowfly, which spread disease(Lindsay. et al, 2013), to avoid that requires building a special ventilated improved pit(VIP) latrine that prevents the flies entering and breeding.  Western style flushing toilets are often inappropriate, they use vast amounts of water and don't utilise faecal matter that could be productive. EcoSan toilets are the opposite, see Figure 3, the goal is to return excreta to the soil when its decomposed and safe, the nutrient rich excreta can improve crop productivity(Wirbelauer et. al, 2003). Maintaining that system can be too expensive for the rural poor in the long term, subsidies are likely necessary(ibid). These are inappropriate for the urban poor who don't have fields to use the excreta on. 

Figure 3, the operation of an EcoSan toilet: source