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‘We Can’t Wait’ — report on sanitation and hygiene for women and girls

‘We Can’t Wait’ — report on sanitation and hygiene for women and girls

By: Amar Guriro

KARACHI: One person in three lacks access to adequate sanitation and the result is widespread death and disease – especially among children and women, disclosed a detailed report “We Can’t Wait” on sanitation and hygiene for women and girls, jointly launched by the UK based international charity WaterAid, Water Supply and Sanitation Collaborative Council (WSSCC) and Unilever Domestos.

The report was issued on the World Toilet Day to be observed tomorrow (Tuesday), designed by the United Nations General Assembly. World Toilet Day was set up to help raise awareness of the 2.5 billion people in the world who don’t have access to a safe, clean and private toilet. It is now recognised as an official UN day.

The purpose of World Toilet Day is to raise awareness about the lack of sanitation in parts of the world and to encourage the policies that increase sanitation access among the poor.

The international community acknowledged the importance of sanitation by including targets in the Millennium Development Goals. Yet with the 2015 deadline fast approaching, we are still far from addressing this global crisis.

By highlighting the direct impact of poor sanitation on people throughout the world, World Toilet Day can help generate action to make sanitation for all a global development priority.

The report states that women are particularly vulnerable, as poor sanitation exposes females to the risk of assault, and when schools cannot provide clean, safe toilets girls’ attendance drops.

“We call on governments, international and regional organisations, local communities, the private sector and civil society to examine what more can be done to rapidly expand access to sanitation. Population growth and urbanisation make this an even more urgent task. We simply cannot wait. By acting decisively we can now make a positive impact on global health, education, women’s safety, social equality and economic growth for generations to come,” the report quoted the demands of Jan Eliasson, United Nations Deputy Secretary-General.

The reported states that the improving sanitation would make 1.25 billion women’s lives both safer and healthier and improved sanitation could mean every girl being able to stay in school when she reaches puberty, and all women having a safe place to go so that they are free from fear of assault and the loss of dignity from going in the open.

“It could free women from the burden of helping their children and family members use a toilet, which is far from home and difficult to use. It would help women to take on paid work and to stay at work during menstruation so that they can earn more and invest this back into a better life for themselves and their families. Every day around 2,000 mothers lose a child to diarrhoea caused by lack of access to safe toilets and clean water,” the report stated.

At a global level, the report “We simply can’t wait” addresses the sanitation crisis. Of all the Millennium Development Goals, the target to divide the proportion of the global population without sustainable access to safe sanitation is lagging the furthest behind. 2.5 billion people still lack access to toilets. That’s more than one in every three people. It’s worth stopping to think about that. And this number is likely to increase rather than decrease due to rapid urbanisation, unless we take urgent action now.

2.5 billion people still without access to adequate sanitation

The report also disclosed about the challenge of achieving target 7 of the MDGs – to divide the proportion of people without sustainable access to safe drinking water and basic sanitation and MDG 4 to reduce the under-five mortality rate by two-thirds – could be met by sustained partnerships between governments, businesses, NGOs and communities. Significant progress has been made towards achieving these targets. “Since 1990, almost 1.9 billion more people now have access to improved sanitation. But this is not enough. If progress continues at the current rate the global community will not meet MDG 7C by 2015. There are still 45 countries in the world where less than half of the population has access to adequate sanitation facilities. Around 700,000 children die every year from diarrhoea caused by unsafe water and poor sanitation. That’s almost 2,000 children a day,” the report went on to add.

Poor sanitation has significant impacts on the safety, well-being and educational prospects of women. Girls’ lack of access to a clean, safe toilet, especially during menstruation, perpetuates risk, shame and fear. This has long-term impacts on women’s health, education, livelihoods and safety but it also impacts the economy, as failing to provide for the sanitation needs of women ultimately risks excluding half of the potential workforce. To extend the reach of sanitation programmes as we move towards 2015, the United Nations Secretary General’s High Level Panel has recommended that global partnerships between the public and private sectors be considered of central importance.

In his speech during the opening of Budapest Water Summit in October 2013, the UN Secretary General, Ban Ki-Moon, stated that sanitation is one of the three areas critical to sustainable development where more cooperation is needed. Pooling the resources and skills of governments, NGOs and businesses will help to ensure that programmes can be scaled up.

Improving sanitation is high on the agenda of the United Nations, civil society and many corporate and businesses. Where there is a strong business case for the private organisations involved, long-term commercial support can be relied upon to ensure that great numbers of people affected by poor sanitation can be reached.

The report also quoted a case study conducted by Dr Shaheen Khan of the WSSCC from Hyderabad, Sindh, which quoted a young lady Sadia with severe sight impairment. She having graduated from a school for the visually impaired now provides free teaching services to children from the same school she attended. She manages very well day-to-day in her own house; however, using public toilets remains an obstacle.

“I feel ashamed asking a friend to take me to the toilet but there is no other way. The toilets are hazardous and unhygienic anyway, but particularly for me as I have to use my hands to feel the floor and take the proper position.”

Menstrual hygiene matters

Talking about the menstrual hygiene, the report stated that on any given day, more than 800 million women between the ages of 15 and 49 are menstruating. “Yet across the world menstruation remains deep inside the female closet, shrouded in silence, secrecy, embarrassment, shame and indignity. Still, in many cultures, systemic discrimination decrees that girls and women must not talk about their menstrual cycles openly, must not complain, must bear the pain and discomfort in stoic silence and must somehow cope on their own,” the report said.

In 2012, the WSSCC designed and ran a Menstrual Hygiene Lab as part of the Great Wash Yatra that journeyed through five Indian states and 2,000km over 51 days. Twelve thousand girls and women took part in the focus group discussions and 747 completed formal surveys. The results showed 70.9% of the girls had no idea what was happening to them when they began to bleed.

“Many young women thought that they were injured, or had cancer or some other serious disease. Even after they began menstruating, most girls felt unable to talk to their mothers and almost all reported being scared of menstruation. Despite the fact that they make up half of the world’s population – a huge consumer base by any measure – women and girls’ needs around managing menstruation are largely ignored,” disclosed the report.

Managing menstruation with safety and dignity is a human right, embedded within the right to human dignity, the right to equality, bodily integrity, health and well-being. The neglect of menstruation also violates the Convention on the Rights of the Child (CRC), the Convention to Eliminate All Forms of Discrimination against Women and the International Covenant on Economic, Social and Cultural Rights that mentions reproductive and sexual rights.

Additionally, the stigma surrounding menstruation is an extreme and acute form of discrimination, which normalises exclusion, ostracism, and often confinement and incarceration. This is turn violates several human rights including the right to non-discrimination, privacy and the right to freedom from inhumane and degrading treatment, from abuse and violence.

The central practical dimension of menstruation is the need to manage it hygienically, safely and with dignity. This challenge is present across women and girls’ daily lives. Hygienic, convenient and affordable materials for absorbing menstrual flows that are appropriate in a localised socio-cultural context are needed. There are also challenges around privacy, water, soap and available spaces for changing, washing and drying reusable materials and underwear, and the dignified and environmentally safe disposal of used sanitary materials.

But breaking the taboo remains the biggest challenge. Breaking the taboo starts with the right to information and knowledge and the ability of women and girls to talk freely about menstruation without fear or shame, but with confidence and pride. Alternative spaces for women and girls to discuss menstruation and to learn how to manage it better are needed, and boys and men must be informed and aware in order to support and empower the females around them. The onset of the first period should become something that young girls anticipate with full preparation and confidence rather than ignorance, fear and shame, as is currently the case across much of the world.


The report recommended that the governments make strengthening the sanitation sector and bringing the MDG target back on track an immediate and urgent political priority and also the governments (of both developing and donor countries) across the world keep their promises and implement the commitments made at national level, regional level and global level.

“Furthermore, they must significantly increase financial resources to the sector, use these resources wisely and ensure that the most marginalised and vulnerable people are targeted,” said the report.

The post-2015 development framework must have a clear focus on eradicating extreme poverty by 2030, and UN member states are urged to consider a dedicated goal on water and sanitation that sets ambitious targets to achieve universal access to water, sanitation and hygiene so that:

* No one practises open defecation

* Everyone has safe water, sanitation and hygiene at home

* All schools and health facilities have safe water, sanitation and hygiene

* Water, sanitation and hygiene are sustainable and inequalities in access are progressively eliminated

Sanitation should be integrated into education policy supported by sufficient resources and concrete plans to ensure that:

* All schools have adequate sanitation facilities including hand washing facilities and separate toilets for boys and girls with access for students with disabilities

* Specific provision is made at school for establishing proper menstrual hygiene management facilities

* Hygiene promotion is featured as an important part of the school curriculum from primary level

“The role for public private partnerships in addressing the sanitation crisis has been formally recognised. More actors in the private sector must realise the social and business opportunities and invest in social development. More frequent and cross sector collaboration is essential to achieving real progress,” stated the report.

Daily Times

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