When I started my public health project on WASH (Water, Sanitation and Hygiene) in Ganjam, Odisha, in the four intervention villages of my host organisation Dakshin Foundation, I had the opportunity to develop a nuanced understanding of WASH. One of the critical perspectives I’ve adopted is examining how WASH impacts the community, particularly its most vulnerable members. These often include women and people from lower caste and class backgrounds. This perspective intersects with the reality that, despite being the most affected, these groups also have the least autonomy and decision-making power at both the community and household levels. In this blog, I aim to explore the role of gender in WASH interventions and share our observations from the four villages in Ganjam
The connections between gender and WASH stem from the traditional roles women play in household-level WASH activities, such as cooking, cleaning, care work, and water collection etc. The gender division of labour in most societies places the burden of family wellbeing, health, and hygiene on women. The burden of inadequate WASH infrastructure, access, and practices affects each gender differently, with one gender disproportionately bearing the heavier cost. Additionally, women and girls have unique needs related to menstruation, bathing, urination, and defecation.
The time women spend on ensuring family wellbeing and health, due to unmet WASH needs, could be used for education, earning income, participating in politics, or even rest and leisure. Reducing the burden associated with WASH tasks would not only save time but also improve women’s physical and psychological health. The Unpaid care work, including WASH-related tasks, poses a significant barrier to achieving gender equality. Furthermore, women carers are directly affected when family members fall ill from preventable waterborne diseases, increasing their already heavy workload. (Sweetman & Medland, 2017)
Examining WASH from a gender perspective requires looking beyond technical aspects of services and infrastructure to focus on social relations and power dynamics. (Sweetman & Medland, 2017). The WASH sector has traditionally taken a technical approach, resulting in solutions and systems that often overlook the roles and needs of women and girls and miss the opportunity to address gender dynamics.However, there has been a growing focus on gender-specific WASH interventions and research. The Sustainable Development Goals (United Nations General Assembly, 2015) notably emphasize the importance of linking WASH and equality, specifically in targets 6.1, which aims for “universal and equitable access to safe and affordable drinking water for all,” and 6.2, which seeks “access to adequate and equitable sanitation and hygiene for all and end open defecation, paying special attention to the needs of women and girls and those in vulnerable situations.” (Agol & Harvey, 2018).
To address these issues, it is essential to reconceptualize WASH not only as a fundamental aspect of public health but also as a critical component of gender equality, social justice, and environmental justice. Interventions in this area are often evaluated based on a narrow set of health outcomes, such as reductions in diarrhoea and improvements in child growth. This limited focus has created a “knowledge silo” that neglects a wide array of potential benefits, including time savings, enhanced livelihoods, and broader health and well-being. Additionally, the lack of data disaggregation by sex and other social identifiers has been realised as a major obstacle to understanding the comprehensive impacts of WASH interventions. (Macura et al., 2023)
Another area to focus can be the gap in understanding household sanitation decision-making through a gender lens. This perspective is critical for comprehending how gender dynamics influence choices related to household sanitation. Moreover research highlights the importance of examining structural, political, and ecological barriers that affect the adoption of toilets and the promotion of healthy behaviours. In many studies women have mentioned that the decision to purchase or build latrines ultimately rested with their husbands, who would only proceed if they perceived a genuine need. This underscores women’s limited involvement in decision-making and resource allocation regarding toilet construction. (Khanna & Das, 2015).
During our exploration and interactions in the villages, it became evident that men and women had distinctly different responses, interests, and levels of information regarding WASH concerns. Often, men were not fully aware of the extent of the water crisis in their households, focusing instead on the financial aspects, such as the cost of borewells and handpumps. They also tended to downplay the seriousness of the lack of washrooms.
I am sharing some of the issues we identified that illustrate how WASH is a gendered issue in our intervention villages.
Water Collection Responsibilities: Water collection and ensuring its availability are primarily the responsibility of the women in the household. They often make 3 to 4 trips a day to collect water, with each trip taking approximately 20 to 30 minutes or more, depending on the water source’s location. In some lanes, women have to walk to the end of the village to collect water, while in others, they have nearer access. On average, they spend about two hours a day on water-related tasks. This significantly impacts the time they can dedicate to themselves amidst other responsibilities. Furthermore, the stress and role of fetching water are not shared with other household members.
Impact on Work and Economic Opportunities:In fishing villages, many women also work outside the home, either by preparing and selling dry fish or as construction workers, requiring them to leave for work at a specific hour. This timing often coincides with when water is available from the taps. Some women reported that they have to go back and forth, while others delay leaving for work, creating more problems due to the unreliable water timings. This impacts their economic opportunities. If a mother cannot afford to miss work, she often asks her adolescent daughters to fetch water or stay back to collect it. This was especially reported in Podampeta, where girls sometimes go to school late or miss school entirely. This affects their education and perpetuates the generational cycle of roles and responsibilities.
Household Chores and Daily Planning:The inconsistent timing of water availability also dictates how women plan their days. They often have to delay household chores, especially cooking, which affects how they allocate time and manage other responsibilities and caregiving activities for the family. Most women shared that fetching quality water for the family has been a constant source of stress for many years. Although the situation improves at times, it is never consistent, and they face recurring challenges.
Open Defecation Practices: In the villages, areas for open defecation are informally segregated based on a social understanding. Men typically move towards the beaches and lakes, while women head to nearby forests, which are often cashew plantations. During the cultivation season, guards and workers arrive in the morning and leave in the evening, forcing women to go early in the morning when it’s still dark or late after sunset. While many have adapted to controlling their biological needs, it can still be inconvenient, leading to restrictions to biological needs at times. Mothers have expressed a desire for better provisions for their adolescent daughters.
Privacy and Safety Concerns: Older women often state that they prefer going out in the open, feeling that no man will look at them, as they have done this throughout their lives. However, younger women have raised concerns about privacy and safety. Many participants shared that even mothers in late pregnancy, mothers right after delivery, people recovering from surgery, and other vulnerable groups also have to go out and often find it challenging.
Menstrual Hygiene: Regarding menstrual hygiene, it was noted that even women who usually use washrooms at home go for open defecation during their periods to bury used pads in the sand. This was mentioned in a group discussion in Purunabandha. Others shared that managing menstrual hygiene becomes difficult during those days due to the lack of an enclosed, safe space with running water to change.
Personal Hygiene and Health Complications: Due to the lack of facilities for personal hygiene and sanitation, women often report experiencing white discharge and heavy bleeding. ASHAs (Accredited Social Health Activists) in group discussions shared that girls as young as 6 or 7 years old have to be taken to doctors for white discharge. Women also experience issues with heavy bleeding, including during several months of pregnancy, which is uncommon and a concern. Due to frequent health complications, ASHAs in Nuagaon shared that many women had to undergo hysterectomies at an early age. One hypothesis could be frequent and untreated reproductive tract infections (RTIs) or urinary tract infections (UTIs).
Therefore, it is essential to consider gender as a crucial lens when planning WASH initiatives in our intervention villages in Ganjam, Odisha.
References:
Agol, D., & Harvey, P. (2018). Gender differences related to WASH in schools and educational efficiency. Water Alternatives, 11(2), 284-296. Retrieved from http://www.water-alternatives.org/index.php/alldoc/articles/vol11/v11issue2/432-a11-2-6
Khanna, T., & Das, M. (2015). Why gender matters in the solution towards safe sanitation? Reflections from rural India. Global Public Health. https://doi.org/10.1080/17441692.2015.1062905
Macura, B., Foggitt, E., Liera, C., & others. (2023). Systematic mapping of gender equality and social inclusion in WASH interventions: Knowledge clusters and gaps. BMJ Global Health, 8, e010850. https://doi.org/10.1136/bmjgh-2022-010850
Sweetman, C., & Medland, L. (2017). Introduction: Gender and water, sanitation and hygiene. Gender & Development, 25(2), 153-166. https://doi.org/10.1080/13552074.2017.1349867
