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The Politics of Women's Health

A Gender Perspective on Water Resources and Sanitation

Women’s Access to Water: A Security Issue

A talk by Marcia M. Brewster, Senior Economic Affairs Officer, United Nations Division for Sustainable Development at the Technology and Culture Forum at MIT “The Future of Water,” November 3, 2005.

I was extremely pleased to receive an invitation to speak on Women and Water at this particular institution, known as the bastion of technical expertise attended by the world’s finest engineers. Why would MIT be interested in this topic, I wondered? Perhaps the message that I have been trying to send out for the last 25 years has finally penetrated the walls of this prominent male-dominated institution. Perhaps these engineers have come to understand that projects actually work better when women are involved in water management. Or perhaps it is because funding is available for research in such areas. In any case, I commend the Technology and Culture Forum for focusing on these important issues during its 2005 program “The Future of Water,” and I am truly honoured to be here.   

It is your generation that will be called upon to make the changes required to avert a world water crisis. While world population tripled in the 20th century, the use of renewable water resources increased six-fold. It is estimated that by 2025 two-thirds of the world’s population will face moderate to severe water shortages, unless current habits change. Water and sanitation remain at the top of the international economic and social agenda, following the World Summit on Sustainable Development in 2002 in Johannesburg, South Africa, and as the main themes for the Commission on Sustainable Development in its 2004–05 cycle. The International Year of Freshwater 2003 has ended, and an International Decade of Action, 'Water for Life' has begun. All of these efforts have been launched because the international community recognizes the crucial importance of water and sanitation to sustainable development, poverty alleviation, health and gender equality.

I don’t know how may of you have heard the expression ‘The Silent Tsunami”. This refers to the monthly death toll of over 200,000 people in developing countries who die from preventable water-borne diseases. This is almost equivalent to the deaths in the Indian Ocean tsunami every single month, and yet it is seldom noticed or talked about – and it is entirely preventable. At the end of 2004 some 1.1 billion people lacked access to safe drinking water, and 2.6 billion - 40% of the world’s population – lacked access to basic sanitation services. The Millennium Development Goals include pledges by Heads of State to reduce by half the proportion of people without access to safe drinking water and basic sanitation by the year 2015. The time frame coincides with the ‘Water for Life’ Decade.

While these goals may seem ambitious, they are actually very modest. We are not talking about providing a tap and a flush toilet in every house. The WHO definition of access to safe water is 20 liters or 5 gallons per person per day within one kilometer’s walking distance from the household. And the definition of basic sanitation is a sanitary means of excreta disposal. This could just mean dehydration or composting of human waste to make it safe for recycling in agricultural fields, as is widely practiced in China and elsewhere. It is estimated that the investment required to meet the water and sanitation goals is an additional $20-30 billion a year, twice what is now spent in those developing countries – and a fraction of the cost of the war in Iraq. Many of the solutions being practiced are small-scale and cost effective technologies such as hand pumps, rainwater harvesting systems, solar distillers and improved pit latrines. But these and other low-cost sustainable solutions need to be widely replicated and managed by communities, including women.

Tonight we will consider the situation of the women and girls in Africa, Asia and other poorer parts of the world who lack access to safe water and sanitation. These amenities that we take for granted are a matter of survival, personal dignity and human security for those women. I will outline some of the sources of insecurity and provide some examples of how women have responded with innovative solutions.

Regarding access to water resources, water is increasingly becoming an important strategic resource, and control over water is a source of power and economic strength. Thus, this vital resource essential for sustaining life and development can also be a root cause of socio-political stress. Power relations between women and men are often at the heart of providing, managing and conserving our finite water resources.

In most cultures, women are primarily responsible for the use and management of water resources, sanitation and health at the household level. Over the years, women have accumulated an impressive store of environmental wisdom, being the ones to find water, to educate children in hygiene matters and to understand the impact of poor sanitation on health. At the same time, women and girls are often obliged to walk many hours every day fetching water, while men are rarely expected to perform such tasks.

Daily water collection, however, may expose women to the threat of violence and health hazards. Attacks against women by men or wild animals may occur when they are carrying water in remote areas or where women have to relieve themselves in the open after nightfall. They may also suffer gastric disorders from waiting until dark to defecate in the open. Having access to water nearer the household reduces violence against women as well as the time spent fetching water, allowing time for other activities, including training, growing food and income generation. Yet women often have no voice and no choice about the kind of services they receive.

Access to water for agricultural production presents another source of insecurity to women. Food security is often dependent on women's subsistence production to feed the family, which in turn may be contingent on land rights. However, in many countries, land tenure and associated water rights pass only among the male members of the family. Thus, women lack legal rights of access to water, even though their accumulated knowledge is valuable for managing and protecting water sources and watersheds. Sometimes indigenous women are taking the lead in their communities to protect water resources and demand water rights. For example, in north-eastern Brazil, the Rural Women Workers’ Movement has mobilized women to revitalize a small local river in the water scarce area. This involves community education, i.e., teaching local people not to dump their sewage into the river, in addition to planting native species of trees along the river banks.  Women and indigenous groups will only have secure access when they are recognized as citizens, land holders and contributors to the development process.  This is now more important than ever, as agriculture is increasingly “feminized” due to wars, pandemics, and the exodus of men seeking paid work in urban areas.

With regard to access to sanitation and hygiene education, a focus on gender differences is of particular importance. Often the availability of latrines in schools can enable girls to get an education, especially after they reach puberty, by providing privacy and dignity.  It is particularly important that the public institutions with the most extensive and sustained public outreach – schools and health centres – should become learning and demonstration centres for good hygiene and its benefits. UNICEF, in collaboration with the Water Supply and Sanitation Collaborative Council and others, has been focusing on providing water and sanitation in schools in over 70 countries, and this has been one of the most successful programs sponsored by the UN. The project began in 2000 in such countries as Burkina Faso, Colombia, Nepal, Viet Nam and Zambia. Besides supporting the installation of separate facilities for boys and girls, the program provides low-cost teaching aids and life-skills hygiene education to primary schools.

In Morocco, the Rural Supply and Sanitation Project of the World Bank aimed to reduce the burden of girls “who were traditionally involved in fetching water” in order to improve their school attendance.  In the six provinces where the project is based, it was found that girls’ school attendance increased by 20 % in four years, partly because they spent less time fetching water. Convenient access to safe water reduced the time spent fetching water by women and young girls by 50 to 90 %, allowing them to use this time more productively. 

Improving access to water and sanitation and changing hygiene behaviours have large benefits to society as a whole through improvements in health, education and productivity. These benefits justify continued public sector support to communities and households. The success and effective use of water and sanitation facilities will depend on the involvement of both women and men in selecting the location and technology of such facilities, and taking responsibility for management, operation and maintenance. For example, in eight slums in Tamil Nadu State in India, women’s self-help groups organized and managed a water and sanitation project that has visibly benefited the entire community.  With the advent of drinking water facilities and low-cost toilets, as well as the provision of training and educational programs, the number of households with toilets increased from 8 to 22% from 1999 to 2001 and the incidence of diarrhoea fell from 73 to 10 % among children.  The members of the self-help groups became entrepreneurs and decision-makers and the entire community has been empowered by the change.

Another threat to water security for women can arise when private companies get involved in water utilities and inappropriately raise prices. As a majority of the world’s poor, women are significantly affected when the price for water services is raised. Even though poor women may place a high priority on accessible, clean water, they may be forced to use contaminated water that is free rather than clean water, which they cannot afford. This of course impacts the health of the community, and may result in much higher costs for health care. A community in Central Java, Indonesia has been challenged by a bottled water plant that has caused a drastic decline in water for irrigation.   In response, community members established the Klaten People’s Coalition for Justice, which seeks to reduce the plant’s extraction rate and has established a community monitoring system. Ultimately the group aims to close down the bottling plant. Women’s active participation has not only increased their self-confidence and skills, but also taught them to conduct research, share information and discuss issues effectively with other members.
Finally, there is the source of insecurity due to armed conflict or natural disasters, such as floods. Water can become a weapon or a target during armed conflicts. Flood-control dikes may be intentionally destroyed to inundate enemy territory, or water supplies and wells may be deliberately contaminated to harm an opponent. Women are disproportionately affected by man-made and natural disasters, as a result of low political and economic status, poor education and health. Women have high death rates in disasters, as they often do not receive warnings or information about hazards and risks, and their mobility may be restricted for cultural reasons.  In 2004, the Centre for Environmental and Geographic Information Services in Bangladesh implemented a project on flood vulnerability, risk reduction and better preparedness through a community-based information system in a flood-prone zone.  As a result, in that year’s flood women as well as men benefited from new alert mechanisms, such as drum beating, microphones in mosques, and a flag network.

As can be seen from some of the above examples, the potential contribution of women should not be underestimated. It can vary from fundraising to active work on construction, preventive maintenance and repairs to paying for water with labour.  In Zimbabwe and Lesotho, local women are being trained to build latrines as well as to repair and maintain boreholes. In South Africa, community members, a majority of whom were women,  participated in a brick-making project established to provide materials for latrine construction.

Currently most of the training available in developing countries, however, is aimed at water resources, particularly civil engineers and technical specialists, with very few programmes  aimed at expertise in social development, sanitation or hygiene education. A gender perspective can improve capacity building at the community level, with affirmative action programmes aimed at encouraging women and girls to get a  better technical education and to get on-the-job training in operation, maintenance and management of water and sanitation facilities. 

As indicated throughout this talk, the projects in which women and men have an equal say have a better chance for success and sustainability because they address the needs of both.  A study by the International Reference Centre for Water and Sanitation (IRC) of community water and sanitation projects in 88 communities in 15 countries found that projects designed and run with the full participation of women are more sustainable and effective than those without such involvement. This supports an earlier World Bank study that found that women’s participation improved the effective use of water and sanitation facilities. Policy makers may be more interested in ensuring the success of water projects than in promoting gender equality, and approaching the subject of gender and water from a development angle will support them. To succeed, however, women and men need access to information about technology, design and financing, as well as access to credit, and the ability to participate effectively in decision making.

An interesting development in the last few years is that a number of women have been appointed as ministers of water and environment in countries all over the world. We now have a list of some 40 such women, many of whom have introduced affirmative action programs into their water policies. Our UN Interagency Task Force on Gender and Water has been working with some of these women ministers and compiling case studies and recommendations for action during the Water for Life Decade. The recommendations are contained in the paper: “A gender perspective on water resources and sanitation”, produced for the Commission on Sustainable Development in April 2005. It is available on the Web at http://www.unwater.org/downloads/bground_2.pdf.

Much of the advocacy work on water and sanitation is being spearheaded by broad-based partnerships such as the Water Supply and Sanitation Collaborative Council (WSSCC), with its WASH campaign (‘Water, Sanitation and Hygiene for all’) in over 100 countries; the Global Water Partnership (GWP), the Gender and Water Alliance, and the World Water Council, and NGOs such as WaterAid and Oxfam. These partnerships are providing very important support in terms of technology transfer, technical assistance, capacity building and community development. They employ well-designed education programs to demonstrate the linkages between water, sanitation, hygiene, and health.

To summarize, our work at the international and national level aims to:

  • Strengthen legislation for land and water rights, particularly for women and indigenous people; 
  • Mobilize resources to improve access to safe water, adequate sanitation, and water for productive purposes;
  • Develop capacity and encourage equal participation among men and women in training and decision making;
  • Ensure public discussion and equitable tendering procedures in any move to privatize water services;
  • Promote sanitation by channelling efforts for marketing sanitation through women’s organizations, schools and health clinics;
  • Provide technical assistance to local authorities and communities regarding low-cost technologies and access to information;
  • Engage women leaders to serve as role models in the effort to mainstream gender in water management at all levels; and
  • Support partnerships among the business community, governments, civil society and other interested parties that can provide support to all these efforts.

The value of an event like today is to interact with you and to get you involved in finding solutions that will provide enough water for everyone without causing a water crisis. The task for you students is to select the appropriate topics for research and field work that can support some of these efforts and make a difference to water use and conservation. Research topics could range from re-use applications, economic incentives and technical innovations to social interventions and community mobilization.

The issue of water security for women in developing countries is one of the most fundamental problems facing them. I appeal to you, as stewards of the planet in the future, to keep this in mind as you choose your careers. You can certainly make an important difference with just a modest contribution. We look forward to working together with all of you during the International Water for Life Decade.

Thank you for your attention.

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