A panel discussion on Addressing Discrimination and Neglect in WASH: An Uncomfortable Conversation took place at Stockholm World Water Week on 29 August 2019. It included interventions from 6 organisations under the auspices of the Swiss Water Partnership, and was facilitated by Kerstin Danert (Skat).
This session addressed the specific needs of people who are often neglected or discriminated against, including women, girls, poor people, prisoners, people with mental health issues and sexworkers. Below is a brief overview of the topics discussed during the session. You can watch a video of the session recording here.
John Brogan (Terre des Hommes) described the situation in prisons. More than 11 million people globally live in prisons, over half of them in low- and middle-income countries – and the global prison population is rising. In the context of the SDGs and universal access, a lot of work has been done to increase and improve access to WASH services in institutions such as schools and health facilities. However, prisons are often left out of these efforts. Not a lot of research done on this topic: UNC recently published the first systematic review of environmental health conditions in prisons. While the most common risk factor identified was contaminated food and/or beverages prepared or handled in the institution's kitchen, few studies had conducted in low- and middle-income countries, biasing the results of this review. Getting access to prisons is often difficult: working on WASH infrastructure can however open doors to study prison populations and the specific needs of prisoners, including women and children. Indeed, as Shivani Swamy (Livinguard Technologies) pointed out, in India, children are allowed to stay in prisons with their mothers until the age of 5. Their needs, and that of women, are often neglected.
A participant also pointed out that a project by an NGO to improved sanitation conditions in a prison was killed off by senior management, as it wanted to be seen to help out women and children rather than prisoners which may be a harder sell to the public and to donors. Another participant thanked the panellist for raising this issue, which had been highlighted by the UN rapporteur on the rights to water and sanitation.
Lucie Leclert (Swiss Water & Sanitation Consortium) addressed the topic of menstruation, which remains taboo for many people. Lucie outlined the lack of adequate infrastructure in schools, and the fact that girls are very often not informed before their first menstruation. Menstruation can be a factor in missing or dropping out of school. Boys and girls should be included when discussing menstruation: the Swiss Water and Sanitation Consortium developed the Blue Schools kit, which includes a chapter entitled "Grow and change", which it focuses more broadly on puberty changes and provides practical exercises and games for children, to give them information about menstruation.
Menstruation is also a topic of interest for Shivani Swamy (Livinguard Technologies) whose company has started to manufacture Saafkins, which are reusable sanitary napkins, for women in India. It addresses the specific needs of some vulnerable groups, including women in prisons and sexworkers, who may being unable to afford underwear. Her experience in accessing a women's prison in India is that women often have no access to soap, no privacy – it becomes difficult for women to manage their menstruation in these conditions. Furthermore, she highlighted that her company had received some backlash from people on social media for addressing the needs of these women as they were perceived as 'not needy' or not deserving improved access to menstrual pads.
One of the participants (Esther de Vreede from the organisation Simavi – who is also a member of the SDC Sub-RésEAU Africa pointed out that while it is often assumed that girls miss out on school because of menstruation. Research shows that lack of sanitation infrastructure or pads is not the main reason why girls miss out on school. In Uganda, for instance, pain during their periods was the main factor for girls missing school. She also suggested to talking about Menstrual Health Management rather than Menstrual Hygiene Management, which implies that menstruation is unhygienic.
Carolien Van der Voorden (Water and Sanitation Collaborative Council (WSSCC)) outlined that CLTS (an well-known methodology whereby communities are mobilised to completely eliminate open defecation) may not be as inclusive as we would like to think. A study from WSSCC on inequality in CLTS showed some examples of discrimination for people with mental health issues. In one case, a man was banned from a village so that the community could achieve Open Defecation Free status while the inspectors were visiting. People were also forced to take out loans to achieve the minimum standard that the community had set for latrines. In one case, this led to an elderly man losing his land. There are also positive examples of CLTS being inclusive and considering the needs of vulnerable people, but we need to be aware of these other cases. WSSCC is now taking action by making CLTS facilitators more aware of inequalities and preconceptions, in order to ensure that these initiatives do no harm, and has published a new handbook on equality and discrimination for CLTS facilitators.
Vasco Schelbert (EAWAG) explained that shared sanitation facilities are predominant in low-income and informal settlement in cities. They can take many forms: shared between households, public or community toilets. However, shared facilities are not considered a basic service under the JMP ladder for sanitation, which is used to monitor the SDGs. For this reason, public authorities and NGOs alike do not invest in these solutions, which is excluding a service which people in informal settlements use and need. EAWAG is working on standards to be able to assess the quality of shared sanitation services, with a view to incorporate this in global monitoring systems such as the JMP.
Nadia Benani (SDC) emphasised the role of donors in raising awareness in relation to issues which are uncomfortable but need to be addressed to help the most vulnerable. She highlighted the need for donors to move away from the concept of "trickle down economics" in order to focus on the poorest and most marginalised people in society. The magnitude of people excluded in the WASH sector is huge – half of the world's population do not have access to adequate sanitation facilities. SDC's approach is to engage with a range of partners in order to promote innovative approaches which support vulnerable people.
The rapporteur, Soraya Kohler (Swiss Water Partnership), concluded that many barriers in the WASH sector still need to be overcome for marginalised and vulnerable populations for the goal of universal access to WASH to be achieved. We need to ensure that issues around equality and discrimination – and on the Leave no one behind concept more broadly – remains on the agenda in international development and in the water sector more specifically.