Period poverty and the struggle of sanitation

Following my previous post, I am going to explore the trouble that sanitation poses for women in Africa. Whilst there are rural water deficits of which I have mentioned, this post is going to home in more on urban areas where there is still a lack of facilities despite the greater prevalence of infrastructure. Ultimately, the challenge urban areas face is that infrastructure growth has to match the fast growing urban populations (Davis, 2006). In addition, the foreground of concern in African infrastructure has been centred around providing clean water and it has been assumed that improved sanitation will follow. However, sanitation is of paramount importance and should not be neglected. Poor sanitation can result in widespread disease such as diarrhoea. Of the deaths caused by this disease, 88% are due to unsafe water, poor sanitation and inadequate hygiene activity. With the lack of academic focus on toilet habitats, (George, 2008) alongside a lack of successful projects due to inappropriate top-down implementation, the development of solutions has been restricted (Jewitt, 2011). Hence, there are many settlements in Africa which suffer from inadequate sanitation, such as Mathare Valley in Kenya.  Mathare is a collection of slums in Nairobi which inhabits roughly 400,000 individuals (Mathare Foundation), of which nearly 85% share a single toilet and the nearest facility is over 50m away (Corburn and Hildebrand, 2015). This post will explore the case study of the slums of Mathare and the issues arising from poor sanitation that women face.

Mathare Valley. Source

Whilst a lack of sanitation affects everyone, women take an unequal share of this burden due to a lack of dignity and ‘sexual violence and harassment associated with use of community toilets or sites’ (Winter, 2019). An obvious problem with a lack of sanitation is the diseases that arise from poor maintenance and poor hygiene habits. One of the biggest challenges is that there is a lack of education  around the importance of maintaining a high level of hygiene. This becomes even more difficult when young girls have restricted education due to expectations for them to carry out household tasks instead of attending school, and hence the availability of this limited teaching is reduced further. As women and young girls are expected to collect water, they are naturally more susceptible to contracting disease from contaminated water than men. This coupled with a lack of sanitation facilities results in a higher prevalence of ill health amongst women. A study conducted between 2011 and 2013 in Mathare indicated that only 45% of women reported that they had good health when their male counterparts demonstrated a health rate of 62% (Corburn and Hildebrand, 2015). Another factor that needs to be considered is that women are can be deemed as responsible for household activities including caring for the family. If women and young girls are most likely to contract water-related illnesses, and the same demographic is responsible for caring for the sick, they suffer double discrimination which places even further time restrictions on their ability to get an education or a formal job.

 Typical Mathare toilet. Source 

Women also take greater burden from a lack of sanitation due to the difficulties of menstruation. Whilst there is high absenteeism for young girls from schools due to their requirement to help in the home, it is further heightened due to the issue of the unavailability of menstrual products. It was reported that in Kenya, ‘less than a quarter of primary and secondary schools met the national standards’ for the number of toilets per pupil including the number of separate gender spaces (Corburn and Hildebrand, 2015). In slums, this issue is exaggerated due to severely inadequate sanitation facilities. Young girls are faced by the issue of ‘indecency’ of bleeding in public which forces them to stay at home and away from an education (Corburn and Hildebrand, 2015). As a result of the female menstrual cycle, there is a strong correlation between girls dropping out of school and puberty (Kaiser, 2019). Period poverty hits schoolgirls with the most ferocity as many are unable to afford menstrual products and can be forced to use rags or leaves, or to simply stay at home. This is partially due to their inability to decide the distribution of household income due to the male-dominated arena (Kaur et al., 2018). Where individuals do have access to sanitation products, one of the further challenges they face is that there is no easy way to dispose of it and it often is discarded in open areas. There is also the challenge of cultural taboos which can prevent women and young girls from taking part in societal activities such as attending religious buildings or even eating meals with men (WaterAid, 2018). This is on the basis that periods are viewed as 'dirty', lowering female dignity. In the context of Mathare, the lack of sanitation facilities and toilets also makes them subjects of physical and sexual violence due to poorly fitted locks and lighting, especially at night. In Kibera, another Kenyan slum, 36% of women living in the slum reported that they have physically been forced to have sex with relation to the use of toilets (Corburn and Hildebrand, 2015). If women are viewed as indecent when on their periods, and the most discreet way to manage their cycle is by going to the toilet in the dark, then they are going to be more susceptible to sexual harassment which is more common at night.

I have described how the lack of sanitation facilities and toilets can disproportionately affect women in the context of a Kenyan slum, highlighting the urgency for sanitation solutions where water is scarce. It is imperative that sanitation is not placed on the back-foot of the provisioning of clean water, and it is crucial that the education system takes responsibility for informing children about the menstrual cycle. The next post will take a look into ways to alleviate sanitation issues and to further bring about justice and dignity for the female menstrual cycle.