‘How does lack of access to toilets and poor sanitation affect girls and women?’

by Emelie Samuelsson Herrera,
Communications Officer at the Right to Quality Education Team.
9 November 2020

Maya Oppeheim, “Young Women most at risk of global sanitation crisis and sexual violence when using unsafe toilets, report warns” (2019)<https://www.independent.co.uk/news/world/sexual-violence-young-women-global-sanitation-crisis- toilet-a8746421.html> Accessed 9 November, 2020

Globally, around 2,3 billion people do not have access to basic sanitation facilities, and nearly 1 billion (15% of the world population) people defecate in the open. 1 Open defecation 2  and no access to basic sanitation kills millions of people each year; it is a crisis that aggravates the world’s most pressing problems, such as national security, weak economies, deadly epidemics, and catastrophic climate change. 3 Of all the 673 million people practicing open defecation, 91 % live in rural areas. This practice is thus rising across sub-Saharan Africa, which increased from 204 million in 2000 to 220 million of people practicing it in 2015. 4

Although open defecation and lack of basic sanitation facilities affects  everyone, specifically children, women and girls are disproportionately affected by open defecation and the lack of basic water, sanitation, and hygiene facilities (Hereinafter, “WASH”).

“The threat of violence and the leers of men mean that most women wait until nightfall before trudging out into the open (…), so many women face assault and rape while going to the toilet outdoors. (..) Many hold their bladders for up to 13 hours at a time, exposing them to urinary tract infections and other health problems” 5

Open defecation puts girls and women in a vulnerable position due to the fact they have to travel long distances from their house to find a private open place to defecate and manage their menstrual necessities. As a result, there is an increase in vulnerability to violence, such as, verbal, physical, and sexual, which affects women and girls physically and psychologically. 6 Thereon, women and girls are more prone to urinary infections, and diseases, such as diarrhea, intestinal worm infection, but also hepatitis, polio, and other. 7

Hence, few studies show, that women have an increased need for water for hydration, sanitation and hygiene during menstruation, pregnancy, the postnatal period and while caring for sick family members or young children, which puts them in a disadvantageous position. 8

Open defecation has not only caused a significant impact on women’s and girl’s health and safety, but it has also negatively affected girl’s attendance at school. According to UNESCO, in Africa, 1 in 10 girls miss school when menstruating 9their attendance decreases when girls are not provided with toilets and the right WASH facilities. In countries where menstruation stigma is strong, a lack of separate toilets for boys and girls means that girls do not have a place to safely, and privately, use the toilets, and change and dispose their pads. 10

The practice of open defecation and lack of WASH facilities is a risk to women and girls in regards to sexual exploitation, personal safety, and a high risk to public health for the entire community. 11 The United Nations Sustainable Developments Goals 6 (Hereinafter “SDG 6”) calls for access to adequate and equitable sanitation and hygiene for all, with special attention to women and girls, including managing defecation, urination and menstrual needs with dignity.12 It is more than clean that providing proper toilets, and WASH facilities can help protect girls and women – among other things – from sexual assault; decrease their vulnerability to diseases; and enable them to go to school continue their education.

  1. Global Citizen Maya Zaynetdinova, “Poor Sanitation practices are ‘the Greatest Nightmare of Africa” (2018<https://www.globalcitizen.org/en/content/open-defecation-rises-in-sub-saharan-africa/> Accessed 9 November, 2020
  2. Open defecation is when people defecate in the open, such as in the fields, forests, bushed, lakes and rivers, beaches, and other open spaces- rather than using a toilet. UN News, “Transformational Benefits of ending outdoor defecation: Why toilets matter”(November 2019 <https://www.un.org/development/desa/en/news/sustainable/world-toilet-
  3. David Brand, ”Why Clean Water is so Critical for Women and Girls Everywhere”(April 12, 2018)<https://www.globalcitizen.org/en/content/wash4women-campaign-explainer/>Accessed 9 November, 2020
  4. (n 2) Maya Zaynetdinova, “Poor Sanitation practices are ‘the Greatest Nightmare of Africa”
  5. The Guardian “Toilet isn’t a dirty word” 2017 <https://www.theguardian.com/global-development/2017/nov/13/akshay-kumar-toilet-isnt-a-dirty-word-my-latest-film-made-me-love-the-loo?platform=hootsuite>
  6. Corburn J, Hildebrand C, “Slum sanitation and the social determinants of Women’s health in Nairobi, Kenya.” (Journal of Environtal and Public Health) 2015.
  7. World Health Organization, “Sanitation”(14 June 2019) <https://www.who.int/news-room/fact-sheets/detail/sanitation> Accessed 9 November 2020
  8. World Health Organization, “Water, Sanitation and Hygiene: measuring gender equality and empowerment” (14 May2019)<https://www.who.int/bulletin/volumes/97/6/18-223305/en/> Accessed 9 November 2020
  9. https://www.globalcitizen.org/en/content/wash4women-campaign-explainer/
  10. Caruso BA, Clasen TF, Hadley C, et al. “Understanding and defining sanitation insecurity: Women’s gendered experiences of urination, defecation and menstruation in rural Odisha, India”(BMJ global health) (2017)
  11. (n 3) UN News, ‘Transformational benefits of ending outdoor defecation: Why toilets matter.
  12. UN Sustainable Development Goal 6: Ensure availability and sustainable management of water and sanitation for all, <https://sustainabledevelopment.un.org/sdg6> Accessed 9 November, 2020