MDP Student Lauren Jacobson’s, ““Going Beyond the Bowl to Achieve Gender Equality”

/ / Global Health Voices @ UCBerkeley

I had the pleasure to hear Archana Parker speak at the UC Berkeley Blum Center on October 1, 2015. Archana Parker is a Program Manager at the Water Supply & Sanitation Collaborative Council (WSSC), a United Nations council that focuses on sanitation and hygiene in collaboration with governments, NGOs, communities, and the private sector. According the Archana, the council is not donor driven and is funded through the UN. Their focus is in Southeast Asia, South Asia, and Africa, and their activities are based on the Human Development Index. While water management is a huge global concern, the WSSCC focuses mainly on sanitation and hygiene, as there are many other “players in the water arena,” as Patkar put it.


The WSSCC works with both the users of their services and governments, in order to make both behavior and policy changes. They do not take on short-term projects, but rather focus on ongoing changes with local governments and the global sphere. An example of some of the global initiatives the WSSCC takes part in and supports include WASH (Water, Sanitation, Hygiene- a program that helps build infrastructure, monitors behavior, and gathers data), and the UN’s Sustainable Development Goals (SDGs) introduced in September 2015. According to Patkar, the WSSCC’s priority is capacity building, which includes building infrastructure, professional training, working with governments and NGOs. A main area of interest is helping to changes the behavior of community members, an initiative that is directly supported through the Global Sanitation Fund. The idea is that individual agencies can bring about behavioral change by empowering women. A major challenge and goal for their programs is to bring de facto managers of sanitation (women) to become leaders and effect change.


One overarching belief of the WSSCC is that everyone is disabled at some points in their life, and face sanitation and hygiene challenges. A cultural shift takes place for adolescents during puberty, especially for young women. With the onset of puberty, crucial psychosocial changes take place, which brings about challenges, and greater restrictions, especially among women. This process is often made exponentially more difficult by the silence that surrounds the process of menstruation, which is often a cultural taboo, particularly in South, Southeast Asia and Africa.   The WSSCC therefore chose puberty as an entry point for a path to educate and empower women who are held back by this natural process.


Various services are provided in India, Senegal, Niger, Cameroon, Cambodia, Kenya, Uganda, and Zimbabwe, where taboos surrounding menstruation are extreme, and women face many challenges. An example of an educational initiative is a traveling carnival throughout India that lasts for 51 days, and focuses on group questions that women might normally be hesitant to ask, surrounding their bodies and menstruation. Policymakers and practitioners are brought in to listen to these young women, and realize the importance of taking on menstruation issues (as many originally have doubts about its necessity). The outcome of this initiative was that hygiene and menstruation management was included in India’s policy changes in 2013. Billions of dollars are now being fed into programs relating to outside defecation and sanitation, including menstrual hygiene management.


Some key issues that were addressed by Patkar during her lecture include the following:

Ÿ Break the silence, and break common stereotypes and cultural taboos—a strategy structured around listening and global advocacy work.

Ÿ Change the space of the conversation, so that women feel comfortable. It is important to

provide women with a safe space to talk to someone (a professional) about their concerns, private places to physically clean their pads properly, and reuse them safely.

Ÿ Reuse and disposal: a major obstacle to the proper disposal of menstrual products is that

sanitation workers are less inclined to handle these materials than handling any other sort of waste, due to cultural taboos and cultural myths.

Ÿ The program starts at home, and then can be spread to others. Women are often alienated

by their own family members, and left out of prayers and rituals, while menstruating, which often brings about a feeling of shame.

Ÿ Recognizing the intersectionality of issues, particular in rural areas, where people are

fighting for their livelihood to begin with. These problems related to poverty often

intersect with cultural restrictions placed on women. In West Africa, girls are often not in

school to begin with, so they are not being kept home by their periods. Rather, their basic

human rights are denied, and they are forced to work through their periods, often with no


Ÿ Though illegal in most African countries, 90% of women in Kedougou experience genital

mutilation; more than 25% of these women report contracting infections during their


Ÿ Women throughout the world face fear, trauma, and psychosocial stress with the onset of

puberty, to varying degrees.


Interventions and overall goals discussed by Patkar included:

Ÿ Impact evaluations: evaluating the impact of sanitation intervention (the life-cycle approach,

advocacy, and overall review of WSSCC)

Ÿ Multi-stakeholder approach: the collaboration of governments, NGOs, the private sector,


Ÿ Millennium Development Goals (MDGs): While they had a great effect, they left major gaps

in outcomes, due to the fact that they sought to reduce poverty by 50%, which did not help

the people living in extreme poverty, as it was easier to bring those closer to the poverty

line out of poverty. Also, when addressing gender equality, the MDGs focused mostly on

education, and even then, only primary education.

Ÿ Sustainable Development Goals (SDGs): According to Patkar, the SDGs’ focus is much more

comprehensive, seeking to eliminate, not simply reduce, poverty. Gender equality is

spelled out throughout the goals, using language referencing stigma and discrimination. Also present is equal access to services, including clean water, sanitation, and hygiene.

Ÿ Breaking down caste issues in India, as reliance on culture and tradition can often further

disempower certain communities.

Ÿ Research of environmentally safe disposal (i.e incinerator, composting, disintegrating

products,…), researching various products (cloth v. disposable pads), and the possibility of biodegradable, environmentally friendly materials. This requires local hands-on monitoring, and a scientific research organization has taken on this project pro-bono.


During the Q & A, Patkar was sure to emphasize that the WSSCC was less concerned with menstrual products themselves, and were more responsible for information about body and rights; having the right products does not solve the issue of women disempowerment. Even by simply addressing menstruation, they are not tackling the whole issue- the entire onset of puberty changes the place of women in society. It does not even resolve the lack of school attendance by women; this is caused by structural inequalities in the system. As some issues are resolved, others come up. For example, the construction of separate toilets for men and women does not take into account transgender rights.


I believe that female hygiene is a crucial issue in development. When I began to think about the impact, I realized that 50% of the world who have passed through puberty, has to manage this issue for approximately 25% percent of their lives (unless they are pregnant or post-menopausal–which bring about their own health concerns). For a topic that is so important, it receives an astonishingly low amount of public attention and open discourse, especially in the developing world. When speaking with Patkar after the lecture, we discussed reproductive rights, and she said that issue is one that they stay away from because it is so volatile, and that they are using menstruation as an access point to address women’s disempowerment and shame that is often brought about during adulthood. This made me think about ways in which development practitioners can use education, and access to professional counselors as a way to empower marginal communities. This, in turn, can lead to greater development and even grassroots initiatives.


One thing that made me a bit sad is when Patkar said that the involvement and advocacy of men in theses issues is much more effective than women. I truly wish that women were able to control their own lives and bodies, without having to appeal to men in power. This is not just an issue in the developing world, but impacts women everywhere. Hopefully the implementation of the SDGs and other organizations and agencies like the WSSCC will help alter this paradigm.