A 'shit' definition
The topic for this week addresses the intersections between gender, water-collection and disease. Whilst many studies have examined the threat of water-borne diseases across the African continent, few have explored distance to the water source as a risk factor. A potential explanation for this gap is the understanding and use of the term “improved water source” within dominant discourse.
Global institutions such as WHO and UNICEF carry significant weight within the realm of policy-making and in fact, established a joint program for monitoring water supply in 1990. Consequently, the language deployed by these institutions is important, determining how policies will materialise.
An “improved water source” includes piped household water, public taps or standpipes, boreholes, protected wells, springs and rainwater collection. It came to be defined as ‘that which can be accessed within 30 minutes’.
Arguably, the ambiguity of the term has led to little improvement for the lives of women - the primary water collectors. It fails to appreciate that 30 minute trips - and the consequences - are still a significant infringement upon human rights. It also dismisses the quality of water produced by such sources, assuming that “improved” equates to “zero risk of contamination”.
Water-borne Diseases
When a source is considered “improved”, little examination or further study is carried out. This complicates the process of mapping unsafe water points, meaning that illnesses and deaths are not always linked to the direct cause. Without awareness of the source, the problem goes untreated and death rates remain catastrophic. Regrettably, Sub-Saharan Africa and South Asia have the highest death rates from diarrheal diseases (Figure 1).
Figure 1: Map of the Global Death Rate from Diarrheal Diseases, 2017
Case Study: Tanzania
A study in Tanzania demonstrated that in 92% of the households which have access to an “improved water source”, the majority of the bore wells had concentrations of E. coli less than 1 CFU/100ml (the World Health Organisations’ international drinking water standard).
After bearing the burden of collection, these women have little choice but to use the contaminated water for cooking, bathing and cleaning. This contributes to mortality rates amongst children under the age of 5. In Tanzania, 8% of infants die a premature death as a result of diarrhoea. Across the entire population, it accounts for 30,859 deaths per annum.
Importantly, households with walking distances greater than 30 minutes collect less water; women are unable to carry heavy loads such long distances. This reduces the amount available to the household for hygiene purposes, such as washing hands. Improved sanitation could reduce incidence of diarrhoea in Tanzania by up to 47%.
How does this affect women in particular?
Whilst women bear the burden of water collection, they’re also the first members of the household to sacrifice their share of water, instead prioritising their children and partners. This means that they cannot maintain their own hygiene; increasing the risk of contracting diseases. In Kenya, for example, hospitalisation rates due to diarrheal diseases are higher for women than for men.
Additionally, the ambiguity of “improved water source” means that the link between open defecation and certain water points, is overlooked. Due to socio-cultural taboos and a lack of toilets, women are forced to wait until dark in order to defecate in private. In many cases, this has contaminated nearby water sources and increased the transmission rate of diseases between women. Clearly then, this definition isn't "improved" to the extent that it benefits female life.
Language matters
Whilst I'm not suggesting that the definition of an "improved water source" is the leading cause of water-borne diseases, language does matter. This is especially true when used by global institutions that strive to slash mortality rates across Africa. By reassessing the idea of “improved” as “safe”, contaminated sources can be mapped accurately, gendered impacts can be included and mortality rates reduced. Importantly, global institutions can be held accountable for their 'shit' definitions.
Inproved water sources is another good attempt to tease out yet another complex intersection of water, gender and health. Maybe more information about the situation in Tanzania, specifically what is the annual death rate for women, deaths that are linked to watere related illness, this could help us understand the inequality and violence that underscores access to water for women (or maybe not). Referencing is good and linkes were well embede, but i could not make much of the map, maybe some explaination about the context.
ReplyDeleteI've referenced the map within the blog now, as it was demonstrating that South Asia and sub-Saharan Africa have the highest annual death rates as a result of diarrheal diseases. That's a good point about Tanzanian death rates, I will research this and include it. Thank you!
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