November 19 is World Toilet Day – and a chance to highlight the role of toilets in gender inequality. Global health expert Marni Sommer says a lack of female-friendly toilets holds women and girls back, and calls on engineers to design spaces more suited to their needs.
Yesterday the South African government committed to eradicating all pit latrines in school toilets. Except for those of us who avidly follow the topic of toilets, this announcement probably brought little reaction. Yet too many schoolchildren are being injured due to dilapidated toilets, with girls in particular vulnerable to sexual harassment and assault. Few people likely know that November 19 marks World Toilet Day. But in this age of #metoo and other efforts to eliminate discrimination against girls and women, toilets represent one of the final frontiers.
For billions of girls and women in low-resource contexts today, a form of gender discrimination quietly impacts their daily life, one in need of disruption: the world of toilets. It is an unsexy topic at best, but it is essential to place it front and center in the ever-expanding discussion of gender equality.
Around the world, and particularly in low- and middle-income countries, engineers build toilets in schools and workplaces, bus stations, peri-urban slums and refugee camps that are designed the same for everyone. While studies have shown that certain cultures have unique sanitary practices, including girls’ and women’s varying preferences for spaces in which to manage monthly menstruation and other sanitation needs, little attention has been given to the actual design of the toilets that are constructed. For example, many toilets don’t have a shelf on which to place sanitary pads or cloths. Others lack a lock on the inside of the toilet door, or may not even have a door. Many have no lighting for safe nighttime use. And too often they are built co-joined with male toilets, raising the risk of “peeping Toms.”
As someone who has been studying the menstrual hygiene management needs of girls and women for over a decade, I see the #metoo campaign, along with the important conversations happening around the U.S. in relation to bathroom laws, as a unique opportunity to disrupt the engineering of toilets in low-resource contexts (including low-income areas of the U.S.), and create a new “normal” of a female-friendly toilet.
The urgency of this need was particularly prominent in a study we conducted jointly with the International Rescue Committee, aimed at building on the evidence on menstrual management in humanitarian emergencies. Site visits to displacement and refugee camps and informal settlements in Myanmar, Lebanon and Tanzania revealed the ways in which a lack of female-friendly sanitation facilities, including inadequate access to water and disposal mechanisms for used menstrual materials, was hindering girls’ and women’s abilities to manage their menstruation with dignity and in comfort.
In response, we developed the Menstrual Hygiene Management in Emergencies Toolkit, in which we propose (in partnership with 27 humanitarian response organizations such as UNCHR, OFDA and Oxfam) a new design for a “female-friendly toilet,” one that will shift the standard in both development and emergency contexts in low- and middle-income countries to one that fits the actual needs of girls and women.
Toilets Matter for Health
However, girls’ and women’s unique sanitation needs, and a new normative standard for female-adapted toilet design, go beyond the issue of menstruation. As we detail in a recent article, societal expectations in many countries regarding female modesty lead many girls and women to seek out private spaces for sanitation after dark, such as near railroad tracks or in fields.
At the most basic level, this creates discomfort and anxiety, poses safety issues and creates a vulnerability to violence while practicing one of life’s most basic bodily functions. At a more complex level, girls and women have reported abstaining from food and drink because of the absence of female-friendly toilets (which are safe and easily accessible, and have locking doors, water nearby and adequate-sized stalls).
The unique needs of girls and women go beyond just menstruation and everyday sanitation. They may have other episodes of vaginal bleeding from miscarriage or after having a baby, or heavier bleeding due to fibroids, which require frequent changing of cloths and pads. They may be pregnant and need more space in a stall than the average man, with pregnancy also creating a need to urinate more frequently. Confronting girls and women may be, for example, communal toilets located in peri-urban slums that have very dirty floors (so it’s not possible to place clean sanitary cloths and pads on them), pay-for-use facilities, or ones that force girls and women to stand in long lines, making them vulnerable to harassment, or that are completely unsafe after dark.
Female-Friendly Toilets Are Overdue
While adaptation is needed, there being no one-size-fits-all toilet for girls and women in this world, we are overdue a different standard for female-friendly toilets. Not only should modifications include a shelf or hook inside and a door with a lock, but location is important too. For example, building toilets in refugee camps or schools that join together male and female toilet infrastructure can create embarrassment, vulnerability to being spied on and toilet use avoidance. The latter may impact the ability to engage in school and other critical activities of daily life, such as standing in line to get water or pick up food distributions in camps. It may also increase girls’ and women’s levels of stress and anxiety.
The world is currently focused on the U.S. elections, the #metoo movement and other critical issues affecting the rights of girls and women around the world. However, it’s time to turn our attention to making toilets news-worthy enough to ensure girls and women around the world have access to female-friendly toilets every day of their lives.