From the Shallows to the Deep: who is taking the lead?

Women, Water and Leadership Conference Session 8: Is Sanitation only A Womens Business? ADB, Manila 14 February 2014

Wading that extra mile - making sanitation accessible to all through unconventional and innovative approaches that empower women
Neeta Pokhrel Urban Development Specialist South Asia Urban and Water Division, ADB
The views expressed in this paper are the views of the authors and do not necessarily reflect the views or policies of the Asian Development Bank (ADB), or its Board of Governors, or the governments they represent. ADB does not guarantee the accuracy of the data included in this paper and accepts no responsibility for any consequence of their use. The countries listed in this paper do not imply any view on ADB's part as to sovereignty or independent status or necessarily conform to ADB's terminology.

Sanitation is hard business

Not a priority for policy makers and consumers Perception of high costs
Lack of awareness on implication/ benefits Low willingness to pay

The do nothing option is expensive

Research in 2013 on hidden economic costs of inadequate water and sanitation services in South Tarawa, Kiribati: estimated at A$4.3 - A$9.1 million per year ~ A$75-A$160 per capita.
17% 12% 7%
Treatment cost (recurrent clinic & hospital) Medicine only Patient and family time lost & misc cost (HHs)

29%

35%

Productive value of lives lost (Country) Loss of Tourism (Scenario 2, S Tarawa) (Country)

What is the do nothing option costing in actual terms in India?

37.7 million Indians affected by waterborne diseases annually and 1.5 million children reported die of diarrhea alone. economic burden of poor water and sanitation facilities is estimated at $600 million a year based alone on 73 million working days lost due to waterborne disease annually. Every $1 spent on water and sanitation generates the equivalent of $8 in saved time, increased productivity and reduced health care costs!

and a womens business it is

It impacts women most! Inadequate sanitation limits their education and employment opportunities causes their time poverty - as primary caregivers they spend significant time looking after sick children and relatives impacts their physical security and dignity

Sanitation only sewerage or expensive

Improvement in health can be achieved irrespective of the type of sanitation. There are options many factors are involved in selection of the best option and each of the options can be used successfully. No easy solution, especially for dense urban areas.

Selecting the appropriate sanitation system

Sanitation system Pour flush toilets Sewered pour-flush toilets Conventional septic tanks Conventional sewerage
Cairncross and Feachem, 1993

Relative annual costs 10 40 90 100

Selection and success of sanitation systems are heavily dependent not only on technical, economic and political factors but also on their social appropriateness and ownership by the community factors that are influenced heavily by women and their leadership during design and operation process .

Case studies of making sanitation more accessible and involving womens leadership
Case 1: Exploring and designing low-cost sanitation systems and involving women in facilitating their acceptance (research findings), Kathmandu, Nepal Case 2: Promoting womens leadership in project design and implementation in South Tarawa Sanitation Improvement Sector Project, Kiribati

Case Study 1 (Nepal): Exploring sanitation alternatives in Kathmandu

Case study 1 (Nepal) : Why low cost sanitation?

Conventional (Rs) Sewer Pipe Manholes (tota;lnumber = 14) Junction boxes, Interceptor tanks and Rodding Eye Connection Chamber Costs Skilled Labour Costs Unskilled Labour costs Septic tank fitting and modification Total (NRs) % of conventional 242577 100% 115674 48% 13400 39900 58000 16000 13400 10000 16000 13400 16500 84174 35% 86240 36% 10000 20000 13400 133277 56000 Settled1 (Rs) 28274 Settled2(Rs) 28274 Simplified(Rs) 42840 -

- It consumes less water, is flexible and a more participatory option.

Case study 1 (Nepal): Womens leadership influential in achieving outcomes

Woman engineer explored appropriateness of the entire system, including women and child friendly toilet designs All user committees led by women All focus group discussions led by women All surveys led and conducted by women Influential in convincing the community on the merits of low cost sewerage over conventional

Case study 2 (Kiribati): South Tarawa Sanitation Improvement Sector Project

Rapidly urbanizing atoll of 50,000 people Piped water supply for 2 out of every 48 hours, 8% pit latrine, 39% septic tanks and 20% open defecation Inadequate sanitation is a key contributor to environmental degradation and water- borne disease

Case study 2 (Kiribati): Project design promoted womens leadership in overall project delivery
Project ($22.5 million) implemented over 8 years Women leaders from Government in senior government roles acted as key decision-makers on sanitation policy and project design Strong Gender Action Plan that promoted womens leadership during design, implementation and long-term service delivery and improvement

Case study 2 (Kiribati): Promoting womens leadership in project implementation

Advocates for change: women expressed greatest dissatisfaction with current sanitation situation - influenced project design and delivery from the community-level Appropriate project design: women leading infrastructure design to ensure that it meets needs of users Sustainable service delivery: women driving sustainable operations and maintenance practices

Case study 2 (Kiribati): Key features of Gender Action Plan

Contractors hiring 30% women for equal work and pay Gender sensitivity training carried out for government agencies Engagement with womens groups and NGOs to address sanitation and hygiene issues at grassroots level 50% engineering scholarships and workplace attachments awarded to women

Summing up
It pays to consider unconventional and innovative options that may be more appropriate, effective and inexpensive. Involving women facilitates wider community acceptance. Womens leadership in sanitation projects results in more appropriate design, strengthened implementation and sustainable outputs, because they:
have more potential to influence sanitation and hygiene behavior, ensure that needs of users are met, and play a key role in its long-term sustainability.