Keynote lecture at Water WISER Conference

Towards holistic WASH: From rights ‘to’ to rights ‘in’ sanitation services

By Amita Bhakta

Photo © Lee Bosher

On 21st June 2022, I had the honour and pleasure of returning to Loughborough University, where I did my PhD on the WASH needs of perimenopausal women, as a keynote speaker at the Water-WISER Early Career Researcher conference. On a broader note, it was of course very exciting to be back at an actual physical conference and meeting some amazing PhD students and colleagues and friends for the first time since the COVID-19 pandemic began. The timing of the conference was apt, as in recent times, I have been reflecting thoroughly on observations I am making in WASH research and practice, and trying to determine routes forward not just on a personal level but in terms of the future directions I want to see the WASH sector go in. We can only truly ‘leave no one behind’ if we as researchers and practitioners become more holistic ourselves. In this blog, I provide some highlights of my lecture exploring the need for more holistic approaches in WASH, moving from looking at rights ‘to’ to rights ‘in’ sanitation services.

The theme of my talk was in keeping with the wider theme of the conference and the need for greater emphasis on interdisciplinarity and cross-collaboration between the different sub-disciplines in the WASH sector. I took a moment at the start of the lecture to look back at my academic journey through publications. Starting with a journal paper on accessible eco-housing and disability from my geography MRes, through to publishing my PhD on the WASH needs of perimenopausal women, and most recently, my reflections on the rights and inclusion of sanitation workers demonstrated my trans-disciplinarity. From a WASH perspective, there lay a key question: how did a researcher with a very social background and was talking all things menstrual hygiene and feminism, end up publishing an article on sanitation work?

Rights ‘to’ sanitation: Don’t just talk, build!

My experience of interdisciplinarity began as soon as I set foot into the WASH sector as a human geographer who was looking at issues such as menstrual hygiene, bathing and laundry for perimenopausal women for my PhD, at a time in the early 2010’s when equity and inclusion and debates on the rights to sanitation were just taking off.  I took the opportunity of the lecture  to draw on how by putting women at the centre using feminist techniques such as oral history interviews, PhotoVoice and participatory mapping, actually resulted in very technical, infrastructural recommendations. Thinking back to doing my fieldwork at the hottest time of the year in Ghana, the perimenopause was such a taboo topic, that it was only by engaging directly with women through feminist oral history interviews, where they could speak to me privately, or through giving them a camera where they could show me through pictures that they were taking through PhotoVoice, or by doing some  community mapping that I could begin to understand perimenopausal women’s WASH needs. Thereafter came the turning point in my journey towards the infrastructural and technical sides of the sector. I recalled how during my interactions with women in Accra and Kumasi, over and over again, their message to me was clear: don’t just talk- BUILD! Nothing that they needed was new, all of the solutions emerging did not require any more than ensuring that they were designed and built correctly- connect drains to bathing facilities, build bathrooms inside to keep us safe when we bathe at night after night sweats, add seats to bathing areas, provide water supply in the toilets to wash ourselves, build us laundry facilities, in essence, build better! I demonstrated through my lecture how I therefore ended up with incredibly technical recommendations for what I perceived to be a very social and feminist issue.

Since this point, my journey has always been one of trying to work across the sub-disciplines of WASH, as I began to see the overlaps and the junctions where social feminist research meets, well, engineering. It is where these overlaps lie, where as a sector we tend to miss certain issues that are ‘hidden’. In my PhD years, the needs of perimenopausal women were hidden, not only because the women themselves wouldn’t openly discuss it, but also because neither those working in equity and inclusion or who were engineers  had paid attention- until my own supervisor had the courage to break away from the discussions and advertise the studentship I was to take up and hold  over 6 extraordinary years. Since graduating and now working as a consultant, my publications on how PhotoVoice can support research on a range of issues from  WASH and disability, to hygiene promotion,  and writing guidance on supporting people living with incontinence as part of a team of engineers and social scientists, reflected to the postgraduate researchers in the lecture theatre how interdisciplinary collaboration is so important in WASH research.

Rights ‘in’ sanitation: equity and inclusion for sanitation workers delivering services

I spent a good part of the lecture reflecting on my recent adventures into the rights of sanitation workers and in the sub-discipline of faecal sludge management, something which I did not expect to do way back in 2013 when my WASH journey began. I call this concept rights ‘in’ sanitation, because it is about the rights of the workers delivering inclusive sanitation services, which is a step-change in the current focus on service users in communities from an inclusion perspective.  It all began at a WaterAid webinar I attended early in the first stages of lockdown back in 2020. I knew very little about it before hand and directly due to years of a sense of faecal sludge being ‘the other side’ of WASH during my PhD years, I just hadn’t engaged with it. But as I listened in to WaterAid India  discussing their study on manual pit emptiers and sweepers, I came out with so many questions and observations. How do women engaged in sweeping and waste picking handle their MHM needs if they’re out and about on the streets of cities from Delhi, to Lahore, to Lagos? Stemming  from my PhD, what happens if you’re perimenopausal and a sweeper, and suddenly find yourself unexpectedly starting your periods out of the blue or you’re experiencing incontinence and you’re in need of a toilet and can’t access it? Or you’re having hot flushes, but don’t have access to any facilities to wash at work? As I listened, my perceptions of sanitation work as solely a technical issue were fast being dispelled. They were talking about caste-based discrimination, which was indeed in my PhD literature review as part of tracking the history of equity and inclusion and the work of Deepa Joshi. Workers were being injured in the line of duty as they descended into sewers with lifelong  impairments and wider impacts on their lives – that’s if they hadn’t lost them- and there I saw a clear ‘inclusion’ issue which is now widely discussed in WASH: disability.   I was reading articles in newspapers and blogs as I delved deeper which reported on the challenges faced by menstruating sweepers . Some of my hunches before I began exploring rights ‘in’ sanitation are indeed turning into a reality. Women waste workers have no access to toilets for menstrual hygiene, said the article. This for me, demonstrates clearly how groups such as sanitation workers are falling through the cracks.

I asked the researchers to look carefully at the fact that from both equity and inclusion and  faecal sludge management perspectives, both sub-disciplines in the sector are focused on a common area: rights.  Recalling the fantastic experience I had last year organising and running the Sanitation Workers Forum with a brilliant interdisciplinary team of early career researchers, the threads connecting equity and inclusion to faecal sludge and solid waste management became clearer. Papers at the Sanitation Workers Forum talked about transgender workers; ill-fitted PPE for women, because service providers and managers were not considering gender in the design; the burden of childcare for women workers. These papers demonstrated clearly how important it is to think about rights in sanitation as well as the rights to sanitation. Sanitation workers being denied access to household toilets through the Swachh Bharat Mission in India on the basis of occupation and caste, shows how not thinking about sanitation service providers from a rights-based approach can leave them behind in WASH.

Calls to action

I ended my lecture emphasising the need for researchers in the WASH sector to look for more commonalities between us as we explore a wide range of different topics. Making clear that I too, am an early career researcher myself, I identified three key action points for us to take forward as a community, to become more holistic:

  • We need to engage more between us as researchers looking at different topics in different sub-disciplines. Talk to our peers, our supervisors and academics you don’t usually speak to, to find opportunities to address complex issues and often hidden issues in WASH.
  • Be bold and daring and open minded. If you’re seeing something in your work that doesn’t usually ‘fit’, but is really important and interesting, don’t hesitate to reach out to people you’d least expect to talk to. Mechanisms to bridge work on equity and inclusion with ongoing work on sanitation and faecal sludge management are needed now. It’s on us as early career researchers to start doing this as the future of the WASH sector if we are going to follow through.
  • Think broadly. As you do your research, be aware of connections to other areas of WASH. Take the unexpected findings seriously and follow through where needed – no matter where it takes you. If we’re looking at delivering inclusive WASH, then we need to be inclusive as researchers and be as open minded as possible. If like me, your menstrual hygiene research leads you to recommending the sector to build drains, go with it!

We have more in common as researchers, and there are many areas where our paths cross and we seldom notice. Let’s make conscious efforts to work across our silos, not within, to truly leave no one behind.