Leaving no-one behind in the Sustainable Development Agenda

We need to look at hidden knowledge

The post-2015 agenda through the Sustainable Development Goals (SDGs) focusses on aiming to ‘leave no-one behind’ in global development.  The SDGs seek to provide a blueprint for people, the planet, peace and prosperity for now and the future, whilst addressing the key challenges of climate change and protecting the environment. The goals are broad, and consider the needs of groups which are commonly known to be left behind, such as women and girls. But, in our efforts to achieve these goals, we need to increase our awareness of issues faced by different individuals, which are not widely discussed or visible to others: we need to look at hidden knowledge.

What is hidden knowledge?

Hidden knowledge is knowledge which is known by a particular person or specific group of people, but is not recorded in written form, nor is it shared with others. I became familiar with the concept of hidden knowledge when I did my PhD on the water, sanitation and hygiene (WASH) needs of women who are making the transition to menopause (perimenopause) when menstruation permanently ceases, in urban Ghana. Addressing these needs is key to meeting SDG6 to provide access to WASH for all by 2030. During this stage of life, women experience symptoms such as hot flushes, night sweats, urine incontinence and heavy and irregular periods, all of which require adequate hygiene to manage. But, women seldom discuss these practices in public, and their WASH needs are a form of hidden knowledge. In many societies, regardless of culture, women’s sexual and reproductive health issues are shrouded in taboo, and the perimenopause is no exception.

We can understand what hidden knowledge is through a 2 x 2 matrix, known as the Johari Window. The Johari Window contains 4 types of knowledge held by an individual:

  1. Public knowledge: knowledge which is known to yourself and others. We can all see whether water supply systems in a rural community are working
  2. Blind knowledge: knowledge which is known to others but not to yourself. An engineer may know the benefits of sanitation, but the community you live in may not
  3. Hidden knowledge: knowledge which is known to yourself but not to others. The WASH needs of perimenopausal women are hidden knowledge because perimenopausal women are aware of their personal issues, but others (including other perimenopausal women) are not
  4. Unknown knowledge: knowledge which is not known to yourself or to others. The best way to dispose of used sanitary pads may not be known to the community, and  WASH professionals may not be aware that this is an issue nor would they have a solution to addressing these problems

Known to self

Unknown to self

Known to others

Public, or open knowledge
Blind knowledge

Unknown to others

Hidden knowledge

Unknown knowledge

Figure 1: The Johari Window (Image: Amita Bhakta)

Knowledge can be classed as ‘hidden’ because of different factors. It may be that although some people have this knowledge as individuals, it has not been written down. Taboos in local contexts, can make it difficult to discuss issues such as menstruation and menopause are experienced with anyone. These taboos can also mean that certain issues are neglected by development professionals and therefore some sections of society will be left behind. Some issues can be particularly hidden due to multiple aspects of a person’s identity which exclude them from society, known as intersectionality and make these issues ‘invisible’ to professionals such as WASH engineers. The voice of the disabled, older woman confined to a room in an urban slum may be missed, because her multiple identities of being disabled, female, older and a slum dweller leaves her on society’s fringes. Yet, it is these multiple aspects which come together to leave their needs as hidden knowledge and therefore not addressed by development professionals.

Finding hidden knowledge for global development: learning from feminism and perimenopausal women

Understanding the hidden WASH needs of women who were going through the perimenopause in Ghana required appropriate techniques. Not being able to read about these issues in any paper or book or article, meant that I had to look for alternative ways to find out about them. And so, I went to the experts: the perimenopausal women with inadequate access to WASH facilities. In the low-income communities of La, Accra and Kotei, Kumasi, I experimented with feminist approaches which would enable women to open up to me and share their hidden knowledge about their daily WASH needs. Feminist approaches can access women’s voices which are seldom heard, because they focus on researching with women, rather than on women. Women become active participants in research and become equal to the researcher, which means that they can be actively involved in social change. Putting the women at the centre of the research and create a space for us to talk about the things that they would not share with anyone else. To do this required me to use three feminist participatory methods, which can provide learning for development researchers and practitioners to find hidden knowledge:

  1. Feminist oral history: this is a technique to capture women’s voices which are traditionally ignored by historical sources. Oral history is the act of recording the speech of someone with interesting to say, and analysing their memories. It challenges traditional scientific approaches such as lab experiments, to allow women to share their hidden issues through the researcher. I recorded the voices of perimenopausal women in La and Kotei. Through our conversations in urban compounds, I was able to identify  the intimate and private experiences of bathing, doing laundry and managing heavy menstrual periods (up to 80ml, or  6 tablespoons of blood lost) during the perimenopause with inadequate access to user friendly infrastructure for the very first time. Women told me about struggling to find ways to conceal heavy blood stains on community toilet pit latrine slabs with water or tissues, or to dispose of soiled materials discretely in the absence of incinerators, because they did not want others to see it. The costs of repeatedly going to pay-per-use community latrines mounted up for women who were often without jobs and needed to change heavily stained menstrual cloths regularly. Enabling the women to speak with me in conversation and as equals enabled them to open up to me about novel and wide-ranging issues unique to them, which until then, they had remained silent on.
  2. Participatory mapping: As I sat with groups of 6-7 women to annotate pre-printed Google maps, they began to tell me things which would not be easy to spot as an outsider. Women were embarrassed to dispose of blood-stained wastewater after bathing into the street or open and uncovered drains. Using community dumpsites was difficult when trying to discretely dispose of soiled menstrual cloths, or to carry waste to because of joint pain. Mapping discussions could relate hidden issues directly to the space and different features of the community that were known to all, such as water points and toilet blocks. What was hidden became public, and visible to me as a development professional to see what was needed to be addressed.

    Figure 2: Participatory map produced with perimenopausal women in Kumasi (Photo: Amita Bhakta)
  3. PhotoVoice: I experimented with a technique known as PhotoVoice, in which I gave 5 women a ‘point and shoot’ digital camera over 3 days, and asked them to take pictures of their WASH activities or infrastructural issues relating to the perimenopause. The photos they took drew me into their most private spaces, and showed me for the first time how difficult the neglected issues in WASH of bathing and doing laundry are, because of a lack of user friendly infrastructure and ageing-related joint pains. Community latrines were too far to walk to and women became tired.


Figure 3a: Laundry of a perimenopausal woman in Kumasi (Photo: Elizabeth)
Figure 3b: Bathhouse in Accra (Photo: Rebecca)

Moving forward with the SDGs: accessing hidden knowledge through participation

As development practitioners and researchers, there are steps we can take to ensure we access hidden knowledge among marginalised groups to ensure we leave no-one behind and meet the SDGS:

  • Consider the practical elements of our techniques of engaging with people with hidden issues such as perimenopause, incontinence, or menstruation. Use theories such as feminism to put people experiencing less-discussed issues at the centre of our work, and create space for them talk to us.
  • Explore the needs of individuals in the community by acknowledging the different aspects of their identity (known as intersectionality), instead of focusing on one aspect alone. We can identify issues which are overlooked by understanding different parts of someone’s life. A disabled woman in a slum may have different menstrual hygiene-related infrastructural needs to women who are able-bodied, and the cross-over of being disabled, as well as a woman in a slum, can provide a unique perspective on action to ensure they are not left behind.
  • Acknowledge local taboos to understand why something is hidden. Use this information to shape how you plan to engage with topics that are sparsely discussed.
  • Think about creative ways to find hidden knowledge. Knowledge can be in spoken form, or as this blog shows, presented in visual forms by participants.