World Water Week 2019 – Women as WASH Champions

Women and water: women as the champions of WASH

by Gaby Alfieri

This article is the last in the author’s three-part series focusing on urban water, hygiene and sanitation (WASH) and the issue’s relationship to gender inequity. The relationship between women and WASH in cities is a unique and complex one, and it has been the center of this week’s blog series. The first post discussed the detrimental effects of water insecurity on the wellbeing of pre- and postpartum women. The second and most recent post examined the indispensable role of WASH in promoting menstrual health. Both of these articles outlined problems associated with the current state of inadequate urban WASH. Now, in the last post, we examine a key component in addressing these problems: seeing women as leaders of change.

Globally, women and girls identify WASH as a priority. Starting in 2018, the White Ribbon Alliance (WRA), a maternal health advocacy organization, launched the What Women Want Campaign (WWW). WWW dared to ask a very simple question: what is it that the world’s women—not organizations, governments, or companies—want in order to promote their wellbeing? For many women, this was first time that an organization had expressed interest in hearing their thoughts and desires.

“Our open-ended question lets women and girls set the agenda, as opposed to beginning with a premise of what is important or asking them to decide among a set of options. Women’s answers were often unexpected, challenging assumptions and shining new light on the realities of their daily lives.” – Kristy Kade, WRA Deputy Executive Director.

1.2 million women between the ages of 15 and 59 and in over 100 countries answered the question, and each response counted towards the WWW final report. To the surprise of the WRA, WASH came out as the second most common demand globally, behind respectful and dignified care. In fact, across all age groups WASH consistently ranked in the top three demands. Other highly-ranked demands were still closely related to the availability of secure water and sanitation, including dignified care. It is arguably impossible or unlikely to provide dignified care in water-insecure and unsanitary health facilities. A lack of clean hospital beds, sanitized medical supplies, or the ability to wash one’s hands can deprive a woman of her sense of dignity. Closely-related menstrual health management—as explored in yesterday’s post—was also a key concern, especially among girls aged 15-19.

Women as champions of WASH

Historically, women have served as their own WASH champions. Efforts to improve water and sanitation systems in urban areas are often the result of the work of female activists. For one such example, look to the work of women in Michigan’s cities. 

In the fall of 2014, the city of Detroit switched its water source from Lake Huron and the Detroit River to the Flint River, the consequences of which were devastating. Female leadership proved key in advocating for the affected community. Dr. Mona Hanna-Attisha, a Flint pediatrician, was one of the first to expose the city’s water crisis. After noticing higher levels of lead in her patients, Hanna-Attisha shared her findings at a hospital press conference, after which government officials dismissed her. As a result of her persistence, the Flint water crisis gained nationwide exposure. Also important in advocacy was Monica Lewis-Patrick, the CEO and President of We the People of Detroit. With a long track record of WASH advocacy in Detroit communities, Lewis-Patrick went on to advocate for Flint residents and became known as Flint’s Water Warrior.

Across the world, in countries of the Global South, women have also played an indispensable part in efforts to secure WASH. In the 1980s, the government of Malawi announced a plan to introduce piped water for 50 of the country’s districts. Each district established committees tasked with managing water systems and finances, and males constituted 90% of all committee members. Most of the committees soon fell behind on payments, maintenance, and even attendance rates at meetings.  Female community members stepped forward to pick up their slack, and soon women comprised a majority of committee members. The attendance rates at meetings increased, and payments and maintenance became more consistent. Though many of these women came from rural communities, WWW is proof that women of all settings value WASH, and evidence from past development projects shows women will make an effort to secure their right to it. 

Furthermore, at the level of high policy, the late head of the Ministry of Water and Environment (MWE) in Uganda, Maria Mutagamba, made WASH a focal point of her tenure and implemented strategies to increase female participation in MWE. Largely as a result of her work, the percentage of female urban water and sanitation board members increased from 18% in 2006 to roughly 50% in 2015. But, this is arguably the exception rather than the rule. If women are most often responsible for accessing and managing water in their households, they must be included in decisions about water on a governmental and development level.

Women and WASH going forward


The perspectives, participation, and leadership of women and girls are key for successful WASH policies and initiatives going forward. Women may not offer the panacea for these global injustices, but they bring crucial perspectives and knowledge to WASH dialogues. Women experience the effects of water insecurity in ways that men do not, menstruation being a good example, and women are most often responsible for water acquisition. It is this unique experience with and relationship to WASH that can serve as a catalyst for more sustainable solutions that better account for the issue’s complexity. 

Though challenges lie ahead, the global WASH community must continue to push for greater respect for and inclusion of women’s voices. Only then can norms shift and greater WASH be secured in cities worldwide. It’s what women want, and it’s time to listen.

Author Gaby Alfieri is an intern at IHC Global. She is a rising sophomore at Northwestern University studying history and global health.