Clean Water and Improved Sanitation: A Global Crisis That Challenges Women and Children

Everyday women and children spend 200 million hours collecting water for their families, and 260 million hours looking for a place to defecate. Those who do not have immediate access to water have to find alternative ways to safely consume water. This task of providing water for a family falls upon the women and children, and like stated above, consumes time that could be spent at school, holding a job, or caring for the family in other ways. Similarly, limited access to bathrooms deters girls from going to school, especially those who are menstruating.

The issue lies deeper than just the struggle to locate water and improved sanitation. Global water consumption doubles every year, worsening the conditions stated above for women and children. Therefore, limiting water consumption is a key role in improving the access to clean drinking water, and in term women’s education. So, does this mean that there is a duty for people with access to clean water to use it more responsibly in order to salvage this declining resource? Is it possible to limit the amount of water consumed on a global scale? Because it is women and children – two marginalized groups in society – who are primarily affected, how does one prioritize their needs? This paper will analyze these questions through the examination of the water and sanitation crisis, highlighting the concerns of women and children from global perspectives, and questioning the treatment of one of the world’s most valuable and finite resource: water.


In our current world, according to WASH (Water Sanitation and Hygiene), 2.5 billion people do not have access to improved sanitation, and 844 million people do not have access to clean water. This is a prominent issue that risks worsening as global water consumption is doubling every twenty years, outpacing the rate of population growth by two times (World Water Organization). The lack of access to clean water and proper sanitation leads to a multitude of health risks, reduction of education, environmental concerns, and economic loss. Through my research I discovered that women and children are most strongly affected by the water and sanitation crisis. There is a lack of equality in the ways in which women and men handle the crisis, as women are the primary collectors of water for their families when water is not on-site. Aside from examining how lack of access to clean water and sanitation effects women and children, I will also look at how this specifically affects two different countries – Ethiopia and Peru. I chose to do this in order to examine the issue from different perspectives and provide more specific information rather than only general, globally-scaled information. The examination of the water and sanitation crisis poses the concerns and questions of how water is consumed globally, if there is a global responsibility to consume water in a particular way, and if one group or individual has the power to make this decision. As well, actions outside organizations have been taking to minimize the amount of people who lack access to clean water and improved sanitation creates the complication of how limited outside interference in cultures should be. Overall, my paper will discuss the water and sanitation crisis and the large issues it creates for women and children.

Information on the Water and Sanitation Crisis

To understand the global water and sanitation crisis, I will delve into the research that I did on both. As defined by the UN, water that is safe to drink contains “scientifically assessed acceptable levels of toxicity to either humans or aquatic organisms.” For example, if there are 5 or more milligrams of nitrogen per liter of water, this indicates water pollution from human and/or animal waste or agricultural run off (UN). Thus, the quality of water is affected by both human and environmental factors. If you remove human involvement, water quality would be determined by dust and bedrock materials being blown by wind into water sources, the natural seeping of organic minerals and soil into water sources, runoff from hydrological factors, and biological processes within the aquatic environment (UN). Sources of water pollution from humans include: sewage; agricultural runoff; fossil fuel burning; and bush fires (UN). The ingestion of contaminated water can lead to a multitude of fecal-oral pathogens, like arsenicosis, or fluorosis, as well as intestinal parasites and diarrhea. As well, the lack of access to water leads to lack of personal hygiene, as water is used for many hygienic needs. Examples of diseases that come from poor hygiene include, trachoma and scabies. Lastly, intestinal parasites affect 1 in 3 school children leading to a reduction in physical growth and impairment of intellectual development (Unilever Domestos, WaterAid, and the Water Supply & Sanitation Collaborative Council). As a whole, diseases from drinking unclean water lead to 3.4 million deaths each year, which is more deaths than those that result from all sources of violence, including wars, further emphasizing the large magnitude of this global issue (UN).

The large quantity of unclean water results in a scarcity of clean water that currently leaves 844 million people in our world without access to safe drinking water ( The three countries whose populations have the least amount of readily available clean water are Uganda, Ethiopia, and Nigeria (Africa Public Health.Info). However, populations globally are affected by the scarcity of clean water, each to varying degrees. Similarly, countries and communities have different water consumption habits around the world, leading to an explicit divide in how clean water is considered to individuals with different lifestyles. It is important to consider that there are different levels of accessibility to clean water. Communities or individuals can either have water on sight, 30 minutes away by foot, or farther than 30 minutes away on foot. For example, 40% of Uganda’s population travels 30 minutes or more each day by foot to retrieve clean water (Africa Public Health.Info).

When looking at the global accessibility to improved sanitation, in total, 2.6 billion people do not have access to sufficient sanitation ( When looking at the areas that are most heavily impacted by the sanitation crisis, of the top 25 countries without improved sanitation, 19 of them are in Africa (Africa Public Health.Info). Lack of access to adequate water and sanitation is responsible for causing more loss in GDP in Sub-Saharan African countries than the amount that they gain in aid for the water and sanitation crisis (Africa Public Health.Info). More than 85% of the populations in Chad, Niger, and Ethiopia are without access to improved sanitation (Africa Public Health.Info). Ethiopia’s population in particular is one that has both a high amount of people without access to basic sanitation and without access to clean water.

Basic sanitation is defined by a flush or pour-flush toilet to a piped sewer system, septic tank or a pit latrine, a ventilated improved pit latrine, a pit latrine with slab, or a composting toilet (UN). On the other hand, unimproved sanitation includes an open pit, bucket, hanging latrine, or open defecation (WHO/UNICEF). As previously noted, sewage is a water pollutant. Human and animal defecation – that is poorly managed – effects human health through drinking water, sewage, indirect contact, and other possible consumption through food, thus leading to the spread of fecal-oral pathogens. This is a common occurrence, as only 39% of the worlds human waste is safely managed (Thomas). An increase in global urbanization is putting a strain on sanitation and water infrastructures because new urban buildings are being put up without proper infrastructure planning leaving many without access, or leaving human waste uncontrolled (Fink). UN Water For Life Decade notes that, “over half of the hospital beds in the developing world are occupied by people suffering from preventable diseases caused by unsafe water and poor sanitation.”

The Global Impact of the Water and Sanitation Crisis

The water and sanitation crisis affects many countries in all continents. In order to see the impact of the crisis on a more detailed level, I decided to dedicate research to two countries with similar, yet different, experiences with the water and sanitation crisis – Ethiopia and Peru. Through doing so, I am able to broaden my research and knowledge on the water and sanitation crisis, as it affects people globally at different lengths. To put the two countries in perspective, the GDP per capita of Ethiopia is $2,200 USD, which is ranked 205 out of 229 countries (CIA). The GDP per capita of Peru is $13,300 USD which is ranked 120 out of 229 countries (CIA). The population of Ethiopia is 108 million, and the population of Peru is 31 million (CIA). Lastly, 21% of Ethiopia’s population lives in an urban area, and 78% of Peru’s population lives in an urban area (CIA).

Only 28% of the Ethiopian population has access to improved sanitation ( This is up just 3% in the last roughly 30 years. However, between 1990 and 2015, open defecation practice fell from 92% to 29% of the population (USAID). With regard to the level of access of safe drinking water, 57% of the population in Ethiopia has access (USAID). This low number is due to a multitude of factors. The main ones being that agricultural activity is the largest consumer of water (93%), population growth has put strains on the water supply, and varying rainfall patterns and extreme climate events have made water scarce in some regions and degraded water quality (USAID). An abundance of droughts have made the water crisis more intense. With a drought at hand, diseases spread more rampantly, women and children spend more time looking for water because surface water has dried up, and stagnant water that is available becomes home to mosquitoes ( In a study of 16,702 homes in Ethiopia, 99% of rural households do not have water on sight, and the primary water collector is an adult woman (Grimes). Similarly, 4.7 million women in Ethiopia spend more than 30 min collecting water each day (Grimes). The country did reach its millennium development goal target of almost halving the number of people who do not have access to safe drinking water (USAID). As of now, the Ethiopian government is aiming to invest more money into improved water infrastructure, however improvements have not been able to make a national impact thus far.

In comparison to the water crisis in Ethiopia, urban improvements to both sanitation facilities and access to safe water have become more prevalent causes of concern for the government in Peru. However, the majority of where these two important things need to be improved is in rural areas. When looking at the Peruvian population, 76% have access to improved sanitation facilities, and 86% have access to clean water resources ( The majority of where both resources are scarce are in rural areas in Peru. One of the causes of this include the melting of Peruvian glaciers due to global warming (Fluence). This has caused flooding and mudslides which ruin surface water sources. As well, the glaciers are a source of water, so their loss eliminates a potential clean water supply. Secondly, one third of Peru’s population lives in the capital city of Lima. However, Lima receives less than 1 inch of rain per year and relies on three rivers for potable water for the entire city (Fluence). Thus, surface water is an important water source for many of Peru’s citizens. 1.5 million residents who live in homes without running water rely on overpriced water trucks (Fluence). Often times this water is contaminated either from the source it was collected from or from sitting in barrels that mosquitoes lay their eggs in. Citizens with running water pay pay 1.3 sols (about $0.25 USD) per m3 to Lima’s water utility, SEDAPAL (Fluence). Those who do not have access to this company pay 20 sols (about $6.00 USD) for the same amount of drinking water from these private trucking companies (Fluence). However, the poverty rate is slowly declining and the economy is growing. Similarly to Ethiopia, Peru met their millennium development goal. The current administration, the Vizcarra administration, has a plan to close the gap between Peru’s water and sanitation infrastructure. SEDAPAL is looking to invest $7 billion USD in water infrastructure. Some of this money will be used to improve sewage treatment and tap water (Fluence).

The Effects of the Water and Sanitation Crisis Women and Children

In all places that are heavily affected by the water and sanitation crisis, women face additional challenges along with having limited access to both. Women are the primary collectors of water for their family if they live in a house where there is not water on-site. It has been estimated that women spend about 200 million hours a day finding and collecting water for their families ( A study of 24 sub-Saharan countries reveals that when the walk to collect water for one’s family was more than 30 minutes, 3.36 million children and 13.54 million adult females were burdened with the task of collecting the water (UNICEF). This is crucial time that could be spent receiving an education, caring for children, working a job, or taking care of themselves. This time that women spend collecting water also harms the economy because it eliminates half of the population from having a steady job. As well, pregnant women need clean water to a greater degree than most – for their deliveries and their newborn. Child mortality rates are linked to unclean water consumption. 15% of deaths of children under 5 are due to diarrhea, which is caused by unclean water consumption and unimproved sanitation practices (WHO).

Secondly, women take 266 million hours each day finding a place to go ( Both water collection and finding a place to relieve themselves puts women at risk of sexual violence. Many times women go looking for places to defecate in groups because there is the potential risk that forms of sexual violence may occur when they are alone. As well, women must dispose of sanitary products in any place that they can find. These places often end up being open bodies of water – contaminating it and making not safe to consume – or even sewage systems – ending up clogging them.

Just as women are a group that is strongly affected by the water and sanitation crisis, so are children. The biggest impact that the water and sanitation crisis has on children is the reduction of their opportunity to attend school. Education is lost at the expense of water collection. A study in South Africa shows that children spend a total of about 19.5 hours on domestic activities, and water collection consumed a majority of those hours (Graham). Children leave school fatigued from not having water or from having to collect water before school (Graham). Older siblings sometimes have to miss school to watch their younger siblings while their mothers go to collect water (Graham). Children sometimes work transporting water for others to pay school fees depending on where they live and go to school (Graham). For girls, menstruation cycles provide issues in school because of the lack of toilets (Estrin). If there are any toilets, there is still a lack of privacy. This serves as a deterrent to many girls, causing them to drop out once they start their periods. Dropping out of school makes girls more vulnerable to early marriage and childbearing.

Additionally, children are more susceptible to obtaining water related diseases than adults are. About 1.8 million children under the age of 5 die from water related diseases. This number accounts for 17% of deaths in this age group (UNICEF). Because girls are two times more likely to be collecting water than boys in their family, they can be weakened by energy loss from carrying water, infected with intestinal worms from contaminated water, as well as harmed by repeated infections (Graham). This exposes them to the risk of getting anemia which becomes significant when they start menstruation. Diseases, like those mentioned earlier, affect all people, but most specifically women and children because of their prominent role in water collection.

As discussed above, the water and sanitation crisis places different burdens on women than it does men. There is an explicit gender inequality when it looking at the way that women are challenged by the water and sanitation crisis compared to men. Firstly, it is easier for men to “go” in more public places than it is for women. As well, there is a privacy issue that women are faced with and men are not. Privacy when relieving oneself is something that is valued by many, as well as deprived of by many. One of the main reasons that young girls in water-stressed countries are less likely to attend school – aside from because they need to help out at home, or because of water-related diseases – is that there is a lack of privacy surrounding toilets or because of a lack of basic sanitation at school. It has been recorded that in India, 23% of girls drop out of school when they start menstruating (Cunningham). This is a process that young girls cannot avoid, yet their futures are jeopardized because of it. They are having to risk their education for the sake of having privacy and safety around their periods because of the lack of basic sanitation in schools. Dropping out of school at a young age coincides with women not having as high of a potential to succeed in higher paying fields of work because they are therefore less-educated than men are. The lack of ability for a women to hold a higher paying occupation results in less economic opportunities for women to succeed in. This ripple effect is seen in Ethiopia as the literacy rate for women is 40%, with 77% of women participating in the workforce. For men, the literacy rate is 57%, with 88% of men participating in the workforce (CIA). This discrepancy, as could be predicted, shows that improving literacy rates or education would improve employment for women. Providing a woman with an education and the ability to enter the workforce has the potential to improve the woman’s quality of life. It is important to also consider that one’s quality of life cannot be determined by an outsider who does not know the actual quality of life that an individual feels is their own. A woman’s quality of life is subjective to her experience, but by providing her with access to safe water and improved sanitation, more opportunities become available for the woman.

As previously mentioned, water collection is a task that falls on the women of a family – usually mothers and daughters – which raises the argument over whether or not this is a fair burden to place on soley women. On one side of this argument, some may claim that this is unfair because of the effects that carrying water has on women, one of which is time restraints. The time it takes to carry water can be used to gain an education. Because of the discrepancy in literacy rates, it is clear that women do not have the same amount of time that men do at school. On the other side of this argument, some may say that because the man’s role in the family is to provide an income, women should collect the water. In traditional cultures, it is the role of the women to take care of domestic chores. Water collection can be seen as a form of a domestic chore. However, in Sub-Saharan African countries, where the water crisis is very prevalent, women on average work a workday that is 50% longer than men, under harsher conditions (Panella). Therefore, this emphasizes the overall disparity in the labor performed by women to deal with the water crisis versus men.

However, it is important to consider the alternatives to having women collect water. In the vast majority of regions where water is scare, it is unlikely that the cultural norms of many of these places will shift from having water collection be the role of women to it being the role of men. However, it is still necessary to consider that if it is not women collecting the water for their families, then it would be the men of the family. This would still pose the same problems of reducing a young man’s ability to attend school and increasing his potential of obtaining illness and disease from water collection. Therefore, by removing women from water collection, another group will be similarly affected by the task. A solution that would eliminate the crisis of lack of access to clean water and how it affects women is not to have another group collect water, but to provide clean water for women and their families. However, this task is not as simple as it may appear.

Global Responsibility and Duty

Some may argue that governments and independent organizations have a responsibility to step in and aid communities that are in need of clean water and improved sanitation. It is especially a government’s responsibility to make the standard of living better for its people. A way for governments to take action is to provide the people with knowledge on the risk of unclean water consumption and usage of improper sanitation habits. In Vietnam, a law has made handwashing and indoor plumbing mandatory practices in schools built within the last 10 years, which is an important mandate as washing hands reduces the risk of obtaining diarrhea-related diseases by 30% (Estrin). As well, India’s Prime Minister Narendra Modi has set aside $40 million USD to be used to improve sanitation infrastructure – latrines and toilets – starting in October of 2019 (Estrin). These two examples support the argument that governments need to invest money and time into aiding the water and sanitation crisis as they have the power to do so. However, not all governments have the capacity and economic security to invest millions of dollars into water infrastructure plans, thus leaving more responsibility upon independent organizations. Independent organization like are already making progress in communities to improve the standard of living. They have been helping many countries, including Peru and Ethiopia, to reduce the amount of people without access to safe water and sanitation. They highlight individual communities and families so that those who want to donate see where their donations will be going. Some would argue that this aid is completely necessary as many small, water-stressed communities are not able to come up with the funding to improve the infrastructure that is needed. If no improvements have occurred thus far without any external help, than none will. Lastly, some would argue that organizations and governments have the responsibility to uphold the Human Right to Water and Sanitation, as it is a human right that is bestowed upon all people.

On the other hand, some may argue that outside organizations may not have a responsibility to aid communities because these improvements should be made at the local or internal level. This could stem from the argument that communities may not want outsiders coming in and impeding on their culture. These actions may not be fair to the people in these communities if new practices were to impose on there way of living. Therefore, some would argue that if outside interference is used, there should be regulations as to how much is allowed. However, I believe that governments have the responsibility to provide support to their population if they are being affected by the water and sanitation crisis. The amount of interference that outside organizations have with communities should be regulated in some way so that outside cultures are not completely replacing what might be a well-established cultural norm.

It can be argued that humans around the world have a duty to use water responsibly. Even though our earth is composed of 70% water, only 1% of Earth’s water is acceptable freshwater for consumption (Statistica). To put global water consumption habits into perspective, the U.S is the leading consumer of drinking water by a margin of 165 liters ahead of Canada, which is the country that is the second highest consumer of drinking water (Statistica). As a global population, we do not conserve water as we should, however, how does one person or group regulate the amount of water that humans as a whole population can or cannot consume. It can be seen as an obstruction of freedom to restrict the amount of water that humans consume, but it is a necessary task in order to help alleviate the struggles that some people face due to lack of access to water. An example of where a limit to water consumption was put into effect was in California in June of 2018. A state legislation announced that Californians would be limited to using 55 gallons per person per day for residential water usage (Weiser). However, with a policy like such, there is no legitimate way to enforce the limitation, rather it stands as an aspiration that the state holds for its residents (Weiser). This can serve as a model for a larger scaled attempts to limit water usage. It is difficult to actually assess with current technology whether or not individuals actually follow water consumption guidelines, therefore making them impractical, but also necessary for the future.  

Although there is inconsistency in the way that countries consume water – it was previously noted that the U.S consumes more water than any other country – limiting the water that U.S citizens consume is not easy to manage, and also may not address the water and sanitation crisis on a global level. For example, the lack of access to clean water is one factor that contributes to a multitude of consequences that include high mortality rates, spread of disease, and gender inequality. However, it is not a guarantee that a limitation to water consumption would attribute to a solution to the imbalance in the way that women are affected compared to men, but it is a fair assumption to say that by limiting water consumption globally, less women would need to travel long distances to collect water as it would become less scarce. As a whole, humans around the world have a duty to use water responsibly, but it would not be possible to create a worldwide regulation on water consumption without opening up further issues such as a restriction of natural human rights.  

The water and sanitation crisis also offers an issue of where one should prioritize efforts. When looking specifically at the U.S, many areas face clean water issues, like Flint, Michigan. When the city of Flint transferred their water source to Lake Huron, problems arose do to their water infrastructure. In September of 2015, after Flint residents noticed discolored, smelly water coming out of their faucets, Virginia Tech conducted a study that showed that 40% of Flint household’s water supplies contained elevated levels of lead (CNN Library). This lack of proper water infrastructure is something that is seen globally, but is not as common in the U.S, therefore, organizations like prioritize their efforts to helping the water crisis in other countries where the crisis affects more people. It can be noted and argued by some that it is a fact that the water and sanitation crisis affects more people in other countries at a different extreme than it does to people in, for example the U.S. As mentioned above, countries like Peru and Ethiopia both struggle with access to clean water resources, but to a different magnitude than each other and other countries. Because of this, Ethiopia receives more attention from organizations and people globally. This attention and similar attention that some other countries receive results in where efforts to provide aid are prioritized. When looking at LifeWater’s website – an organization dedicated to providing clean water to those in need – there is a subdivision titled “Most Urgent Need” that lists two projects in Uganda in need of more donations, showing that there is a distinct priority that some organizations place on certain areas which are faced with the water crisis (LifeWater). This priority may also come from the moral desire to do what is right by helping those who are faced with “worse” struggles than others. However, residents of Flint, Michigan are still victims of the same water crisis that is seen in Ethiopia. On the other side, some may argue that governmental efforts to aid the global water crisis should be focused on solving the issue at home before aiding those in other countries. To support this argument, it can be suggested that in a country like the U.S, the government should not neglect its own population. It can also be argued that one of the roles of the government in the U.S is to support the people, in which providing access to clean water would follow suit. However, it is difficult to assess which groups of people should receive aid first, as help cannot be granted based on the struggle level of one person against another.

Similarly, addressing the needs of women with regard to the water and sanitation is a key component to achieving global gender equality. Based on this, it can be argued that the needs of women should be addressed before those of men. As noted previously, by providing access to clean water and improved sanitation, women are more likely to attend school, which gives them the likely opportunity of entering the workforce. Not only does this bridge the gap between men and women in education and labor, but it also improves the global society by increasing the number of people who are literate. Secondly, 15% of the global population practices open defecation (WHO/UNICEF). The women under this statistic are more likely to be sexually assaulted. Based off this information, it can be argued that the impact that the global water and sanitation crisis has on women should be prioritized when compared to men.

On the other side, one may argue that the lack of access to clean waste and improved sanitation effects all people globally, and therefore aid should not be spearheaded towards one group of people. It is not fair to a population in suffering to prioritize some but not others. This also brings up the issue of being fair or unfair to a whole group of people. However, the issues the that the global water and sanitation crisis provide for people is already unequal in those who are affected mostly by it.


In conclusion, there are some possible solutions to the crisis that have been proposed or are currently in action. The UN is looking for support for the WASH crisis from both public and private sectors (Unilever Domestos, WaterAid and the Water Supply, Sanitation Collaborative Council). Private sectors have been working with governments to find solutions. As well, many smaller organizations are doing successful work, but private sectors can scale up where they reach by providing capital and other resources. Another way to aid the process is by supporting local workers, so that new opportunities can open up. This would bring economic prosper to the countries in need of new sanitation infrastructure by getting local workers involved in the process. This is also a solution that educates the community and aides them in alleviating the crisis without imposing outside norms into a specific culture. On another note, multi-billionaire Bill Gates has created a toilet that can take human waste and convert it into clean water, electricity, and fertilizer. This product is not on the market, but is a possible solution to providing both adequate sanitation and clean water. However, the cost of one of these toilets is very high and unattainable for most. There have also been some successful private-public partnerships: The Creating Sanitation Markets (CSM) is a partnership led by World Bank Water and Sanitation Program; Unilever Domestos works with a number of public organizations to form partnerships. They partnered with UNICEF on the CATS (Community Approaches to Total Sanitation) program which promotes change through mass media and messages in schools (Unilever Domestos, WaterAid, and the Water Supply & Sanitation Collaborative Council)

Overall, the water and sanitation crisis creates both mental and physical health issues for all people affected by it. Women, children, and education are impacted greatly because of the divide in the work that they do to deal with the crisis when compared to men, as well as putting their safety and privacy at risk. By focusing on two specific countries, I was able to see how the lack of access to WASH varies based on location, economic, and governmental factors. However, it is still a worldwide crisis that is only slowly improving. It is difficult to assess whether or not governments or outside groups have the responsibility to help communities, to what degree should aid be given, and if there is a duty to alter personal lifestyles in pursuit of improving quality of life for others. However, through my research I have learned that the global water and sanitation crisis is also women’s crisis, and that providing both clean water and improved sanitation to women globally has the power to improve their access to education and opportunities for their futures.

By Jill DiTommaso

Works Cited

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