What It Means to Be a Girl or Woman When Water Is Scarce

A girl washes her hands in the new bathroom built with support from UNICEF at her primary school in the small village of Sintchan-Farba, Guinea Bissau. Photo: Prinsloo/UNICEF

Water is a basic human right. Yet half the world experiences severe water scarcity for at least part of the year, according to a report from UN-Water. As climate change strains the global water supply, the devastating impact on girls and women is coming into full view. Bottom line: Closing the water gap is essential for the health and well-being of girls and women everywhere.

“The climate crisis is a water crisis … which automatically becomes a women’s and girls’ crisis,” says Anu Gautam, a Knowledge Management Specialist at the United Nations Children’s Fund (UNICEF) who focuses on water, sanitation, and hygiene (WASH).

The latest edition of the UN World Water Development Report sheds new light on the extent of this crisis. Over 2 billion people worldwide do not have clean drinking water and 3.5 billion lack access to safe sanitation and hygiene, such as working toilets or extra water and soap for regular handwashing.

For girls and women across the world, the situation gets even more complicated.

“Water is life. It’s your personal hygiene. It’s your menstrual hygiene,” says Marije Broekhuijsen, a WASH Specialist and Gautam’s colleague at UNICEF. For nearly 20 years, she has worked in development and emergency situations — from Ethiopia to India to Yemen. Water is “also your household hygiene, your food hygiene. “It’s your health. If you don’t have clean water, you’ll get sick,” she adds.

Following flash floods in Burka District, Baghlan Province, northern Afghanistan, a girl receives drinking water provided by UNICEF. Photo: Madina Qati Musadiq/UNICEF

Climate Change Is Fueling a Water Crisis for Girls and Women

As climate change intensifies, droughts and floods will occur more frequently and severely in many regions of the world, including South Africa — exacerbating the water and sanitation burden for girls and women. “It’s because climate change causes either more water in some areas where you don’t need it or can cause less water in areas where you need more,” explains Gautam.

The responsibility of fetching water becomes an even more stark reality for girls in countries where climate change worsens drought. In fact, girls are nearly twice as likely as boys to bear the responsibility and spend more time collecting water each day, according to the 2024 UN-Water report.

As a young girl living in South Africa, Anita Dywaba, a UN Foundation Next Generation Fellow, was given the task of collecting water. She remembers playing and skipping on her way home, sometimes losing her balance and breaking the bucket she was carrying, causing water to spill. She would be punished for losing water, not realizing at the time just how precious it was for her family.

She was just a kid then. But as a university student in Grahamstown (now Makhanda), Dywaba better understood the implications of water scarcity. While she was there, the region experienced “water shedding,” the practice of going without water due to shortages. Households would get a limited supply of water that had to last for two days, with more water available only every third day.

At a UNFPA innovation workshop in New York Headquarters, Anita Dywaba, Next Generation Fellow shares solutions for adolescents and young people to better access information regarding sexual and reproductive health and rights. Photo: Courtesy of UNFPA

“I would dread my time of the month because I have to go to lectures, I have to go to school,” Dywaba says. “To be a productive person on top of not having water and not being able to fully wash yourself … and feel clean for two days is quite crazy.” She later took a role with the United Nations Population Fund (UNFPA), the UN’s sexual and reproductive health agency.

Climate-induced water scarcity also means girls and women must travel farther or make additional trips to secure enough water for their households. Walking long distances and carrying heavy loads can be not only burdensome, but also dangerous for girls and women.

“Imagine a person needs to collect three liters of water per person per day for a family of 15,” says Gautam, who is originally from Nepal. If she’s pregnant and already carrying a baby on her back, Gautam adds, the load would be equivalent to three to four times her own weight.

Venturing out to collect water or to simply use the bathroom — especially at night — also puts girls and women at greater risk of being sexually harassed or assaulted, jeopardizing their safety, dignity, health, and well-being. More time looking for resources can also mean less time for classroom learning, upskilling, or other personal pursuits beyond household duties. What’s worse: Some girls are forced to withdraw from school entirely when clean water and safe toilets aren’t available, undermining future opportunities.

Two teen girls from Aria Primary School in Uganda would miss class during their menstrual cycles. With the district’s new girls’ bathroom and clean water, the initiative aims to increase their comfort and reduce absenteeism. Photo: Hugh Rutherford/UNICEF

Water Is Essential for Girls’ and Women’s Health

People who menstruate need access to private, secure toilets — which are all too rare in hundreds of countries lacking access to clean water. That means a toilet with a working lock on the door, a bin for sanitary products, clean water, and light. “It’s not just a toilet; it is really a menstrual-friendly toilet that girls need,” says Broekhuijsen.

For the first time, a global report by UNICEF and the World Health Organization (WHO) includes additional analysis on menstrual health among adolescent schoolgirls. The findings highlight major gaps in menstrual health and hygiene, particularly in schools. Less than 1 in 3 schools globally have bins for menstrual waste in girls’ restrooms. In the least developed countries, this drops to 1 in 5 schools, and only 1 in 10 schools in sub-Saharan Africa.

While these findings are a strong start — only 30 countries have relevant national data available — the need for more global data is profound. “We don’t know how many women are not actually able to meet their menstrual health needs, and the fact that we don’t know while so many of us are menstruating every month is really astonishing,” says Broekhuijsen.

Menstrual products are not always available or affordable, and sometimes they’re impossible to store safely, especially in places where women’s health remains highly stigmatized. This was the case for one young woman from an Indian village, recounts Dywaba.

Marije Broekhuijsen, a WASH Specialist with UNICEF, in the field in Yemen, one of the countries where she has worked on a number of water, sanitation, and hygiene projects. Photo: UNICEF Yemen

Without electricity for proper lighting or options for storing menstrual products, this young woman accidentally put her menstrual cloth on top of an ant farm. She was trying to hide the cloth, as menstruation was considered taboo, so she stashed it outside of her home. That night when she needed to use it, she couldn’t see the insects.

“She wore it and unfortunately, you know, the ants then crawled up into her cervix,” causing several health complications, explains Dywaba. “So, it’s cases like those that necessitate having safe and private toilets for women to take care of themselves.”

Climate change is taking an already difficult situation and making it worse. And it’s not just drought causing implications on health and well-being. On the other side of the spectrum is an overabundance of rainfall and severe floods, as Gautam points out. These circumstances fuel the spread of infectious diseases such as cholera, which as primary caregivers, girls and women are more likely to contract. At the same time, these conditions also contribute to the spread of malaria, dengue fever, Zika virus, and other vector-borne diseases, which can cause miscarriages, premature birth, and anemia among pregnant women. Broekhuijsen adds that “hotter days, more rain and higher humidity can even increase the risk of reproductive tract infection.”

When climate change worsens, some women end up moving to gain access to essential, basic services. Moving, however, has the potential to limit access to information and resources including lifesaving health services and treatment for urinary tract infections, contraception, and safe abortion. In fact, according to a United Nations Development Programme (UNDP) report, on gender, climate, and food security, 80% of people displaced by climate change are women.

Remember, “the needs of [girls] and women are special,” says Gautam. They’re different from boys, and the needs of transgender people, non-gender conforming people, and other populations also must be considered when it comes to menstrual hygiene, she says.

UNICEF’s Knowledge Management Specialist Anu Gautam joins the Pa'o tribe in the Shan state in Myanmar as they celebrate their Open Defecation Free Status. Here, they inaugurate the piped drinking water supply system supported by UNICEF for ensuring universal access. Photo: Courtesy of Anu Gautam

How to Close the Global Water Gap for Girls and Women

There are several reasons water is scarce for girls and women, especially when examining the issue through an intersectional lens such as climate, gender, and health. Without access to water, let alone clean water, the need for WASH facilities becomes their utmost burden. And the need for solutions that include these girls and women becomes all too real.

By Providing Education and Innovation

Providing access to more sanitary products such as pads and tampons is a simple yet impactful step that could allow girls and women to manage their menstrual cycle without burden, stress, or fear. Education is another, say Broekhuijsen and Gautam, including openly educating girls about what to expect during menstruation.

Broekhuijsen shares that in Ethiopia, for example, there is a strong, contextual focus on ensuring that girls have adequate support in schools. That comes in the form of having teachers who know about menstrual health, integrating special rooms for girls to change and rest, and fostering peer support.

While in Uganda, Dywaba learned about an innovation — “a new way of thinking” as she describes it — called Smart Bags for Girls. The bookbag was solar powered so it could generate electricity, allowing girls to do their homework. The pack also included a menstrual kit with reusable pads. Some of those pads were made from sugar cane and bamboo, which underscores how girls and women resort to necessary alternatives to manage their hygiene.

Three young girls hold clean cups of water, thanks to a UNICEF-provided water point and other newly built WASH facilities at the Baan Nai Rai School in the southern Pang Nga Province in Thailand. Photo: Palani Mohan/UNICEF

By Leaving No One Behind

Paying attention to underserved and overlooked communities is remarkably important, notes Gautam, who has visited several countries while working in the East Asia and Pacific Regional office in Bangkok. In Vietnam, for example, government and health officials report that some 90% of the population now has access to basic sanitation, water and hygiene. But all she could think was: What about the other 10%?

“People who live on the sideline, on the borders, does it mean they have to suffer because they are living there? Isn’t their human right as equal as mine and yours and the [members of] the government?” she said. “We talk about the last mile, we talk about those who are underserved. We really … have to ensure that everybody, every individual, every [boy] and girl fulfills his or her right.”

It’s also essential to meet people where they are. Distributing more menstrual pads isn’t the only solution — nor is it enough if girls and women don’t have proper clothing to use them. “How would you use a pad if you don’t have underwear?” asks Broekhuijsen.

Students from different classes participate in the Champions of Menstrual Hygiene Management (MHM) program in Mali, where they learn to manufacture sanitary pads so girls and women can manage their menstrual hygiene. Photo: Seyba Keïta/UNICEF

By Including Women

Most importantly, expanding access to clean water and sanitation will require sustained support and political will from governments and global leaders. That starts with planning and budgeting that can then be converted to policymaking — providing access to clean water closer to where girls and women are, notes Gautam. High-level leaders can help break the stigma around menstrual hygiene, too, as Indian Prime Minister Narendra Modi did in a first-of-its-kind national address, notes Broekhuijsen.

Menstrual health is now having its much-needed spotlight on the global stage. Thanks to grassroots organizers and workers, it has since been integrated into global health, education, human rights, and gender equality and equity agendas across the Sustainable Development Goals (SDGs). In 2022, the WHO rallied behind the need for menstrual health to be recognized, framed, and addressed as a health and human rights issue, not solely a hygienic issue, to encompass the needs of women, girls, and people who menstruate in different life stages.

“If [women] didn’t have to fetch water over miles every day, then they [wouldn’t be] excluded from social decisions that are made in the community,” Dywaba notes. This is a tremendous loss because women have a much more nuanced understanding of local resource management, and women’s political leadership has shown greater responsiveness to citizen and community needs. That includes climate-related policies and projects.

Although girls and women bear the brunt of the climate crisis, they are also a powerful constituency capable of delivering effective solutions and lasting change. Recognizing the importance of meaningfully including women in decision-making processes, the UN Framework Convention on Climate Change (UN Climate Change) Secretariat developed the Gender Action Plan, which calls for women’s “full, equal, and meaningful participation” in international climate processes, so they could have lead roles in decision-making on climate action and solutions.

“It’s really important that we invest in WASH, and we meet the basic climate resilient WASH needs of women and girls,” says Broekhuijsen. “It can help them reach their full potential, but in a dignified way … it’s their right.”

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