Like many 15-year olds girls, Sabina Roka used to get embarrassed in front of the boys in her class, though Sabina’s worries were not about spots and trainers. Sabina goes to Simle School in Nepal and until recently she had to use the boys’ toilets because there were no girls-only facilities. This was not only embarrassing – especially when she had her period – but insufficient number of toilets can result in illness, high absenteeism, drop-outs from school and even an impact on the national economy.
“Before the school had toilets we used to go into the bush and hide under the bamboo,” Sabina told WaterAid, who built the new toilets, “sometimes the boys would see us and tease us. We were embarrassed.”
For students in the UK the very idea of going to the toilet in front of their classmates – boys or girls – would be simply horrifying but it is a reality for millions of children across the world. In a survey of 60 developing countries the report, Raising Clean Hands, by a number of non-governmental organisations including Save the Children, CARE and the World Health Organisation (WHO), found that two-thirds of school children in these countries do not have access to proper sanitation facilities. In Nepal, as in many developing countries, this has been driving students, and in particular girls, out of schools.
Hitting puberty is complicated enough at the best of times and yet when you don’t have private female toilets, things get even trickier. Sabina explains how during menstruation “we didn’t have anywhere to go and change our pads. After each lesson there is a bell and then we have to go to the next class. If you aren’t there in time you miss the class and so when we had our period we often had to attend one class and then miss the next.’ Many girls find it easier to stay at home when they are menstruating. This results in 10-20% absenteeism each academic year by girls.
It is not just embarrassment keeping bright female students like Sabina out of the classroom but illness too. UNICEF estimates that in schools in developing countries one toilet can be shared by more than 50 students and that can lead to a spread of diseases such as diarrhoea. The World Health Organisation estimates that 40% of cases of diarrhoea are picked up at school, and globally the disease is responsible for the deaths of 4000 children each day. The disease also leads to a loss of 272 million school days each year.
Things have gotten better at Simle School. WaterAid has built gender-sensitive toilets for boys and girls and provided training in proper hygiene for students and staff. This has led to a marked improvement in attendance and health. The report Raising Clean Hands shows that providing toilets for girls can result in increasing the attendance of female students by up to 11%.
“We really struggled before and it’s hard to compare then and now as there is so much improvement,” Sabrina said, standing in front of the new school toilets, “we feel very happy that we don’t need to miss classes anymore and that we can carry on with our studies .”
Another consequence of facilitating girls’ education is the impact on the economy. Research shows that girls like Sabina who are educated are better protected from exploitation and AIDS, less likely to die during childbirth and more likely to raise a healthy baby. The Raising Clean Hands report states that for every 10% increase in female literacy a country’s economy grows by 0.3%. Indeed the economic benefits of investment in sanitation have also been proven by reports from UN-Water which show gains of $3 to $34 per every $1 invested, leading to a gross domestic product increase of 2-7 per cent.
Taken all together, it would seem reasonable that there should be an investment in adequate sanitation systems for girls in schools. However, in Nepal, a country where 55% of the people live below the poverty line there is little money to build toilets.
The government of Nepal has recognised that proper sanitation is important to its country. The National Urban Water Supply and Sanitation Policy (2008) describe the need for sanitation as being necessary “not solely for reasons of moral obligation, but because it is in the best public interest to do so.”
It has also proclaimed its commitment to the Millennium Development Target (MDT) by setting an objective to ensure that in the next five years half the number of people who currently do not have access to toilets will get proper sanitation facilities.
The organisation Nepal Water for Health estimates that to achieve this goal they will need to build 14,000 toilets a month. The government needs international aid to achieve this but the amount of aid for sanitation projects has been falling. A recent report by the UN- Water Global Annual Assessment of Sanitation and Drinking water shows aid commitments for water and sanitation fell from 8% of total development aid to 5% between 1997 and 2008, a neglect the WHO calls “a strike against progress” .
At Simle school female students are enjoying a basic “luxury”: having the sanitation facilities to stay healthy and to remain in school. Not all female students in Nepal are so lucky. Toilets are one of the least glamorous of topics and are commonly ignored by school administrations, governments and now the developmental aid sector.
For students like Sabina, an investment in toilets can pay dividends, not only at a personal level but also to the wider economy, benefiting an entire generation. Now it falls to donors, international aid agencies and the Nepalese government to ensure sufficient investment in toilets, so that many more girls like Sabina can realise their potential with dignity.
This feature was written between 6 March and 30 April 2010 as part of the Guardian International Development Journalism Competition