Having a toilet is not enough: the limitations in fulfilling the human rights to water and sanitation in a municipal school in Bahia, Brazil

Abstract

BackgroundThis article addresses the enjoyment of the human rights to water and sanitation (HRTWS), in particular access to toilets, in a public school in Bahia, Brazil.MethodsParticipant observation of the school’s routine, focus groups with students in grades 8 and 9 of primary school (13 to 17 years old) and individual, semi-structured, interviews with members of school staff were applied, exploring access to water and sanitation by adolescent girls and boys.ResultsStudents and school staff reported that the amount of toilets was insufficient and that their conditions were often inadequate because they were plugged or dirty. The impact on girls is greater as toilets do not offer a clean and healthy environment for menstrual hygiene management. Several elements of the normative content of the HRTWS, especially accessibility, acceptability, quality, safety and dignity, were largely not fulfilled. The study identified that, to comply with the HRTWS, it is necessary to go beyond infrastructure, as the lack of maintenance; cultural elements and student participation hinder the usage of sanitary facilities. Since schools can be privileged spaces to train critical and reflective citizens and to foster autonomy and emancipation, education oriented by human rights and citizenship is an opportunity for a more equitable society. By increasing access to social, economic and cultural rights in all phases and aspects of life, including when children and adolescents are in a school environment, people are able to enjoy better living conditions and a higher standard of health.ConclusionsThe study raised the importance of considering each community’s sociocultural aspects in analyzing access to sanitary facilities in schools, which are spaces where citizens’ rights should be exercised and fulfilled.Electronic supplementary materialThe online version of this article (10.1186/s12889-019-6469-y) contains supplementary material, which is available to authorized users.

U.S. Adolescent and Adult Women’s Experiences Accessing and Using Toilets in Schools, Workplaces, and Public Spaces: A Multi-Site Focus Group Study to Inform Future Research in Bladder Health

“…In public spaces, self-restricting use largely arose from perceived lack of cleanliness. Previous research has suggested that women and men have unique expectations when accessing public toilets, and adolescent and adult women highly value cleanliness [10,30,40,41]. Although, to our knowledge, little published research explores cisgender men’s acceptance of porta-potties and public toilets, our data suggest that many public toilets are not acceptable to cisgender women, and their current availability may not improve toilet access and use in this population.…”

Linkages between sanitation and the sustainable development goals: A case study of Brazil

“…We also identified research on the links between sanitation and gender inequalities, for example, regarding public sanitation facilities that are not suitable for Menstrual Hygiene Management (MHM) as researched by Coswosk, Neves‐Silva, Modena, and Heller (2019) whose work is relevant for SDG5 on gender equality (5.1–2) and SDG4 on education (4.5, 4.a). Similarly, academics have researched how poor sanitation conditions increase risks to maternal health, particularly among low‐income groups, and how health education being integrated into health programmes in Brazil can support better hygiene practices (targets 5.6, 3.7) (Victora et al, 2011; Villela & Monteiro, 2005).…”

Gender Equality and Social Inclusion in Relation to Water, Sanitation and Hygiene in the Oromia Region of Ethiopia

“…Additionally, the lack of appropriate sanitation facilities had multiple implications for women, girls, and SEG [ 11 , 12 , 24 , 45 ]. In areas where open defecation is widely practiced, women fear openly defecating during the daytime due to privacy concerns.…”

“…Even during the night, open defecation itself is difficult for women and exposes them to risks of violence [ 16 , 17 , 19 ]. In schools, lack of WASH facilities, sanitary pads, and space to timely change their pads forces girls to interrupt classes, fall behind on assignments, and often leave school early, which subsequently affects their school attendance and performance [ 25 , 26 , 27 , 45 , 46 , 47 , 48 , 49 ]. Similarly, other SEG also lack access to inclusive (accessible) toilet facilities which forces them to travel to far places to look for open space [ 12 , 30 ].…”

“…Limited access to water often deters many from routine handwashing practices, putting their health at risk. Resulting unhygienic conditions, due to a lack of water and sanitation facilities, causes women and girls to face criticism and mistreatment by their peers and husbands [ 23 , 45 , 47 , 48 ]. In schools, their attendance and ultimately their performance is negatively affected during menstruation because of a lack of sanitary pads, lack of rooms to change their pads and keep their privacy, and misconceptions of boys which results in teasing and shaming [ 23 , 24 , 33 , 34 ].…”