Razi Berry

A recent article underlines a widespread form of gender discrimination – inadequate access to private toilets. This is a serious problem for girls and women around the world, and perhaps one of the most pervasive forms of gender discrimination. There has been an increase in advocacy and research in this area, however little has actually been done globally to improve designs, guidelines and placement of toilets for women and girls. This research has been conducted through Columbia Mailman School of Public Health and the International Rescue Committee, and published in a special issue on Water, Sanitation, and Hygiene in Humanitarian Contexts in Water,an open-access journal.1

Fact: girls and women have different sanitation needs compared to their male counterparts

It is a fact that girls and women have different sanitation needs compared to their male counterparts. Roughly a quarter of all adult women globally are menstruating at any one time. This poses a significant obstacle for hygiene where private and safe facilities are not accessible, such as in urban slums and displacement camps.

“At the most basic level, adolescent girls and women around the world have increased and distinct water and sanitation-related needs, the product of their physiology, reproductive health processes linked to menstruation, and pregnancy, and safety concerns,” said senior author Marni Sommer, DrPH, MSN, associate professor of Sociomedical Sciences at Columbia Public Health. “This can be especially challenging for girls and women living in low-resource or over-crowded contexts, such as urban slums, displacement camps and informal settlements.”

Common for women and girls to experience stress, embarrassment, physical discomfort and even gender-based violence

It is common for women and girls to experience stress, embarrassment, physical discomfort and even gender-based violence as a result of limited access to toilets with locking doors and rubbish containers for menstrual waste disposal.

Previous research notes consultation with girls and women regarding hygiene and sanitation needs is uncommon

Previous research has highlighted that consultation with girls and women regarding their hygiene and sanitation needs is relatively uncommon, such as in humanitarian relief contexts. Consultation with women and girls is often problematic by social and cultural taboos around menstruation, and expectations of female modesty, as well as a general discomfort discussing this topic.

In addition to menstruation considerations, girls and women commonly take on caretaker roles for young children or elderly which require them to assist family members into toilets. These roles have tendencies to increase even further discrimination and stress levels.

Looking for and actually finding a toilet

Looking for and actually finding a toilet while away from home often affect activities girls and women participate in, such as attending school, visiting the market, or standing in long lines for their family’s daily water. Access to toilets at workplaces may impact productivity, attendance, wellbeing.

Research strives to bring awareness for the need for female friendly toilets

This research strives to bring awareness for the need for mainstreaming provisions for female friendly toilets, which would have significant implications for meeting the United Nations’ Sustainable Development Goals around health, education, sanitation, economic empowerment and gender.


  1.  Schmitt ML, Clatworthy D, Ogello T, et al.  Making the Case for a Female-Friendly Toilet. Water 2018, 10(9), 1193. https://doi.org/10.3390/w10091193

Photo by Soragrit Wongsa on Unsplash

Razi Berry is the founder and publisher of the journal Naturopathic Doctor News & Review  that has been in print since 2005 and the premier consumer-faced website of naturopathic medicine, NaturalPath.  She is the host of The Natural Cancer Prevention Summit and The Heart Revolution-Heal, Empower and Follow Your Heart, and the popular 10 week Sugar Free Summer program. From a near death experience as a young girl that healed her failing heart, to later overcoming infertility and Chronic Fatigue Syndrome and Fibromyalgia through naturopathic medicine, Razi has lived the mind/body healing paradigm. Her projects uniquely capture the tradition and philosophy of naturopathy: The healing power of nature, the vital life force in every living thing and the undeniable role that science and mind/body medicine have in creating health and overcoming dis-ease. Follow Razi on Facebook at Razi Berry and join us at  Love is Medicine  to explore the convergence of love and health.

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