Deepening our understanding on a proactive approach to Do No Harm in inclusive WASH

An expert blog by Di Kilsby, Gender and Social Inclusion Consultant to Water for Women. Water for Women and SNV Netherlands Development Organisation recently hosted the Fund’s first regional learning event,  ‘Systems strengthening for inclusive WASH – leaving no one behind’ in Kathmandu, Nepal for 50 Water for Women partner representatives. This blog is the second in a series of expert blogs developed as part of the event.

Systems are made up of people 

Water, sanitation and hygiene (WASH) systems are made up of people, who exist within broader social, cultural and political systems; and success depends on the actions and mindsets of those people. These were key reflections from Water for Women Fund (the Fund) partners in Kathmandu during the South Asia Regional Learning Event, ‘Systems Strengthening for Inclusive WASH - Leaving No One Behind.’

Do No Harm in inclusive WASH systems 

Water for Women is committed to ‘pushing the boundaries’ on gender and social inclusion (GSI) in WASH, to ensure WASH systems benefit all, including the most marginalised. It has identified Do No Harm (DNH) as central to collectively strengthening GSI in WASH. Any WASH (or other) program can potentially result in negative consequences, particularly for marginalised people, who live with ongoing vulnerability to harms, ranging from smaller, ‘everyday’ incidents of discrimination and exclusion to severe forms of harm including physical violence. Inclusive WASH approaches actively challenge unequal norms and power imbalances, which can lead to backlash and increased risks of violence.

By sharing experiences and reflecting on practice with a ‘systems strengthening’ lens, partners highlighted DNH lessons learned and promising practices from project delivery and research perspectives.

Recurring themes on DNH as an approach to strengthening inclusive WASH systems included:

• the importance of partnerships, particularly with rights-holder organisations (RHOs), and the multi-stakeholder approach;
• the need to bring diverse perspectives to the table, centre marginalised identities, and promote those voices in decision-making and leadership;
• the need for intentional processes including efforts within organisations to uncover and address unconscious bias;
• the importance of careful research and analysis in gaining deep insight into complex and sensitive issues about marginalised groups and the potential for causing or exacerbating harm;
• the importance of taking calculated risks and taking time to work with marginalised communities in a way that does no harm;
• building awareness of the vulnerabilities that people from marginalised groups face in their day-to-day lives is critical to winning trust, finding suitable solutions and avoiding exposing individuals to increased risk; and,
• applying systems thinking, and recognising that this means looking at the bigger picture, sometimes means thinking outside the box.

It will be valuable over coming months for Water for Women partners to reflect further on the implications of these ideas for WASH and WASH systems strengthening.

 Water for Women GSI Consultant, Di Kilsby pictured during a field visit that took place on day two of the learning event in Nepal

Centering marginalised voices to ensure meaningful inclusion 

To ‘do no harm’ requires deep understanding of the complex dynamics of people’s lives. ‘Nothing about us without us’ is a strong principle for inclusion, and is critical to DNH. Listening to the voices of those who are so often marginalised and silenced requires openness to hearing about the totality of their experiences. It is critical to recognise marginalised people and their representative organisations as integral to the ‘people’ part of the system, and meaningful partnership is key to this. 

During the event, one of the Water for Women partners, the Centre for Advocacy and Research (CFAR) from India, shared experiences of a strong model of partnership with a RHO representing transgender people. A representative from the RHO, also present at the event described how the partnership goes beyond looking only at WASH needs, to looking also at stigma, self-stigma and social isolation as barriers, and considering livelihood, housing and other needs of transgender members of the community. She warned against token ‘inclusion’ where people from marginalised communities such as hers are ‘just brought in for taking pictures and that’s it, we are used only for this and it looks like we are being included’. This, she said ‘hurts us most of all.’

CFAR Project Manager for Bhubaneshwar, Soumya Mishra, said of the partnership, ‘we are not always seeing everything in terms of project targets. Small help is given as friends.’ Describing their marking of World Toilet Day by organising, with support from the RHO, a Pride March, Soumya said that ‘presenting different identities in peak hour in the main streets is powerful; people who see this can see what we mean by “leave no one behind.”’

Safety while finding solutions

Working in WASH means addressing issues that are made challenging by taboos around bodily functions. Applying a GSI and DNH lens requires also addressing specific harmful taboos and stigmas associated with particular marginalised groups and their bodies. Until recent years, menstrual hygiene management (MHM) was absent from WASH thinking due to taboos that create shame and silence about the issue, and the absence of women from WASH decision-making. During a session on MHM, partners shared lessons from within and beyond Water for Women.

Jane Wilbur from London School of Hygiene and Tropical Medicine (LSHTM) shared the experience of action research in Nepal, funded by the Gates Foundation, which aimed to empower adolescent women with intellectual disabilities to manage their own menstrual hygiene with dignity. The research used a sensitive approach, including DNH measures for participants, who are from a highly marginalised group and have very specific needs, to engage and to feel safe during the process. Jane shared that, in identifying and discussing menstrual taboos and the resulting restrictions on women, ‘lots of carers were in tears as they realised the harm the cultural restrictions were doing’. This experience also highlighted the importance of taking time to reflect on ‘invisible’ norms, in order to challenge and change thinking and practice. Other partners, Thrive Networks, World Vision and SNV also shared experiences of working to address stigma and taboos related to MHM within their contexts.

Building shared commitment to DNH

Two years into the Fund, this event has confirmed that inclusion is genuinely embedded in partners’ thinking and approaches, and DNH is gaining more focus. Several partners reflected on learning that, in the face of inequality, ‘doing nothing does harm.’ Demonstrating a growing commitment to the principle of ‘nothing about us without us’, the group participating throughout the week included one man with a disability and two transgender women. National Federation of the Disabled, Nepal also played an active part in the workshop. I look forward to seeing how partnership through Water for Women continues to help us deepen our collective understanding and implementation of DNH as critical to leaving no one behind.

Authored by Di Kilsby, Gender and Social Inclusion Consultant to the Water for Women Fund

Di Kilsby is an independent Gender and Social Inclusion consultant with around three decades’ experience as a practitioner, trainer, researcher, facilitator and advisor, focusing on gender equality, social inclusion, children’s rights, and monitoring and evaluation in international development across Asia, Africa and the Pacific Islands. Di has been part of the GSI team with the Fund Coordinator team since project commencement, and is currently providing short term GSI inputs to the Fund.

About SNV

SNV is a not-for-profit international development organisation that makes a lasting difference in the lives of people living in poverty by helping them raise incomes and access basic services. SNV focuses on three sectors: agriculture, energy and water, sanitation and hygiene (WASH), and has a long-term, local presence in over 25 countries in Asia, Africa and Latin America.

About Water for Women

Water for Women is Australia’s flagship Water, Sanitation and Hygiene aid program supporting improved health, equality and wellbeing in Asian and Pacific communities through socially inclusive and sustainable water, sanitation and hygiene (WASH) Projects. Water for Women is delivering 18 WASH projects in 15 countries and 11 research projects over five years (2018-2022). The Fund supports regular knowledge and learning events with Fund partners to facilitate the cross-fertilisation of ideas and strategies.