Thursday, April 3, 2025

WASH Is Power: Why Water, Sanitation, and Hygiene Must Lead the Global Development Agenda

Author : AM Tris Hardyanto


 WASH is not just about water or toilets—it’s about power, dignity, and survival. Behind every broken pipe and missing toilet is a deeper story of injustice, inequality, and silent suffering. Over 3 billion people are still denied their basic human right to clean water and sanitation. This isn’t a technical glitch—it’s a global failure. It’s time we see WASH for what it truly is: a fight for justice.

1.   WASH Is Not Just a Sector, It Is a Struggle for Justice

Water, sanitation, and hygiene (WASH) are indispensable components that transcend technical amenities; they embody a fundamental struggle for justice, dignity, and health. The framing of WASH as a mere sector often obscures its role as a critical intersection of political, economic, and ethical dimensions that shape the lives of billions. The dire global statistics underscore the necessity of reframing—over 2 billion people lack access to safe drinking water, while 3.6 billion are without adequate sanitation services. These figures reflect systemic policy failures and inequities rather than mere accidents of geography or demographics, as pointed out in various studies (Suryani et al., 2023; Behnke et al., 2018).

The implications of inadequate WASH services are profound; they are linked to higher rates of infectious diseases, increased poverty, and social exclusion. A systematic review highlights that subpar hygiene practices and inadequate sanitation in humanitarian settings lead to elevated health risks, particularly in refugee camps (Ramesh et al., 2015; Shannon et al., 2019). Systemic neglect must be met with a robust global response, prioritizing WASH within the broader framework of sustainable development goals (SDGs), precisely Goal 6, which emphasizes universal access to WASH (Suryani et al., 2023; Behnke et al., 2018).

The current article serves as a clarion call, not just to acknowledge the importance of WASH but to explore how it serves as a frontline defence against disease and exclusion. Elite interests and political manoeuvres often attempt to capture and commodify WASH systems, leading to discrimination and inequitable service delivery (Chirgwin et al., 2021; Al-Hamawi et al., 2025). Addressing WASH issues is, therefore, not merely a humanitarian imperative; it is a matter of justice, deserving of prioritization in global development agendas.

One compelling illustration of these dynamics can be observed in the challenges faced by refugees, particularly those in camps with limited resources. A scoping review on infectious disease prevention in crisis-affected settings highlights that inadequacies in WASH services correspond with increased disease prevalence, such as cholera in refugee camps (Polonsky et al., 2021). Furthermore, systematic reviews indicate that improving sanitation infrastructure leads directly to better health outcomes, thereby underscoring WASH's role as a catalyst for social transformation (Ramesh et al., 2015; Taylor et al., 2015).

In uncovering the hidden power dynamics within WASH, it becomes evident that issues surrounding access and equity are not merely technical problems but are deeply intertwined with governance, resource allocation, and societal values. The urgency of the situation demands robust advocacy for reform, inclusive participation in decision-making, and a determination to eradicate the barriers faced by displaced and marginalized populations (Altare et al., 2019); (Saifee et al., 2021;

Consequently, public health narratives must begin to prioritize WASH as foundational to health equity and social justice. As evident in research conducted in refugee camps, successful WASH interventions typically involve not only infrastructural improvements but also community engagement and education (Mahamud et al., 2011; Shapna et al., 2023). Such participatory approaches can foster a sense of ownership among beneficiaries, leading to sustainable improvements in hygiene behaviours and overall health outcomes.

Moreover, the COVID-19 pandemic has amplified the vulnerabilities faced by those living in concentrated settings, such as refugee camps, highlighting the interconnected nature of health and WASH services. Studies indicate that during the pandemic, inadequate WASH practices exacerbated the spread of the virus among vulnerable populations (Saifee et al., 2021; Bohnet & Rüegger, 2021). Hence, integrating WASH standards into emergency response strategies has become critical (Kabir et al., 2020).

Looking forward, the implications are clear: advancing the WASH agenda requires a comprehensive understanding of its relevance within the broader global discourse on human rights and social equity. Involves a commitment not only to increasing funding for WASH initiatives but also to ensuring that these efforts are inclusive and responsive to the needs of the most marginalized (Suryani et al., 2023; Hossain, 2021; Stout et al., 2025). Only through such an approach can we truly harness the power of WASH to facilitate health and uphold the dignity of the excluded.

 

2.  What Is WASH? An Overview of Water, Sanitation, and Hygiene

Water, sanitation, and hygiene (WASH) represent an integrated approach essential for promoting public health, enhancing quality of life, and achieving sustainable development. Each component—water, sanitation, and hygiene—plays a significant role in preventing disease transmission and fostering social equity. Specifically, access to safe and reliable drinking water is fundamental to human survival and well-being, impacting various dimensions of life, including physical health, economic productivity, and educational advancement (Suryani et al., 2023; Behnke et al., 2018).

2.1 Water: The Essence of Life

Water serves as a critical resource for daily life, underpinning health and hygiene. The provision of safe drinking water is necessary to avert waterborne diseases, which remain prevalent in regions with inadequate water infrastructure. According to the World Health Organization (WHO), approximately 2 billion people still lack access to safely managed drinking water services (Ramesh et al., 2015). Access to clean water not only reduces the incidence of disease but also facilitates improved nutrition and hydration, which are vital for overall health. Moreover, evidence illustrates that safe water sources significantly decrease the incidence of diarrhoea and other gastrointestinal illnesses (Shannon et al., 2019). Therefore, effective water management policies are pivotal to ensuring health equity and resilience, particularly in marginalized communities.

 

2.2 Sanitation: A Pillar of Public Health

Sanitation, defined as the safe management of human waste through the use of toilets and proper waste disposal systems, is equally crucial. Inadequate sanitation leads to significant public health challenges, including the spread of infectious diseases. The United Nations reports that without proper sanitation facilities, around 3.6 billion individuals lack access, leading to adverse health impacts and social consequences such as exclusion from educational and economic opportunities (Chirgwin et al., 2021). Furthermore, improved sanitation practices contribute to reducing mortality rates, particularly among children under five, as they are particularly vulnerable to diseases related to poor sanitation (Al-Hamawi et al., 2025; Polonsky et al., 2021). Comprehensive sanitation systems, therefore, play a critical role in mitigating the public health burden associated with unsafe waste disposal.

 

2.3 Hygiene: Behavioral Practices for Health

Hygiene encompasses practices that promote health and prevent disease transmission, including handwashing, menstrual hygiene management, and safe food handling. Handwashing with soap is one of the most effective measures for preventing infectious diseases, as it significantly reduces the transmission of pathogens responsible for illnesses such as diarrhoea and respiratory infections (Taylor et al., 2015). Studies show that proper handwashing at critical times can reduce the incidence of diarrhoea by up to 30% and respiratory infections by approximately 20% (Altare et al., 2019). In contexts where access to clean water is constrained, promoting effective hygiene behaviours becomes imperative for improving public health outcomes, especially during health crises such as pandemics, where the risk of disease transmission is heightened (Saifee et al., 2021).

 

2.4 Interconnectedness of WASH Components

The interdependence of water, sanitation, and hygiene highlights that addressing these components individually is insufficient; they must be integrated for optimal health impact. For example, the efficacy of sanitation systems is heavily reliant on the availability of safe water for hygiene practices such as handwashing (Mahamud et al., 2011). Evidence indicates that combined WASH interventions are more successful in reducing disease incidence than isolated efforts (Shapna et al., 2023; Bohnet & Rüegger, 2021). The synergistic effect of WASH initiatives not only improves health outcomes but also empowers communities, particularly women and girls, who often bear the brunt of inadequate WASH facilities due to the associated health risks and societal stigmas concerning hygiene (Kabir et al., 2020).

Moreover, economic analyses suggest that improved WASH facilities lead to substantial economic benefits by reducing healthcare costs, increasing productivity, and enhancing educational opportunities. For instance, investments in WASH infrastructure have been shown to yield a return of $4.3 for every dollar spent due to decreased healthcare costs and increased economic productivity (Hossain, 2021). Thus, prioritizing WASH is not only a moral imperative but also a strategic investment for sustainable development.

 

2.5 Challenges and the Path Forward

Despite WASH's recognized importance, considerable challenges remain in achieving universal access. These challenges include inadequate governance, resource allocation, and ongoing disparities in access, particularly in low-income and marginalized communities. Additionally, ongoing crises such as climate change and pandemics exacerbate existing vulnerabilities, highlighting the urgency for resilient and responsive WASH policies (Stout et al., 2025).

To address these challenges, it is critical to advocate for integrated WASH policies that promote equitable access and participation from affected communities. Engaging stakeholders and fostering collaboration among governments, NGOs, and the private sector can help overcome barriers and implement effective WASH programs that reflect local realities (Pirc et al., 2016).

In conclusion, WASH is a multifaceted sector that encapsulates the essence of public health, equity, and sustainable development. By recognizing the interconnectedness of its components—water, sanitation, and hygiene—global efforts can be mobilized to enhance health outcomes, foster social inclusion, and drive economic growth. To achieve these goals, collective action and strong political commitment are essential in elevating WASH within the global development agenda.

 

3.  Why Is WASH Urgent Now?

The urgency surrounding Water, Sanitation, and Hygiene (WASH) issues has reached a critical juncture, necessitating immediate attention and action from global leaders, policymakers, and communities alike. Every day, approximately 700 children succumb to preventable diseases due to unsafe water and poor sanitation conditions (Suryani et al., 2023). Staggering statistic serves as a poignant reminder of the dire consequences of neglecting WASH infrastructures and highlight the need for prioritization in both development agendas and humanitarian responses.

 

3.1 Health Implications of WASH Deficits

The persistence of diseases such as cholera and typhoid underscores the direct health implications of inadequate WASH facilities, particularly in marginalized communities where the burden is disproportionately felt (Behnke et al., 2018; Ramesh et al., 2015). Cholera—notably endemic in areas with compromised sanitation—claims thousands of lives annually, predominantly affecting the most vulnerable populations, including children under five (Shannon et al., 2019). Evidence indicates that cholera bacteria thrive where cleanliness and safe drinking water are lacking, further illustrating the immediate need for robust WASH interventions (Chirgwin et al., 2021). Similarly, typhoid fever remains a recurrent threat, emphasizing that without fundamental improvements in water quality and sanitation systems, outbreaks are unavoidable and devastating (Al-Hamawi et al., 2025).

 

3.2 Climate Change and WASH Vulnerability

Furthermore, climate change has intensified challenges related to water scarcity, exacerbating sanitation breakdowns globally. Increasing instances of extreme weather events, such as floods and droughts, disrupt essential water supplies and sanitation services (Polonsky et al., 2021; Taylor et al., 2015). Environmental stress has a remarkable impact on communities in low- and middle-income countries.

 

3.3 Social Inequities Magnified by WASH Deficiencies

The inequities inherent in WASH access have further implications, reflecting and magnifying broader social injustices within society. Marginalized groups, including women, children, and refugees, are disproportionately affected by inadequate WASH services, which often lead to reduced educational opportunities, increased health risks, and social exclusion (Altare et al., 2019; Saifee et al., 2021). For instance, the presence of functional school sanitation facilities significantly correlates with female students' attendance and dropout rates during menstruation, highlighting gender-specific barriers exacerbated by WASH deficits (Mahamud et al., 2011). Therefore, addressing WASH inequities is not only a matter of health but also a fundamental human rights issue, intertwining with broader social justice initiatives (Shapna et al., 2023).

Despite the pressing urgency to address WASH challenges, these issues remain underfunded and under-prioritized within national and international frameworks. The global investment gap in WASH remains substantial, with rising costs and economic downturns further complicating funding efforts (Bohnet & Rüegger, 2021). National development strategies must incorporate WASH priorities as central components of health systems, recognizing that comprehensive WASH initiatives will also yield economic and educational returns, thus catalyzing broader growth (Kabir et al., 2020).

 

3.4 Call to Action for WASH Integration

To combat these escalating challenges, it is essential to centre WASH within national development strategies and constitutional law. Integration necessitates a commitment to allocate resources and collaborate across multiple sectors—government, civil society, and private stakeholders (Hossain, 2021). Engaging communities in participatory WASH initiatives can foster ownership and responsibility for local improvements, ensuring that interventions are contextually relevant and sustainable (Stout et al., 2025).

Public dialogue and discourse surrounding WASH must also be amplified. By raising awareness about the critical impacts of inadequate water, sanitation, and hygiene access, collective action can be mobilized to advocate for necessary reforms (Pirc et al., 2016). Initiatives can be structured to transparently address financial and governance issues, ensuring that WASH is no longer relegated to the background of development agendas but prioritized as a universal right (Chen et al., 2024).

 

3.5  A Collective Responsibility

In conclusion, the imperative to address WASH concerns has never been more urgent. The convergence of health crises, environmental challenges, and social inequities requires a cohesive response that prioritizes water, sanitation, and hygiene as integral to public health and human development. Addressing these challenges is not merely a duty of affected communities but a global responsibility to uplift the most vulnerable and create a healthier, more equitable world for all.

 

4.  WASH Is More Than Infrastructure—It is a System

Water, Sanitation, and Hygiene (WASH) is often perceived mainly as a matter of infrastructure, emphasizing the importance of physical components like pipes, pumps, toilets, and treatment plants. However, a comprehensive understanding of WASH reveals that successful interventions go beyond these tangible aspects, encompassing behavioural change, governance structures, and social equity (Tseole et al., 2022) (Neto, 2018). Recognizing WASH as a multifaceted system is critical for developing sustainable solutions that genuinely enhance public health and welfare.

 

4.1 Integrated WASH Systems: A Comprehensive Approach

The effectiveness of WASH systems necessitates an integrated approach that combines hardware, such as infrastructure, with software components, including community engagement and behaviour change strategies. Sustainable access to WASH services means ensuring that systems are long-term, affordable, and resilient, adaptable to both environmental and societal changes (Ahmed et al., 2021); (Dreibelbis et al., 2013). Such sustainable systems are vital in the face of escalating climate challenges and shifting demographics that demand innovative approaches to water and sanitation provision.

One key aspect of achieving sustainable WASH is inclusive design. Facilities must cater to the needs of various demographics, including women, girls, individuals with disabilities, and economically disadvantaged groups. For instance, designing latrines that are accessible to all can dramatically improve the utilization rates of sanitation facilities (Wu & Wang, 2010). Studies indicate that inclusive WASH policies not only provide equitable access but also enhance community resilience and engagement, contributing to better long-term outcomes (Tseole et al., 2022).

Another crucial component of an effective WASH system is local ownership, which fosters community-driven planning and accountability. Community involvement not only empowers individuals but also engenders a sense of responsibility towards maintaining the infrastructure and adhering to hygienic practices (Coffeng et al., 2018; Dalisay et al., 2024). Local ownership can be achieved through participatory approaches that engage communities in the decision-making process, resulting in solutions that are both contextually relevant and culturally sensitive.

Moreover, policy integration across sectors is fundamental for fostering an effective WASH system. WASH considerations should permeate various ministries, from health to urban planning, to ensure coherent strategies that align with national and local development plans (Nyambe & Yamauchi, 2021). Integration can facilitate resource allocation, improve service delivery, and enhance the overall efficiency of health and education interventions tied to WASH improvements (Humphrey et al., 2019).

For instance, schools equipped with robust WASH facilities not only contribute to better health outcomes but also enhance children's educational experiences and performance. Research shows that improved WASH conditions in schools correlate with higher attendance and reduced dropout rates, particularly among girls during menstruation (Lehmann, 2010; Morgan et al., 2017). Thus, integrating WASH policies into educational frameworks can yield significant benefits in terms of student engagement and learning outcomes.

 

4.2 Behaviour Change: The Soft Side of WASH

Behaviour change is another vital component of a successful WASH system. It is not enough to provide hardware if individuals do not adapt their practices to utilize the facilities effectively (Dreibelbis et al., 2013). Initiatives that promote handwashing, safe food handling, and menstrual hygiene management are essential for maximizing the health impact of WASH interventions. The Integrated Behavioral Model for Water, Sanitation, and Hygiene (IBM-WASH) emphasizes understanding contextual factors that mitigate or enable these behaviours (Dreibelbis et al., 2013).

Education campaigns must be sensitive to local cultures and social norms, enhancing participation and compliance (Abendroth & Jensen, 2003). For example, training community leaders and engaging local advocates can heighten awareness and willingness to adopt new sanitation practices (Momberg et al., 2020). Evidence suggests that community-led approaches, including social marketing techniques, can effectively shift attitudes and behaviours surrounding hygiene and sanitation (Momberg et al., 2020).

4.3 Governance: The Framework for Effective Implementation

Effective governance structures also play a crucial role in the implementation and sustainability of WASH projects. Policies must be underpinned by strong regulatory frameworks that ensure equitable access and maintain service quality (Setyono et al., 2018). Governance extends beyond policy formulation; it encompasses the monitoring and evaluation of WASH services to ensure compliance and address emerging challenges. Inefficient governance can result in stalled progress and inequitable service distribution, particularly in low-income regions where the need is greatest (Brouwer et al., 2022).

The establishment of multi-sectoral partnerships can enhance WASH's governance landscape. Collaborative efforts among governmental entities, non-governmental organizations, and private sector partners can stimulate innovation and resource sharing. Such partnerships can result in comprehensive WASH programs that address not just infrastructural needs but also the underlying socioeconomic factors that contribute to inadequate service provision (Humphrey et al., 2019).

 

4.4  Engineering and Empowerment in WASH

In conclusion, WASH is far more than just the infrastructure; it is an intricate system that weaves together physical, behavioural, and governance aspects to deliver sustainable, equitable services. Achieving WASH success hinges on recognizing the necessity of sustainable access, inclusive design, local ownership, and policy integration. With these elements in mind, it becomes evident that investments in WASH are not merely expenditures on infrastructure but strategic interventions that promote health, dignity, and empowerment across communities.

 To truly enhance WASH systems globally, it is imperative to adopt a holistic approach that encompasses both engineering and empowerment, ensuring that every individual has access to safe water, adequate sanitation, and the knowledge necessary to maintain high standards of hygiene.


5.  The Academic Foundations: A Science-Driven Sector of WASH

Water, Sanitation, and Hygiene (WASH) is not merely a sector characterized by infrastructure; it is a multidimensional domain that intersects multiple disciplines, making it a science-driven sector critical to public health and societal well-being. Understanding the complex nature of WASH requires examining its foundations in public health, engineering, environmental science, social sciences, and policy and governance. Intersectionality enhances the efficacy of WASH initiatives and highlights the imperative to adopt a holistic approach to overcome contemporary challenges.

5.1 Public Health: The Core of WASH

At the forefront of WASH is public health, wherein WASH interventions serve as essential mechanisms for disease prevention, nutritional improvement, and maternal health enhancement. The intricate relationship between poor sanitation and the prevalence of diseases like cholera and typhoid underscores the necessity of a robust WASH system. For instance, a randomized controlled trial conducted in rural Bangladesh demonstrated that improving sanitation access could significantly reduce the incidence of diarrheal diseases Parvez et al., 2021). Furthermore, adequate water supply and sanitation facilities directly correlate with improved maternal health outcomes, highlighting WASH's role as a vehicle for enhancing overall public health in vulnerable populations (Amaral, 2022).

 

5.2 Engineering: The Backbone of Infrastructure

Engineering disciplines provide the necessary framework for designing and constructing adequate WASH infrastructures such as water treatment facilities, sewage systems, and hygienic toilets. These structures must not only meet basic functional requirements but also ensure safe and efficient resource management and pollution control. The application of innovative engineering solutions in water treatment can dramatically improve water quality, making it accessible and safe for consumption. Moreover, the design of public sanitation systems needs to accommodate the surrounding environment while being sustainable in the long run. Studies have indicated that well-engineered systems benefit immensely from adaptive management practices that consider local hydrology and community needs (Dawkins et al., 2024).

 

5.3 Environmental Science: Resource and Pollution Management

Environmental science is integral to understanding the dynamics surrounding water resources and the ecological impacts of sanitation practices. Effective resource management is pivotal for maintaining water quality and ensuring the sustainability of water supply in the face of growing environmental challenges and climate change. Scientific assessments have shown that integrated watershed management offers a more holistic approach to resource management, particularly in regions threatened by pollution and over-extraction (Kayingo et al., 2022). field contributes valuable insights that inform better policies and practices aimed at mitigating pollution and enhancing the resilience of water and sanitation systems.

 

5.4 Social Sciences: Addressing Behavioral and Equity Issues

The role of social sciences in WASH is crucial for understanding human behaviour, gender disparities, and issues of inclusion and access. WASH interventions must consider the social dynamics that influence people's attitudes and practices regarding sanitation and hygiene. For example, behaviour change initiatives that promote handwashing and safe hygiene practices have been shown to significantly improve health outcomes in communities (Langenmayr et al., 2024; Rohim & Wulandari, 2019). Additionally, the social construction of gender significantly impacts access to WASH services, where women and girls often bear the brunt of inadequate sanitation facilities, leading to increased vulnerability and health risks (Moreno et al., 2023). Thus, incorporating social science perspectives is essential for designing equitable and inclusive WASH programs.

 

5.5 Policy and Governance: Frameworks for Implementation

Effective governance and strong policy frameworks are fundamental to the implementation and sustainability of WASH initiatives. Policies must be inclusive and focused on addressing inequities in access while ensuring adequate funding and resource allocation across sectors. The integration of WASH considerations into existing public policies requires a concerted effort across various levels of government and civil society organizations. For instance, governance structures that emphasize accountability and local participation can lead to improved service delivery and community trust. As scholars argue, decentralized governance enhances responsiveness to local needs, thereby fostering better implementation of WASH policies (Burns, 2021; Cespedes et al., 2022).

 

5.6 WASH as a Science-Backed, People-Centered Imperative

To summarize, WASH stands at the intersection of multiple scientific disciplines, making it a robust and essential aspect of public health and societal development. By integrating public health insights, engineering advancements, environmental sciences, social sciences, and strong policy frameworks, WASH can effectively address the complex challenges faced today. Stakeholders must recognize WASH not merely as infrastructure but as an interconnected system requiring a comprehensive approach to service delivery.

The evolving challenges posed by climate change, urbanization, and health emergencies underline the importance of a science-driven and people-centred approach to WASH. As we move towards achieving global health equity and ensuring dignified living conditions for all, leveraging WASH's interdisciplinary nature will catalyze meaningful changes in health outcomes and quality of life across communities.

 

6.  Where  Series Will Go

The impending series aims to unravel the intrinsic issues within the Water, Sanitation, and Hygiene (WASH) framework by presenting cases that illustrate how WASH failures are symptomatic of deeper systemic problems. The forthcoming exploration will reveal that these failures are not merely due to a lack of knowledge regarding WASH implementation but instead stem from underlying factors such as power dynamics, neglect, and social injustices entrenched within the systems governing these vital services.

 

6.1 Case Study Overview: South Africa's Sanitation Crisis

The initial article of the series, titled "Toilets, Contracts, and Capture: The Hidden Cost of Corruption in South Africa's Sanitation Crisis," will spotlight a particularly damning illustration of WASH's failings in South Africa. Here, the narrative will focus on the tragic circumstances surrounding vulnerable populations, exemplified by children falling into poorly maintained pit latrines. Dramatizes the broader implications of a sanitation crisis driven by corrupt practices whereby powerful elites exploit toilet contracts for personal gain, turning sanitation—a fundamental human right—into a commodity tied to political capital. The case will underscore how poverty intersects with corruption, creating dire public health consequences and suffering for marginalized communities Ramesh et al. (2015).

6.1.1 The Power of Politics in WASH

The sanitation crisis in South Africa serves as a stark reminder of how power relations can dictate the quality and availability of essential services (Pande et al., 2018). Corruption in the awarding and management of sanitation contracts can result in substandard facilities being constructed, significantly impacting public health outcomes. Ultimately, it reflects broader societal inequities where access to safe sanitation becomes a privilege rather than a right (Eurien et al., 2021). The nexus between sanitation infrastructure, economic interests, and political capture raises critical questions regarding accountability and citizen engagement in the management of WASH resources.

6.1.2 Understanding Disease Outcome Correlates

Moreover, analyzing the implications of WASH failures on disease incidence offers further evidence of the urgent need for reform. Regions afflicted by substandard sanitation facilities often experience heightened risks of waterborne diseases such as cholera and typhoid fever, which disproportionately affect those living in impoverished conditions. For instance, outbreaks of cholera have been traced to drinking water contaminated by faecal matter, underscoring the critical importance of credible sanitation infrastructure and governance (Pande et al., 2018; Eurien et al., 2021).

As cases of cholera demonstrate, the occurrence of such outbreaks can be exacerbated by inadequate responses from health authorities, often influenced by political corruption that favours profit over public welfare. The cholera outbreak triggered by contaminated water sources in Uganda illustrates how compromised infrastructure leads to devastating outcomes for communities already afflicted by poor sanitation conditions (Hoffman et al., 2023).

6.1.3 Accountability and Governance in WASH

The forthcoming article will argue for a sustainable and accountable approach to WASH governance wherein the experiences of affected communities drive the policy framework. The case study on South Africa will highlight the implications of neglect and corruption, but will also focus on potential solutions rooted in local community engagement and improved transparency in the management of WASH resources. As recent studies indicate, community participation is paramount in ensuring equitable access to sanitation and hygiene facilities and in fostering accountability among service providers (Poulos et al., 2011; Zhan et al., 2023).

Moreover, the investigation emphasizes the necessity of a rigorous approach to monitoring the efficacy of WASH interventions, including regular assessments of infrastructure quality and accessibility, to ensure persistent improvement in public health outcomes (Chakraborty et al., 2024). aligns with the critical need for integrated strategies that address not only physical infrastructure needs but also the underlying socio-political determinants of health.

 

6.1.4 Moving Forward: A Call to Action

As we prepare to dive into these vital discussions, the intent is to build momentum around the importance of centring WASH in policy debates and development strategies. By drawing attention to real-life implications—and the often invisible cost of corruption and neglect—the series aims to mobilize advocates, policymakers, and communities toward joint action. Addressing the disparities in WASH access stands as a testament to our ethical commitment to human rights and global health equity.

 

6.2 Water for Profit: How Jakarta's Poor Paid the Price of Privatization

The narrative of water provision in Jakarta, Indonesia, serves as a compelling case study illustrating the far-reaching ramifications of privatization in essential public services. The move to privatize the water supply was intended to attract investment and improve service delivery but has instead exacerbated inequalities, leaving marginalized populations to bear the brunt of a system that profits privatized interests rather than serving community needs. As the article will explore, the privatization of water in Jakarta has had profound repercussions on poor households, leading to critical questions about whether remunicipalization could offer a pathway to justice.

6.2.1 The Promise of Privatization

When global water corporations were invited to manage Jakarta's water supply, promises were made regarding enhanced efficiency, expanded access, and improved infrastructure. However, the privatization efforts resulted in a stark dichotomy between affluent and impoverished communities. Initial studies shed light on the dichotomy, indicating that while wealthier neighbourhoods enjoyed improved water services, poorer communities faced increased tariffs and subpar infrastructure Leong, 2015). The structural inequities embedded in privatized water management reveal a troubling truth: profits were prioritized over equity, fundamentally undermining the objectives of improved service delivery and universal access.

The privatization model has not only shown limited success in generating fairness in service provision but has, in many instances, led to reduced accountability and transparency in operations. Reports have indicated that financial mismanagement, corruption, and inefficiencies have marred many private-sector initiatives, resulting in water supply shortages and quality issues for low-income families, who are often left without recourse (Tariq & Zhang, 2021). Thus, while the promise of better water delivery lingered on the horizon, the reality for many Jakarta residents was deterioration in both access and quality.

6.2.2 The Impact on Poor Households

As Jakarta's water privatization unfolded, its most vulnerable citizens paid the steepest price. Poor households relying on piped water face exorbitant rates, driving them to seek alternative sources, which are often contaminated and unsafe. For instance, studies indicate that communities in less affluent areas lacked reliable access to clean drinking water, leading to an uptick in waterborne diseases, including cholera (Waturangi et al., 2013). The paradox of privatization thus became evident: the very model thought to enhance service delivery ended up exploiting those least able to afford it.

The systemic neglect witnessed amidst privatized schemes further aggravated social issues, such as increased family financial burdens and diminished health outcomes. Community members from affected neighbourhoods reported significant economic strains due to high water tariffs, exacerbating the cycle of poverty and limiting access to basic hygiene practices (Firdaus et al., 2023). For families already grappling with economic hardships, the added financial burden of accessing clean water served as a debilitating factor, uprooting their livelihoods and overall well-being.

6.2.3 Speculative Urbanism and Environmental Costs

Beyond the immediate financial implications, the privatization of water in Jakarta intersected with broader themes of speculative urbanism. As private entities sought to profit from water supplies, the socio-environmental impacts were palpable. Urban algal blooms, deteriorating freshwater quality, and rising flood risks are just a few of the environmental challenges exacerbated in the wake of privatized management, where short-term profits overshadow long-term environmental sustainability (Colven, 2022). The speculative nature of urban management—prioritizing development projects for private gain—threatens to dismantle the ecological foundations necessary for sustainable community living.

In essence, the drive to commodify water resources resulted in severe social inequities and significant environmental degradation. Jakarta's struggle with pollution from industrial effluents and urban runoff highlights the critical need for better environmental governance frameworks that integrate water management with comprehensive urban planning strategies.

2.2.4 Remunicipalization: A Path to Justice?

Given the challenges that privatization has posed, discussions surrounding remunicipalization have gained traction as a potential remedy for Jakarta's water crisis. Remunicipalization refers to the process of returning water services to public control, advocating for more equitable management practices that prioritize community needs rather than profit motives. Early evidence from other cities globally suggests that remunicipalization can lead to improved service delivery, greater accountability, and more inclusive decision-making processes (Tariq et al., 2019; Wu & Leong, 2013).

Re-establishing public control of water services could pave the way for reforms that ensure basic water access as a human right, fostering trust and engagement between communities and governmental bodies. Participatory governance models, which include community input in decision-making, could empower citizens to reclaim their right to safe drinking water, creating avenues for enhanced service quality and reduced public health risks.

Furthermore, for remunicipalization to be effective, it must be accompanied by comprehensive policy frameworks that prioritize equity and transparency. Involves not only re-evaluating current pricing models but also investing in infrastructure upgrades that address the systemic disparities experienced by poorer neighbourhoods. The potential for localized solutions is evident; studies have shown that community-based structures are effective in promoting equitable access while strengthening local capacity for sustainable management (Lubis et al., 2024).

2.2.5  Conclusion: A Call for Systemic Change

In summary, the privatization of Jakarta's water services illustrates the troubling outcome of prioritizing profit over public welfare. As poor households have borne the cost of failed privatization schemes, the urgent need for systematic change grows clearer. Remunicipalization poses a viable path toward justice, offering a framework for addressing the inequities entrenched in current management structures.

However, achieving meaningful change requires commitment from all stakeholders, grounding solutions in community needs, environmental considerations, and transparent governance. As the article highlights, the intersection of social, environmental, and economic factors within the water sector is critical in shaping a more just and sustainable future for Jakarta's residents, ensuring that water is managed as a public good, accessible to all, with the well-being of communities at its core.

 

6.3 Toilets Without Water: India's Caste Divide in the Age of Sanitation Missions

The narrative surrounding sanitation in India has often been celebrated for its ambitious targets, particularly in light of programs such as the Swachh Bharat Mission (SBM), designed to achieve an open-defecation-free nation. On paper, the metrics suggest impressive strides toward improved sanitation access; however, the lived realities of many communities, especially among marginalized populations, tell a different story—one of exclusion and systemic inequity. The article delves into how India's caste divide significantly impacts access to sanitation, illuminating a critical flaw in the country's sanitation missions.

6.3.1       The Illusion of Progress: Metrics vs. Reality

In recent years, India has purportedly made great strides in sanitation, with claims of over 100 million toilets built and significant reductions in open defecation rates. However, studies highlight that these achievements do not reflect the on-ground realities faced by many households, particularly those belonging to Scheduled Castes (SC) and Scheduled Tribes (ST). For instance, research indicates that households from these demographics utilize improved sanitation facilities 10% less than those from forward castes, further entrenching existing inequalities Kumar et al., 2024). While statistical improvements might commend governmental efforts, they often mask the lived experiences of many individuals who continue to lack adequate sanitation infrastructure.

Moreover, the focus on infrastructure often ignores the necessity of connecting toilets to a water supply, as sanitation without water renders these facilities nonfunctional. The critical aspect of water availability is frequently overlooked in sanitation metrics, leading to a façade of progress while systemic barriers continue to impede meaningful change for the most marginalized (Jain et al., 2023). Disconnect reveals the urgent need for a comprehensive approach that addresses not only toilet construction but also the vital necessity for a consistent water supply to enable their proper use.

6.3.2 Caste Dynamics and Sanitation Access

The existing sanitation framework in India remains heavily influenced by caste dynamics, with societal norms and deeply ingrained prejudices shaping access and utility. The neglect of marginalized communities in the allocation of sanitation resources reaffirms existing structures of exclusion. Dwelling space becomes a determinant of access, wherein poor rural and urban residents often lack private toilet facilities due to socioeconomic constraints (Jain et al., 2023). Such structural inequalities undermine the effectiveness of sanitation missions and exacerbate health disparities and social injustices.

Furthermore, while the construction of toilets is a positive step, it often fails to consider the socio-cultural barriers that influence sanitation practices. Initiatives must recognize that the caste system's pervasive influence affects not just access but attitudes toward sanitation and hygiene practices within the community. Reports reveal that many low-caste individuals still face stigmatization when utilizing sanitation facilities, which discourages adoption and contributes to the persistence of open-defecation practices (Shekhar, 2023).

6.3.3 The Role of Public Policy and Accountability

Public policy has a pivotal role in addressing the disparities entrenched in India's sanitation landscape; however, the SBM has been criticized for primarily focusing on infrastructure development without adequately addressing the associated socio-cultural issues (Curtis, 2019). Accountability mechanisms remain crucial in ensuring that sanitation efforts do not marginalize already disadvantaged groups. While SBM provides subsidies for toilet construction, insufficient oversight allows for discrepancies in the actual use and maintenance of these facilities, perpetuating cycles of exclusion (Sahoo et al., 2015).

Moreover, women face unique challenges related to sanitation access, often dictated by societal norms and expectations. A lack of decision-making power in sanitation-related issues exacerbates gender inequalities and restricts women's ability to advocate for necessary changes within their communities (Shekhar & Dwivedi, 2024). Addressing these gendered disparities requires a more integrative approach to sanitation policy, prioritizing gender-sensitive practices and emphasizing the importance of women's voices in decision-making processes.

6.3.4 Realizing True Sanitation Equity

The path to genuine equity in sanitation requires a multifaceted approach that combines the construction of safe, functional toilets with robust water supply systems and the promotion of water and sanitation (WASH) education. Efforts must recognize that sanitation challenges cannot be resolved through infrastructure alone; they require a thorough understanding of the socioeconomic and cultural contexts that govern these communities.

By addressing the overlaps between sanitation access and caste inequalities, India can work towards dismantling the systemic barriers that inhibit access. Engaging communities through participatory methods—where beneficiaries have a voice in the design and implementation of sanitation solutions—can foster a sense of ownership and accountability. An empowering approach is essential to ensure that sanitation interventions genuinely reflect the needs of all community members, particularly the marginalized (Dandabathula et al., 2019).

In conclusion, while India's sanitation missions may present statistics that appear favourable, they often obscure the profound realities of caste-based inequities. For actual progress to be realized, authorities must transcend mere metrics and commit to inclusive sanitation strategies that prioritize equity and social justice. Only then can the goal of a genuinely open-defecation-free India become a lived reality for all citizens, irrespective of their caste or social standing.

6.4 Lead in the Pipes, Silence in the Halls: The Flint Water Crisis and Racialized WASH Failure

The Flint water crisis emerged as one of the most significant public health emergencies in recent American history, revealing the intersection of environmental justice, systemic racism, and government negligence. The story of Flint, Michigan—a city plagued by contaminated drinking water and an ineffective government response—serves as a harrowing example of how public health crises disproportionately affect marginalized communities. Despite being part of a wealthier and ostensibly developed nation, Flint's residents faced a poisoned water supply and a silent government, which highlights broader issues of inequality embedded within the Water, Sanitation, and Hygiene (WASH) framework.

6.4.1 The Crisis Unfolds: A Breach of Trust

The Flint water crisis began in April 2014 when the city switched its water supply from Lake Huron to the highly corrosive Flint River, a decision made under a state-appointed emergency manager aiming to cut costs amid a financial downturn. Crucially, the water from the Flint River was not treated with anti-corrosives, resulting in lead leaching from ageing pipes into the drinking water Kruger et al., 2017; Reuben et al., 2022). The immediate impacts of the decision were profound, with residents reporting foul-smelling and discoloured water yet facing a deafening silence from local and state officials who failed to recognize or address the emerging issue until significant public health consequences were evident (Kruger et al., 2017; HeardGarris et al., 2017).

 Silence and lack of accountability revealed a systemic disregard for the predominantly Black and low-income population of Flint, exacerbating feelings of distrust towards governmental institutions. Many residents voiced concerns over not just the water quality but their broader safety, health, and economic well-being, which were further destabilized by governmental mismanagement (Lee et al., 2016; Brooks & Patel, 2020). The psychological impact of these experiences has been profound, contributing to increases in anxiety, depression, and stress-related disorders among community members (Brooks & Patel, 2020).

6.4.2 Neurodevelopmental Impacts and Long-Term Consequences

The public health repercussions of lead exposure in Flint cannot be overstated. Research has shown that childhood lead exposure leads to declines in cognitive function and behavioural problems, with long-term consequences such as lower academic performance and increased rates of behavioural disorders (Lee et al., 2022). The role of lead as a neurotoxin places Flint's children at an increased risk of enduring developmental challenges that they may carry into adulthood (Reuben et al., 2022). Furthermore, studies indicate that the crisis has triggered long-term impacts that may manifest in increased mental health issues and socioeconomic mobility challenges as these children grow up (Hammer, 2017).

Public health responses have often failed to address the depth of these issues adequately, revealing gaps in understanding the socioeconomic background of affected populations. Flint residents have experienced the compounded effects of systemic racism, environmental injustice, and economic hardship long before the water crisis emerged, leading to heightened vulnerability during and after the crisis (Key et al., 2024; Rosinger & Young, 2020). The attention paid to the immediate health impacts of contaminated water, while important, must be complemented by efforts to understand and mitigate these long-term consequences effectively.

6.4.3 Race, Class, and Environmental Justice

The Flint water crisis encapsulates a profound intersection of race and environmental justice, where governmental decisions exacerbated existing inequalities. Historical patterns of neglect towards communities of colour outline how decisions made at the state level failed to consider the voices of marginalized populations (Hammer, 2017). The Flint emergency manager's decision to switch water sources not only overlooked the potential health impacts but also sidelined community protests and concerns, leading to an exacerbation of distrust and disillusionment among residents (Lee et al., 2016; Stanley, 2016).

Community activism has been a critical response to failure, with Flint residents mobilizing to demand accountability and effective responses from their government. Grassroots organizations have played a pivotal role in amplifying community voices and advocating for necessary governmental changes, highlighting the importance of self-advocacy in the face of systemic neglect (Roy & Edwards, 2019). Still, the need for institutional reforms remains urgent, particularly in fostering governmental frameworks that prioritize the health and welfare of vulnerable populations.

6.3.4 Towards Resilience and Restorative Justice

The trajectory towards repairing the harm caused by the Flint water crisis involves more than merely restoring access to clean water; it requires a commitment to restorative justice that acknowledges historical wrongs and actively seeks to redress systemic inequality. The restorative approach necessitates active community engagement in policy formulation and implementation, ensuring that affected voices lead the way in promoting social equity (Foote & Leon, 2023). Furthermore, comprehensive public health strategies must prioritize long-term health monitoring and intervention programs to address the acute and chronic health effects experienced by Flint residents, particularly children who remain vulnerable to the impacts of lead exposure.

In addition, effective remediation measures hinge on integrating WASH policies with broader public health frameworks that account for the socioeconomic and racialized contexts of affected communities. Integration can enhance resilience and empowerment among residents, ensuring that their experiences and insights shape future interventions that strive for not only recovery but also meaningful systemic change (Rosen et al., 2017).

6.3.5 Conclusion: Lessons from Flint

The Flint water crisis is a glaring example of how failures in WASH infrastructure and governance can lead to devastating outcomes for marginalized communities. The interplay of toxic water, racialized neglect, and political indifference constitutes a public health tragedy that underscores the systemic need for reform in both water safety and public health policy. Policymakers must acknowledge the historical and contemporary factors contributing to such crises, leveraging the lessons of Flint to foster transparency, accountability, and justice in environmental management going forward.

Ultimately, the fight for clean water in Flint reflects a broader struggle for social justice, where the voices of marginalized communities must be at the forefront in shaping the narratives, policies, and practices that affect their lives. Addressing the inequities of the Flint water crisis demands a commitment that goes beyond remediation—it requires a fundamental reshaping of how society values and protects the health of all its members, re-establishing trust in the very institutions that are sworn to serve and protect.

 

6.5 Water Belongs to the People: Chile's Constitutional Battle Against Oligarchic Control

In recent years, Chile's water crisis has crystallized the fundamental struggle over access to water as a human right and the need for equitable governance of critical resources. The article explores the historical context of water privatization in Chile, particularly during the dictatorship of General Augusto Pinochet, and the mechanisms through which commodification has marginalized indigenous populations and vulnerable communities. At the heart of the issue lies a critical question: can drafting a new constitution reclaim water as a common good and address the systemic inequalities perpetuated by decades of oligarchic control?

6.5.1 Privatization and Its Consequences

In 1981, under Pinochet's regime, Chile implemented a neoliberal economic framework that introduced its notorious Water Code, establishing private ownership over water resources García-Bartolomei et al., 2022; Budds, 2013). transformation permitted water rights to be treated as tradable commodities, exacerbating inequalities and concentrating control within a few oligarchic entities. For indigenous communities, particularly farmers reliant on subsistence agriculture, this meant reduced access to water, leading to dire consequences for their livelihoods (Correa et al., 2020) (Sola et al., 2024). The water scarcity issues plaguing rural regions have fueled social discontent, highlighting the tensions between economic growth driven by mining interests and the rights of local populations.

Research indicates that neoliberal water policies have disproportionately affected marginalized groups, including indigenous farmers, who often lack formal water rights essential for accessing vital resources (Garreaud et al., 2017; Correa et al., 2020). The commodification of water has, therefore, not only restricted access but also undermined traditional practices tied to indigenous communities' cultural identity and agricultural sustainability.

6.5.2 The Drought and Its Impacts

Chile has been grappling with extreme drought conditions for over a decade, exacerbating the existing water crisis and highlighting the vulnerabilities of its water management systems (OcampoMelgar et al., 2021); (Salinas & Marín, 2023). Recent climatic analyses link prolonged drought to both human-managed changes in water allocation through privatization and environmental factors such as climate change (Jackson et al., 2019; Macpherson & Salazar, 2020). The interplay of these issues has heightened tensions surrounding water use among diverse stakeholders, leading to conflicts over water distribution and exacerbating inequality.

Furthermore, the drought has fueled calls for the re-evaluation of water policies and the urgent need for effective governance frameworks that prioritize community access rather than market-based solutions. As water scarcity intensifies, the need for a new constitutional approach that addresses both environmental sustainability and social equity has become increasingly apparent (Baer, 2017).

6.5.3 The Role of Social Movements

In response to the systemic oppression encountered under privatized water governance, various social movements have emerged, emphasizing water as a fundamental human right and a common good. These movements have mobilized public sentiment in favour of constitutional reforms aimed at ensuring equitable access to water resources. Notably, the 2019 nationwide protests that erupted in Chile catalyzed discussions about the necessity of a new constitution, framing water governance within a broader discourse of social justice and environmental stewardship (LozanoParra et al., 2021); (Garbe, 2022;

The prominent "water commons" agenda reflects the desires of communities to reclaim control over water resources through a collective governance model that emphasizes communal ownership and the collaborative management of water systems (Salinas & Marín, 2023). Indigenous groups have been instrumental in advocating for constitutional changes, seeking recognition of their rights to water resources and the protection of traditional practices that sustain their communities.

6.5.4 The Constitutional Process and Future Prospects

The constitutional process currently underway in Chile represents a historic opportunity to address the inequities perpetuated by previous water management policies. After the drafting of a new constitution, citizen consultations played a key role in articulating diverse perspectives on water rights and governance. Proposals to declare water a typical suitable and institutional mechanism for its equitable distribution have gained traction, fostering optimism that grassroots movements can reshape policy agendas (Aitken et al., 2016; Budds, 2013).

To effectively reclaim water rights for all, the new constitution must establish strong legal protections and institutional frameworks that prioritize community engagement, sustainability, and equity in water governance. Academic and policy discussions have emphasized the importance of incorporating indigenous perspectives and knowledge systems into broader water management strategies (Garbe, 2022; Alipour et al., 2018). Reconceptualization not only champions inclusivity but also recognizes the intrinsic connections between water, cultural heritage, and socioeconomic sustainability.

6.5.5   A Path to Equitable Water Governance

In conclusion, the fight to redefine water governance in Chile encapsulates broader struggles for social justice and environmental sustainability. The interplay between past injustices and present realities necessitates comprehensive reform that centres on participatory governance and recognizes water as a planetary common good.

As Chile navigates its constitutional battle, the outcomes will not only impact the nation but may set important precedents for addressing water rights and governance in similar contexts worldwide. Embracing a holistic approach that prioritizes equity, respect for Indigenous rights, and environmental resilience can pave the way for a more just water future—one that truly belongs to the people.

7.  Conclusion: Make WASH Political. Make It Public.

 Series has illuminated the multifaceted nature of Water, Sanitation, and Hygiene (WASH) as more than just infrastructure—it is a fundamental site of resistance, transformation, and social justice. The stories from South Africa, Indonesia, India, the USA, and Chile have showcased how WASH is entangled with issues of power, neglect, and inequality across different contexts. As we move forward, it is imperative to elevate the discourse surrounding WASH from the back rooms of bureaucracy to the frontlines of justice.

WASH is power; its control reflects a society's values and priorities. Communities that are deprived of access to clean water and sanitation are often marginalized and disenfranchised, facing systemic barriers that go beyond mere infrastructural inadequacies. These barriers are deeply rooted in socioeconomic disparities, historical injustices, and racial inequities, as evidenced in the case studies presented. The Flint water crisis exemplifies how vulnerable populations can bear the brunt of governmental neglect and systemic racism, leading to dire public health outcomes and diminished trust in institutions Kruger et al. (2017).

Furthermore, the stark realities faced by indigenous farmers in Chile and poor households in Jakarta reveal that water privatization and commodification have failed to serve the needs of the most vulnerable (Correa et al., 2020). The narratives of exclusion and disenfranchisement compel us to reassess our understanding of WASH as a human right—a right that must be claimed and defended through active civic engagement and structural transformation. Failing to recognize such disparities only perpetuates cycles of injustice, underscoring the need for communities to organize and demand accountability in public health policies that influence their lives.

Effective WASH governance must embrace political engagement and public discourse centred on human rights. As Gusmano et al. articulate, persistent inequalities in health services highlight the need for actionable policies that prioritize equity in health systems (Gusmano et al., 2017). The lesson from Flint and the privatization failures in Chile signal the necessity to transform WASH into an active political issue rather than a mere administrative concern. Through advocacy and grassroots movements, communities can shift the narrative around WASH from a state of neglect to one that prioritizes access, inclusion, and agency.

Moreover, the potential for remunicipalization in places like Jakarta lays bare the opportunity for communities to reclaim ownership of their water resources, ensuring that they are managed for collective benefit rather than profit (OcampoMelgar et al., 2021). Similarly, the ongoing constitutional debate in Chile reflects an emerging recognition that water belongs to the people and that their rights must be enshrined in law to overcome the legacy of oligarchic control (Sola et al., 2024).

In conclusion, it is essential to activate WASH as a political topic through collective mobilization that emphasizes the need for equitable access, participatory governance, and social justice. Only then can we begin to dismantle the systemic structures that render water a privilege rather than a right. WASH is undeniably a cornerstone of public health, but it also embodies the larger struggle for justice in society. By standing together, demanding change, and advocating for the rights of all individuals to access clean water and sanitation, we can begin to create a future where WASH serves as a mechanism of empowerment rather than exclusion.


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