While surveying the low income areas of southern Punjab in Pakistan, where she was to start a sanitation project, engineer Naheed Ghazanfar stopped by one of the houses to drink water. However, Ghazanfar was taken aback to see the women of house looking horrified as she drank an entire glass of water. When she asked the reason for their surprise, Ghazanfar was told that, no matter how thirsty they were, women in that area could never take the risk of drinking a full glass of water at one go during the day.

Surprisingly, it was not the quality of the water that compelled women to drink less of it, but their 'imprisonment by daylight'. With no toilets inside the house or in the village, women and girls must go to the nearby fields to relieve themselves. But modesty forbids them to do so during the daytime when they are in full view of men. They have no choice but to limit themselves to a few sips of water all day, so that they can wait until dark before needing to use the fields.

"Although water supply and sanitation programs are intended to benefit women, they have been largely invisible from the planning and implementation process. This is why their needs have never been incorporated," says Ghazanfar.
Ghazanfar, who studied 21 tehsils (blocks) in southern Punjab, considered one of the poorest areas in Pakistan, says that poverty is not the main cause of malnutrition among the women in that area. They have simply decreased their food intake to be able to 'hold on', at times for over 10 hours, before they can go out to the fields.

"The women are so hard on themselves. They ignore their health. Lack of proper nutrition exacerbates the situation. As a result, women look almost twice their age. Even if women want to do something about the sanitation facilities, there is no one to listen to them," contends Ghazanfar, who is also chairperson, Institute of Engineers, Islamabad.

In her study, which was presented at the second South Asian Conference on Sanitation (SACOSAN) in Islamabad earlier this year, Ghazanfar found that while women wanted toilets in the house, men considered it a wasteful expenditure. This lack of women's participation in decision-making in sanitation and related developmental programs has adversely affected the overall socio-economic development of Pakistan, Ghazanfar says.

According to her study, 80 per cent of rural households and over 18 per cent of urban households did not have toilets in the house. Using fields as toilets also creates a hygiene hazard, in addition to the health consequences for women.
Pakistan's Environment Ministry concedes that there are almost no public toilets in small and medium towns and villages. It also admits that this has impacted negatively on public health. However, government officials say that at the provincial level, the delivery of water and sanitation facilities is the responsibility of the local government.

Although Pakistan has reserved seats for women at the local government level, elected women members are rarely allowed to voice their opinions. Women councilors often feel marginalized as their presence is not considered meaningful. More often than not, proposals made by women councilors are shot down despite the availability of funds, says Ghazanfar.

She contends that women and girls can be trained in the installation and construction of toilets. In fact, a woman will be able to earn more as a plumber than she can by embroidery or cotton picking in the fields. But woman are not encouraged to take up this profession because it would affect the wages and employment of the men.

"The government doesn't realize what it is losing by marginalizing the role of women from the entire process," says activist Perween Rehmani. According to her, unless the voices of women are heard and heeded, any effort made to improve sanitation facilities will be incomplete as it will not incorporate their needs. However, once their suggestions are incorporated into the process, women can bring a dramatic turnaround in their own health and that of the community.

This is why the Orangi Pilot Project-Research and Training Institute (OPP-RRT), a non- government organization based in Karachi, focused on women. Rehmani, who is the director of OPP-RRT, says when they began their work in the low income rural area on the outskirts of Karachi, there were several problems. As this settlement of one million people is not recognized by the government, it is unplanned and lacks proper sanitation facilities. Not surprisingly, as far as health was concerned, women were the worst affected.

Rehmani and her team decided to motivate the women to come forward with their suggestions. Although it took them some time to raise awareness of the importance of proper sanitation and hygiene and the impact it would have on their health and that of their families, women began to show interest.

A low cost sanitation programme to lay lanes and secondary sewers was initiated in partnership with the community. "The community became involved because the women were motivated. The women contributed their own resources, whatever little they could. This helped to strengthen the social process required to bring about change. Therefore, I would attribute the success of the programme, which is now being replicated in Rawalpindi, Lahore and Faisalabad, largely to the efforts of the women," says Rehmani.

The Pakistani government has formulated a national sanitation policy that envisions a hygienic and defecation-free environment. The policy, which is awaiting approval from the Cabinet, also promises to create mechanisms to ensure the involvement of women. However, until then, women will continue to be `imprisoned by daylight'.