Samantha Winter has a master’s in civil and environmental engineering, but the Center for African Studies scholar and social work Ph.D. candidate is becoming much more familiar with social work than science these days.
Winter is being hosted by the University of Nairobi on a Boren fellowship and living in Kenya to carry out her research on women’s sanitation culture in informal settlements in the area. In other words, she’s examining which factors—individual, familial, communal, societal, technological, or accessibility and availability—most influence how women select among available sanitation facilities.
“I’m an engineer…but when I visited these areas, I realized the issues aren’t just about technical needs—it’s about the people,” she said. “People who can’t afford public housing…where most [shelters] are made of iron sheets and cardboard. It’s not always feasible to just build a toilet.”
On October 4, 2016, Winter returned to Rutgers to deliver a presentation to Professor Ousseina Alidou’s Introduction to the Literatures of Africa class on her latest research project, “Women and Sanitation in Nairobi Slums: What's Really Going On,” which expands on previous studies of East African urban sanitation to include a cultural and gendered aspect.
Many homes in the settlements are headed by females, possibly stemming from an uptick in the amount of women going into cities to look for work or to get married, according to Winter. And in an area about the size of Livingston Campus and packed with 200,000 people, access to private facilities is scarce; most opt for public, shared or nontraditional facilities like buckets.
“I got into this field because I wanted to know why women chose to use the facilities in certain ways or places because of unique risks they face,” she said.
One such risk that women may face is sexual assault or violence when using public or shared facilities. Oftentimes, this leads to alternative choices that can cause serious health issues.
“Systems of behavior are often shaped by the environment in which we live,” she said, adding that sometimes, behaviors can cause serious health problems, as is the case in some informal settlements in Nairobi, Kenya. “Women have a higher risk of toxic shock syndrome (TSS) or infection stemming from neglectful menstruation practices or the retention of bodily fluids.”
Winter’s three-phase study uses qualitative and quantitative measures, such as surveys, interviews, and sanitation walks to toilets and other locations to document the availability of private, shared and public toilet facilities and how and when women use them. About 900 women participated.
From that data, Winter created five common sanitation profiles based on women’s access to and use of private toilets, public toilets, shared plot or family toilets, or alternative methods of urine/feces disposal during the day and night.
A small percentage, she said, had private toilets installed in their homes. More often, women visited public facilities or shared toilets with about 30 other people in the vicinity. She also measured the use of nontraditional facilities.
More than half of the women reported living in homes that lacked private facilities. However, many had regular access to public or shared facilities but instead used buckets or other nontraditional receptacles after dark.
“A woman could fear going out at night,” she said. “While most women have never experienced violence, the fear is strong. We also found that men didn’t leave their homes at night because they also feared being attacked or for fear that their families would be put at risk if they left to use [other facilities.]”
And it’s much more complex. While Winter also used available facilities in the settlement to experience firsthand issues that women reported, she said that “gaining trust” with interviewees was “hard to do.”
"These folks have had other outsiders come in and promise them things and then nothing happens,” she said. “My goal is not to go in there and promise to do an intervention. I like to create networks—my approach is to earn their trust and have the women talk to other women about their ideas at their speed. In the third phase of my project, I’d like the women of the settlement to work together and feel empowered to conceptualize and implement ideas that may ultimately help others make decisions that benefit their health.”