My TIME.com column today on the tortuous experience – especially for women – of living without proper sanitation. I can’t forget trudging — mercifully only as a short-term voyeur — through villages in Africa and South Asia, with no idea where to change tampons, no idea how people cope without toilet paper and pads and even buckets of water and soap. And yet everywhere I went, people were bathing in rivers like this photo, trying to stay clean and maintain their dignity, which in some ways only worsens the problem. I know these stories don’t get nearly as many hits as my pieces on movies and sex, but I really like to dust off that public health degree once in a while and am grateful to my wonderful editor, Ruth Konigsberg, for letting me publish it.
Urination isn’t one of the first words that leaps to mind when people think of civil rights, but activists in Mumbai have launched a new campaign called the “Right to Pee” to redress gross inequities in the allocation of public restrooms. In New Delhi, for example, according to the New York Times, there are more than 1,500 public restrooms for men and only 132 for women.
The burden of bad sanitation affects almost all poor people but it falls disproportionately on females: in urban areas, there is a fee for most public washrooms, but men can use urinals for free and they frequently relieve themselves in public when facilities are lacking. In rural areas, where most people have to defecate openly, women are often subject to harassment or assault when they relieve themselves. To avoid the need to urinate, they often withhold hydration, a practice resulting in high rates of urinary-tract infections, heatstroke and other health problems. And coping with menstruation in the absence of privacy, water or sanitary products can be a nightmare…