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Remote Indigenous women face many barriers to good sanitation. What can we do?

Indigenous women and girls in remote Australian communities face multiple barriers when it comes to sanitation, particularly around menstruation. Yet solutions are in reach, according to one industry expert.

Dr Nina Hall, a researcher at the University of Queensland's School of Public Health, is lead author of a report that looks at 17 agencies that provide water, sanitation and hygiene services in remote communities across mainland Australia. Entitled Water, sanitation and hygiene in remote Indigenous Australia: A scan of priorities, it brings to light these realities and highlights areas of concern.

The report found that some girls are missing school due to inadequate infrastructure and facilities, which was later confirmed by several Indigenous organisations. In other scenarios, various sanitation products and lower-cost substitutes were being flushed down toilets due to the lack of discreet disposal options, resulting in system blockages.

Hall, who will be speaking at the World Toilet Summit later this month, said that while the problems identified in the paper are all solvable, the situation taken as a whole is complex, with various cultural, structural, historical and economic factors coming into play.

Affordability is one leading concern, with for-profit stores in remote towns sometimes charging twice the amount for sanitary items that an urban dweller would pay – a problem exacerbated if the individual or family is struggling to support themselves on a low income.

With cultural sensitivities around menstruation overlapping with low-population townships, “[these products] can also be really embarrassing to buy as well if it’s a male shopkeeper, and more so if it’s a male shopkeeper who is your relative,” Hall said.

Government subsidisation is one solution, but Hall said legislators and other groups can find inspiration in sustainable models created by developing countries overseas. She gives an example in a policy adopted by the Kenyan government, where a new line in every public school budget has been added to provide quarterly sanitation supplies for girls.

Instituting ‘health hardware’ in buildings – many of which are decades old, overcrowded, poorly built and poorly maintained – is another step towards better sanitation practice. This can be as simple as “a shower that can turn on and off and isn’t gummed up with groundwater calcification, a lock on the door so you can use the bathroom in privacy, a bin that can be removed and a toilet that flushes”, Hall said.

Education around sanitation management is another issue, with stretched resources and chronic underfunding both in school curriculums and health services. While valuable knowledge is transferred down generations by women community elders, Hall said that dislocations experienced by Indigenous women since colonisation has affected traditional teaching.

“Many have lived through mission time and had the influence of the church around body privacy, which is another taboo laid on top of the existing ones,” Hall said.

As one NGO representative stated in the report’s opening pages: “This is not new stuff”. Yet Hall believes that positive change and heightened awareness is under way, taking hope from the overwhelming number of positive responses the report and her subsequent article on the Conversation generated.

The Department of Prime Minister and Cabinet in Indigenous Affairs has expressed interest, while various Indigenous women’s groups have reached out to the University of Queensland to form partnerships in identifying needs and solutions.

One of these groups is the National Australian Aboriginal and Torres Strait Islander Women's Alliance, with representative and Arrernte woman Wendy Anders speaking alongside Hall at November’s Summit event.

In her work and practice, Hall has seen the movement of global researchers and practitioners in the area of menstrual hygiene management responses grow. She is encouraged too by the fact that in Australia, the response is Indigenous-led – meaning culturally appropriate processes and options can better take shape.

The World Toilet Summit will be held in Melbourne from 20-21 November - register now. To learn more about national and international water and sanitation issues, click here.

Hear from from Dr Nina Hall: