By Rebecca L. Evans
Thirty years on from my first visit to KKFI or Kapatiran-Kaunlaran Foundation Inc., I have had the privilege to return in a research capacity. I am working with the Water and Engineering Development Centre of Loughborough University in the United Kingdom and my thesis is WASH (Water, Sanitation and Hygiene) challenges in informal settlements/slums, particularly pertaining to MHM (Menstrual Hygiene Management).
I would like to share some of my initial observations with you. I have looked at Water, Sanitation, Handwashing, Solid Waste and MHM in these areas: Manila North Cemetery (urban); Dump Site at Looban, Bulacan (rural); Tramo, a peri-urban site in Pulilan; and R. Papa Street, Manila (Urban).
Firstly, I have seen very big improvements with regard to water. Piped water is available 24/7 here in Manila and there has only been one stoppage during my stay. Even the informal settlements are served with household connections (except MNC) and individual meters on 1-inch diameter flexible piping.
A culture of purchasing filtered drinking water has also been established very effectively. Water is sufficient and affordable for most. This in itself will have led to a reduction in water-washed and water-borne diseases.
Regarding sanitation, there has been a cultural shift so that most people are using comfort rooms (CRs) and open defecation is not practiced in the city (although it still is in the rural areas). Even in the informal settlements, people have dug pit latrines where they can. Most are pour-flush as water is available. However, they may be shared by a number of families, even 20-plus extended family members and friends. Status is conferred by having a pedestal CR.
All the women I talked to have an aspiration to have a private CR.
Hand-washing is a bit of a hit-and-miss. Many people know they should be hand-washing but they tell me they are lazy, or they forget. There is a lack of understanding about the importance of washing with soap amongst those that are uneducated.
Generally speaking, solid waste and its disposal has got worse. There has been a proliferation of plastic, here in Manila fuelled by the fast-food chains, but everywhere plastic is being used because it is cheap, convenient and, ironically, hygienic.
I have eaten food off plates wrapped in plastic to avoid washing up and making sure it is clean. The solid waste is accumulating in the streets and blocking drainage systems. Although there is an efficient garbage collection system that comes regularly, there isn’t an understanding or commitment to separation and recycling. The environment is being degraded.
Speaking to women about MHM, they face the same challenges as women the world over: worrying about leaking, staining, where to change, privacy, washing hands and disposal. The extent to which it limits their activities is not fully understood. It certainly is limiting to girls and students who are in education; they can’t always concentrate, they can’t take part in everything and they may need to go home. It is also limiting to working women for the same reasons.
But for those in project areas who live in and around their homes, bringing up families, it does not seem to be such a worry. Many are not regularly menstruating due to the constant cycle of childbirth. It is difficult to say whether a coping strategy for menstruation is to stay at home, and a consequence is to have babies, or whether it is the other way round.
Nearly all women and girls would choose to use disposable napkins during their menstruation, for the comfort and protection they afford. Women who stay at home or who are trying to save money, might use cloths. Tampons are not available here and caused much curiosity.
I have identified some common cultural traditions surrounding menstruation: On your first menstruation you should jump down three times in order to have a menstruation that lasts three days; you should not use disposable napkins otherwise your menstruation will stop; you should wipe the menstrual blood on your face to prevent pimples; you should stay in the house; and, finally, during your menstruation, you should not take a bath.
The extent to which these were practiced varied, though many people saw them as old wives’ tales.
In Manila North Cemetery, there are no household connections for water as it is not recognised as an informal settlement, merely a squat. However, there is a hand-pump and deep-well, and people are earning sufficient as tricycle drivers mainly, to buy water to meet their needs.
However, there are very few CRs and many people are using “flying latrines,” (plastic bags which then go in the garbage). In regard of MHM, most women can afford to buy napkins at the “sari-sari” store and dispose of them wrapped in plastic into the garbage, adding to the solid waste problem.
In Tramo, Pulilan, the community has water connections, CRs and garbage collection. The main problem identified here is the anti-social behaviour of some of the residents. Tramo is known as “Little Tondo” because of the fighting and drinking culture. This prevents some people getting sufficient rest and was a particular complaint of menstruating women.
In Looban, at the dumpsite, the environment is full of waste. There is plastic in the mud underfoot, diapers in the trees—it is everywhere. Although there are some household connections for water, there is also a hand-pump, which provides free water. This community is very poor as their livelihood has been curtailed due to the closing of the dumpsite.
The hand pump broke while I was there. Hand-washing is rare and they said soap was too expensive and too strong. The people are not using sufficient water with soap for bathing, and I noticed a lot of water-washed diseases such as conjunctivitis, ringworm, scabies, boils, prickly heat.
The children looked malnourished and many have rotten teeth. This community was also the least educated that I visited and very superstitious, for example, not taking a bath during menstruation. This community needs education as well as practical assistance.
In Tondo, the main challenge is poverty. Most of the workers are onion and garlic peelers, and their incomes are small. Although they have household connections for water, they tell me they may disconnect them to save money. The women and girls don’t always have enough money to buy sanitary products and have to resort to using old underwear during their menstruation.
These observations will form the basis of my paper and we are hoping to share the work globally at the Water and Engineering Conference in Kenya in July. Our purpose is to capture the voice of women, and add to the academic literature which is informing governments and donors who are designing programs to make sure they are inclusive.
With my research complete, I was pleased to return to the dumpsite on my last weekend, changing my last dollars to buy some hygiene kits for the children of Looban. We ran a hygiene education session and I was very pleased that we could give out 70 sets of soap, washcloth, toothbrush, toothpaste, shampoo, powder and some napkins. I very much hope that when I get back to the UK, I can continue to support this work.
My final reflections are really about what it has been like to revisit “Kapatiran” after 30 years. Well, it was 30 years too long!
I made life-long friends when I came, who I see regularly on Facebook, and it has been my joy and my honor to have been able to meet up with so many during my stay. Some of you may know Ate Nila Basilio, for example, who I was glad to see in Pampanga. She really looked after me when I was young. And you all know Kuya Danny. But the absolute highlight of my life was to meet up with my “sponsored child” from R. Papa Street, Webster Obina, who was able to finish his computer engineering degree and is now a grown man with a wife and family, with a good job that takes him all over the world. He treated me to dinner in Makati City. I was so proud!
Kapatiran then, and now, is like a family. I have found my old family, but I have also found my new Kapa-tiran family. It has been a wonderful experience to have met so many lovely and passionate people in the new generation.
I have enjoyed sharing work, travel, devotions, street food (still not sure about “balut,” though) and birthdays. I am indebted to you all: Ma’am Nancy Nicolas and Ate Glenda Gutierrez for making my visit possible; Kuya Danny Tangonan for looking after me in KKFI’s guesthouse; Ate Love Daroy-Gagno for organizing an incredibly rich exposure; Joharrah Rafanan, Brian Fernandez, Ruzelle Camposano, and LJ Basilio for their fantastic translating skills; Joanna, Teacher James Aguilar, Ate Ana Martin, Ate Lilia Bejer for making me so welcome in the office and including me in such fun times, Ate Evelyn Tendero and Malou Angoluan for making time for me, and Brian again for ensuring that I learn and experience as much as I possibly can about Filipino culture, language, food , politics, etc.
I have been richly blessed in meeting you all. You inspire me to continue with this work.