March 22 is World Water Day. As we focus on the power of safe water to transform people's lives, we must recognize that the burden of providing water falls disproportionately to women and girls, such as these women carrying water in rural Kenya. Photo provided by Bethany Caruso.

Imagine going through your day without ready access to clean water for drinking, cooking, washing or bathing. Around the world, 663 million people face that challenge every day. They get their water from sources that are considered unsafe because they are vulnerable to contamination, such as rivers, streams, ponds and unprotected wells.

And the task of providing water for households falls disproportionately to women and girls.

Water, a human right, is critical for human survival and development. A sufficient supply of biologically and chemically safe water is necessary for drinking and personal hygiene to prevent diarrheal diseases, trachoma, intestinal worm infections, stunted growth among children and numerous other deleterious outcomes from chemical contaminants like arsenic and lead.

I have carried out research in India, Bolivia and Kenya on the water and sanitation challenges that women and girls confront and how these experiences influence their lives. In my fieldwork I have seen adolescent girls, pregnant women and mothers with small children carrying water. Through interviews, I have learned of the hardships they face when carrying out this obligatory task.

An insufficient supply of safe and accessible water poses extra risks and challenges for women and girls. Without recognizing the uneven burden of water work that women bear, well-intentioned programs to bring water to places in need will continue to fail to meet their goals.

Heavy loads

So, what is it like for women who live in places where sufficient and safe water is not readily accessible?

First, collecting water takes time. Simply to get water for drinking, bathing, cooking and other household needs, millions of women and girls spend hours every day traveling to water sources, waiting in line and carrying heavy loads — often several times a day. In a study of 25 countries in sub-Saharan Africa, UNICEF estimated that women there spent 16 million hours collecting water each day.

When children or other family members get sick from consuming poor quality water, which can happen even if the water is initially clean when collected, women spend their time providing care. These responsibilities represent lost opportunities for women’s employment, education, leisure or sleep.

Collecting water also requires tremendous physical exertion. Water is heavy. The United Nations recommends 20-50 liters of water per person per day for drinking, cooking and washing. That amounts to hauling between 44 and 110 pounds of water daily for use by each household member.

And in many places, water sources are far from homes. In Asia and Africa, women walk an average of 6 kilometers (3.7 miles) per day collecting water.

Carrying such loads over long distances can result in strained backs, shoulders and necks, and other injuries if women have to walk over uneven and steep terrain or on busy roads. The burden is even heavier for women who are pregnant or are also carrying small children.

Even when a household or village has access to a safe water source close to home, residents may not use it if they believe the water is inferior in some way. As one woman told my research team in India:

Tube well water quality is not good… water is saline. Cooking is not good due to this water. Not good for drinking either. People are getting water from that neighboring village…. for cooking we get water from the river.

In this community, the neighboring village was at least a kilometer away.

Fetching water can be very dangerous for women and girls. They can face conflict at water points and the risk of physical or sexual assault. Many of these dangers also arise when women do not have access to safe, clean and private toilets or latrines for urinating, defecating and managing menstruation.

Now imagine that you have managed to get water, but only a limited supply. How will you allocate it? Women need water for hydration, regular hand-washing, washing their bodies, and cleaning clothes and materials when they are menstruating in order to prevent urogenital infection.

But in areas where water is scarce, women and girls may sacrifice so that other family members can use water. In a study that assessed how water insecurity affected rural women in Ethiopia, 27.8 percent of women surveyed reduced the amount of water they used for bathing, 12.7 percent went to bed thirsty and 3.7 percent went an entire day without drinking water.

One woman described many challenges, including the possibility that no water would be available when she finally reached a source; the struggle to complete domestic tasks, such as washing clothes and cooking, in the time she had left after fetching water; and worries that not completing this work would lead to arguments with family members.

When conditions such as drought make water scarce, women have to travel farther to collect it and make more frequent trips, expending more time and energy. Water scarcity has been shown to increase women’s stress in Bolivia, Brazil, Ethiopia and Mexico.

And global demand for water is increasing. The United Nations forecasts that if current water use patterns do not change, world demand will exceed supply by 40 percent by 2030. In such a scenario, it is hard to imagine that women’s and girls’ experiences will improve without intentional efforts.

A focus on women's needs

When communities initiate programs to improve access to water, it is critical to ask women about their needs and experiences. Although women and girls play key roles in obtaining and managing water globally, they are rarely offered roles in water improvement programs or on local water committees. They need to be included as a right and as a practical matter. Numerous water projects in developing countries have failed because they did not include women.

And the inclusion of women should not be ornamental. A study in northern Kenya found that although women served on local water management committees, conflict with men at water points persisted because the women often were not invited to meetings or were not allowed to speak.

We also need broader strategies to reduce gender disparities in water access. First we need to collect more data on women’s water burden and how it affects their health, well-being and personal development. Second, women must be involved in creating and managing targeted programs to mitigate these risks. Third, these programs should be evaluated to determine whether they are truly improving women’s lives. And finally, social messaging affirming the idea that water work belongs only to women must be abandoned.

UN Secretary-General Ban Ki-moon has called empowerment of the world’s women “a global imperative.” To attain that goal, we must reduce the weight of water on women’s shoulders.

Bethany Caruso is a postdoctoral (FIRST) fellow in the Department of Environmental Health at Emory University. This article first appeared in The Conversation.