The ones left behind. The bottom of the pyramid. The poorest of the poor. The excluded. The last mile. The richest 1% of the population owns more than 50% of the planet’s wealth, and the disparity is growing. But is a focus on wealth the right way to understand inequalities? Money, or lack thereof, is a smokescreen that stops us from seeing the underlying causes of inequality. Poverty is more often the consequence, and not the cause, of inequalities. In challenging the received wisdom on the reasons for inequalities, we can better understand what causes inequalities, and consequently how to address them.
I have been fighting inequalities throughout my career, as the UN Special Rapporteur on the Human Right to Water and Sanitation and now as the CEO of the Sanitation and Water for All global partnership. We are getting better at talking about the need to address inequalities. Here, I articulate five ways in which we can do things differently to actually affect change.
Let us take deliberate steps to understand who has been ‘left behind’
We need more accurate and reliable data on exactly who has been ‘left behind’ in order to make a change. At present, many countries simply do not know who is being excluded from accessing water and sanitation services, or why. As a result, nothing is done.
There are many reasons why data on access to water, sanitation and hygiene is missing or inaccurate. Individuals may be invisible because they are literally hidden from view, sequestered inside homes – older persons, persons with disabilities.
People living in remote areas, far from administrative centres are out of sight out of mind. People living in informal settlements, and homeless people, are frequently not included in official statistics or planning processes. Therefore, the first task is to identify who is being excluded, to ask difficult questions, to travel further, to dig deeper to understand what inequalities exist and why, in order to put in place the right policies, strategies and budgets to address them. The Joint Monitoring Programme of the water and sanitation sector is working hard to address this lack of data and is exploring ways of measuring inequalities in access according to ethnicity, language and geographical area. Is also one of the central issues in the SWA 2019 Sector Ministers’ Meeting, which will gather over 60 ministers responsible for water, sanitation and hygiene from all continents.
Let us understand how inequalities accumulate
Inequalities work in layers, and the impact accumulates where individuals belong to more than one of the groups that suffers discrimination. For example, people with disabilities are stigmatized and invisible, but add to that the cultural limitations placed on women or girls and increase it with discrimination against certain ethnic or language groups, and the inequalities felt by those individuals will increase.
Inequalities also accumulate across generations - discrimination in one generation will negatively impact and diminish opportunities for later generations. The opposite is also true – in the accumulation of advantage. Your parents’ wealth and level of education is a better indicator of your own wealth and educational achievement than anything else.
There is therefore not just one way to resolve inequalities.
Confronting stigma, the socially acceptable discrimination
Because stigma is socially constructed, it is also socially accepted. Based on a concept of ‘us’ and ‘them’, it leads to exclusion that is not acknowledged as problematic.
Access to water and sanitation can be particularly critical for stigmatized groups, since stigma is often closely linked to perceptions of uncleanliness, untouchability and contagion. Stigmatized people such as homeless populations, menstruating women and girls, refugees, slum dwellers, Roma communities, Dalits and women suffering from obstetric fistula are often perceived as dirty – without recognition that their lack of access to water is a significant contributor to their stigmatization.
Targeted interventions can open our eyes to our own prejudices and propose actions to overcome them. It is easy to speak of irrational discrimination and prejudice in cultures and contexts other than our own, but harder to see the prejudice in our own cultures.
Rejecting the ‘trickle-down’ myth - the last must be first
The ‘trickle-down effect’ has been debunked by economists, and yet is still being used as an argument for leaving people living in hard-to-reach areas and informal settlements to last. According to standard discourse, by delivering better services to the people who can afford to pay more, utilities will increase their income and be able to extend services beyond the formal urban areas.
As we have seen in many countries, this approach is not borne out by the evidence. All too often, people living in formal areas who have access to good municipal services continue to pay low tariffs due to political expedience and an unwillingness to raise tariffs. On the other hand, people living in informal settlements are paying much more for their substandard services. Governments and utilities need to be prepared to invest in poorer areas and put the furthest behind first. This is the only way to make SDG 6 a reality.
Mind your language!
If we want to ensure equality in access to services, we have to change not only the way that we think, but also the language that we use. We know that the SDGs demand that we ‘leave no-one behind’, that we focus on vulnerable and marginalized people, and this is critical for achieving universal access to services.
But we also have to think carefully about how we express ourselves.
When we talk about reaching ‘the last mile’, we are setting up expectations that we will only address the most difficult to reach at the end of the process, rather than putting those people first. When we refer to “the bottom of the pyramid” we are using the imagery of ‘top’ and ‘bottom’ to describe individuals who are, essentially, equal.
To achieve truly inclusive services, let us ensure that the language that we use is inclusive, recognizes inequalities, and works to address and not reinforce them.