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The task of fetching water defines life for Binayo. She must also help her husband grow cassava and beans in their fields, gather grass for their goats, dry grain and take it to the mill for grinding into flour, cook meals, keep the family compound clean, and take care of her three small sons. None of these jobs is as important or as consuming as the eight hours or so she spends each day fetching water.

In wealthy parts of the world, people turn on a faucet and out pours abundant, clean water. Yet nearly 900 million people in the world have no access to clean water, and 2.5 billion people have no safe way to dispose of human waste—many defecate in open fields or near the same rivers they drink from. Dirty water and lack of a toilet and proper hygiene kill 3.3 million people around the world annually, most of them children under age five. Here in southern Ethiopia, and in northern Kenya, a lack of rain over the past few years has made even dirty water elusive.

Where clean water is scarcest, fetching it is almost always women's work. In Konso a man hauls water only during the few weeks following the birth of a baby. Very young boys fetch water, but only up to the age of seven or eight. The rule is enforced fiercely—by men and women. "If the boys are older, people gossip that the woman is lazy," Binayo says. The reputation of a woman in Konso, she says, rests on hard work: "If I sit and stay at home and do nothing, nobody likes me. But if I run up and down to get water, they say I'm a clever woman and work hard."

In much of the developing world, lack of water is at the center of a vicious circle of inequality. Some women in Foro come down to the river five times a day—with one or two of the trips devoted to getting water to make a beer-style home brew for their husbands. When I first came to Foro, some 60 men were sitting in the shade of a metal-roofed building, drinking and talking. It was midmorning. Women, says Binayo, "never get five seconds to sit down and rest."

On a hot late afternoon I go with her to the river, carrying an empty jerry can. The trail is steep and in places slippery. We scramble down large rocks alongside cacti and thornbushes. After 50 minutes we reach the river—or what is a river at certain times of the year. Now it is a series of black, muddy pools, some barely puddles. The banks and rocks are littered with the excrement of donkeys and cows. There are about 40 people at the river, enough so that Binayo decides that the wait might be shorter upstream. The wait is especially long early in the morning, so Binayo usually makes her first trip before it is light, leaving her son Kumacho, a serious-faced little man who looks even younger than his four years, in charge of his younger brothers.

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