Water, Sanitation and Hygiene (WASH)

The United Nations General Assembly explicitly recognised access to safe drinking water and sanitation as a human right, and acknowledged the essential nature of water and sanitation to the realisation of all human rights in 2010. However in many contexts persons with disabilities are excluded from accessing water, sanitation and hygiene (WASH) services for reasons including poor or distant placement of WASH infrastructure, inaccessible toilets and water supplies, exclusion from community hygiene awareness and general WASH planning processes, and stigma and discrimination.

Persons with disabilities may have greater water requirements than some other community members – for instance, if they use their hands for mobility or for balance while going to the toilet, they will have increased washing needs. It is vital that their needs are specifically considered in all aspects of WASH programming.

Inclusion of persons with disabilities in WASH programs typically requires only minor modifications, and when built into program design represents minimal additional cost. Improved accessibility of WASH infrastructure also benefits other members of the community, such as children, frail older people, pregnant women, and people who are ill or temporarily injured.

When persons with disabilities are included in WASH programs they may experience greater dignity and self-reliance, improvements in health and nutrition, and greater access to education if school WASH facilities are accessible. WASH-related caregiving duties that are usually borne by women and girls, such as fetching water, may be reduced for family members of persons with disabilities. Inclusion in WASH community processes and provision may also increase the visibility and self confidence of persons with disabilities, and enhance their inclusion and participation in other aspects of community life.

The available resources are mainly designed for WASH practitioners. Many focus on accessible infrastructure, and are useful for this aspect of WASH. However, it is also necessary to consider inclusion throughout the whole program management cycle, and to ensure community education and decision-making processes are also inclusive.

See also: Accessible infrastructure and communications

Human Rights Watch (2017) Going to the Toilet When You Want: Sanitation as a Human Right Website with link to full report

This report provides powerful evidence of how denying access to sanitation is a human rights violation. It investigates provision of sanitation in facilities such as schools, prisons, health facilities, residential facilities for people with disabilities, and workplaces. While not focused solely on people with disabilities, the report provides a wide range of examples which highlight the additional discrimination faced by people with disabilities (and particularly women and girls with disabilities) accessing sanitation in a range of settings. It would be useful to provide evidence for use in advocacy on the rights of people with disabilities to access sanitation and how a lack of accessible sanitation can restrict participation in society.

White S, Kuper H, Itimu-Phiri A, Holm R and Biran A (2016) A qualitative study of barriers to accessing water, sanitation and hygiene for disabled people in Malawi HTML with link to PDF

This research study explored the WASH priorities of persons with disabilities in Malawi and the barriers faced in accessing WASH. No two individuals reported the same set of barriers which highlights the importance of listening to people with disabilities and including them in WASH planning processes. While other WASH publications have focused primarily on barriers in accessing WASH for persons with disabilities, this study also looked at WASH needs associated with disability and the consequences of not having these met. It found that persons with disabilities and caregivers may have different or greater WASH needs (e.g. additional bathing requirements as a result of incontinence). Not having these met was seen to result in poorer health, stigma and reduced self esteem. This report is useful background reading for WASH Program managers to understand the range of challenges persons with disabilities face in accessing WASH and the importance of disability inclusive practices.

Jones H and Reed B (2005) Water and sanitation for disabled people and other vulnerable groups: designing services to improve accessibility (PDF 13.8 MB, chapters available for separate download) Also available in French

This online book is a useful resource for program planners and service providers who require detailed guidance on accessible design and practical WASH infrastructure solutions at a household level. It gives background on disability and WASH and details approaches to accessibility, for various impairment groups. It also includes detailed case studies from several countries of specific types of technology for making household WASH facilities accessible. It is useful for those wishing to gain an understanding of the breadth of accessible WASH infrastructure.

WEDC (2011) Inclusive design of school latrines: How much does it cost and who benefits? (PDF 1.9 MB)

This briefing note covers the main issues for inclusive sanitation in educational settings, provides indicative costings and includes design and construction recommendations.

Gosling L (2010) Equity and inclusion: A rights-based approach (PDF 813kb)

This report outlines WaterAid’s approach to equity and inclusion (including disability inclusion). While the report considers specific organisational actions and implications that are not relevant to those outside WaterAid, it also describes a useful conceptual framework for understanding equity and inclusion in WASH more broadly, and thinking beyond accessible infrastructure.

WaterAid Inclusive WASH website

This website is hosted by WaterAid with contributions from a range of organisations. It is an online learning portal for WASH practitioners. It includes an extensive resource guide, forums, case studies, webinars and training materials regarding the inclusion of persons with disabilities, as well as the poorest of the poor, people living with HIV/AIDS or chronic illness, and women and girls. It is regularly updated. Whilst aimed at practitioners, the site provides helpful examples and practice notes that can be used to inform policy and larger programs.

Humanity & Inclusion Source: Key list resources on inclusive WASH and disability (updated regularly)

Handicap International, is a comprehensive and frequently updated online resource centre on disability inclusion. Its key list on WASH includes a number of resources, mostly providing practical guidance to support implementers of WASH programs. The list was compiled by WaterAid and the Water, Engineering and Development Centre (WEDC) in the UK.

CBM Australia (2012) Inclusion made easy: A quick program guide to disability in development – WASH Chapter (in Part B) (Word 145 KB, PDF 455 KB)

This practice guide provides broad programming guidance for disability inclusive WASH using a twin track approach. It also includes case studies and checklists. It has been designed for implementing WASH partners, particularly program managers/officers. It is also useful for organisations involved in program review and interactions with implementing partners.

WaterAid and Water, Engineering and Development Centre (WEDC) Inclusive WASH: what does it look like? (PDF 78 KB)

This one page checklist gives a benchmark of an inclusive WASH program at a community level, including inclusive processes, designs, communication, monitoring and evaluation as well as accessible infrastructure. It may be useful to inform the monitoring and evaluation frameworks of larger WASH programs that include community initiatives.

WaterAid (2011) What the Global Report on Disability means for the WASH sector (PDF 378 KB)

This briefing paper highlights the main findings of the World report on disability and how they relate to the WASH sector, including barriers and enablers for inclusive WASH. It also applies the main World report recommendations to WASH programming, with specific examples of projects focusing on accessible infrastructure. The briefing provides some guidance on the development of national accessibility standards in relation to WASH.

WaterAid Inclusive WASH website: case studies

This page contains a number of implementer level case studies of inclusive WASH, which are helpful for understanding what disability inclusive WASH can look like at a community level.

Washington Group on Disability Statistics technical presentation

Jennifer H. Madans Ph.D., Associate Director for Science, National Center for Health Statistics (NCHS) and Mitchell Loeb,
Health Scientist, NCHS from the secretariat of the Washington Group on Disability Statistics delivered a technical session
on how to use the Washington Group questions in monitoring data systems and how to disaggregate data by disability
followed by a question and answer session at the University of Melbourne on Thursday, 30 April 2015. The presentation
was organised by the Australian Government Department of Foreign Affairs and Trade.

Presentation from the Washington Group on Disability Statistics
Picture of a woman in Bangladesh who is a wheelchair user at an accessible water pump. The water pump is low enough to be reached sitting down, and has a long handle which she is using to collect water in a plastic bucket underneath.

Photo: Wahid Adnan, Drik 2012

Kazol (23, Bangladesh) fetches water from a wheelchair accessible pump. To read Kazol’s full story click here. Copyright: Centre for Disability in Development/CBM Australia