Building the evidence for effective disability-inclusive water, sanitation and hygiene

4 min read
Image: WaterAid/ Sokmeng You

On International Day of Persons with Disabilities, colleagues from Cambodia, Bangladesh and Australia highlight our work on disability-inclusive water, sanitation and hygiene (WASH) and a new research collaboration with the London School of Hygiene and Tropical Medicine.

It is estimated that 15% of the world’s population lives with a disability. In Cambodia and Bangladesh, as in many other countries, people with disabilities often experience greater challenges (PDF) accessing the WASH services they need than do people without disabilities. For example, a person who has difficulty seeing may experience challenges accessing their household’s toilet if it is not designed to specifically meet their needs. In 2018, we documented the challenges women living with disabilities in rural Cambodia faced in accessing WASH.

When I have my period, I need warm water for a bath. But I don’t have warm water so I access the pond, which is not really clean.

A 29-year-old woman who has difficulty walking, rural Cambodia.

This imbalance extends to people’s exposure to hygiene and WASH promotion, a situation magnified during the COVID-19 pandemic. For example, a person with hearing difficulties may miss out on life-saving hygiene messages, unless public health communications are presented in a range of formats that accommodate their requirements.

Now, in the COVID-19 pandemic, it [WASH] has become a lifesaver issue for the whole world. So, a strong commitment from the stakeholders and policy makers is required to address this challenge collaboratively to build a safe, respectful and dignified society.

Salma Mahbub, Secretary-General of Bangladesh Society for the Change and Advocacy Nexus (B-SCAN).

Jotti, 12, who has a rare physical disability, walks down the ramp from her family's customised disability-friendly toilet in Khulna, Bangladesh. 24 August 2020.
Jotti, 12, who has a rare physical disability, walks down the ramp from her family's customised disability-friendly toilet in Khulna, Bangladesh. 24 August 2020.
Image: WaterAid/ DRIK/ Habibul Haque

Working with people with disabilities to promote their WASH rights

Our vision of everyone, everywhere having access to clean water, a decent toilet and good hygiene means we shine a spotlight on the WASH needs and rights of people living with disabilities in low- and middle-income countries. Throughout our work we aim to promote the rights of people with disabilities to access safe, accessible and appropriate WASH at home, at school, when using healthcare services and in public spaces.

We collaborate with disabled people’s organisations to empower people with disabilities to drive advocacy and influencing efforts for their rights to WASH. In driving hygiene and WASH solutions we’ve advocated inclusive and empowering COVID-19 hygiene responses. And we strive to influence governments to adopt disability-inclusive WASH policies and services – for example, over the past five years we have supported the Royal Government of Cambodia to develop and test Disability-inclusive WASH Guidelines. And in Bangladesh we have been working for many years with local government to improve availability and understanding of gender-sensitive and disability-accessible public toilets in its major cities.

Participants write on a large sheet in a creative workshop to enable disabled people to raise concerns about accessible WASH to local decision makers.
As part of work to change perceptions and increase understanding of accessible WASH, in Cambodia we worked with creative group Epic Arts and disabled people’s organisations on an inclusive workshop with local decision makers, aiming to raise to stakeholders the concerns of people with disabilities.
Image: WaterAid/ Sokmeng You

New research with the London School of Hygiene and Tropical Medicine

This year we have been pleased to begin a new collaboration with the London School of Hygiene and Tropical Medicine (LSHTM) on disability-inclusive WASH. The research will help us and other WASH actors to better understand the effects that disability-inclusive WASH is having on people in Cambodia and Bangladesh, and to apply this evidence in other countries.

Supported by the Water for Women Fund, from the Australian Department of Foreign Affairs and Trade, this two-year research project aims to help improve disability-inclusive and gender-sensitive WASH policy making in developing countries through generating policy and practical guidance for national governments.

Through the project, we and LSHTM will partner with local disabled people’s organisations in Cambodia and Bangladesh to document and analyse the WASH-related experiences of women and men with disabilities in rural communities. The project will explore how disability-inclusive WASH policies are implemented, and look at gender-related issues such as women occupying care and support roles for family members with disabilities.

This research project is a good project for Cambodia. All findings about difficultly, barriers, and needs of persons with disabilities, we will bring to policy makers for improvements of implementation and guidelines. We hope to learn best practices on improving inclusive WASH from Bangladesh and share learning across both countries as this is a regional project.

Monika Mak, Executive Director of the Cambodia Disabled Persons Organisation.

We will use our findings to inform best practice and develop a set of practical guidance for policy makers and practitioners. The research will contribute to the building of a stronger evidence base for what works and what is blocking progress on disability-inclusive WASH in Cambodia and Bangladesh. These practical materials will help governments to design inclusive and accessible hygiene approaches to respond to the COVID-19 crises in low- and middle-income countries.

Mahfuj-ur Rahman is Project Manager HLP at WaterAid Bangladesh. Pharozin Pheng is Equality and Inclusion Manager at WaterAid Cambodia. Chelsea Huggett is Equality and Inclusion Technical Lead at WaterAid Australia.