Inclusion Made Easy: A Quick Program Guide to Disability in Development
Part B
Disability Inclusion: WASH
“Having access to safe drinking water and sanitation is central to living a life
of dignity... the rights to water and sanitation further require an explicit focus
on the most disadvantaged and marginalised”1
Key facts

20% of people who live in poverty in developing countries have a disability
and all need safe access to water, sanitation and hygiene (WASH) facilities.

Social isolation and taboos around discussion of personal hygiene increase
exclusion for people with a disability from promotion and education of WASH.

Use of hands for support during defecation for people with a disability
increases risk of acquiring and transferring disease.

Inaccessible or distant water sources can force people with a disability to
depend on others for water collection.

People with mobility or vision impairments need accessible and safe latrines
as open defecation is more difficult due to vulnerability to falls or animal
attacks.2
“Here in the area I live in they don’t treat me badly. It was worse in another
place. When I was in my village they treated me unfairly, sometimes I wanted
to go and have a wash down at the tap, they would lead me to a different
road and I would end up banging into something and they would all laugh.
After that I thought to myself I don’t want to stay here anymore in the
village, I would rather live in Honiara”.3
Reasons for disability inclusion in WASH programs

Applying universal design principles 4 to WASH will create greater inclusion
for all community members including people with a disability, pregnant
women and the elderly. These focus on good design which is accessible to all
at a low cost in comparison to the cost of exclusion. The additional expense
for making school latrines accessible is less than 3% of the total cost.5

Community Led Total Sanitation, when using a disability-inclusive approach,
ensures all community members are participants in improved health
outcomes.

Over 884 million people do not have access to safe drinking water,6 which is
a fundamental right for all people and is especially important for people with
a disability given many WASH facilities are designed without considering the
needs of all members of a community.

Increasing accessible WASH facilities in community settings and schools will
improve broader education and life outcomes for people with a disability.
Disability-Inclusive WASH will also reduce work load of families in care-giving
tasks. Ensuring inclusion of people with a disability in community-awareness
activities will reduce the rate of acquiring and spreading disease.

Disability-inclusive WASH, when located in a safe and central area with good
lighting, will enhance protection of all vulnerable people including community
members with a disability.
How to include people with a disability in WASH programs
The WASH sector is comparatively well-resourced in terms of knowledge of
disability inclusion and mainstreaming, particularly in terms of accessible
infrastructure and facilities. WASH facilities globally are still, however, generally
not built to universal design principles.
The following principles, which adhere to a human-rights approach to disability,
are used to demonstrate inclusion of people with a disability in all development
programs and sectors.
Awareness of disability and its implications
Participation and active involvement of people with a disability
Comprehensive accessibility through addressing physical, communication,
policy and attitudinal barriers
Twin track identifying disability specific actions combined with mainstream
approaches
Awareness

Identify the number of people with a disability within the community. This
information can be gathered, for example, through meeting local people with
a disability and DPOs, census data, household surveys, Community-Based
Rehabilitation (CBR) and disability services and facilities for inclusive
education.

Collect information on types of disabilities and barriers experienced.

Deliver awareness-raising activities on the importance of disability-inclusive
WASH including information on disabilities, attitudes and capacity.
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
Use media and promotion campaigns to present information about accessible
and inclusive facilities and emphasise case studies that highlight people with
a disability who have benefited from inclusive WASH activities.
Participation

Involve people with a disability in all stages of the program, especially in
design to ensure facilities and locations are accessible.

Work with Disabled Peoples Organisations (DPOs) and other agencies already
present in the community to help identify people with a disability and the
barriers they face in accessing WASH information and facilities.

Allocate a budget to cover travel and participation expenses along with
attendance time for people with a disability and DPOs to actively be involved
in consultations.

Recognise the value of people with a disability in creating innovative solutions
to make WASH facilities accessible.

Identify, incorporate and promote solutions to WASH developed by local
people with a disability into program design and infrastructure planning.

Ensure people with a disability are invited to consultations, involved in village
WASH committees and targeted in hygiene education.

Consider communication techniques and access requirements, as well as
overcoming isolation, stigma and discrimination.

Consider how people with a disability can participate actively in activities, not
just benefit from them.
Comprehensive accessibility
Comprehensive accessibility = physical, communication, policy and
attitudinal access

Identify the preferred communication mode for individuals with a disability.
Note that not all people who are blind will have been taught Braille, likewise,
not all individuals who are Deaf or hard of hearing will have sign language
skills.

Be prepared to source alternative communication options including large
print, Braille, pictorial, audio and sign language based on individual
requirements. These may be arranged through local partners, inclusive
education services, CBR and disability organisations.
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
Promote effectiveness of universal design principles as facilities designed for
people with a disability are accessible to all: including elderly, those with
temporary injuries, children and people with a disability.

Hold consultations and other meetings in physically accessible venues.

Ensure that written communication is accessible to people with a disability
using large print, Braille, plain language, pictorial and audio formats.

Identify ways to disseminate WASH information through non-formal or
innovative channels to ensure children with a disability who do not attend
school are reached and involved in programs.

Encourage organisations to apply good WASH practices in their own
buildings.

Ensure accessible WASH facilities are written into contracts or Memorandums
of Understanding with design and construction partners.

Address disability concerns within organisational policies and strategies.

Dispel myths, negative attitudes and perceptions about people with a
disability and highlight their capacity, rights and participation in consultation,
planning and implementation.
“It is a big problem … for us people with a disability, we are unseen,
forgotten and people don’t treat us right. We are often not involved in
things”.7
Twin track
Twin track enables full inclusion through mainstream access
working alongside disability specific supports
Mainstream
Disability specific
Build facilities according to universal
design principles.
Encourage development and
promotion of innovative access
solutions from people with a
disability and DPOs.
Encourage all contractors to operate
in accordance with disability-inclusive
principles in their contracts and
Train local community members in
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activities.
Hold consultation meetings and
community training in accessible
spaces.
Advocate for laws and policies to call
for disability-inclusive WASH in all
infrastructure, knowing that when
WASH facilities are accessible, people
with a disability will be included in
broader community activities.
Position WASH facilities in a location
most accessible to women and girls
with a disability. In doing so,
facilities will be accessible to all.
techniques to support people with a
disability who experience barriers in
access to WASH.
Identify disability-related barriers
as early as possible and advocate
for inclusive programs and facilities.
Identify priority activities within the
community where members with a
disability are in greatest need of
specific inclusive WASH facilities.
Engage with DPOs to conduct
disability access audits for WASH
facilities.
Ensure that there are indicators that
explicitly address disability such as
number of accessible WASH trainings
and facilities.
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Case study: Inclusive Water, Sanitation and Hygiene (WASH)
in Timor Leste
WaterAid
Summary of program:
In 2011 a collaborative project occurred in Timor Leste with the Leprosy Mission,
WaterAid, Plan International, DWASH, BESIK, disability consultant Huy Nguyen and
Timor’s DPO: Ra’es Hadomi Timor Oan (RHTO). The aim of the project was to include the
needs of people with a disability in mainstream water, sanitation and hygiene (WASH)
projects in rural districts. The project involved visiting villages in these rural districts and
both participating in informal sessions with locals and providing training in practical ways
of meeting the WASH needs of people with a disability (e.g. building bamboo seats to be
placed over squatting toilets for use by people who are not able to squat). This project
exemplifies the positive outcomes that can be achieved through collaboration between
NGOs and government agencies. It also demonstrates an approach to disability-inclusive
WASH.
How disability has been included
During this project, all individuals and organisations worked closely with the local DPO
(RHTO). Working with RHTO contributed significantly to the project, not only in terms of
providing invaluable links to the local community and building rapport with other locals,
but also in helping to overcome cultural difficulties. The success of the project can be
partly attributed to the meaningful inclusion of the DPO in all stages of the project’s
planning and implementation.
Outcomes from the project include recommendations for positive and practical
approaches to improving disability-inclusive development within WASH projects and the
development of training resources (including a guide to individual engagement with a
person with a disability; an inclusive WASH checklist; minimum requirements for public
toilets; and an example training timetable).
Lessons learned
 The success of WASH projects which also address the needs of people with a disability
is strongly influenced by the involvement of the local DPO and local disability
advocates in all stages of the project, including the early planning stages.
 Development programs should consider long-term design implications especially in
use of WASH facilities by people with a disability.
 When conducting any form of disability-inclusive development, it is important to train
the staff of the agency in the needs of people with a disability.
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Checklist for disability inclusion in WASH programs

Is data being collected regarding the needs and priorities of people
with a disability during planning and throughout the entire program
cycle?

Are consultations held in physically accessible venues?

Are disability related objectives and indicators identified in the
planning stage?

Have local DPOs been used in the consultation and planning process?

Have a diverse range of people with a disability and DPOs been
engaged to maximise their contribution and input into all phases of
the program?

Is there budget allocation to cover participation expenses and attendance
time for consultations with people with a disability and DPOs?

Has someone with a disability been employed in the project?

Have privacy, hygiene, security and protection needs of all people
with a disability, especially women and girls, been considered? Have
WASH programs, including accessible infrastructure, been embedded
in schools? (A lack of accessible or appropriate WASH facilities is a
common reason for low participation in education, especially for
teenage girls with a disability.)

Is WASH information and education material accessible to people with
a disability using large print, Braille, plain language, pictorial or audio
formats?

Are budgets reflective of disability-specific requirements and universal
design principles?

Are women, men and children with a disability directly involved in monitoring
and evaluation activities?

Are program outcomes and impacts for people with a disability being
measured?

Have existing disability-inclusive WASH programs and facilities been
promoted and modelled?

Are international agreements and local laws and guidelines used in
advocacy to promote rights to disability-inclusive WASH?

Have people with a disability been employed in the program?
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Useful resources for disability inclusion in WASH programs
Gosling, Louisa. (2010). Equity and inclusion: A rights-based approach.
WaterAid:
http://www.wateraid.org/documents/plugin_documents/equity_and_inclusion_english.pdf
How to Build an Accessible Environment in Developing Countries: Manual #2 –
Access to water and sanitation facilities. (2008). Handicap International.
http://www.handicapinternational.fr/fileadmin/documents/publications/Manual2-2_light.pdf
Jones, H., Parker, K.J. & Reed, R. (2002). Water Supply and Sanitation Access
and Use by Physically Disabled People: A literature review. WEDC, Loughborough
University: http://wedc.lboro.ac.uk/docs/research/WEJY3/Literature_review.pdf
Jones, Hazel & Reed, Bob. (2005). Water and Sanitation for Disabled People and
Other Vulnerable Groups: Designing services to improve accessibility. WEDC,
Loughborough University.
Source – International Information Support Centre has links to resources on
inclusive WASH and disability:
http://asksource.ids.ac.uk/cf/keylists/keylist2.cfm?topic=dis&search=QL_WASH10
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References
1
OHCHR. (n.d) 'Special Rapporteur on the human right to safe drinking water and sanitation'
retrieved from
http://www.ohchr.org/EN/Issues/WaterAndSanitation/SRWater/Pages/SRWaterIndex.aspx
2WaterAid.
(2006). Equal Access for All – 2: Water and sanitation access for people with
motor disabilities. Retrieved from
http://www.wateraid.org/documents/plugin_documents/briefing_note_disability.pdf
3
‘Thomas Seaita’, End the Cycle. (2010). Thomas Seaita’s story. Retrieved from
http://www.endthecycle.org.au
4
The Center for Universal Design, NC State Office. (2008). Universal Design. Retrieved from
http://www.ncsu.edu/dso/general/universal-design.html
5
WEDC. (2011). Briefing Note 1: Inclusive design of school latrines - how much does it cost
and who benefits?' Leicestershire: WEDC. Retrieved from
http://wedc.lboro.ac.uk/resources/briefnotes/BN001_School_Latrines.pdf
6
Right to Water. (2011). The Rights to Water and Sanitation: Essential Statistics. Retrieved
from http://www.righttowater.info/statistics/
7
‘Ben Esibaea’, End the Cycle. (2010). Ben Esibaea’s story. Retrieved from
http://www.endthecycle.org.au
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