People with disabilities, older adults, older adults with disabilities and those that care for them, often have a greater need for WASH facilities and services and may also have different WASH requirements than people without disabilities. Below we summarise some key insights from research on disability, ageing and WASH:
- Inaccessible WASH: WASH access is considered to be one of the biggest challenges of daily life for many people with disabilities.
- A range of barriers to accessing WASH: People with disabilities, older adults, older adults with disabilities face a diverse range of barriers to access. These include physical barriers and environmental factors such as uneven terrain or muddy ground, as well as barriers associated with built infrastructure, such as steps or inappropriate pump handles. Studies show that people with disabilities find it difficult to use the toilet without coming into contact with urine or faeces. In Vanuatu, this was more likely for older adults, people with physical disabilities and older adults with disabilities. Institutional barriers include policies and institutions within the WASH sector that overlook the needs of people with disabilities and older adults or prevent their participation in the design and delivery of WASH programmes. Lastly, social barriers arise through interaction with other people and result from cultural beliefs or practices. Social barriers may include beliefs that a disability is due to a curse or is contagious and consequently that people with disabilities should be kept away from WASH facilities. The barriers people with disabilities, older adults and older adults with disabilities face when accessing WASH typically vary by individual, socio-demographic factors and context.
- Ensuring meaningful participation is vital: Improving WASH access for people with disabilities, older adults and older adults with disabilities is challenging to do at scale. It is likely to require meaningful consultation with people with disabilities and older adults on infrastructure, the sharing of a range of inclusive WASH technologies, providing support to these populations (financial, social and in terms of labor), and thorough training of staff on inclusive programming.
- Increased marginalisation during humanitarian crises: The barriers that people with disabilities and older adults face when accessing WASH facilities and services are often more pronounced in crises given the changes that crises cause to the physical and social environment. During emergencies, people with disabilities, older adults, and older adults with disabilities are more likely to be marginalised by WASH programmes.
- People who experience incontinence have additional WASH requirements: Incontinence is a complex social and medical issue, and people who experience it and their caregivers need to use more water and soap for washing hands, bathing and doing the laundry, in addition to ensuring easy access to a toilet or other assistive products. Without it, the health and dignity of people who experience incontinence and their caregivers is compromised. Older adults, pregnant and new mothers, children, people with disabilities, and older adults with disabilities are most likely to experience it, and severity increases with age. Research in Vanuatu showed that people with disabilities were two times more likely to experience incontinence than people without disabilities. The Sphere Standards, a set of standards for humanitarian response, now includes guidance on addressing incontinence.
- Intra-household WASH inequalities: Data from 34 countries shows that households that include a person with a disability typically have reduced access to key water and sanitation services. Even if households with a person with a disability have access to WASH facilities, the individual with a disability typically has reduced access in comparison to other family members. They also face greater challenges in accessing facilities and services autonomously, consistently, hygienically, with dignity and privacy, and without pain or fear of abuse.
Want to know more about considering disability in COVID-19 hygiene programmes:
- Why should we include people with disabilities in the COVID-19 response?
- Are people with disabilities at higher risk during the COVID-19 pandemic?
- What specific barriers might people with disabilities face in relation to handwashing with soap?
- How can we ensure people with disabilities are included in all COVID-19 hygiene promotion programmes?
Written by: Jane Wilbur
Initially Reviewed by: Hannah Kuper, Islay Mactaggart, Sian White, Chelsea Huggett
Last updated: 08.09.2020