Disability and the WASH sector

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Disability and the WASH sector

WaterAid has published an interesting report about "disability and the WASH sector". You can see the announcement and link here on Sanitation Updates:
sanitationupdates.wordpress.com/2011/10/...and-the-wash-sector/

www.wateraid.org/documents/report__what_..._the_wash_sector.pdf

This report gives an overview of the information relevant to the water, sanitation and hygiene (WASH) sector in the world’s first report on disability. It also highlights how WaterAid is addressing the recommendations in the report, as well as where we could develop our approaches further.

++++++++++

I have 2 comments to make:

a) I am interested in this activity of WaterAid and wonder if this is available also to everyone or only to WaterAid partners:

++++++

Awareness-raising training on
equity and inclusion,
highlighting disability, has
been provided for all staff in
the UK and in country
programmes.
Through a partnership with
WEDC, we are rolling out
technical training in equity
and inclusion to WaterAid
staff via webinars and
workshops. The training
modules are designed so that
they can be shared more
widely with staff and
partners.
Training has been provided
by disabled people in
WaterAid country
programmes to raise staff
awareness of the issues

++++++++++

b) As with most of these documents there is a strong focus on adapting simple pit latrines. But maybe the sanitation system itself needs to be changed radically to suit the needs of people with disabilities. I have already mentioned elsewhere on this forum that I believe that toilets must move closer to the bedrooms (or classrooms) - reducing the access distance is so important in my opinion. And here my hypothesis is that bench UDDTs have great potential (as they can be indoors). (Peepoos, mobile toilet pots, waterless uni-sex urinals may be other interesting options)

See this factsheet of ours:
von Muench, E., Duering, I. (2011). Making sustainable sanitation inclusive for persons with disabilities - Factsheet. Deutsche Gesellschaft fuer Internationale Zusammenarbeit (GIZ) GmbH, Eschborn, Germany. [390.33 KB]
www.susana.org/lang-en/library?view=ccbktypeitem&type=2&id=1210

So I am wondering what the WaterAid staff think of these suggestion?
(I will also contact the author, Jane Wilbur, directly and hope that she is keen to take part in the discussion here).

Greetings,
Elisabeth

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  • Doreen
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Re: Disability and the WASH sector

Quite an interesting report from WaterAid. Thumbs up!

Elisabeth you are right! It is so important to move the toilets closer to the bedrooms and classrooms. I am really impressed by the concept of the bench UDDTs because the toilet can be located indoors and even on any level of the house reducing walking distances and increasing security. By the way, in addition to reading the factsheet that Elisabeth mentioned "Making sustainable sanitation inclusive for persons with disabilities" it would also be very worthwhile to visit the flickr collection on toilets, urinals and bathing units for people with disabilities (worldwide)
www.flickr.com/photos/gtzecosan/sets/72157626092736007/

Here you shall find a variety of facilities which have been adapted in some way to make them more easily usable by people with disabilities.

All of us at some point in our lives might face some form of disability. Basic infrastructural structures need to be implemented to assure accessibility of sanitation facilities for disabled people. It is also important to incorporate inclusive designs taking into consideration age and gender aspects especially in terms of menstrual hygiene management. That way, all groups have access to safe sanitation facilities. This is possible through the active inclusion of key stakeholders and through carrying out baseline surveys in the communities. Engaging stakeholders is top priority so that different approaches and technical solutions can be implemented depending on the different types of disabilities in the communities.

I look forward to further discussions on technical solutions and feedback from Wateraid.

Best regards

Doreen

Doreen Mbalo

Sustainable Sanitation Programme and Sustainable Sanitation Alliance (SuSanA) Secretariat
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  • Jane
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Re: Disability and the WASH sector

Thank you for your comments on my report - it’s wonderful to read people’s thoughts on mainstreaming disability in sanitation. To answer your first question, I thought I would firstly give a bit more background on the training.

In partnership with the Water, Engineering and Development Centre (WEDC) at the University of Loughborough, WaterAid has developed a technical training programme of written assignments, webinars and workshops for country programme and UK staff. These encourage participants to explore ways to make water, sanitation and hygiene more accessible to vulnerable and marginalised groups.

One of the challenges has included getting staff to complete the online training as it is self paced learning, without an academic qualification at the end. We have had organizational buy in and managers have encouraged staff to take part in this training, which has really helped.

We have found this course invaluable as it has really increased people’s awareness for the need of accessible designed programmes which address all barriers (environmental, attitudinal and institutional). The training programme is designed for other organisations to complete and WEDC is considering the best way to take this forward. We plan to roll it out to our partner organisations.

I completely agree that reducing the distance to toilets is a key addressing the natural environmental barriers people face – this includes distance from toilets and/or open defecation areas and terrain. The bench UDDT looks really interesting – I’ll circulate that to WaterAid staff.

In terms of ensuring everyone has access throughout the life cycle, we must be mindful of children, menstruating women, pregnant women, older people and people who are chronically ill; these people may or may not be disabled. Mainstreaming inclusive development (inclusion, equity and access) which looks at the hardware and software components of programming is arguably, the best way to can do this.

We’ve documented some of our attempts to do this. You can find the reports and briefing notes under ‘further information’ on our website www.wateraid.org/international/what_we_d...d_inclusion/8352.asp . These include ‘creating user friendly water and sanitation facilities in Nepal’ and a really interesting accessibility audit of our work in Madagascar (‘Diagnostic d’accessibilite’). There’s also a write up of an evaluation I did of WaterAid’s project in Ethiopia, which was designed to meet the needs of disabled people within their service delivery work (‘briefing note – principles and practices for inclusive development’). Findings and recommendations covered inclusive development, understanding the power relations and inviting strategic participation across power levels for more empowering interventions.

In terms of menstrual hygiene management, Sally Piper’s just completed her MSc thesis in collaboration with WaterAid Malawi. It’s called ‘toilets are not enough’. Her findings are fascinating as they cover access, gender relations and attitudinal barriers related to the cultural context. I think she’s a member of this forum, so might post some comments too, but I’ll also send her an email to highlight this discussion to her.
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  • Jane
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Re: Disability and the WASH sector

Dear All

I'd like to correct my blog above where I said that the WEDC training programme is designed for other organisations.

The training is not designed for other organisations to complete. WEDC would welcome the opportunity to design similar mixed mode trainings, which would be tailored to the needs of the organisation.

We (WaterAid) highly recommends it to other organisations! The person to contact is Hazel Jones (WEDC) who will also respond further when she's back from Mumbai.

Warm wishes

Jane
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  • muench
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Re: online training course?

Dear Jane,
Thanks very much for your postings!
I look forward to hearing more about Sally Piper's thesis on MHM in Malawi, I hope she will announce it here soon (have you e-mailed her already?).

Regarding the mentioned online courses on disability in the WASH sector for WaterAid staff, I am still a little bit confused. Do I understand right that WaterAid paid WEDC to develop the course materials (specifically for WaterAid staff), and that the materials are now not available for self study but only for fee-paying students? Or did I misunderstand? Wouldn't it be useful for the sector to make the online course materials available to everyone (but if someone wants tutoring and take it in a manner which includes feedback on assignements etc. then they would have to pay)?

(This is how I used to run the ecosan online courses back in 2007/2008 when I was working at UNESCO-IHE in Delft: all the materials were available for free in a demo version, but to take the course in a structured way, together in a group and with tutoring support, then people had to pay a course fee - this worked very well. I am not 100% if my successor, Mariska Ronteltap, continued with it in the same fasion, but I think she did).

My second point about the bench UDDTs: what is WaterAid's feelings about this technology at this stage? It is not very new technology but perhaps still not so well known. By the way, composting toilets are also often set up with such a bench, e.g. in Sweden, e.g. Carl Lindstrom told me it makes it easier to use for people with disabilities (I had posted this elsewhere on this forum, under sanitation systems, UDDTs).

Kind regards,
Elisabeth

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Dr. Elisabeth von Muench
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Re: Disability and the WASH sector

Hullo,

My name is Sally and Jane of WaterAid introduced me to the forum, so thank-you Jane. Elisabeth, we met at the dry toilet conference in Tampere. I am also posting this in the menstrual issues part of the forum.

++++++
---> Note by moderator: please go to the category "Menstrual Hygiene Management" of this forum, where you will see the very interesting posting of Sally Piper!
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  • Doreen
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Re: Disability and the WASH sector

Dear All,

After some research in low income urban areas here in Nairobi last week, I feel that it is paramount to further stress the importance of including and mainstreaming people with disabilities in sustainable sanitation.

People with disabilities face a number of challenges accessing sanitation facilities in low income areas. It is beneficial and paramount to ensure that they are incorporated right in the initial stages of the design and implementation phases.

Last week, I met a lady in Kibera who was disabled. Her pit latrine was situated outside the house and she could only access it if her relatives provided assistance. The pit latrine was completely full when I visited. As she cannot squat, she had a tiny seat in the latrine which she could use whilst in the toilet and cleansing herself. She bought the seat for KSh 300 which is EUR 2.70. Unfortunately sometimes the seat breaks down and it has to be repaired. During this time, her relatives have to carry her inside the toilet. There are no support rails that she can use inside the toilet.

[/url][/img]

I asked her what her ideal toilet would look like and she said that she would like one where she can sit and one that was inside her house. There are no hand washing facilities next to the toilet making it hard for her to clean herself. She told me that sometimes she has diarrhoea. I believe that this is attributed to the lack of hand washing facilities after using the toilet. Sometimes it is very difficult for her to access the toilet at night when all her relatives are asleep. This made me very upset because this affects her dignity and self esteem :(
It also has an impact on her family as they have to constantly wash her soiled clothes and bed sheets. Therefore the provision of a seat is not enough. A primary barrier is the distance from her house to her toilet.

[/url][/img]

Please let us revive this topic, try and share ideas and information on how we can ensure that people with disabilities especially in low income urban areas are catered for sustainably. I would like to hear about what other developing countries are doing to ensure that vulnerable groups are put into the forefront.

Personally I think the only option here is the Bench UDDT.
See the factsheet that contains information about the Bench UDDTs here: www.susana.org/lang-en/library?view=ccbktypeitem&type=2&id=1210

It requires little space and is very suitable for persons with disabilities. It is so important to ensure that they have an accesible toilet. It is their right!

I look forward to your thoughts.

Best regards

Doreen

Doreen Mbalo

Sustainable Sanitation Programme and Sustainable Sanitation Alliance (SuSanA) Secretariat
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  • JKMakowka
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Re: Disability and the WASH sector

Ask the people of the French NGO Handicap International, they are specifically focusing on these issues. The NGO HelpAge is also another player in this subsector.

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  • muench
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Re: Disability and the WASH sector

Dear JKMakowka,
I think Doreen's point is more that all players who are in water/sanitation should considere disability issues, not just some specific NGOs. On top of that, my very limited experience with these issues is that the "classic" NGOs, like Handicap International, are not necessarily on top of the latest developments in sanitation - and only promote conventional pit latrines with some basic adaptations for people with disabilities, instead of a radically different approach which would come from innovation in the sanitation sector. Such as bench UDDTs or mobile toilets where the toilet comes to the person instead of the person to the toilet! (e.g. Peepoos or mobile urine diversion toilets like Mosan, which is being discussed here on the forum: forum.susana.org/forum/categories/52-mob...s-portable-solutions )

Dear Doreen,
Thanks for your points and story - it always helps to have a concrete example in mind when we discuss these issues!!

By the way, there is an interesting initiative underway with the German ministry BMZ (our ministry for economic cooperation and development) - the one of which behalf GIZ carries out the program which I lead - which says that all development cooperation work, no mater which sector, should consider issues of "inclusion" (for people with disability). I am curious how this sign of political will for inclusion will trickle down to our actual programs on the ground.

Regards,
Elisabeth

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  • JKMakowka
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Re: Disability and the WASH sector

muench wrote: Dear JKMakowka,
I think Doreen's point is more that all players who are in water/sanitation should considere disability issues, not just some specific NGOs. On top of that, my very limited experience with these issues is that the "classic" NGOs, like Handicap International, are not necessarily on top of the latest developments in sanitation - and only promote conventional pit latrines with some basic adaptations for people with disabilities, instead of a radically different approach which would come from innovation in the sanitation sector.


Hello Elisabeth,

I was a bit in a hurry when I wrote that comment... and you are of course right regarding that comment that all WASH actors should keep this in mind. However this is in fact the very agenda Handicap International is trying to promote.

When I was working with them for a short time last year, I also realized that they are lacking in specific WASH expertise, as obviously the majority of their staff are health experts. Never the less, we had some very helpful discussions about how to adapt the latest WASH tech. to the needs of disabled people.

Reading some manuals and common sense will bring you only so far in this regard... much better is to discuss this with the actual disabled, or to get a broader view, with professionals working with disabled every day.
Therefore I was suggesting to get into contact with an NGO that is focussing to make all players aware of these issues and try to get them involved.

Regards
-Krischan

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  • Doreen
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Re: Disability and the WASH sector

Dear All,

I sent the following letter to the organisations below regarding issues pertaining to people with disabilities and the WASH sector.

- UN Enable: United Nations Convention on the rights of persons with disabilities
- Association for the physically disabled in Kenya (ADPK)
- Handicap International
- CBM

I have not yet received feedback. The UN however did write back stating that they have forwarded my email to the experts at the Committee on the Rights of Persons with Disabilities and Handicap International sent me an email that they have forwarded my request to the technical department so I am eagerly waiting for their input, advice and thoughts.

Nonetheless I thought it would be important for me to share the email that I wrote with you.

++++++++++++


Dear Sir/ Madam,

My name is Doreen Mbalo. I work for the GIZ Water Sector Reform Program in Nairobi Kenya.

I would like to receive some information about how you are approaching the issue of ensuring that people with disabilities especially in low income urban areas in developing countries have access to sustainable sanitation. In addition, I would like to know whether you have any best practices around the world in the sanitation sector that you can share.

I ask because people with disabilities face a plethora of challenges accessing sanitation facilities in low income areas in my country Kenya. I know this is not restricted to Kenya but also to other developing countries. It is therefore beneficial and paramount to ensure that they are incorporated right in the initial stages of the design and implementation phases of any sanitation facilities. It is their right as per Article 9 and 28 of the UN convention on the rights of persons with disabilities. In addition, we involved in international development are mandated to ensure that our programmes are inclusive of and accessible to persons with disabilities.

I had the opportunity to meet a lady in Kibera (a slum in Nairobi) who was disabled 3 weeks ago. Her pit latrine was situated outside the house and she could only access it if her relatives provided assistance. The pit latrine was completely full when I visited. As she cannot squat, she had a tiny seat in the latrine which she could use whilst in the toilet and cleansing herself. She bought the seat for KSh 300 which is EUR 2.70. Unfortunately sometimes the seat breaks down and it has to be repaired. During this time, her relatives have to carry her to the toilet. There are no support rails that she can use inside the toilet.

I asked her what her ideal toilet would look like and she said that she would like one where she can sit and one that was inside her house. There are no hand washing facilities next to the toilet making it hard for her to clean herself. She told me that sometimes she has diarrhoea. I believe that this is attributed to the lack of hand washing facilities after using the toilet. Sometimes it is very difficult for her to access the toilet at night when all her relatives are asleep. This affects her dignity and self esteem. It also has an impact on her family as they have to constantly wash her soiled clothes and bed sheets. Therefore the provision of a seat is not enough. A primary barrier is the distance from her house to her toilet.

Personally I think the only option here is the Bench UDDT. It is a toilet that requires little space, can be situated inside the house and is suitable for persons with disabilities. It is so important to ensure that they have an accessible toilet.

- See the factsheet that contains information about the Bench UDDTs here: www.susana.org/lang-en/library?view=ccbktypeitem&type=2&id=1210

- Please find discussions in the SuSanA forum about mainstreaming people with disabilities in the sanitation sector here: forum.susana.org/forum/categories/26-hea...the-wash-sector#1279

- It would also be very worthwhile to visit the SuSanA flickr collection on toilets, urinals and bathing units for people with disabilities (worldwide) Please follow this link for the flickr collection: www.flickr.com/photos/gtzecosan/sets/72157626092736007

It would be great if someone contributed and gave us some information preferably in the discussion forum on how best to move forward and the appropriate methodologies on how to incorporate the main stakeholders right in the initial stages of the design phase.

I look forward to your input. Thanks in advance.

Best regards

Doreen Mbalo

Doreen Mbalo

Sustainable Sanitation Programme and Sustainable Sanitation Alliance (SuSanA) Secretariat
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  • Doreen
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Re: Disability and the WASH sector

Dear All,

I am sorry that I constantly have to bring sad news from the field but yesterday we were visiting plot level households near Gichagi in Rift Valley here in Kenya. I had the opportunity to enter a plot where I spoke to a woman about her current and desired sanitation situation. She told me that she has no toilet in the plot therefore she has to go to the neighbouring plot whenever she needed to visit the toilet.

She has two disabled children, one special needs and the other was not able to walk. Due to the lack of sanitation facilities in the home and within the plot, her children wore diapers. I asked her where she disposed the diapers and she told me that she would throw them in the neighbours pit latrine everyday. Her children are 12 and 15 years old.

Even at night when it is not safe, she leaves the house to go to the neighbours plot to visit the toilet. The conditions that she is living in are just terrible. I was deeply disheartened by her situation. :(

I asked her what her desired sanitation facility would look like. She told me that she admires the flush toilet as her children would be able to sit and use the toilet. She said that it could however be difficult to maintain the toilet as water is scarce in Gichagi.

In addition, she would prefer a toilet inside her house or right next to the plot so that she doesn’t have to go to the neighbours when she needs to use the toilet.

Regards

Doreen

Doreen Mbalo

Sustainable Sanitation Programme and Sustainable Sanitation Alliance (SuSanA) Secretariat
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Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ) GmbH
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