Hi everyone,

A recently published rapid review by SSD for DfID has highlighted how people with disabilities are likely to be much more vulnerable to contracting and dying from COVID-19. Of the several attitudinal, environmental, and institutional factors that aggravate risks for people with disabilities, the report identifies barriers to basic hygiene (p.12):  

“Barriers to implementing basic hygiene measures, following social distancing or self-isolation measures: A recent disability briefing from the WHO (2020) notes that people with disabilities may have difficulties implementing basic hygiene measures during the pandemic due to physical barriers, for example sinks that are physically inaccessible. In addition, stigma and discrimination from others when using household or public facilities, for example due to misconceptions that people with disabilities could contaminate water sources or latrines (UNDESA, 2019). Inaccessible WASH facilities in LMICs has also been highlighted by DPOs since the start of the pandemic (expert contribution from Disability Rights Fund). Reports from prior to the pandemic note that women and girls with disabilities more often report anxieties about their privacy, safety and security, and incidents of physical and sexual harassment and assault while accessing sanitation facilities (Caruso et al. 2017; Stevenson et al. 2016; Caruso et al. 2018; Sommer et al. 2015). These barriers are likely to be more severe in humanitarian settings and informal settlements. In addition, women and girls with disabilities experience challenges with menstrual hygiene management including particularly due to stigma (House et al. 2012), and women and girls often take responsibility for assisting with sanitation and hygiene for people who are sick, older people and people with disabilities (Enfield, 2018). Disability rights advocates have reported that some people with disabilities who require support from a carer to meet their essential needs such as washing and feeding may not be able to maintain distance from their carers (OHCHR, 2020a; ITV, 2020; Bernhard, 2020). WHO (2020) has noted that for some people with disabilities it is necessary to touch surrounding objects (for example hand rails) to obtain information from the environment or for physical support, which puts them at risk of contracting COVID-19.”

As many WASH programmes are now re-tooling for COVID prevention, its important that people with disabilities and other vulnerable high-risk groups are at the forefront of outreach efforts… or else they’ll be overlooked during information campaigns, or when designing facilities in schools, health centers, and at home.

What tools, resources, approaches, or real-life examples for improving hygiene services and/or reducing stigma for people with disabilities would you recommend for COVID outreach and prevention activities? The well-known  Compendium of Accessible WASH Technologies from WEDC, SHARE, and WaterAid, for example, offers some ideas for affordable handwashing facilities (which I believe is currently being updated). UNICEF has also put together a useful brief which includes important response considerations for children and people with disabilities, noting that messaging on COVID may not reach people with visual, hearing or intellectual impairments. Resources like these would be useful to consider in SuSanA's  COVID & WASH practical guides and resources  as well.

I also imagine new measures for social distancing are forcing many outreach efforts to be more creative, as the usual mass community meeting used in many rural contexts may not be possible.  I’m wondering if anybody has any examples of how this is being done, and what measures are taken to ensure that people with disabilities are not left out.