Dear Sally Piper

Could I know, when your thesis (Toilets are not Enough) will be finally ready and, whether that will be available on this forum? I'm attracted by the topic, and look forward to going through the thesis.

Regards,

F H Mughal

The subject of disability and WASH is a neglected and overlook area when planning for programme intervention, including in schools for the disabled.

We have just concluded a study on WASH challenges of primary schools pupils attending schools for the physically challenged in a senatorial district in Osun State which revealed how the situation was, ranging from availability and use of contaminated water, to non availability of water, toilet and hygiene facilities designed to fit the various types of disabilities (physical, mental, hearing and visual impairment).

their coping strategies were also too bad to be mentioned and revealed neglect of these pupils that required special attention to fulfill their potentials in Nigeria.

Dear Mastulah,

Just to confirm what Elisabeth mentioned above, please go ahead and use my photos. If you require further information about the pictures, please contact me once more.

Best regards,

Doreen

Dear Mastulah,

Doreen might have missed seeing your question but I know her well and know that she would be happy for you to use her photos for your work. So please go ahead.

We have also collected more photos on the topic "sanitation and disability" here (showing good and bad (non-accessible) examples):
www.flickr.com/photos/gtzecosan/collections/72157626218080958/

If anyone has more photos to contribute to this collection, please e-mail us at This email address is being protected from spambots. You need JavaScript enabled to view it..

Here an example for a bad design (inaccessible: for UDDTs often the stairs are too steep; when there are ramps, they are often too steep and often have no landing at the top):

Kendu Muslim Mixed Secondary School: UDDTs by Sustainable sanitation , on Flickr

Good example (also a UDDT but "sunk installation"):

Toilet building by Sustainable sanitation , on Flickr

See more in the flickr sets themselves (click on the link above that comes with the photos).

See also this factsheet if you don't know it already:
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

Regards,
Elisabeth

Hallo Doreen,

I have seen you message indeed the communities should come out to assist the older and young who can squat on toilets to have decent toilets. I have also liked your pictures in the message can you kindly allow me to use them on our website and in East Africa Public Toilets Guide published by organisation for East Africa. We are also putting up a serous campaign towards having public toilets in the region that can be used by PWDs, the older people and kids. I will be grateful to Doreen if she allows me to use her photos.

Mastulah
Publicity Director
CAGIEA
This email address is being protected from spambots. You need JavaScript enabled to view it.

Dear All,

This week I had the opportunity to visit my relatives home in Shimba hills here in Kenya and one of the first things that I went to do was to inspect her toilet.

I haven’t been to the rural home for quite a long time. It is a traditional pit latrine.I was pleasantly surprised to see that she has improvised her pit latrine by mounting a toilet seat so that she can be able to seat instead of squat as she can’t squat anymore.



What other interesting ways have you also seen to make traditional pit latrines and VIPs accessible to the elderly, children and people with disabilities?

Now as much as it looks somewhat decent in the picture, there were still quite a number of flies and the smell was quite strong (lack of a vent pipe). There was no light at night so we had to use a lamp or a torch. This is a relatively new toilet, the last one filled up.They abandoned it, removed the superstructure and constructed another one. My relative lives almost 2 hours away from the next town and there are no exhausters or manual pit emptiers in the area (Infact she has never heard of manual pit emptiers and was shocked when I told her how they carry out the collection). Below is the superstructure. It is quite a distance from her house which is also very common here.



Once a toilet fills up in Shimba Hills, they disown it and build another one.

Best regards

Doreen

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

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

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

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

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.

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.

[img]http:// [url=http://www.flickr.com/photos/gtzecosan/6840646046/][img]http://farm8.staticflickr.com/7203/6840646046_c9608376d0_z.jpg[/img][/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.

[img][url=http://www.flickr.com/photos/gtzecosan/6986759887/][img]http://farm8.staticflickr.com/7061/6986759887_c5843875e6_z.jpg[/img][/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