Skip to 0 minutes and 13 secondsJane Wilbur: 844 million people around the world have no choice but to drink dirty water, and lack enough for washing, cooking, cleaning, and food production. This makes them sick and it effects their education and livelihood.

Skip to 0 minutes and 34 seconds2.3 billion people lack access to adequate sanitation, so they have to defecate in the open. This means that faeces and urine ends up untreated in the environment, and disease can spread fast.

Skip to 0 minutes and 52 secondsWater and sanitation infrastructure provides the physical conditions for hygiene, but good hygiene behaviours, such as hand washing with soap, can prevent disease. Without hygiene, the benefits from safe water and sanitation are limited.

Skip to 1 minute and 11 secondsDisability and water, sanitation, and hygiene access are related to poverty. People with disabilities in poor communities often lack water, sanitation, and hygiene, or WASH, or they are unable to access the amount required to meet their needs.

Skip to 1 minute and 33 secondsEvees, who has partial paralysis due to having polio as a child, directed this self portrait. She explained, 'I have difficulty getting enough water for myself. You can see the blue bucket. That's what normal people carry. But I can only fit a small green one on my trike.' People with disabilities who rely on carers to collect their water may limit their water consumption. A man with a disability in Uganda said, 'the disabled person is not practical in life. He cannot do anything that requires water. So his need for water is decreased.' Access to WASH services for people with disabilities is limited partly because facilities are not accessible.

Skip to 2 minutes and 25 secondsWhat do you think would make it difficult for a person with a disability to use this latrine?

Skip to 2 minutes and 36 secondsThe barriers to accessing this latrine include the narrow entrance, lack of handrails, the steps, there's not enough room inside the toilet for a person and their carer to turn easily, and there's no water inside the latrine, making anal cleansing, hand washing and washing a menstrual cloth in private difficult. Open defecation is a reality for many people with disabilities in poor communities. This photo is of a man with a physical disability in Ethiopia, crawling to the place where he has to defecate in the open. Open defecation affects the health of the person with a disability, but also the health of the whole community, as flies that land on the faeces on the ground also land on people's food.

Skip to 3 minutes and 38 secondsThere's a common misconception in many low and middle income countries that disability is a curse, or that it is contagious. And this means that even if WASH facilities are accessible, people with a disability might not use them because of other people's beliefs. For instance, a young disabled man in Uganda explained, 'they refuse to let me enter the toilet. I've started being embarrassed about my disability.' With greater access to water and a safe, private, and accessible place to bathe, people with disabilities can wash more frequently. And this can increase a person's self-esteem in social interactions. This photo is of Esther Cheelo, who has a vision impairment. And she explained, 'before they brought water, I could bathe once a month.

Skip to 4 minutes and 31 secondsNow, I can bathe two to three times a day. People never used to eat with me because I was dirty and smelling. Now, everyone can eat together as I'm no longer dirty.'

Skip to 4 minutes and 44 secondsA lack of access to WASH services has a negative impact on a disabled person's health, economic status, and ability to participate in society. But it can also have a negative effect on the health of the whole community. Ensuring that people with disabilities have access to sufficient and continuous water, sanitation, and hygiene services, is vital for a more healthy and prosperous society.

WASH case study

In this step, ICED Researcher and WaterAid staff member Jane Wilbur provides a case study of the relationship between disability, and Water, Sanitation and Hygiene (commonly known as “WASH”).

In this video, Jane will describe the global WASH situation, including the number of people around the world who do not have access to clean water and adequate sanitation. Using powerful quotes from research conducted by WaterAid and LSHTM, Jane will explain how people with disabilities might face additional barriers in accessing WASH services, even if these are available to their households and communities.

Once you have watched the video, take a look at some of the interesting resources in the “See Also” section of this page.

What do you think about WASH as a case study of the interaction between disability, health and wellbeing? Is this an area you were aware might be more challenging for people with disabilities, and why or why not was that?

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This video is from the free online course:

Global Health and Disability

London School of Hygiene & Tropical Medicine