Published on: 18/11/2014
A lot of effort is put into getting everyone in the world access to clean drinking water and adequate sanitary services, but is everyone really included? As recent as 2011 the first ever world report on disability has been published by the World Health Organization and the World Bank (2011). It appears that until now disabled people have typically been excluded from interventions and research around WASH.
BRAC wants to ensure that all people in Bangladesh, including the disabled, benefit from their WASH programme. Within the Bangladeshi context very little reliable information is available on disabled people. The World Bank estimates that the figure may be around 15 %, but the 5th Population and Housing Census 2011 states that only 1.4 % of Bangladesh's total population is disabled. While the 2010 Household, Income and Expenditure survey by the Bangladeshi Bureau of Statistics has published a figure of 9 %. These very different figures indicate that research is needed and that renewed attention has to be given to sanitation coverage for really everyone.
The London School of Hygiene and Tropical Medicine obtained a grant from ADRAS (Australian Development Research Award Scheme) for research on access to sanitation for the disabled. The research will be taking place in Malawi and Bangladesh. In Bangladesh, BRAC and IRC will be collecting information on disabilities in relation to sanitation. In January 2014 they conducted a first survey covering 3600 households in a BRAC WASH area. One of the outcomes was that only 39 households indicated that they had at least one person in their house which could not go to the toilet without help. This comes down to 1.2 %. This figure seems really low and the organisations involved wondered whether other issues were influencing this outcome. One reason could be that disabled people do not want to discuss their disability openly. They may prefer to find their own solutions and not burden their family or others with their problems. Or households have found their own solution for their disabled family member and therefore felt that the survey questions did not apply to them.
BRAC and IRC have been discussing these findings with several organisations working with the disabled in Bangladesh. They confirm that often when they are visiting households who have requested a wheelchair they discover that a specific crutch would have been a far more suitable solution to the problem if only they had been informed accurately about the problem. Also frequently households who are caring for disabled members do not have sufficient insight into the variety of specific solutions that are available to them. All these confusions clearly indicate that a better insight into disability in connection with sanitation needs to be gained. Further formative research is required with direct involvement of disabled people and their caretakers. The next survey will have focus group discussions to gather more factual data on the real status around disability and sanitation in Bangladesh.
The research BRAC and IRC will be conducting will have various objectives:
To get a better grasp of the problems faced by disabled people on accessing a toilet and what needs to be done improve independent access;To design and implement a strategy that will help mitigate the problems faced by disabled people;To measure the impact of the implemented strategy by conducting a more detailed follow-up survey.
One way of getting accurate information to and from households with disabled families can be through Rural Sanitation Centres. By making these Centres more aware of the problems of this particular group and by providing them with low cost solutions to provide access this could already help improve the situation of disabled persons. Rural Sanitation Centres are supported by BRAC and are autonomous businesses that are a major contributor to sanitation facilities in the BRAC WASH areas. BRAC and IRC will also look for close collaboration with multiple organisations in Bangladesh that are active in supporting persons with a disability. Collaboration and research must bring disabled persons closer to independent access to sanitation.
This blog is based on a WASH Disability Meeting report written by Kristof Bostoen and Marielle Snel.
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