The UN Convention on the Rights of Persons with Disabilities (UN-CRPD) defines disability inclusion as the ability of persons with disabilities to actively contribute and participate in society and requires that the barriers preventing this participation be addressed.

Persons with disabilities are disproportionally affected by poverty and vice versa. Limited or no access to WASH services severely affects health and socioeconomic outcomes, even more so for persons with disabilities, exacerbating inequalities for them and their caregivers. It can also perpetuate poverty, as this is both the consequence and the cause of disability.

According to the WHO and World Bank World Report on Disability, around 15% of the global population – or one in seven people - are women, men, girls and boys with disabilities. In addition, more than 46% of older people (60 years and over) have a disability. 

Persons with disabilities and older people are active members of the affected community and important stakeholders in humanitarian assistance. A variety of sociological factors, such as poverty, security, traditions or cultural practices and access to education and health, can nonetheless (negatively) influence how they are regarded in any specific community. This can vary significantly between communities in the same region or country.

In 2016, the International Community committed to making humanitarian assistance inclusive of persons with disabilities (as required by international humanitarian law and human rights law) by signing the ‘Charter on Inclusion of Persons with Disabilities in Humanitarian Action’ and committing to interventions that are non-discriminatory, participatory and based on cooperation and coordination.

All those working in emergency response must commit to identifying the needs of persons with disabilities and overcoming the barriers that they face in accessing humanitarian interventions. This can be done through: 

• Direct consultation and involvement of representative organisations e.g. those that represent people with various disabilities, including intellectual and psychosocial, as well as families and caregivers throughout the project.
• Carrying out needs assessments (chapter  A ) to identify and understand the barriers that persons with disabilities and older people face in accessing WASH services, recognising that these barriers go beyond merely physical accessibility and are linked to the availability, accessibility, affordability, appropriateness and quality of WASH services.
  
  
• Understanding that a key barrier is the attitude of humanitarian actors towards persons with disabilities and older people. 
  
  
• Integrating disability-sensitive measures into training and implementation, awareness raising and disability rights at different levels with various stakeholders (OPDs, community, government, or non-governmental organisations).
  
  
• Ensuring that MEAL systems (chapter  M ) include data about disability and that inclusive feedback mechanisms are established.

The participation of persons with disabilities and/or their OPDs is essential to understand the barriers that women, men, girls and boys with disabilities face in accessing hygiene programmes and to address them accordingly. Hygiene programmes need to be inclusive, but persons with disabilities must also be actively involved in decision making, in line with ‘nothing about us without us!’ and the general principles of the UN-CRPD.

Process & Good Practice

• Assess each situation carefully. There is no ‘one size fits all‘; persons with disabilities are not a homogenous group. Implement an inclusive WASH response by collecting and recording information on disability as soon as possible.

• Identify OPDs or older people in the assessment and work with them to assess the affected population’s different needs as well as the policy environment and existing support available for people with disability and older people.

• Involve persons with disabilities, their families and carers, OPDs and I/NGOs working in the sectors of disability and age-inclusion when planning and implementing the WASH intervention P.9.

• Consider people’s communication needs such as the use of sign language, large font or subtitles. Use easy to understand and context-specific materials. A mix of formats is a good way to reach as many people as possible (chapter  C ).

• Carry out Household Visits T.18 where possible. They can increase access to information for all and help to identify the unmet needs of older people, persons with disabilities (such as incontinence), those who are housebound or those with intellectual or cognitive impairments.

• Hold events nearer to people’s houses where possible to ensure better access. Consider help with transport if this is not possible as well as access at the specific venue.

• Ask persons with disabilities or their caregivers for their feedback to ensure that communication is inclusive. Ensure that promotional material does not portray persons with disabilities or older people in a way that perpetuates stigma.

• Involve people with different disabilities when designing new WASH facilities, and ensure existing facilities are modified to be fully accessible. Carry out Accessibility Audits T.1 with older people and people with different disabilities to identify what needs to change and how people can access facilities in a dignified and safe way.

• Assess whether there is a need for specific hygiene products or additional supplies (e.g. water for additional washing, incontinence pads, soap, bedpans, commodes, urine bottles or potties, P.6).

• Encourage and support the inclusion of persons with disabilities and older people on WASH committees as outreach workers, caretakers or paid agency personnel and include their representation in WASH IEC material.

• Support or encourage WASH school clubs that are inclusive of children with disabilities E.6. They can support wider attitudinal change to disability by, for example, involving children with disabilities as WASH champions T.22, discussing disability and ensuring that facilities are accessible.

• Ensure that outreach activities are conducted in addition to school-based WASH or menstrual hygiene activities to include the many children with disabilities who are not in school.

• Train persons with disabilities and older people as facilitators, technicians, hygiene promoters or WASH committee members. They may need additional support such as assistive devices, sign language or the help of caregivers.

• Integrate disability-inclusive programming into capacity strengthening initiatives for agency and government staff, hygiene promoters and/or community health workers. This can be done in partnership with local OPDs and other representative organisations.

• Ensure that data is collected on gender, age and disability and make disability-inclusive feedback mechanisms available. Use the ‘Washington Group’ Short Set of Questions on functioning as a tool for disaggregation of data by disability.

• Consider holding regular workshops about the rights of persons with disabilities and disability-inclusive WASH at an interagency, agency and community level, ensuring close follow-up by the implementing organisation.