Water and sanitation service systems are seldom planned to accommodate people who have functional limitations, although their livelihood and wellbeing, as with most other people, are linked to their access to and control over environmental resources for food, water, and shelter. Lack of access to water and sanitation systems often make people with disabilities dependent on others for their basic needs, and furthermore, more vulnerable to the risk of contracting diseases.
In many cases, latrines are not accessible by people with physical limitations. A community project to build latrines in Zambia, for example, did not benefit persons with disabilities as these latrines were not usable for them. They did not have a sitting pan and the doors were too narrow for a wheelchair to enter. The same toilets were used for bathing purposes. One woman with disabilities said that she bathed only at night and used the bushes as a toilet.
A similar problem is reported in a Ugandan primary school. High door locks, limited space inside the latrine, taps which are too high make it difficult for children with wheelchairs to use the toilet. Children who crawl find the floor too dirty, especially as they often crawl with bare hands. Where the water source is not close by, users find it difficult to carry water to the latrine for washing. Or in other cases, toilets may be located some distance from classrooms without access ramps. The United Nations Educational, Scientific and Cultural Organization (UNESCO) estimates that 90% of children with disabilities in developing countries do not attend school in part because of inaccessible toilets.
In addition, steps to reach a water source, slippery floor surfaces and apron walls all impose barriers. In the household, narrow doorways, water storage containers without handles make it difficult for people with disabilities to access water. Barriers also exist in the natural environment, like long distances to water sources, rough terrain, rivers with soft or rocky banks and uneven slopes to reach the water. These all impede access for those with physical impairments, especially in rural areas.
The World Bank-funded water and sanitation promotion project in the Western provinces of China is notable because it emphasizes accessible water and sanitation systems taking into account the needs and preferences of different sections of the community --- particularly women and other vulnerable groups such as people with disabilities or chronic illness, and elders. In constructing water systems, latrines, and other sanitation facilities, a community and households are involved in selecting the technical options of facilities appropriate to their needs. The project pays extra attention to the usability of facilities for people with disabilities and elders.
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