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World Water Week — the annual focal point for global water issues — runs in Stockholm, Sweden this week (31 August – 5 September). At the meeting a research consortium involving the international NGO WaterAid is set to present findings of its research into making water, sanitation and hygiene (WASH) technology accessible for disabled people in Uganda and Zambia. 
The logic of making WASH disability-inclusive in communities extends beyond the benefits to disabled people themselves. Key targets set by the UN to stop open defecation by 2025 won’t be met if even one person in a community continues to practise it. 
Existing water and latrine facilities are often inaccessible, which means that disabled people have no choice other than to openly defecate. Inappropriate community interest in their sanitary habits forces them into secret and dangerous practices.
In recent years WaterAid and Loughborough University’s Water Engineering and Development Centre (WEDC) have created simple, low-cost and low-tech designs for latrines. These designs have features including handrails, raised seats and wider entrances to cubicles so that wheelchairs can get through them. [3,4]
WaterAid’s present research from Uganda and Zambia, conducted with WEDC and the University College London’s Leonard Cheshire Disability Centre, is giving focused, in-depth insight on what good, accessible WASH can and should look like in poorer communities. For example, researchers found that even simple measures to make toilets accessible are rarely in place. These include making approach paths to toilets level, marked and clear of hazards, and having low-angled entrance ramps with a handrail.
But installing accessible facilities is only part of the pathway towards full inclusion of disabled people in hygienic WASH practices. WaterAid has also been undertaking accessibility audits: practical discussions between the people installing the facilities and the users — male and female, non-disabled and disabled people with different impairments.  Researchers found these were fantastic first steps towards establishing a fuller range of necessary measures for disability inclusion. These measures include sharing information so everyone can access it, raising awareness about the challenges that different people face, and addressing inappropriate negative attitudes towards disabled people so they can participate more meaningfully in establishing WASH facilities that the whole community can use.
Researchers found that in Zambia the accessibility audit was a powerful tool. It enabled implementers to observe first-hand how difficult it is for disabled people to access standard WASH facilities, leading them to call for immediate change. And it gave vulnerable people an opportunity not only to express the challenges they face, but also to show the valuable insights they could contribute.
Disabled users’ input and feedback on specific designs is crucial to ensure their suitability — and sustainability.
There are a growing number of practical resources available for disability-inclusive WASH — it has proven itself a leading sector considering technologies suitable for use by disabled people. Key resource websites are provided by WaterAid, WEDC and the online resource centre for disability and inclusion Ask Source. [6,7] One especially useful summary is an inclusive WASH checklist. 
The cost of making water points, hand washing facilities and latrines accessible can be minimal. But the cost of not doing so is infinitely more both in terms of community health if disabled people are excluded. It is simply a logical choice for all.
Sue Coe has worked in international development for 25 years across Africa, Asia, Europe and the Middle East. Now a development and disability inclusion consultant, she previously worked for World Vision, Practical Action (formerly ITDG), VSO and Action on Hearing Loss (formerly RNID). Sue can be contacted at [email protected]
 World Water Week Addressing Equity in the Water, Sanitation and Hygiene Sector (Conference programme 2014)
 UN News Centre<a href="http://www.un.org/apps/news/story.asp?NewsID=44452#.VAOakvldV8F> Deputy UN chief calls for urgent action to tackle global sanitation crisis</a>(UN, 21 March 2013) Institute of Development Studies, Disability: Making CLTS Fully Inclusive (IDS, 2014)
 Water Engineering and Development Centre, Inclusive design of latrines — how much does it cost and who benefits? (July 2011)
 Accessibility audit of water and sanitation facilities (Water Engineering and Development Centre and WaterAid, accessed 2 September 2014)
 Equity and Inclusion in Water, Sanitation and Hygiene (Loughborough University, accessed 31 August 2014)
 Inclusive WASH and disability (Ask Source, accessed 2 September 2014)
 Inclusive WASH: What does it look like? (WaterAid and WEDC, accessed 31 August 2014)