The below is an excerpt of the full article. Article and references are accessible as open accessonline at Sustainability 2012, 4(11), 3023-3041; doi:10.3390/ su4113023 at http://www.mdpi.com/2071-1050/4/11/3023
Approximately 884 million people lack access to safe water sources and more than 2.6 billion people do not have access to sanitation(a system for the collection, transport, treatment and disposal or re-use of human excreta and associated hygiene ) . Access to clean water and sanitation is also a major challenge faced by disabled people around the world although concrete numbers do not exist. According to the Statement of the Committee on the Right to Sanitation (45th session, E/C.12/2010/1) of the United Nations Committee on Social, Economic and Cultural Right, “over a billion people still have no option but to practice open defecation”; no numbers have been generated for disabled people so far. The statement highlights further that “girls do not go to school in many parts of the world for lack of toilets, or lack of separate toilets for them” .
Access to toilets is also essential to disabled girls and boys [4;5] however no numbers exist as to extend of this problem. According to the 2004 United National General Assembly resolution 58/217, “water is critical for sustainable development, including environmental integrity and the eradication of poverty and hunger, and is indispensable for human health and wellbeing” . Sustainable management of water resources is seen as vital for economic growth, public health, food security and stable societies .
Access, availability and affordability to water and sanitation is seen as essential for sustainable development and poverty eradication . According to the World Health Organization World Report on Disability and Rehabilitation, “Households with a disabled member are more likely to experience material hardship including food insecurity, poor housing, lack of access to safe water and sanitation, and inadequate access to health care” . Furthermore, “people with disabilities have poorer health outcomes, lower education achievements, less economic participation and higher rates of poverty than people without disabilities” . Cramped urban settings are often linked to decrease in water and sanitation access with over proportional negative impact on disabled people . Access to WASH is a human right [11-13]. Various international instruments have affirmed the right to clean water or sanitation or both over time .
However many obstacles prevent access to clean water and to sanitation facilities for disabled people among others physical (distance to latrines or defecation areas, rough paths, narrow entrances & lack of space inside, steps to latrines, slippery floors, difficulty squatting – nothing to hold onto , need to put hands on latrine floor to balance), institutional (discriminatory legislation, policies/strategies that ignore disabled people, lack of consultation with disabled people, lack of information about accessible design options, lack of staff understanding, training, or experience on accessible designs, lack of mechanisms or forums for consultation with disabled people), economic (cost of constructions, user fees), and social/cultural (low status, harassment, negative traditional beliefs, pity, stigma, shame, overprotection, isolation, misinformation).
An independent expert presented in 2010 a framework to the Human Rights Council “for assessing good practices [for providing clean water and sanitation] from a human rights perspective, using five normative criteria (availability, quality/safety, acceptability, accessibility and affordability) and five cross-cutting criteria (nondiscrimination, participation, accountability, impact and sustainability)”. We highlight in this commentary various benefits of providing access to clean water and sanitation for disabled people and the barriers to these benefits.
Access to WASH is a human right [11–13]. This article outlined that (a) providing people with disabilities with clean water and sanitation as part of the general design of water and sanitation infrastructures for the community produces a multitude of benefits (see Figure 1 below) but also faces various barriers; (b) that the economic benefits and other benefit outweigh economic cost attached toproviding accessible clean water and sanitation and (c) that the case could be made stronger if morecost and benefit data in regards to access to water and sanitation for people with disabilities would beavailable; for a variety of measures one has to estimate from the data available fornon-disabled people.
The use of funding from international governmental organizations (IGOs) andNGOs can be beneficial; social funds from organizations such as the World Bank can be effective inproviding the monetary requirements to implement interventions for people with disabilities .However as this article highlighted the funding has to take into account local realities in general andof people with disabilities in particular. Policies and guidelines which currently do not recognize thewater, hygiene and sanitation needs of people with disabilities can easily be revised to include them.However this is not enough. Attitudinal, visibility and other contextual barriers and the lack of dataalso have to be addressed in order to make the change a sustainable reality.
We submit that there is anincreasing effort to deal with the many of the problems outlined in this paper in order to increaseaccess to water, hygiene and sanitation for people with disabilities. The 2012 Report of the United Nations Special Rapporteur on the human right to safe drinkingwate and sanitation  recommended that the post-2015 development agenda should incorporate astand-alone goal on water, sanitation and hygiene, to ensure that universal access to these services;closing the access gap existing between dominant groups and minority groups.
The report states thatfuture goals, targets and indicators on water, sanitation and hygiene must address among othersindividual-related inequalities (sex/gender, age, and disability) in the public and private spheres. It alsorecommends improvement in methodology such as monitoring of gender, age, and disability-relatedinequalities in public facilities such as schools and health facilities.
The UNICEF-WHO JointMonitoring Programme (JMP) working group highlighted that access to water and sanitation servicesis measured at the household level and that therefore household surveys and censuses currently do notallow generating numbers as to intra-household differences in access such as by sex, age,or disability . They suggest adding a question to household surveys “to obtain information aboutthe range and prevalence of barriers experienced by, inter alia, persons with disabilities, older persons,women and girls, and those with healthrelated mobility restrictions” . However, what we still have to see is a widespread and long term application of the strategies andactions suggested with the active involvement of people with disabilities on local and global level.Our findings suggest that there is a need for much more qualitative and quantitative research to fill thedata and knowledge gap in existence. More, best practices also have to be produced.
We submit thatour results suggest that research funding agencies should include access to water and sanitation forpeople with disabilities as a research priority.