The new disability framework from the UK Department for International Development (DFID) will, for the first time, put disabled people at the centre of development programmes. Disabled people are often excluded from development interventions. We know this is the case in the water, sanitation and hygiene (WASH) sector, and WaterAid has been working to change it. The issues Globally, 2.5 billion people lack access to adequate sanitation, and more than 748 million do not have access to safe water. Disabled people are particularly affected, and the impact on them is even greater if they are disadvantaged due to their gender, age, ill-health or location. A few years ago, we failed to convince key policy and decision-makers to take disability seriously in their WASH programmes. They told us that there was no comparative evidence showing the challenges disabled people face to accessing safe WASH services, or how to incorporate disability into development programming. We began to gather that evidence and build a stronger case. Filling the knowledge gap We wanted to understand the barriers that disabled, older and chronically ill people face in accessing WASH services and then learn how to address them. We started an investigation in one ward in Zambia and two districts in Uganda. We joined up with the Water Engineering Development Centre (WEDC) and Leonard Cheshire Disability on our Undoing Inequity project.1 The collaboration spanned the WASH, disability and academic sectors, involving partners in Zambia2 and Uganda.3 Many findings shocked us. Results from our baseline survey clearly showed that disabled, older and chronically ill people face common challenges when accessing WASH services. Challenging perceptions We wanted to work with people who could improve the lives of disabled people. We analysed the baseline survey results with disabled and non-disabled members of the community, ministry officials, and practitioners from the water and sanitation, health, education and disability sectors in Uganda and Zambia. The analysis helped everyone understand who was excluded and why, what barriers disabled people face and what each party could do to resolve these problems. This process galvanised support for the next stage – developing and testing an approach to address the barriers. Involving everyone Within communities we carried out accessibility and safety audits on waterpoints and toilets. The audits helped everyone understand how difficult it was for some people to use standard facilities. The process also challenged traditional assumptions about disabled people, bringing them into the conversation to contribute effective suggestions for changes to facilities. We trained and mentored staff to implement the approach. During a review of the project process, one member of staff described how his perceptions of disabled people changed completely through his involvement in the project. This has transformed his and his family's relationships with a relative with disabilities. Accessible WASH designs To make toilets accessible, we can take actions such as widening entrances, ensuring space inside for a person and their carer to easily turn, and installing handrails and movable wooden toilet seats. Simple adaptations to waterpoints include clearing the path to the water apron, putting in ramps, ensuring space for a wheelchair user to turn easily and incorporating a water container resting stand. But designs can only work if the person using the facility is involved in its construction – there are specific needs and measurements of individuals that must be met, for example the height of toilet seats and handrails. Joyce with her mother, Edisa, in Katakwi district, Uganda. Photo credit: WaterAid/Jane Wilbur Joyce and her mother Edisa live in Katakwi district, Uganda, where WaterAid has been implementing the Undoing Inequity project. I visited them after they had built their own accessible toilet for Joyce. Edisa explained: Before she had to dig in the ground. Sometimes her clothes got littered with faeces. Her hands used to be covered in faeces as she used to cover it with her hands; now her hands will be clean. Pushing for change In 2012, the Permanent Under-Secretary of State, UK MP Lynne Featherstone and Paralympic medallist and TV presenter Ade Adepitan visited our work in Uganda. They saw the challenges disabled people face and how simple it is to change them. During the visit, Lynne Featherstone said: Simple changes and alterations can make a tremendous difference and ensure everyone has the chance to succeed. We need to do much more to identify these and ensure all our aid programmes prioritise them. After the visit, the UK International Development Committee announced an inquiry on disability and development. This time we were ready. Drawing on the Undoing Inequity project, we submitted evidence explaining the barriers that disabled people face when accessing WASH services and described how these can be addressed. WaterAid's Chief Executive, Barbara Frost gave evidence, drawing on our work and her experience in the disability sector. Following the International Development Committee’s report, the UK Government agreed to develop its disability framework. We are delighted that the framework has been launched, especially because WASH is included as a specific work stream. This is a fantastic example of how community voices, strong evidence and solutions can influence decision-makers and drive long-term change. The framework marks a turning point, and will drive us all to make sure the rights of people like Joyce won’t be ignored anymore. Jane Wilbur is WaterAid UK's Equity, Inclusion and Rights Advisor. You can read more of her blogs in The Huffington Post. References 1. This is a DFID-funded project through the Sanitation and Hygiene Applied Research for Equity (SHARE) consortium. 2. The Institute of Economic and Social Research and Development Aid from People to People. 3. Wera Development Agency, Church of Uganda – Teso Diocese Planning and Development Office, the Appropriate Technology Centre. For global policy, practice and advocacy updates and discussion, follow @wateraid on Twitter.