Exploring the implementation of disability-inclusive WASH policy commitments in Bangladesh

Syed Ashfaqul Haque, Executive Editor, The Daily Star

About 2.4 percent of our population are persons with disabilities. Unfortunately, we are unaware and insensitive to the problems they suffer in their everyday life. They don't want sympathy from us. They want equal opportunity. The media can play a big role in creating awareness about this issue.

Hasin Jahan, Country Director, WaterAid Bangladesh

We have reviewed 10 WASH-related policies in Bangladesh to find out how the issues of persons with disabilities are addressed in those policies and how the policies are implemented at the field level. Today, we will share our findings with you. We will incorporate your feedback and finalise the study document.

From my 20 years' experience of working in the WASH sector, I have come to the conclusion that we don't understand the disability issue properly. We think that we are not disabled, we are working for other people. But the reality is that after a certain age all of us will need wheelchairs, and if we make our houses disability-friendly it will ultimately help us.

Secondly, we need to think beyond wheelchair-based access. We need to think about creating access for persons who are vision impaired , hearing impaired and have mental disabilities. We all need to work together to achieve this goal.

Dr Dilara Zahid, Assistant Professor & Director, Institute of Disaster Management and Vulnerability Studies

Disaster Risk Reduction (DRR) and climate change are included in every programme as crosscutting issues. We can easily incorporate these issues into disability inclusive WASH programmes.

Dhaka Declaration 2015+ was adopted at the Dhaka Conference on Disability and Disaster Risk Management in 2018. It made some useful suggestions regarding disability-inclusive WASH initiatives that can be helpful to carry forward the issue.

Bangladesh Bureau of Statistics provides disaggregated data on disability and WASH sector that will be helpful for the study. We conducted a survey on DRR in 2021 covering all the divisions of the country. The survey had some important findings on the access of persons with disabilities to WASH facilities. The study can benefit from those findings.

Last but not least, we have to mainstream the disability agenda in WASH programming.

Mahbub Ul Alam, Associate Scientist, icddr,b

When icddr,b, Unicef and WaterAid started working on menstrual hygiene management, a steering committee was formed. Can we form another steering committee to work on the issues faced by persons with disabilities? It will not only address the WASH issues but also help promote inclusive design for ensuring accessibility for persons with disabilities in every setting, remove barriers and fight social stigma.

We need to look beyond wheelchair access and expand our programmes to address all types of disabilities.

Media and educational institutions can play a big role to reduce stigma and discrimination towards persons with disabilities.

B-Scan and icddr,b are going to survey the current situation of WASH facilities for persons with disabilities. We hope it will contribute to a better understanding of the issue and make our policies and action plans more effective.

Mohammed Monirul Alam, WASH Specialist, Unicef

We need to engage the private sector. They can play a big role in designing, manufacturing, marketing, and maintaining the supply chain of the products that will facilitate implementation of disability-inclusive WASH programmes.

Dewan Mahfuz E Maula, Coordinator, Policy Advocacy, ADD International Bangladesh

We need to sensitise and train government employees on disability issues. It will make implementation of disability-inclusive WASH programmes easier. The service providers also need to have the basic knowledge of the technicalities of inclusive design and accessibility.

We need to involve organisations of persons with disabilities (OPDs) to make our disability-inclusive WASH programmes sustainable. They will take ownership of these interventions even after the completion of the projects.

The Persons with Disabilities Rights and the Protection Act, 2013 calls for the formation of committees at the upazila and district level to ensure proper implementation of the Act. However, most of these committees are inactive. We need to activate these committees immediately.

Md. Nayeb Ali, Deputy Director, Department of Disaster Management

We need to consider the local environment while designing WASH facilities for persons with disabilities. In Rangpur and Gaibandha, for example, there are many chars that remain submerged in water during a certain period of the year. We have to consider these realities while establishing WASH facilities in these areas.

You will be happy to know that all the cyclone shelters and flood shelters are now designed to address the special requirements of women and persons with disabilities.

Salma Mahbub, General Secretary, B-SCAN

The WASH sector needs to understand the different requirements of different types of persons with disabilities and find solutions accordingly. 

We need to provide support to OPDs so that they can sustain and work for their rights. They need to be involved in monitoring the accessibility of the infrastructure built for persons with disabilities. They also need to be trained on WASH issues. The government is going to build toilets across the country. OPDs should be included in this process. We also need to ensure the participation of OPDs in WASH-related research and data collection projects. 

There are several emerging issues such as WASH and menstrual hygiene that need to be included in the Persons with Disabilities Rights and the Protection Act, 2013.

Tony Michael Gomez, Social and Behaviour Change Expert

If the existing policies were implemented properly, a lot of our problems regarding access for persons with disabilities to WASH facilities would have been solved now. People can get away with flouting the disability-inclusive guidance and, therefore, they care very little about it.

Universities talk about innovations and organise various competitions. Do they care about designing products or facilities for persons with disabilities? We need to invest more to create disability-friendly solutions and change the prevailing attitude towards persons with disabilities.

Dr Sheikh Daud Adnan, Deputy Director (Hospitals and Clinics), Directorate General of Health Services (DGHS)

The government has already formulated a law that clearly mentions what services a person with disability will get in public settings. However, we have to identify what changes need to be incorporated into the Persons with Disabilities Rights and the Protection Act, 2013, so that we can provide better services to persons with disabilities.

A bigger sample size would have made the study more comprehensive. The study should also include other forms of disabilities and the different types of problems they face. I would like to know how we can improve the accessibility of persons with disabilities in hospitals.

S.M. Tariquzzaman, Regional WASH Specialist, Asia Pacific, Plan International

The Persons with Disabilities Rights and the Protection Act, 2013 recognises 21 types of disabilities. If we can create facilities for 4-7 types of disabilities, we will be able to cover all types of disabilities. Since we only focus on creating wheelchair access, which is the costliest intervention, we tend to think that creating accessibility for persons with disabilities is very expensive. However, only 8-10 percent of persons with disabilities need wheelchair support. There are many interventions that can help a large number of persons with disabilities with very little funds. We need to invest in those solutions and find more innovative techniques to provide support to persons with disabilities.

Syeda Asma Rashida, Project Manager, Sightsavers Bangladesh

We need to understand inclusivity from a broader perspective. For example, we can provide toilet facilities for persons with disabilities in a regular toilet setting if it is designed in an inclusive way. We can design the handle of a tube-well in such a way that a person with disability can use it.

We need to engage the Department of Public Health Engineering in our effort to make the WASH sector disability inclusive.

There should be a clear guideline in the Persons with Disabilities Rights and the Protection Act on how to turn the policies into actions in order to accomplish its goals and objectives.

Mohammed Shah Alam, Executive Director, Neuro-Development Disability Protection Trust

A government-industry-NGO nexus should be established to boost disability-inclusive WASH initiatives. Persons with disabilities should be involved in designing the solutions they need. They should be included in all the infrastructure projects, particularly in the approval process of housing projects.

Our education curriculum should be designed in a way that promotes disability inclusiveness in every sphere of life. Last but not least, there should be disability desks in all government and non-government organisations to look after the well-being of persons with disabilities.

Tanjim Ferdous, In Charge, NGOs and Foreign Embassies, Business Development Team, The Daily Star & Moderator of the session

Around 2.5 percent of our population are persons with disabilities. They face significant barriers to accessing water, sanitation and hygiene (WASH). Lack of access to WASH facilities has serious impacts on the physical and mental well- being. We need to keep in mind that persons with disabilities have the same rights as any other person to WASH.

Chief Guest's Speech

Ashraf Ali Khan Khasru, State Minister, Ministry of Social Welfare
We have achieved a lot of success in addressing the problems of persons with disabilities. Earlier, persons with disabilities used to be considered a curse and a burden. However, that attitude has changed over time, particularly due to the tireless effort of our Prime Minister Sheikh Hasina and her daughter Saima Wazed Putul. 
All the educational institutions now have ramp facilities. This was made possible due to the special instruction of our honourable Prime Minister. Her daughter has achieved international recognition for her contribution to the well-being of persons with disabilities. 
We need to work more to stop open defecation and improve sanitation facilities in rural areas. We should consider all types of disabilities while designing WASH facilities for persons with disabilities.
Currently, the government is establishing submersible pumps in rural areas. These pumps are installed with tanks and several taps. This has made access to water facilities easier for persons with disabilities. The government is also supplying water by establishing overhead tanks. 
In rural areas, wheelchair users face difficulties due to poor condition of roads. We need to look at this issue and find suitable solutions.
It is an election pledge of our Prime Minister that all the villages will be transformed into towns. We will ensure that all urban amenities are available to rural people. 
I must appreciate WaterAid's effort to highlight the importance of making the WASH sector disability inclusive. I will try to provide all kinds of support to this effort from my ministry. 

Keynote Speech

Mahfuj-ur Rahman, Project Manager, WaterAid Bangladesh

The study was jointly conducted by London School of Hygiene & Tropical Medicine, WaterAid Bangladesh and Identity Inclusion, and supported by funding from the Australian Government's Department of Foreign Affairs and Trade's Water for Women Fund. We have secured ethics approval for this project from Bangladesh Medical Research Council. This was a  24 month-long project which is going to end in  September 2022.

The study found that all the 10 reviewed WASH-related policies, action plans and guidelines have a strong focus on the disability issue, particularly developing infrastructure for improving access to home and public settings. However, the problems of affordability, protection from harm and access to high-quality WASH services were not emphasised strongly in these policy documents. The gender dimensions of disability inclusive WASH initiatives need further attention.  A significant gap in these policies is the lack of recognition of the critical role played by caregivers.

There is a gap in coordination between WASH and disability sectors in Bangladesh. Although the WASH issue is covered in the disability-related policies, it is not systematically addressed at the grassroots level. There is also a knowledge gap among service providers regarding disability-inclusive WASH facilities. In Rangpur and Gaibandha, for example, people have easy access to tube-wells but those are not fit for the use of persons with disabilities. Similarly, the toilets lack the necessary features to ensure access for persons with disabilities. These gaps compromise privacy and create inconvenience for them. Unfortunately, persons with disabilities are not much aware of their right to WASH. It is a positive sign that organisations working with persons with disabilities are now raising their voices to make all the WASH facilities disability inclusive.

We have drawn the following recommen-dations from the study: strengthen inter-agency coordination between WASH and disability sector with a clear plan of action and agreed milestones; follow existing disability inclusion guidelines while implementing national policies; increase investment to create awareness and build technical knowledge and skills of the service providers; prepare a comprehensive compendium incorporating all the accessibility features and demonstrate it at the household level at a mass scale; prepare a harmonised, disaggregated and accessible database on disability and WASH; formulate indicators and monitoring checklist to track plans and progress properly; and ensure meaningful participation of persons with disabilities and caregivers in WASH projects.

Recommendations

• Include WASH in the Persons with Disabilities Rights and the Protection Act, 2013.
• Mainstream the disability agenda in WASH programming
• Form a steering committee dedicated to the disability issues
• Engage the private sector in disability-inclusive WASH programmes
• Ensure meaningful participation of persons with disabilities and caregivers in the WASH projects
• Involve the organisations of persons with disabilities (OPDs) in the planning and implementation of WASH programmes
• Media and educational institutions can play a big role to reduce stigma and discrimination towards persons with disabilities
• Strengthen inter-agency coordination between WASH and disability sector with a clear plan of action and agreed milestones
• Prepare a harmonised, disaggregated and accessible database on disability and WASH
• Look beyond wheelchair access and address all types of disabilities
• Gender dimensions of disability-inclusion in WASH demand greater attention
• Disseminate disability sensitive messages through school curriculum
• Establish help desk for the persons with disability at institutions and UPs