Moving towards transformative approaches to disability inclusion in WASH


An expert blog by Asahel Bush, Disability Inclusion Advisor with CBM Australia. Asahel is currently providing inputs into several Water for Women projects. Water for Women and SNV Netherlands Development Organisation recently hosted the Fund’s first regional learning event, ‘Systems strengthening for inclusive WASH – leaving no one behind’, in Kathmandu, Nepal for 50 Water for Women partner representatives. This blog is the fourth and final in a series of expert blogs developed as part of the event.


There is growing recognition that disability is a normal part of human experience and that people with disability comprise a significant part of the global population: one in seven people, according to the World Health Organisation. We are also starting to recognise that people with disability represent an even larger proportion of those who are yet to benefit from global efforts to achieve universal access to water, sanitation and hygiene (WASH). Achieving ‘WASH for all’ or ‘leaving no one behind’ cannot be done without a deliberate focus on including people with disability.

It was therefore reassuring to see that disability inclusion was quite solidly on the agenda at Water for Women’s first regional learning event held in Kathmandu in early December. The Event brought together WASH practitioners and researchers from across South and South-east Asia under the theme of ‘systems strengthening for inclusive WASH - leaving no one behind’.


Systems are a reflection of society (and its biases)

One of the strongest messages of the week was the idea that WASH systems are not just formal or neutral structures; systems are made of people, and by people. Each of them reflects the norms, beliefs and hierarchies of their society, which in many places tend to reinforce stigmatisation and discrimination towards people with disability. People with disability who are advocates for change have repeatedly told us that the most fundamental barrier they face in society is not physical infrastructure or institutional policies; it is the harmful and exclusionary attitudes held by people.

How then can we expect to see WASH systems where accessible infrastructure is built, discriminatory policies are abolished, or people with disability are involved in decision making, if we don’t first change the deeply-felt attitudes of the people who create and comprise those systems?

For the WASH sector, this poses a challenge and perhaps is something outside of our comfort zone. Many in the sector have become accustomed to thinking about disability-inclusive WASH in terms of technical or infrastructure solutions. Meaningful, transformative change requires challenging the norms, attitudes and beliefs that create systemic exclusion. It requires building awareness, engaging with power dynamics and supporting the social empowerment and inclusion of people with disability well beyond the sector’s traditional approaches.

It also requires pointing this lens internally: at our own individual perspectives and practices and at those reflected in our organisations, since we too are also part of the ‘system’.


Transforming attitudes to transform systems

There are examples of WASH projects which are already applying broader and more transformative approaches to disability inclusion. They are adopting lessons and strategies from community mobilisation and empowerment models, or rights-based development and advocacy projects, and building these into the centre of their WASH sector work. For example, they are prioritising awareness raising and attitude change around disability as a key intervention strategy, rather than seeing it as a subset or ‘spin-off benefit’ of WASH behaviour change approaches.

One effective strategy is supporting the participation and influence of people with disability and their representative organisations (known as DPOs — Disabled People’s Organisations). Having people with disability actively voicing their concerns, advocating for their rights, sitting at the table with WASH decision-makers – and having community members witness this – are powerful ways to build awareness and change negative attitudes and perceptions. It is also a fundamental human right for people with disability: the right to participate in society and be consulted in all decisions which may affect them. As the global DPO movement has been telling us for decades: ‘Nothing about us without us’.

During the Water for Women systems strengthening event, we were fortunate to have been joined by a member of the Nepalese DPO movement. Shivnath Raut Kahar is a champion for disability-inclusive WASH and leader of a disability network in his home district of Sarlahi, where SNV implements its Water for Women project. Shivnath told us that there is not a single school, health post, government office or any public place in his local area that has accessible WASH facilities. When asked why this was the case, he explained that ‘the local government is never consulting with the disability people … their view is that disability means weakness.’ As a result, people with disability risk injury by trying to use inaccessible water points, or they simply do not get the opportunity to attend school or access other public services. Changing this situation requires changing people’s hearts and minds.

Meanwhile, Shivnath is out in his community every week raising awareness about WASH and advocating for inclusion. The Water for Women systems strengthening learning event has given him a lot of new ideas and insights into the WASH sector, a chance to talk to WASH practitioners from across South Asia and a sense of hope that disability inclusion is now firmly on the agenda.

He said that through his many years of work, the SNV partnership and this learning event were the first time he had heard of WASH organisations working around disability issues and trying to understand the barriers which people with disability face on a daily basis. At the same time, with that understanding and awareness comes a responsibility and a call to action: ‘I have big hopes on the different [Water for Women partners], from me, from our disability organisation: we need to make big change.’


Asahel Bush is a Disability Inclusion Advisor with CBM Australia – a role which involves providing training, mentoring and technical advice to international aid agencies to help them strengthen disability inclusion in their programs. His current work focuses on disability-inclusive M&E and implementation approaches across a range of projects in Asia and the Pacific, including in the WASH sector.

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