Sanitation and physical disability: challenges to latrine access in Kakuma refugee camp, Kenya
Access to sanitation services such as provision of latrines is one way of preventing diarrhoeal related infections and promoting public health. Provision of and accessibility to latrines for people with physical disabilities in Kakuma refugee camp has, however, been faced with many challenges. We used traditional anthropological research methods such as in-depth interviews and participant observation to explore some of the challenges faced by people with disabilities in accessing and using latrines. We found that fear of contracting diseases, shame, and lack of resources to construct latrines, as well as technological design, hinders disabled people from accessing latrines in the refugee camp. Lack of latrines for disabled people compounds their vulnerability and there is need for a deliberate effort to mitigate this. The agencies dealing with latrine provision and funding need to explore ways of reducing this vulnerability, brought about by a lack of sanitation facilities that are technologically adaptable to their needs.Bartram, J. and Cairncross, S. (2010) ‘Hygiene, sanitation, and water: forgotten foundations of health’, PLoS Med 7(11): e1000367 <http://dx.doi.org/10.1371/journal.pmed.1000367>.
Dittmer, A. (2009) Towards Total Sanitation: Socio-Cultural Barriers and Triggers to Total Sanitation in West Africa, London: WaterAid.
Greene, L.E., Freeman, M.E., Akoko, D., Saboori, S., Moe, E. and Rheingans, R. (2012) ‘Impact of a school-based hygiene promotion and sanitation intervention on pupil hand contamination in western Kenya: a cluster randomized trial’, American Journal of Tropical Medicine and Hygiene 87(3): 385–93 <http://dx.doi.org/10.4269/ajtmh.2012.11-0633>.
Groce, N., Bailey, N., Lang, R., Trani, J.F. and Kett, M. (2011) ‘Water and sanitation issues for persons with disabilities in low- and middle-income countries: a literature review and discussion of implications for global health and international development’, Journal of Water and Health 9(4): 617–27 <http://dx.doi.org/10.2166/wh.2011.198>.
International Rescue Committee (IRC) (2012a) Environmental Health Programme, Trend Analysis Report, Kakuma Refugee Camp, Kenya: International Rescue Committee Kakuma Programme.
IRC (2012b) Community Based Rehabilitation Database, Community Health Programme, Kakuma Refugee Camp, Kenya: International Rescue Committee Kakuma Programme.
Jones, H., Parker, K.J. and Reed, R. (2002) Water Supply and Sanitation Access and Use by Physically Disabled People: A Literature Review, Loughborough, UK: Water, Engineering and Development Centre, Loughborough University.
Kvarnström, E., McConville, J., Bracken, P., Johansson, M. and Fogde, M. (2011) ‘The sanitation ladder: a need for a revamp?’ Journal of Water, Sanitation and Hygiene for Development 1(1): 3–12 <http://dx.doi.org/10.2166/washdev.2011.014>.
Mollah, K.A. and Aramaki, T. (2010) ‘Social-epidemiological study for evaluation of water supply and sanitation systems of low-income urban community in Dhaka, Bangladesh’, Journal of Water and Health 8(1): 184–91 <http://dx.doi.org/10.2166/wh.2009.201>.
Norman, W.R. (2010) Water, Sanitation and Disability in Rural West Africa: Enhancing Use and Access of Wash Facilities, summary report of the Mali Water and Disabilities Study, Grantham, PA: The Collaboratory for Strategic Partnerships and Applied Research, Messiah College.
Pendo, M. (2013) ‘Mainstreaming disability in humanitarian and development practice’, CBM Workshop, Nairobi, Kenya, August 2013.
Prüss-Üstün, A., Bonjour, S. and Corvalan, C. (2008) ‘The impact of the environment on health by country: a meta-synthesis’, BioMed Cental, Environmental Health 7(7) <http://dx.doi.org/10.1186/1476-069X-7-7>.
Tumwine, J.K., Thompson, J., Katua-Katua, M., Mujwajuzi, M., Johnston, N., Wood, E. and Porras, I. (2002) ‘Diarrhoea and effects of different water sources, sanitation and hygiene behavior in East Africa’, Tropical Medicine and International Health 7(9): 750–6 <http://dx.doi.org/10.1046/j.1365-3156.2002.00927.x>.
United Nations High Commissioner for Refugees (UNHCR) (2013) Monthly Updates, Kenya: Kakuma Refugee Camp.
WaterAid (2008) Creating User-friendly Water and Sanitation Services for Disabled People: The Experience of WaterAid Nepal and its Partners, Nepal: WaterAid.
WHO/UNICEF (2012) Progress on Drinking Water and Sanitation: 2012 Update, New York: United Nations Children’s Fund; Geneva: World Health Organization.
Wolbring, G. and Leopatra, V. (2012) ‘Climate change, water, sanitation and energy insecurity: invisibility of people with disabilities’, Canadian Journal of Disability Studies 1(3): 66–93 <http://dx.doi.org/10.15353/cjds.v1i3.58>.
World Bank (2001) ‘The World Bank and Disability: Including People with Disabilities’, <http://wbln0018.worldbank.org/HDNet/HDdocs.nsf/2d5135ecbf351de6852566a90069b8b6/a16f1100a7ae28ff852567f600636b11?OpenDocument> [accessed 22 April 2014].
SPHERE Project <www.sphereproject.org> [accessed 5 February 2015].
Bartram, J. and Cairncross, S. (2010) ‘Hygiene, sanitation, and water: forgotten foundations of health’, PLoS Med 7(11): e1000367 <http://dx.doi.org/10.1371/journal.pmed.1000367>.
Dittmer, A. (2009) Towards Total Sanitation: Socio-Cultural Barriers and Triggers to Total Sanitation in West Africa, London: WaterAid.
Greene, L.E., Freeman, M.E., Akoko, D., Saboori, S., Moe, E. and Rheingans, R. (2012) ‘Impact of a school-based hygiene promotion and sanitation intervention on pupil hand contamination in western Kenya: a cluster randomized trial’, American Journal of Tropical Medicine and Hygiene 87(3): 385–93 <http://dx.doi.org/10.4269/ajtmh.2012.11-0633>.
Groce, N., Bailey, N., Lang, R., Trani, J.F. and Kett, M. (2011) ‘Water and sanitation issues for persons with disabilities in low- and middle-income countries: a literature review and discussion of implications for global health and international development’, Journal of Water and Health 9(4): 617–27 <http://dx.doi.org/10.2166/wh.2011.198>.
International Rescue Committee (IRC) (2012a) Environmental Health Programme, Trend Analysis Report, Kakuma Refugee Camp, Kenya: International Rescue Committee Kakuma Programme.
IRC (2012b) Community Based Rehabilitation Database, Community Health Programme, Kakuma Refugee Camp, Kenya: International Rescue Committee Kakuma Programme.
Jones, H., Parker, K.J. and Reed, R. (2002) Water Supply and Sanitation Access and Use by Physically Disabled People: A Literature Review, Loughborough, UK: Water, Engineering and Development Centre, Loughborough University.
Kvarnström, E., McConville, J., Bracken, P., Johansson, M. and Fogde, M. (2011) ‘The sanitation ladder: a need for a revamp?’ Journal of Water, Sanitation and Hygiene for Development 1(1): 3–12 <http://dx.doi.org/10.2166/washdev.2011.014>.
Mollah, K.A. and Aramaki, T. (2010) ‘Social-epidemiological study for evaluation of water supply and sanitation systems of low-income urban community in Dhaka, Bangladesh’, Journal of Water and Health 8(1): 184–91 <http://dx.doi.org/10.2166/wh.2009.201>.
Norman, W.R. (2010) Water, Sanitation and Disability in Rural West Africa: Enhancing Use and Access of Wash Facilities, summary report of the Mali Water and Disabilities Study, Grantham, PA: The Collaboratory for Strategic Partnerships and Applied Research, Messiah College.
Pendo, M. (2013) ‘Mainstreaming disability in humanitarian and development practice’, CBM Workshop, Nairobi, Kenya, August 2013.
Prüss-Üstün, A., Bonjour, S. and Corvalan, C. (2008) ‘The impact of the environment on health by country: a meta-synthesis’, BioMed Cental, Environmental Health 7(7) <http://dx.doi.org/10.1186/1476-069X-7-7>.
Tumwine, J.K., Thompson, J., Katua-Katua, M., Mujwajuzi, M., Johnston, N., Wood, E. and Porras, I. (2002) ‘Diarrhoea and effects of different water sources, sanitation and hygiene behavior in East Africa’, Tropical Medicine and International Health 7(9): 750–6 <http://dx.doi.org/10.1046/j.1365-3156.2002.00927.x>.
United Nations High Commissioner for Refugees (UNHCR) (2013) Monthly Updates, Kenya: Kakuma Refugee Camp.
WaterAid (2008) Creating User-friendly Water and Sanitation Services for Disabled People: The Experience of WaterAid Nepal and its Partners, Nepal: WaterAid.
WHO/UNICEF (2012) Progress on Drinking Water and Sanitation: 2012 Update, New York: United Nations Children’s Fund; Geneva: World Health Organization.
Wolbring, G. and Leopatra, V. (2012) ‘Climate change, water, sanitation and energy insecurity: invisibility of people with disabilities’, Canadian Journal of Disability Studies 1(3): 66–93 <http://dx.doi.org/10.15353/cjds.v1i3.58>.
World Bank (2001) ‘The World Bank and Disability: Including People with Disabilities’, <http://wbln0018.worldbank.org/HDNet/HDdocs.nsf/2d5135ecbf351de6852566a90069b8b6/a16f1100a7ae28ff852567f600636b11?OpenDocument> [accessed 22 April 2014].
SPHERE Project <www.sphereproject.org> [accessed 5 February 2015].
Bartram, J. and Cairncross, S. (2010) ‘Hygiene, sanitation, and water: forgotten foundations of health’, PLoS Med 7(11): e1000367 <http://dx.doi.org/10.1371/journal.pmed.1000367>.
Dittmer, A. (2009) Towards Total Sanitation: Socio-Cultural Barriers and Triggers to Total Sanitation in West Africa, London: WaterAid.
Greene, L.E., Freeman, M.E., Akoko, D., Saboori, S., Moe, E. and Rheingans, R. (2012) ‘Impact of a school-based hygiene promotion and sanitation intervention on pupil hand contamination in western Kenya: a cluster randomized trial’, American Journal of Tropical Medicine and Hygiene 87(3): 385–93 <http://dx.doi.org/10.4269/ajtmh.2012.11-0633>.
Groce, N., Bailey, N., Lang, R., Trani, J.F. and Kett, M. (2011) ‘Water and sanitation issues for persons with disabilities in low- and middle-income countries: a literature review and discussion of implications for global health and international development’, Journal of Water and Health 9(4): 617–27 <http://dx.doi.org/10.2166/wh.2011.198>.
International Rescue Committee (IRC) (2012a) Environmental Health Programme, Trend Analysis Report, Kakuma Refugee Camp, Kenya: International Rescue Committee Kakuma Programme.
IRC (2012b) Community Based Rehabilitation Database, Community Health Programme, Kakuma Refugee Camp, Kenya: International Rescue Committee Kakuma Programme.
Jones, H., Parker, K.J. and Reed, R. (2002) Water Supply and Sanitation Access and Use by Physically Disabled People: A Literature Review, Loughborough, UK: Water, Engineering and Development Centre, Loughborough University.
Kvarnström, E., McConville, J., Bracken, P., Johansson, M. and Fogde, M. (2011) ‘The sanitation ladder: a need for a revamp?’ Journal of Water, Sanitation and Hygiene for Development 1(1): 3–12 <http://dx.doi.org/10.2166/washdev.2011.014>.
Mollah, K.A. and Aramaki, T. (2010) ‘Social-epidemiological study for evaluation of water supply and sanitation systems of low-income urban community in Dhaka, Bangladesh’, Journal of Water and Health 8(1): 184–91 <http://dx.doi.org/10.2166/wh.2009.201>.
Norman, W.R. (2010) Water, Sanitation and Disability in Rural West Africa: Enhancing Use and Access of Wash Facilities, summary report of the Mali Water and Disabilities Study, Grantham, PA: The Collaboratory for Strategic Partnerships and Applied Research, Messiah College.
Pendo, M. (2013) ‘Mainstreaming disability in humanitarian and development practice’, CBM Workshop, Nairobi, Kenya, August 2013.
Prüss-Üstün, A., Bonjour, S. and Corvalan, C. (2008) ‘The impact of the environment on health by country: a meta-synthesis’, BioMed Cental, Environmental Health 7(7) <http://dx.doi.org/10.1186/1476-069X-7-7>.
Tumwine, J.K., Thompson, J., Katua-Katua, M., Mujwajuzi, M., Johnston, N., Wood, E. and Porras, I. (2002) ‘Diarrhoea and effects of different water sources, sanitation and hygiene behavior in East Africa’, Tropical Medicine and International Health 7(9): 750–6 <http://dx.doi.org/10.1046/j.1365-3156.2002.00927.x>.
United Nations High Commissioner for Refugees (UNHCR) (2013) Monthly Updates, Kenya: Kakuma Refugee Camp.
WaterAid (2008) Creating User-friendly Water and Sanitation Services for Disabled People: The Experience of WaterAid Nepal and its Partners, Nepal: WaterAid.
WHO/UNICEF (2012) Progress on Drinking Water and Sanitation: 2012 Update, New York: United Nations Children’s Fund; Geneva: World Health Organization.
Wolbring, G. and Leopatra, V. (2012) ‘Climate change, water, sanitation and energy insecurity: invisibility of people with disabilities’, Canadian Journal of Disability Studies 1(3): 66–93 <http://dx.doi.org/10.15353/cjds.v1i3.58>.
World Bank (2001) ‘The World Bank and Disability: Including People with Disabilities’, <http://wbln0018.worldbank.org/HDNet/HDdocs.nsf/2d5135ecbf351de6852566a90069b8b6/a16f1100a7ae28ff852567f600636b11?OpenDocument> [accessed 22 April 2014].
SPHERE Project <www.sphereproject.org> [accessed 5 February 2015].
Bartram, J. and Cairncross, S. (2010) ‘Hygiene, sanitation, and water: forgotten foundations of health’, PLoS Med 7(11): e1000367 <http://dx.doi.org/10.1371/journal.pmed.1000367>.
Dittmer, A. (2009) Towards Total Sanitation: Socio-Cultural Barriers and Triggers to Total Sanitation in West Africa, London: WaterAid.
Greene, L.E., Freeman, M.E., Akoko, D., Saboori, S., Moe, E. and Rheingans, R. (2012) ‘Impact of a school-based hygiene promotion and sanitation intervention on pupil hand contamination in western Kenya: a cluster randomized trial’, American Journal of Tropical Medicine and Hygiene 87(3): 385–93 <http://dx.doi.org/10.4269/ajtmh.2012.11-0633>.
Groce, N., Bailey, N., Lang, R., Trani, J.F. and Kett, M. (2011) ‘Water and sanitation issues for persons with disabilities in low- and middle-income countries: a literature review and discussion of implications for global health and international development’, Journal of Water and Health 9(4): 617–27 <http://dx.doi.org/10.2166/wh.2011.198>.
International Rescue Committee (IRC) (2012a) Environmental Health Programme, Trend Analysis Report, Kakuma Refugee Camp, Kenya: International Rescue Committee Kakuma Programme.
IRC (2012b) Community Based Rehabilitation Database, Community Health Programme, Kakuma Refugee Camp, Kenya: International Rescue Committee Kakuma Programme.
Jones, H., Parker, K.J. and Reed, R. (2002) Water Supply and Sanitation Access and Use by Physically Disabled People: A Literature Review, Loughborough, UK: Water, Engineering and Development Centre, Loughborough University.
Kvarnström, E., McConville, J., Bracken, P., Johansson, M. and Fogde, M. (2011) ‘The sanitation ladder: a need for a revamp?’ Journal of Water, Sanitation and Hygiene for Development 1(1): 3–12 <http://dx.doi.org/10.2166/washdev.2011.014>.
Mollah, K.A. and Aramaki, T. (2010) ‘Social-epidemiological study for evaluation of water supply and sanitation systems of low-income urban community in Dhaka, Bangladesh’, Journal of Water and Health 8(1): 184–91 <http://dx.doi.org/10.2166/wh.2009.201>.
Norman, W.R. (2010) Water, Sanitation and Disability in Rural West Africa: Enhancing Use and Access of Wash Facilities, summary report of the Mali Water and Disabilities Study, Grantham, PA: The Collaboratory for Strategic Partnerships and Applied Research, Messiah College.
Pendo, M. (2013) ‘Mainstreaming disability in humanitarian and development practice’, CBM Workshop, Nairobi, Kenya, August 2013.
Prüss-Üstün, A., Bonjour, S. and Corvalan, C. (2008) ‘The impact of the environment on health by country: a meta-synthesis’, BioMed Cental, Environmental Health 7(7) <http://dx.doi.org/10.1186/1476-069X-7-7>.
Tumwine, J.K., Thompson, J., Katua-Katua, M., Mujwajuzi, M., Johnston, N., Wood, E. and Porras, I. (2002) ‘Diarrhoea and effects of different water sources, sanitation and hygiene behavior in East Africa’, Tropical Medicine and International Health 7(9): 750–6 <http://dx.doi.org/10.1046/j.1365-3156.2002.00927.x>.
United Nations High Commissioner for Refugees (UNHCR) (2013) Monthly Updates, Kenya: Kakuma Refugee Camp.
WaterAid (2008) Creating User-friendly Water and Sanitation Services for Disabled People: The Experience of WaterAid Nepal and its Partners, Nepal: WaterAid.
WHO/UNICEF (2012) Progress on Drinking Water and Sanitation: 2012 Update, New York: United Nations Children’s Fund; Geneva: World Health Organization.
Wolbring, G. and Leopatra, V. (2012) ‘Climate change, water, sanitation and energy insecurity: invisibility of people with disabilities’, Canadian Journal of Disability Studies 1(3): 66–93 <http://dx.doi.org/10.15353/cjds.v1i3.58>.
World Bank (2001) ‘The World Bank and Disability: Including People with Disabilities’, <http://wbln0018.worldbank.org/HDNet/HDdocs.nsf/2d5135ecbf351de6852566a90069b8b6/a16f1100a7ae28ff852567f600636b11?OpenDocument> [accessed 22 April 2014].
SPHERE Project <www.sphereproject.org> [accessed 5 February 2015].
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