## Compendium Of Accessible Wash Technologies

Hazel Jones and Jane Wilbur (2014) 

## Bathing Latrines Waterpoints Handwashing Further Resources Reaching Facilities Introduction Guidelines For Use

The compendium can be used in various ways: 
•
As a starting point for discussion with households 
•
As a way of encouraging communities to consider design options 
•
This compendium is designed for use by staff working directly with communities - e.g. health workers and community volunteers working with 
disabled and older people and their families in rural 
areas of sub-Saharan Africa. 
•
By disabled people's organisations 
•
As flashcards - images can be enlarged and stuck on card 
•
A few examples of technologies are presented that families can adapt to suit their needs and budgets. Many more options are possible. 
•
As posters - images can be printed and used for group discussions 
•
Most of the ideas are suitable for disabled and older 
people, but are not **only** for them. As we get older, 
many of us find it increasingly difficult to squat and balance,  or we might be injured or sick. These technologies might also make facilities easier and more comfortable to use by everyone in the family. 
•
The ideas are designed to be suitable for household facilities, not for institutional facilities - e.g. schools and clinics - although some ideas might also be useful in these settings. 
Technical specifications are not given, because all dimensions should be based on users' needs. The aim is to provide as much 'independent access' as possible 
- this means facilities that a person can use without help, or with minimum help. If possible, try out ideas first to work out: how high a seat or support rail should be? How wide the entrance should be? To work out how much space is needed inside a latrine, mark out the area on the ground using rocks or branches. Ask different users to try moving and squatting/sitting inside, and adjust if necessary. Costs are not itemised because they will vary between communities. Instead, relative costs of each technology are suggested. 

•
This publication and all images in it are free to 
download here: 
www.wateraid.org/accessibleWASHtechnologies  
 

## Paths Paths Suitable For: Everyone, Especially Users With A Visual Impairment And With Physical Impairments, Including Wheelchair Users.

| Construction         |
|----------------------|
| variations           |
| - Easy to construct  |
| - Simple to maintain |
| - Suitable for users |
| Guide string from    |
| house to latrine     |
| and bath shelter     |
with a visual impairment 
- Can be made 
according to budget 
Clear, level path, lined with rocks 
- Suitable for users 
with visual and physical impairments, 
including 
wheelchair users 
- Can be made 
according to budget 
- Easy to construct 
Landmark posts made from local materials 
using local materials 
- Provides guidance 
for users with a visual impairment 
Cost / labour 
- Regular maintenance 
-  Path could be 
Low 
needed 
- String must be 
lined with painted rocks or landmark posts 
carefully positioned so it is not a hazard to 
other users 
- Rocks are easily 
- Paint rocks white 
Low 
moved or dislodged, which could cause a trip hazard 
or a bright colour to increase visibility 
- Maintenance would 
include regular repositioning of the 
rocks 
- Posts must be firm, 
-  Posts can be 
Low to medium 
and positioned so they are not a hazard to others 
- Regular maintenance 
painted/marked with a bright colour  to increase visibility 
- Use alternative 
needed to check posts are stable 
materials, e.g. rocks, or existing features, e.g. 
trees 

## Ramps Ramps Suitable For: Users With Physical Impairments, Wheelchair Users, Older People, People Carrying Heavy Loads

| Construction Advantages    |
|----------------------------|
| variations                 |
| - Flexible - can be placed |
| wherever needed            |
| - Cheaper than concrete    |
| - Raised sides prevent a   |
| wheelchair rolling off the |
| side of the ramp           |
| Moveable                   |
| wooden ramp                |
| for wheelchair             |
| to access                  |
| facilities with            |
| steps                      |
| - The concrete ramp onto   |
| the apron improves         |
| access for everyone        |
| Wide concrete              |
| ramp to                    |
| handpump                   |
| apron                      |
|                            |
|                            |
|                            |
|                            |
|                            |
| - Smooth, firm, durable    |
| - Gentle gradient so a     |
| Low-gradient               |
| concrete ramp              |
| with raised                |
| sides for safety           |
|                            |
| child can propel           |
| her/himself up and make    |
| a controlled descent       |
| - Raised sides prevent     |
| wheelchairs rolling off    |
Cost/ labour 
- Less durable than 
- Paint raised 
 Medium 
concrete 
- User needs help to 
sides white or bright colour to increase visibility 
move the ramp when needed 
- Ramp requires more 
- Paint raised 
Medium 
space than steps 
- Drainage must be in 
sides white or a bright colour to increase visibility 
the opposite direction to keep the ramp dry 
- Cross-hatching 
- Monitoring needed to 
ensure masons do not make it too steep to reduce cost 
on ramp would 
make it less slippery when wet (see page 8 'Steps') 
- Monitoring of 
- Paint raised 
 High 
construction required 
to ensure gradient not too steep 
sides white or 
bright colour to increase visibility 
- Maintenance needed 
to keep the ground the same level as the end of the ramp 

## Ramps Slope Gradients And Level Of Ease For Different Users How Gradient (Slope) Is Measured "Gradient" Describes The Change In Height Over A Specified Distance. Example 1: Gradient 1 In 8

This slope rises one unit over a distance of eight units. For example, if the distance is 8m, the slope rises 1m. If the distance is 80cm, the slope rises 10cm. If the distance is 4m, the slope rises 0.5m. The gradient (slope) is the same, whether the distance is 8cm, 8 feet, 8m or 80m. 

Example 2: Gradient 1 in 15 
This slope rises 1 unit over a distance of 15 units. If the distance is 15m, the slope will rise 1m. How high will the slope rise if the distance is  
A.  30m? B. 10m? (Answers to the right) 
Only suitable where a helper is always available Absolutely no steeper than this 
1 in 20 is ideal, but it needs a lot of space. 1 in 15 
is a reasonable compromise. 


## Steps Suitable For: Steep Terrain; Where Space Is Limited; Households Or Communities With No Wheelchair Users.

| Construction           |
|------------------------|
| variations             |
| - Many users can       |
| Recommended step       |
| dimensions (for        |
| reference).            |
| manage low, even       |
| steps, especially      |
| when a handrail is     |
| provided.              |
| Jones et al.           |
| (2009)                 |
| - Steps take up less   |
|                        |
| Steps should be        |
| low and even - all     |
| the same height        |
| and depth.             |
|                        |
| space than a ramp.     |
|                        |
|                        |
| - Cross-hatching is    |
| easy to apply -  the   |
| concrete is scored     |
| while wet.             |
| Low concrete steps     |
| with cross-hatching    |
| to reduce the risk     |
| of slipping            |
|                        |
|                        |
| - Useful for all users |
| - Might prevent injury |
| from slipping on       |
| wet steps              |
|                        |
|                        |
| Handrail               |
| accompanying           |
| steps to a protected   |
| spring                 |
|                        |
Cost / labour 
- Steps exclude 
- Paint steps white 
some users, e.g. those using mobility devices. 
or bright colour to increase visibility. 
| - No edge            | - Steps should be of    |
|----------------------|-------------------------|
| consistent height    |                         |
| - Install a guard or |                         |
| handrail             |                         |
| protection for       |                         |
| unstable or          |                         |
| visually impaired    |                         |
| users                |                         |
|                      |                         |
|                      |                         |
|                      |                         |
|                      |                         |
| - Handrail needs     | - Paint handrail and    |
|                      |                         |
|                      |                         |
| Medium               |                         |
| maintenance to       |                         |
| ensure it is stable  |                         |
| and strong           |                         |
| enough               |                         |
| steps white or       |                         |
| bright colour to     |                         |
| increase visibility  |                         |
|                      |                         |

## Movement Aids Movement Aids Suitable For: People Who Move By Crawling; Wheelchair Users Who Need To Get Out Of Their Wheelchair; Or Where A Wheelchair Is Not Available.

| Construction Advantages    | Disadvantages         |
|----------------------------|-----------------------|
| variations                 |                       |
|                            |                       |
| - Reduce abrasion,         | - Lightweight wood    |
|                            |                       |
| Wooden hand                |                       |
| walkers                    |                       |
| cuts and soiling of        |                       |
| hands and thereby          |                       |
| risk of infection          |                       |
| - Locally available        |                       |
| materials                  |                       |
| - Durable                  |                       |
| - Easy to clean            | - Brief initial       |
|                            |                       |
| - Reduce abrasion,         | - Brief initial       |
| cuts and soiling of        |                       |
| knees and thereby          |                       |
| risk of infection          | - Regular maintenance |
| - Durable                  |                       |
| - Easy to clean            |                       |
|                            |                       |
|                            |                       |
|                            |                       |
|                            |                       |
| Rubber                     |                       |
| kneepads made              |                       |
| from used car              |                       |
| tyres. These fit           |                       |
| over the knee,             |                       |
| and rubber                 |                       |
| laces run                  |                       |
| through loops              |                       |
| and tie around             |                       |
| the leg.                   |                       |
Cost/ labour 


- Weight of wood can 
 Low 
be selected to match the user's strength 
would not be as durable as hardwood, so would need to be maintained and 
replaced more regularly. 
demonstration might 
be needed 
 
- An alternative Low 
demonstration might be needed 
design suitable for leg stumps is also 
available: 
and cleaning necessary 

Latrines should be no more than 15m from the household.   

## Superstructure Superstructure Suitable For: People With Mobility Impairments.

| Construction Advantages    | Disadvantages          |
|----------------------------|------------------------|
| variations                 |                        |
| - Materials locally        |                        |
| available                  |                        |
| - Low durability           |                        |
| - Lack of roof means       |                        |
| - Easy and quick to        |                        |
| construct                  |                        |
| - Provides some privacy    |                        |
| Grass walls                |                        |
| attached to                |                        |
| wooden poles;              |                        |
| no roof; curtain           |                        |
| for privacy                |                        |
| .                          |                        |
| - Low privacy              |                        |
| - Materials locally        | - No roof means it is  |
| available                  |                        |
| - Easy and quick to        |                        |
| construct                  | - Curtain difficult to |
| - Mat 'curtain' can be     |                        |
| - Plastic sheeting         | pulled across for      |
| privacy (see image)        |                        |
| Plastic                    |                        |
| sheeting for               |                        |
| walls attached             |                        |
| to wooden                  |                        |
| poles, woven               |                        |
| mat for curtain,           |                        |
| no roof.                   |                        |
| - Wide entrance good for   |                        |
| many users                 |                        |
| - Difficult to allow       | - Durable              |
| - Materials locally        |                        |
| available                  |                        |
| Rammed earth               |                        |
| structure with             |                        |
| thatched roof              |                        |
| - Strong enough to attach  |                        |
| handrails to the wall      |                        |
|                            |                        |
|                            |                        |
Cost/ 
labour 
- Useful as a temporary 
Low 
measure but not ideal long term 
- Spiral construction with a 
it is difficult to use when raining or very hot 
wider entrance would provide greater privacy (see  photo 1, Handrails 
and support) 
- Plastic roof could be 
Low 
added 
difficult to use when raining or very hot close easily damaged, reducing privacy 
- Widen entrance - Add a door with lock for  
Medium to  
high 
privacy and security 
enough light in without reducing privacy 
- Increase number of 
windows (high up) to allow more light in 

## Entrances Entrances Entrances Must Be: A) Wide Enough (Wheelchair Width + 20Cm), And B) Level Enough (Minimal Or No Difference Between Outside And Inside).

| Construction              | Advantages        |
|---------------------------|-------------------|
| variations                |                   |
| - Can be easily           | - No door, so low |
| privacy and security      | accessed by       |
| everyone,                 |                   |
| including                 |                   |
| wheelchair users          |                   |
| Wide and level            |                   |
| entrance to allow         |                   |
| wheelchair access.        |                   |
| Rammed earth              |                   |
| floor.                    |                   |
|                           |                   |
|                           |                   |
| - Level flooring could be |                   |
| - The floor of the        |                   |
| Latrine with level        |                   |
| concrete entrance,        |                   |
| wide enough for a         |                   |
| wheelchair user           |                   |
| latrine is the            |                   |
| same level as the         |                   |
| outside                   |                   |
|                           |                   |
| - Won't stop serious      |                   |
| - Reduces water           |                   |
| flooding!                 |                   |
| Level concrete            |                   |
| threshold with            |                   |
| raised cement             |                   |
| mound to reduce           |                   |
| flooding. Mound is        |                   |
| rounded for               |                   |
| wheelchair access.        |                   |
| inflow without            |                   |
| preventing                |                   |
| wheelchair                |                   |
| access                    |                   |
|                           |                   |
|                           |                   |
|                           |                   |
Cost/ labour 
-  Add a door 
Low to medium 
 Medium to high  
achieved with any type of materials, not only concrete 
Medium 

## Doors **Suitable For:** Users With Mobility Devices, A Helper, Or Carrying A Small Child, Or People Who Are Overweight.

| Construction             | Advantages             |
|--------------------------|------------------------|
| variations               |                        |
| - Easy to open and       |                        |
| close                    |                        |
| - Easily damaged         |                        |
| - Very little provision  |                        |
| - Does not obstruct      |                        |
| Latrine with a           |                        |
| curtain for privacy      |                        |
| made of light cloth      |                        |
| internal space           |                        |
| - Useful temporary       |                        |
| solution                 |                        |
|                          |                        |
| - Outward-opening door   | - Pulling a door is    |
| does not obstruct        |                        |
| internal space           |                        |
| -  Horizontal wooden     |                        |
| - Requires a wide, level |                        |
| struts can be grasped    |                        |
| to close door            |                        |
| Outward-opening          |                        |
| tin door on              |                        |
| wooden frame.            |                        |
| Raised platform          |                        |
| edge acts as a           |                        |
| door stop.               |                        |
| - Easier to close for    | - Higher cost than a   |
| some users               |                        |
| - Each door is narrow so | - Some users find them |
| less obstructive to      |                        |
| passers by               |                        |
| Outward-opening          |                        |
| wooden double            |                        |
| doors with a latch       |                        |
| on outside to keep       |                        |
| closed                   |                        |
Cost/ 
labour 
Low 
for security or privacy 
- Non-door alternatives include spiral-shaped entrance for greater privacy 
- Add horizontal handrail Medium 
harder than pushing it open area in front of door for users to position themselves to open the door 
- Varnish/paint wood to 
High 
single door 
reduce risk of termite damage 
difficult to use 
- Move bolt to the inside 

## Door Handles And Closing Mechanisms

Internet image 

## Door Handles And Closing Mechanisms Suitable For: Everyone, Especially Women And Girls.

| Construction            | Advantages          |
|-------------------------|---------------------|
| variations              |                     |
| - Door must be solid    |                     |
| - User can easily       |                     |
| reach                   |                     |
| - Door can be bolted    |                     |
| - Needs monitoring to   |                     |
| to increase privacy     |                     |
| Horizontal handrail     |                     |
| the full width of the   |                     |
| door on the inside.     |                     |
| Internal bolt.          |                     |
| - Large, chunky bolt    |                     |
|                         |                     |
| is easy to operate      |                     |
| - Easy for all users to | - Does not keep the |
| grasp                   |                     |
| - Materials locally     |                     |
| Carved wooden           |                     |
| handle nailed to the    |                     |
| inside of the door      |                     |
| available               |                     |
| - Easy to construct     |                     |
| - Can be too fiddly for |                     |
| Metal hook and eye      |                     |
| on inside of door       |                     |
| - Ensures privacy       |                     |
| - Easy to install       |                     |
| - Materials locally     |                     |
| available               |                     |
Cost/ 
labour 
- Rail could be made of 
Medium 
enough to fix the rail to  
wood (2nd photo, left), g.i. pipe, chain, or cord 
 
ensure it is securely 
fixed and that the 
bolt slides easily 
- Add a bolt or hook to 
Low 
door closed 
fasten the door closed 
- Handle could also be 
fixed to the door frame for support when entering 
- Instead of a hook, wire 
Low to medium 
some users to operate 
can be looped over a bent nail, or a loop of string wound round a bent nail. 

## Internal Space

Think about: who will use the toilet, and how much space they will need.  
Level 1: Space for users who can stand and enter using support rails, or blind users. Level 2: Additional space for a carer, to use crutches/sticks or to park a wheelchair but not turn. 
Level 3: Space for a wheelchair to enter, shut the door, and turn around inside. 

| Construction                |
|-----------------------------|
| variations                  |
| - Level 1 access: enough    |
| space for this household,   |
| including a user who        |
| needs to use handrails      |
| for support.                |
| Traditional round           |
| superstructure,             |
| cement seat,                |
| wooden handrail             |
| each side, curtain          |
| for privacy                 |
| - Level 2 access:           |
| Entrance corridor,          |
| with wall on left in        |
| front of latrine and        |
| a gap between               |
| corridor and toilet.        |
| wheelchair can enter and    |
| park in corridor. User can  |
| transfer to the toilet      |
| using handrails fixed to    |
| the inside wall.            |
| - Level 3 access: enough    |
| space for wheelchair to     |
| enter, turn, close door,    |
| and park by the toilet      |
| - Space for a carer, and/or |
| Spacious toilet             |
| cubicle, with drop          |
| hole located in the         |
| corner to provide           |
| maximum usable              |
| space                       |
| toilet chair to be moved    |
| to one side when not in     |
| use                         |
Cost/ labour 
- Curtain only (no 
- Increase size of the 
Medium 
door) so privacy is not ideal 
- No space for a 
carer to 
accompany 
superstructure between the seat and entrance, to allow a 
carer and user to turn 
easily 
- Install a door 
- Not enough space 
- Install a door or 
Medium to high 
for a wheelchair to 
turn easily 
curtain to hide the 
wheelchair from view 
- Wheelchair is 
visible from outside, so lacks privacy 
- Handrails on the 
 High 
inside to provide 
support when transferring to the toilet 

## Floor Finish Floor Finish Think About: The Balance Between Hygiene And Safety.  Floors Need To Be Smooth Enough To Be Washed And Swept, But Not So Smooth That They Are Slippery When Wet.

| Construction             | Advantages             |
|--------------------------|------------------------|
| variations               |                        |
| - Materials locally      | - Difficult to get the |
| available                |                        |
| Rammed earth floor       |                        |
| without marram           |                        |
| - Sweepable but not      |                        |
| floor texture right: see |                        |
| above                    |                        |
| washable                 | - Floor dusty and not  |
| very hygienic            |                        |
| - Not easy to clean      |                        |
|                          |                        |
| - Materials locally      | - Difficult to get the |
| available                |                        |
| - Repels urine to a      |                        |
| floor texture right -    |                        |
| see above                |                        |
| certain extent           | - Easier to keep clean |
| - Sweepable and          | than above example     |
| wipeable                 | - Needs regular        |
| maintenance              |                        |
| (smearing with cow       |                        |
| dung)                    |                        |
|                          |                        |
| Rammed earth floor       |                        |
| made of marram           |                        |
| (small stones) and       |                        |
| sand; cow dung is        |                        |
| smeared over to          |                        |
| make it even and         |                        |
| smooth.                  |                        |
|                          |                        |
|                          |                        |
|                          |                        |
| - If the surface is too  | - Locally produced     |
| - Easy to keep           |                        |
| clean - washable         |                        |
| smooth it can be         |                        |
| slippery when wet        |                        |
| - Durable                | - Surrounding floor    |
| Cement slab,             |                        |
| installed level with     |                        |
| earth floor around       |                        |
| it                       |                        |
| might need               |                        |
| maintenance to keep      |                        |
| it level with slab       |                        |
Cost/labour 
- Ensure good water 
Low 
drainage away from the user  
- A slightly rough floor 
is suitable for people using crutches/ 
sticks. 
- Ensure good water 
 Low to medium 
drainage away from the user  
- A slightly rough floor 
is suitable for people 
using crutches/sticks. 
 
Medium 

## Handrails And Support Handrails And Support Suitable For: People Who Are Unstable Or Unable To Walk, Squat Or Stand Unaided

| Construction              | Advantages                 |
|---------------------------|----------------------------|
| variations                |                            |
| - Walls must be strong    | - Easy to construct        |
| - Materials locally       |                            |
| available                 |                            |
| enough to support         |                            |
| user's weight             |                            |
| - Difficult to add after  |                            |
| construction              |                            |
| - Regular maintenance     |                            |
| Bricks                    |                            |
| protruding from           |                            |
| wall for support          |                            |
| to a weak or              |                            |
| visually impaired         |                            |
| person                    |                            |
| WaterAid / COU-TEDDO      |                            |
| needed to ensure          |                            |
| stability                 |                            |
| - Materials locally       | - Rails must be strong     |
| available                 |                            |
| - Easy to construct and   |                            |
| enough to bear users'     |                            |
| weight                    |                            |
| maintain                  | - Not possible to fix to a |
| - Allows user to transfer | concrete floor/slab        |
| WaterAid / WEDA           |                            |
| - Might be difficult to   | to the toilet from the     |
| side                      | keep clean                 |
| - Position and height of  | - Cannot fix to a          |
| Wooden/                   |                            |
| bamboo support            |                            |
| rails fixed to            |                            |
| floor either in           |                            |
| front or on either        |                            |
| side of toilet            |                            |
| (depending on             |                            |
| user's needs)             |                            |
| concrete floor/slab       | rails must involve user    |
| and an assessment of      |                            |
| their need                |                            |
| - Walls must be strong    |                            |
| enough to fix bars to     |                            |
| - Highly durable          |                            |
| - Can be added to         |                            |
| - Walls must be close     |                            |
| existing facility         |                            |
| enough for user to        |                            |
| reach the bars            |                            |
| - Easy to clean           |                            |
| - Bars to be positioned   |                            |
| Metal bars (e.g.          |                            |
| galvanised iron           |                            |
| pipe) fixed to            |                            |
| side wall/s of            |                            |
| latrine                   |                            |
| based on user needs       |                            |
Cost/ labour 
- Half bricks in the wall can 
Low 
also provide mini-ledges for a user to hold on to 
- Varnish/paint rail to stop 
 Low 
termite damage and for easy cleaning 
- For a growing child use 
longer vertical poles, so bar height is adjustable. 
- Horizontal bars at different 
heights might suit some. 
- For concrete floors, pipe 
rails can be cemented in during construction, or screwed to floor later. 
- Paint bars to reduce 
Medium to high 
corrosion and increase durability 
- Several bars at different 
heights on each side might better suit some users 

## Fixed Seat Pan Fixed Seat Pan Suitable For: People Who Have Difficulty Squatting, Including Overweight People, Pregnant Women, Older People And Disabled People.

| Construction            | Advantages                |
|-------------------------|---------------------------|
| variations              |                           |
| - More comfortable      | - Might be                |
| than it looks!          |                           |
| - Gap makes anal        |                           |
| cleansing easy          |                           |
| uncomfortable if gap    |                           |
| between blocks is not   |                           |
| right for the user      |                           |
| - Smooth cement         | - Blocks less stable than |
| a seat so need careful  |                           |
| installation            |                           |
| plaster easy to         |                           |
| clean and more          |                           |
| hygienic                |                           |
| Twin cement-            |                           |
| plastered brick         |                           |
| sitting blocks          |                           |
|                         |                           |
|                         |                           |
|                         |                           |
|                         |                           |
|                         |                           |
|                         |                           |
|                         |                           |
| - Narrow drop-hole  may |                           |
| Brick seat with a       |                           |
| cement screed           |                           |
| -  Durable              |                           |
| -  Comfortable          |                           |
|                         |                           |
| be hard to use          |                           |
| hygienically by         |                           |
| different sized users   |                           |
| - Narrow drop-hole      |                           |
| makes inner walls hard  |                           |
| to clean                |                           |
| - Requires a mould and  |                           |
| Cement bowl             |                           |
| made with mould         |                           |
| - Comfortable           |                           |
| - Durable               |                           |
| - Easy to wipe,         |                           |
| is more difficult to    |                           |
| construct               |                           |
| therefore hygienic      | - Heavy, so needs a       |
| strong sanplat          |                           |
Cost/ labour 
- Paint blocks to repel 
Low 
urine and make them easier to clean 
- Install blocks at an angle 
to suit different users 
- Paint the seat to repel 
Low to medium 
urine and make it easier to clean 
- A wider drop hole would 
be easier and more hygienic for most users 
- Paint the seat to repel 
High 
urine and  make it easier to clean 

## Moveable Seats Moveable Seats Suitable For: Users Who Have Difficulty Squatting, Including Overweight People, Heavily Pregnant Women, Older People, Disabled People …

| Construction            | Advantages             |
|-------------------------|------------------------|
| variations              |                        |
| - Potential for termite | - Easy to construct    |
| - Materials available   | damage                 |
| locally                 | - Enough space         |
| - Height must be        |                        |
| decided based on        |                        |
| user's needs            |                        |
| - Can be moved to one   |                        |
| needed inside latrine   |                        |
| to move the seat        |                        |
| away from the pit       |                        |
| when not in use         |                        |
|                         |                        |
| Low wooden or           |                        |
| bamboo toilet           |                        |
| stool with hole in      |                        |
| seat, placed over       |                        |
| toilet hole, with or    |                        |
| without funnel as       |                        |
| a splash guard          |                        |
| (see lower image)       |                        |
|                         |                        |
|                         |                        |
| side out of the way of  |                        |
| other users who         |                        |
| prefer to squat         |                        |
| - Light and easy to     |                        |
| carry if necessary      |                        |
|                         |                        |
| - Needs accurate        | - Comfortable          |
| - Provides back         |                        |
| support while seated    |                        |
| - Materials available   |                        |
| positioning to reduce   |                        |
| risk of splashing or    |                        |
| soiling                 |                        |
| Standard                |                        |
| varnished wooden        |                        |
| chair with hole cut     |                        |
| in the seat             |                        |
| locally                 | - Needs extra space in |
| - Varnish makes chair   |                        |
| easier to clean so      |                        |
| more hygienic           |                        |
| the latrine so it can   |                        |
| be moved to one side    |                        |
| when not in use         |                        |
| - Might be heavy        |                        |
Cost/ labour 
- Painting or 
 Low 
varnishing would make it more durable, easier to clean and more hygienic. 
- Add a splashguard 
to the front. 
 Low 
 
- Add 'runners' - 
horizontal bars joining the bottom of the legs to better distribute the weight on the floor, to reduce damage (see right). 

## Commode Seats Commode Seats Suitable For: People Who Cannot Reach A Latrine; Small Children.

| Construction                | Advantages                  |
|-----------------------------|-----------------------------|
| variations                  |                             |
| - Can be placed in          | - Container must be         |
| emptied and cleaned         |                             |
| after every use             |                             |
| - A separate private toilet |                             |
| the most convenient         |                             |
| place for the user or       |                             |
| carer, either inside        |                             |
| or outside the house        |                             |
| - Fabric straps             |                             |
| area might need to be       |                             |
| created                     |                             |
| Painted wooden              |                             |
| chair with 'potty'          |                             |
| inserted in hole in         |                             |
| seat. Potty is              |                             |
| removed for                 |                             |
| emptying.                   |                             |
| - Wood needs regular        | support a user with         |
| poor balance                |                             |
|                             |                             |
| painting/varnishing         |                             |
|                             |                             |
| - Painted metal and         | - Container must be         |
| emptied and cleaned         |                             |
| after every use             |                             |
| plastic are strong,         |                             |
| durable and easy to         |                             |
| clean                       | - A separate private toilet |
| - Can be placed in          | area might need to be       |
| created                     |                             |
| - Metal is uncomfortable    |                             |
| the most convenient         |                             |
| place for the user or       |                             |
| carer, either inside        |                             |
| or outside the house        |                             |
|                             |                             |
| for some users - a          |                             |
| home-made padded            |                             |
| ring could be added for     |                             |
| comfort                     |                             |
| - Plank and waist belt      |                             |
| added to provide extra      |                             |
| support                     |                             |
| Metal commode               |                             |
| chair with plastic          |                             |
| inset toilet pan            |                             |
| (bought in local            |                             |
| market).                    |                             |
| Container is placed         |                             |
| beneath the seat            |                             |
| and emptied into            |                             |
| the latrine.                |                             |
|                             |                             |
|                             |                             |
|                             |                             |
|                             |                             |
|                             |                             |
|                             |                             |
Cost/ 
labour 
- Padding can be 
Low to medium 
added to back and sides for extra comfort 
- Seat could be used 
without the potty, placed over the toilet 
hole 
- A bucket could be 
used under the seat instead of a potty 
 
- Car tyre inner tube 
Medium to high 
could also be used as a cushion 

WaterAid/Stephen Segawa 

## Water Provision Water Provision Suitable For: People Who Have Difficulty Carrying Water; People Who Prefer To Sit While Washing

| Construction                |
|-----------------------------|
| variations                  |
| -                           |
| User does not need to       |
| carry water                 |
| -                           |
| Bather can fill secondary   |
| water jar when required,    |
| using  tap to control water |
| flow at point of use        |
| -                           |
| Main water jar filled by    |
| rainwater harvesting, or    |
| by other family members     |
| at their convenience        |
| Elevated large water        |
| storage jar with flexible   |
| hose, with tap to           |
| smaller secondary jar       |
| placed next to bathing      |
| bench. Water fed by         |
| gravity.                    |
|                             |
|                             |
|                             |
|                             |
| -                           |
| User does not need to       |
| carry water                 |
| -                           |
| Container can be filled by  |
| other family members at     |
| their convenience           |
| Plastic water container     |
| hung high in bathroom,      |
| and tipped forward by       |
| pulling rope so water       |
| flows onto bather.          |
|                             |
|                             |
|                             |
|                             |
| -                           |
| Low cost                    |
| -                           |
| Little maintenance          |
| required                    |
| Basin/bowl placed on        |
| wooden table to raise it    |
| to a convenient height      |
| for the bather.             |
Cost / 
labour 
•
Requires space and regular maintenance 
Medium to high 
•
A bathing screen would normally be placed around the bathing area 
•
Relies on rainwater; in dry season large jar must be filled by hand  
•
Storage tank could be made of locally available materials 
Medium 
•
Needs to be filled 
regularly 
•
Height makes it inconvenient to fill 
•
Could also be 
installed in a toilet to 
provide water for anal cleansing/ handwashing 
•
Connect plastic hose and tap for more controlled water flow 
Low 
•
Basin could be placed on large, flat stone, or a wooden stand 
•
Bathers are unable to fill basin themselves so are dependant on others to refill it each time they need it 

## Seats Seats Suitable For: Bathers With Difficulty Standing To Bathe, E.G. Poor Balance, Mobility Difficulties, Stiffness, Heavily Pregnant, High Fever

| Construction        | Advantages        |
|---------------------|-------------------|
| variations          |                   |
| - Locally available | - Stones could be |
| Stone seat          |                   |
|                     | heavy so hard to  |
| move                |                   |
| materials (e.g.     |                   |
| stones, concrete    |                   |
| slab)               | - Might be rough  |
- Durable, strong - Repels water, 
and uncomfortable 
 
easy to clean 
- Seat made or 
- Seat lacks 
drainage 
Wooden stool or chair 
- Unfinished wood 
bought locally according to the 
user's 
specifications 
will deteriorate quickly 
- Soft seat is 
- User sinks into 
comfortable to sit 
- Rubber repels 
water 
seat, so can be difficult to get up without support 
- Webbing provides 
- Might start to sag 
Metal framed 
bathing bench with woven seat made of recycled tyre inner tubes 
good drainage 
with extended use 
Cost/ 
labour 
- Use bricks plastered 
Low 
with cement screed or clay paste to make seat smooth 
- Inflated inner tube can 
be placed on rock for comfort 
 
- Seal wood with 
Medium 
paint/varnish  to make it waterproof 
- To improve drainage, 
replace solid seat with slats, or add holes in seat (see right) 
- Wood frame instead of 
Medium 
metal 
 

## Bathing Equipment Bathing Equipment Suitable For: All Users

| Construction          | Advantages        |
|-----------------------|-------------------|
| variations            |                   |
| - Made from locally   |                   |
|                       |                   |
| - A wooden pole or a  |                   |
| available materials   |                   |
| - Can be installed at |                   |
| Hanging string for    |                   |
| clothes (ideal        |                   |
| height is 1.2 m)      |                   |
|                       | a height suitable |
| for users             |                   |
|                       |                   |
- Made from locally 
 
- If a longer towel is 
available materials 
 
Towel or cloth with a loop or handle at each end. One end is attached to a fixed point, to make it easy to use with 
one hand. 
- Made from locally 
- Not durable 
- Any kind of soft 
available materials 
Bathing sponge: 
made of old fishing 
net and sisal wrapped around a stick and tied with a piece of bicycle tube 
Cost/ 
labour 
Low 
rope can be used 
- The line could also be 
used to hang a privacy curtain 
Low 
used, one loop can be held with a foot 
- For a user with no 
hands, both ends can be fixed 
Low 
material could be used 
- Can be adapted for 
anal cleansing use (and then used solely for that purpose) 

## Apron Layout Suitable For: All Users

| Construction                   | Advantages             |
|--------------------------------|------------------------|
| variations                     |                        |
| - Offers a choice for users of |                        |
| where to stand or sit to       |                        |
| operate pump handle            |                        |
| - Pedestal for container next  |                        |
| to water spout                 |                        |
| Community                      |                        |
| borehole apron with            |                        |
| wide circulation area          |                        |
| and pedestal for               |                        |
| container                      |                        |
| - Drainage channel is in       |                        |
| opposite direction from user   |                        |
| - Layout provides ample        |                        |
| space for users to enter and   |                        |
| turn easily                    |                        |
| - Raised edges prevent a       |                        |
| wheelchair from rolling off    |                        |
| the side of the apron          |                        |
| Community                      |                        |
| tapstand with wide             |                        |
| entrance and                   |                        |
| enlarged circulation           |                        |
| area with raised               |                        |
| edges (still under             |                        |
| construction)                  |                        |
| - Additional space enables a   |                        |
| person with a mobility         |                        |
| device to choose position to   |                        |
| operate the handpump from      |                        |
| - Raised edge round            |                        |
| Community                      |                        |
| borehole with wide             |                        |
| circulation area               |                        |
| added to usual                 |                        |
| circular apron with            |                        |
| raised edge                    |                        |
|                                | handpump reduces water |
| on apron/provides a resting    |                        |
| place when lifting container   |                        |
Cost / 
labour 
Medium 
| - Layout is not suitable    | - A concrete ramp    | Medium    |
|-----------------------------|----------------------|-----------|
| for handpumps               |                      |           |
| - User approaches tap       |                      |           |
| from one side. To           |                      |           |
| approach from other         |                      |           |
| side requires a 180         |                      |           |
| o                           |                      |           |
|                             |                      |           |
| turn.                       |                      |           |
| instead of gravel           |                      |           |
| at the entrance             |                      |           |
| will improve                |                      |           |
| access when                 |                      |           |
| construction is             |                      |           |
| complete                    |                      |           |
| - Drainage hole could       |                      |           |
| become blocked,             |                      |           |
| leading to excess           |                      |           |
| water on apron              |                      |           |
| - Raised edge restricts     | - Can be added to    | Medium    |
| existing borehole           |                      |           |
| structures                  |                      |           |
| access to placing and       |                      |           |
| retrieving water            |                      |           |
| container                   |                      |           |

## Apron Access Via Concrete Ramps Apron Access Via Concrete Ramps Suitable For: People Using Mobility Devices, E.G. Wheelchairs, Crutches, Sticks, People Carrying Heavy Loads

| Construction            | Advantages            | Disadvantages    |
|-------------------------|-----------------------|------------------|
| (all disadvantages      |                       |                  |
| apply to all            |                       |                  |
| examples of ramps)      |                       |                  |
| - Provides              | - Maintenance needed  |                  |
| Concrete ramp to        |                       |                  |
| access borehole         |                       |                  |
| apron                   |                       |                  |
| to keep surrounding     |                       |                  |
| ground the same level   |                       |                  |
| as the end of the ramp  |                       |                  |
| independent             |                       |                  |
| access to apron         |                       |                  |
| platform for            |                       |                  |
| wheelchair users        | - Drainage must be in |                  |
| - Improves access       |                       |                  |
| for everyone            |                       |                  |
| the opposite direction  |                       |                  |
| to keep the ramp dry    |                       |                  |
| - As above              | - Ramp might need     |                  |
| more space than steps   |                       |                  |
| - Monitoring is needed  |                       |                  |
| Concrete ramp to        |                       |                  |
| access                  |                       |                  |
| handpump apron          |                       |                  |
| to ensure masons do     |                       |                  |
| not build ramp too      |                       |                  |
| steep to reduce cost.   |                       |                  |
| (For guidance on        |                       |                  |
| gradients, see page 7.) |                       |                  |
| - As above              | - As above            | As above         |
| Concrete ramp to        |                       |                  |
| access borehole         |                       |                  |
| apron                   |                       |                  |
Improvements/ 
variations 
Cost/ 
labour 
- Paint raised sides 
white or a bright 
colour to make them 
more visible 
 
Medium (as a 
proportion of 
overall 
installation) 
- Cross-hatching on 
Medium 
ramp would ensure it is not slippery when wet   
(For an example, see 
page 10.) 

## Pump Handles Pump Handles Suitable For: Users With Limited Strength Or Grip

| Construction              | Advantages            |
|---------------------------|-----------------------|
| variations                |                       |
| - Provides extra leverage | - Might invalidate    |
| which makes pumping       |                       |
| easier                    |                       |
| - Provides choice of      |                       |
| position to operate       |                       |
| handle from: front or     |                       |
| side                      |                       |
| Bent T-bar with           |                       |
| tube which slips          |                       |
| over the end of a         |                       |
| standard pump             |                       |
| handle. A screw           |                       |
| keeps it in place.        |                       |
|                           |                       |
| - Can be operated from    | - Much heavier than   |
| - Handle not liked by     |                       |
| either side or the front, |                       |
| according to user         |                       |
| preference                |                       |
| - Seat is located to one  |                       |
| Prototype of              |                       |
| adapted pump              |                       |
| handle being              |                       |
| trialled in               |                       |
| conjunction with a        |                       |
| concrete seat             |                       |
| side, so as not to        |                       |
| obstruct standing users   |                       |
| - A completely new        | - India Mk II handles |
| handle is not needed      |                       |
| - Local artisans can be   |                       |
| trained to make P-        |                       |
| handle                    |                       |
| - Can be operated from    | - Not applicable to   |
| P-handle with a           |                       |
| hollow pipe that          |                       |
| slides over the end       |                       |
| of India MK II pump       |                       |
| handle and is kept        |                       |
| in place with             |                       |
| screws                    |                       |
| the side or front         |                       |
| according to user         |                       |
| preference                |                       |
Cost / 
labour 
Medium 
pump warranty 
- Based on testing 
High 
standard handle community who feared children could 
be hit on the head 
with local users, this handle has been rejected in favour of the P-
handle below (but 
is included for interest). - CAD drawing of the 
P-handle: 
vary, so artisans 
must be trained to 
tailor adaptation to handle dimensions 
Initially high (training 
required); 
subsequently medium 
other handpumps, e.g. Afridev 

## Lifting Water Containers Lifting Water Containers Suitable For: All Users, Especially Those With Limited Strength, Difficulty Balancing Or Difficulty Grasping A Container.

| Construction             | Advantages    |
|--------------------------|---------------|
| variations               |               |
| - Lifting the container  |               |
| Pedestal made of         |               |
| bricks plastered         |               |
| with cement screed.      |               |
| Height about 70cm        |               |
| (adult hip height).      |               |
| from floor to head can   |               |
| be split into two        |               |
| separate actions by      |               |
| resting the container    |               |
| midway.                  |               |
| - As above               |               |
| - Lower stand is easier  |               |
| for children and shorter |               |
| people to use than       |               |
| 70cm pedestal            |               |
| Pedestal made of         |               |
| bricks plastered         |               |
| with cement screed.      |               |
| Height about 45cm        |               |
| (adult knee height).     |               |
| - Wall must be very      | - As above    |
| - User can rest the      |               |
| Borehole enclosure       |               |
| wall used as a           |               |
| midpoint for resting     |               |
| water container          |               |
| container, walk to the   |               |
| outside of the wall, and |               |
| pick it up from there    |               |
Cost/ labour 
 
- Height is ideally 
Low 
decided based on testing and feedback from local users (carrying out accessibility audits). 
 
 
- Height is best 
Low 
decided based on testing and feedback from local users. 
High 
sturdy to support heavy containers of water 

## Transporting Water Transporting Water Suitable For: People Using Mobility Devices, Poor Balance Or Strength

| Construction           | Advantages               |
|------------------------|--------------------------|
| variations             |                          |
| - Jerrycan is in an    | - Jerrycan can only      |
| easy-to-access         |                          |
| position               |                          |
| Transporting a 20L     |                          |
| jerrycan of water on   |                          |
| wheelchair footrests   |                          |
|                        |                          |
| be part-filled,        |                          |
| otherwise the weight   |                          |
| of the water risks     |                          |
| tipping the chair      |                          |
| - Jerrycan reduces     |                          |
| space for feet         |                          |
| - Weight is low down   | - Rack under the seat    |
| and no risk of         |                          |
| tipping the chair      |                          |
| might be difficult to  |                          |
| access                 |                          |
|                        |                          |
| 20L jerrycans          |                          |
| carried on a rack      |                          |
| under the seat of a    |                          |
| tricycle               |                          |
| - Avoids difficulty of | - Extremely difficult to |
| lift if using only one |                          |
| crutch                 |                          |
| holding crutch and     |                          |
| container at the       |                          |
| same time              |                          |
| Small jerrycan         |                          |
| carried using a        |                          |
| hook attached to       |                          |
| the crossbar of a      |                          |
| crutch                 |                          |
Cost/ 
labour 
Low 
- A rack behind the seat 
Cost of tricycle is high 
could be easier to access for some 
people. 
- Jerrycan could be 
Low 
placed on the head or in a basket on the back instead 

## Accessing Stored Water Accessing Stored Water Suitable For: Children, People With Limited Strength, Difficulty Bending Or Lifting, Poor Balance, Or The Use Of Only One Arm

| Construction           | Advantages             |
|------------------------|------------------------|
| variations             |                        |
| - Tap enables          | - Might not be on sale |
| controlled flow and    |                        |
| low risk of            |                        |
| contamination          |                        |
| Water stored in a      |                        |
| bucket accessed        |                        |
| via a tap near the     |                        |
| bottom                 |                        |
| - Wide opening of      |                        |
| bucket is easy to fill |                        |
| - Tight-fitting lid    |                        |
| reduces risk of        |                        |
| contamination          |                        |
| - Can or cup is widely | - Storage jar located  |
| available              |                        |
| - No construction      |                        |
| Tin can used to dip    |                        |
| and draw water         |                        |
| from a covered         |                        |
| needed                 |                        |
| - System can be used   | - Potential for water  |
| with any size of       |                        |
| container, e.g. the    |                        |
| bucket above           |                        |
| - Enables a person to  |                        |
| easily pour water      |                        |
| from a jerrycan        |                        |
| Jerrycan tipper        |                        |
| made of square,        |                        |
| light gauge, iron      |                        |
| tubing                 |                        |
| - Robust and durable   |                        |
| - Easy to use          |                        |
Cost/ 
labour 
Medium 
locally 
- Add a handle to the tin 
Low 
or cup to reduce risk of contamination 
outside the house so less convenient than inside 
- Raise the jar and fit a 
tap to avoid frequent removal of cover  
contamination from dipping can 
- Use light materials for 
cover 
 
- Similar tipper can be 
Medium 
constructed for a bucket 
- Can be made more 
cheaply from wood held together with wire 

## Handwashing Handwashing Suitable For: All, Especially People With Weak Legs Or The Use Of Only One Hand

| Construction                 | Advantages                     | Disadvantages       |
|------------------------------|--------------------------------|---------------------|
| variations                   |                                |                     |
| - Easy to construct          | - Difficult to use if          |                     |
| using local                  |                                |                     |
| materials                    |                                |                     |
|                              |                                |                     |
| 5L jerrycan with hole(s)     |                                |                     |
| pierced near the top,        |                                |                     |
| hung from a rail. Jerrycan   |                                |                     |
| is tipped by pressing a      |                                |                     |
| foot on a stick attached     |                                |                     |
| by a string to the lid.      |                                |                     |
| - Not very durable           | - Needs to be regularly filled | - Locally available |
| - Easy to make               |                                |                     |
| Suspended gourd; large       |                                |                     |
| hole for filling, small hole |                                |                     |
| in plug for pouring          |                                |                     |
| - Made with locally          | - Open to                      |                     |
| available materials          |                                |                     |
| - Operated with              |                                |                     |
| Cut-away jerrycan; water     |                                |                     |
| is scooped out with a        |                                |                     |
| 'ladle' made of a plastic    |                                |                     |
| aerosol lid fixed to a stick |                                |                     |
| hands instead of             |                                |                     |
| feet                         |                                |                     |
| - Easy to make               | - Needs constant               |                     |
| using locally                |                                |                     |
| available materials          |                                |                     |
| - Operated with              |                                |                     |
| - Difficult to refill        |                                |                     |
| - Bottle top gets lost       |                                |                     |
| hands instead of             |                                |                     |
| feet                         |                                |                     |
| 1L plastic bottle with       |                                |                     |
| ballpoint pen casing         |                                |                     |
| inserted via a hole near     |                                |                     |
| the bottom. Water flows      |                                |                     |
| when lid is loosened,        |                                |                     |
| stops when lid tightened.    |                                |                     |
Cost/ 
labour 
- Needs to be regularly filled 
Low  
with water 
person cannot use their feet 
Low 
with water - Put lid or cover on top, e.g. 
Low 
contamination 
using cut out section of can 
- Ladle could be pierced with 
holes so water trickles out when it is suspended. It can then be used with one hand. 
- The bottle could be 
Low 
refilling 
replaced with a jerrycan to reduce the frequency of refilling, as long as the lid was tight-fitting. 

## Further Resources

| Resource                                  | Overview                                  |
|-------------------------------------------|-------------------------------------------|
| WEDC Equity and Inclusion resources       | Awareness-raising and training materials. |
| Includes guidance on doing accessibility  |                                           |
| and safety audits for waterpoints, school |                                           |
| and household latrines.                   |                                           |
| Accessible WASH designs for people who    |                                           |
| experience limitations in carrying out    |                                           |
| activities related to WASH.               |                                           |

## Jones H And Reed R (2005)Water And Sanitation For Disabled People And Other Vulnerable Groups: Designing Services To Improve Accessibility. Wedc, Uk.

Guidelines for primary school sanitation in 
Africa. 

## Reed R And Shaw R (2008) Sanitation For Primary Schools In Africa. Wedc, Uk. Wilbur J And Jones H (2014) Disability: Making Clts Fully Inclusive. Frontiers Of Clts: Innovations And Insights, Issue 3, Ids, Brighton.

Short booklet highlighting experiences of disabled people, with practical recommendations for how to make the CLTS process fully inclusive (available in English, French and Portuguese). Technical guidance for making WASH facilities more accessible. 

## Appropriate Technology Centre (2014). A Practical Guide For Inclusive Wash Services At Household And Community Level In Uganda. Ray Normal (2010) Water Sanitation And Disability In W Africa. Phase 1 Report. The Africa Wash And Disability Study - The Collaboratory At Messiah College.

Partnership with World Vision to improve access to safe water, especially for disabled people, in West Africa. Reports, videos and technical drawings available in Additional Resources. 

www.wedcknowledge.lboro.ac.uk/colle
ctions/equity-inclusion/ https://wedcknowledge.lboro.ac.uk/detai ls.html?id=16357 http://wedc.lboro.ac.uk/reso
urces/books/Sanitation_for_ Primary_Schools_in_Africa_ -_Complete.pdf www.communityledtotalsanit ation.org/resource/frontiersclts-issue-3-disabilitymaking-clts-fully-inclusive To be published 
http://www.africawashdisabil
ity.org/ For resources go to >About 
us >Partners & Additional Resources 

# This Compendium Was Developed In Collaboration With: