By Joyce Kantam Kolamong
The simple act of using the toilet is often taken for granted. However, for those living with disabilities particularly physical and visual disabilities, it can be a source of anxiety and exclusion as exemplified by a young girl who restricts eating to avoid the discomfort of public toilet usage.
The dream of a 22-year-old girl living with physical disability is to go through the normal cycle of eating and using the place of convenience with ease. As a form three General Art student of the Northern School of Business, (NOBISCO), in Tamale, Rashida Aminu Timtooni, has been restricted to a wheelchair since she was one year old. She eats once a day because she does not want to feel the urge to pass stool. Rashida must crawl into nearby bush to relieve herself, despite glaring dangers in her attempt to do so. Alternatively, if she must use a public toilet, she leaves her wheelchair outside and crosses into the unhygienic toilet. She prays for her own toilet someday so that she can have three meals a day without inhibition.
Rashida’s detailed Story
In the heart of Choggu-Lowcost, a suburb of the Sagnarigu municipality in the Northern Region, is Rashida Aminu Timtooni, a 22-year-old girl living with a physical disability. She is the first of her parents’ four children. She and her younger siblings live with their grandmother, Aishetu Abubakari. Rashida Aminu Timtooni is impaired from the lower limb and bound to a wheelchair to make her mobile. At age one, Rashida could not crawl, and so could not attempt to take her first step. All efforts by her family to seek orthodox and traditional medicines to enable her walk were not successful. Rashida’s biggest nightmare is how to use a public toilet as the only available legitimate alternative to her. However, she has devised means to ease off herself anytime nature calls. To her, the best alternative is to go to the bush, especially when the sun sets, and this forced habit is always scary, because she does not know the dangers she is likely to face when she crawls into the bush.
“It will be difficult for me because I don’t like using my hands on the floor. Sometimes, it is so disgusting, imagine using your bare hands to crawl to the toilet, the place smells with traces of urine, faeces and sometimes maggots and you are expected to touch and ease yourself. When I come to the school, it is the same story, it is difficult in the school and in the house. My sisters will always send me to the forest to attend to nature’s call and sometimes we come across reptiles including snakes. So I am always afraid when I am feeling like easing myself”.
Rashida says this situation has changed her eating habits. She eats less or nothing at all for the simple reason of avoiding the toilet.
Appeal
The human rights to water and sanitation constitute the rights of every individual, including persons with physical disabilities, devoid of any discrimination. Access and regular use of sanitation facilities by persons living with physical disabilities is important in reducing the risks of contracting diseases associated with poor sanitation.
Rashida is extending passionate appeal to members of the public for support.
“If I get a toilet in the house, I will be very happy, I will be very grateful to the person who will give me that one thing to take off my greatest challenge, so that I can eat normal like everybody, go to school happily and live a dignified life like every child”.
School Management
In the midst of all these challenges, the 22-year-old says she is not giving up on her dreams. She wants to become a Broadcast Journalist. Rashida, however, says her dreams will come to nothing if she does not get the necessary support.
In an interview with Apik Sunday Gregory, Assistant Headmaster in Charge of Administration at the Northern School of Business, (NOBISCO), “Rashida is such a courageous person, she is somebody who can be better off, considering her background and where she comes from, yet she makes time to ensure that she is always in school in good time, you will appreciate the fact that she is doing her best”. He said.
On the home front, Rashida shares a single room with her three siblings, grandmother and five other family members. They all sleep on the cold bare floor. With her grandmother no longer working due to an accident that affected her knee, things are worse. Her grandmother, Mma Ashetu Abubakari, shed tears as she revealed that, sometimes, her granddaughter goes to school on an empty stomach, because there is neither food nor money to give her. “Any form of assistance from people will be much appreciated”.
Fighting for Inclusion
Rashida says societal neglect, stigma and the mindset that persons with disabilities cannot make it in life, pushes her to go to school every day to prove society wrong. “I want to become a journalist so that I can speak and advocate for people like me who are disregarded and looked down upon. I will fight and get to Parliament so that people of my kind can have access to education, social amenities and dignified life”, she emphasized.
Disability and Access
Lack of access, especially outside the home, remains one of the challenges for persons with mobility impairment, especially in the developing world. Toilets across the country are usually not user friendly to persons with physical disabilities. The doors are narrow, meaning no access for persons using wheelchairs. The sanitary condition of most of the public toilet facilities are in bad state. Typical example of the social and local government neglect of PWDs is the situation expressed by Rashida when she sadly says she crawls through the dirty hand filthy floor at most facilities, while a few PWDs who may be privileged, may get to use reusable plastics or gloves to aid in crawling through these disability unfriendly facilities. The inescapable routine of they not getting their lower limbs protected is obviously a discouraging phenomenon.
Again, many other sanitary conditions are ill-prepared with little attention for persons with physical disabilities. Persons with disabilities, especially those living in developing countries, encounter challenges in accessing to water, sanitation and hygiene, including physical, institutional, social and attitudinal barriers. This is particularly true for persons with severe disabilities.
Furthermore, in many countries, persons with disabilities are less likely to live in households with access to improved water and sanitation, and less likely to live in a dwelling with hygiene and sanitation facilities on the premises. The ignorance or otherwise of improperly siting these facilities can create difficulties for persons with disabilities who experience mobility issues, in locating the bathroom and in waiting in queues.
Moreover, evidence in many developing countries indicates that more than one in seven persons with disabilities finds the toilet at home and outside hindering or not accessible ( WHO, 2011 World Report on Disability). Lack of accessibility of toilets outside the home is also a challenge and prevents persons with disabilities from participating in society.
Human Rights and Sanitation
All people are entitled to water and sanitation without discrimination. Marginalized groups – women, children, refugees, indigenous peoples, persons living with disability and many others situations, are often overlooked, and sometimes face active discrimination from those planning and governing water and sanitation improvements and services, and other service users. Access to safe, affordable and reliable drinking water and sanitation services are basic human rights. They are indispensable to sustaining healthy livelihoods as well as maintaining people’s dignity. Human rights to water and sanitation are essential for eradicating poverty, building peaceful and prosperous societies, and ensuring that ‘no one is left behind’ on the road towards sustainable development. International human rights law obliges States to work towards achieving universal access to water and sanitation for all, without any discrimination. The key elements of the rights to water and sanitation are availability; accessibility; affordability; quality, and safety, and acceptability. The lack of good sanitation and sanitary conditions has a knock-on effect, affecting the pursuit and enjoyment of other human rights. It obstructs the right to health and life, and hampers the right to education. The human right to water and sanitation constitutes the right of every individual, including persons living with physical disabilities, devoid of any form of discrimination. Access and regular use of sanitation facilities by persons living with physical disabilities is pivotal in reducing their risk of contracting diseases associated with poor sanitation. The lack of accessible sanitation facilities may lead to embarrassing situations as it deprives them of their most fundamental and private needs. It may also result in unemployment, injustice, discrimination, isolation, and exclusion from public engagements. Besides, it promotes their well-being and prevents other diseases associated with their conditions.
Addressing Public Toilet and Disability
Persons with disabilities, especially those living in developing countries, encounter challenges in accessing water, sanitation and hygiene, including physical, institutional, social and attitudinal barriers. In the Northern region, persons with disabilities live in households with less access to improved water and sanitation, and less likely to live in a dwelling with hygiene and sanitation facilities on the premises. This can create difficulties for those who experience difficulties in mobility, in locating the bathroom and in waiting in line. Data available (WHO, 2011 World Report on Disability), indicates that more than one in seven persons with disabilities finds the toilet at home hindering or not accessible. Lack of accessibility of toilets outside the home is also a challenge and prevents persons with disabilities from participating in society. Around two billion people currently lack safely managed WASH services, with conflicts, climate change and inequality, thereby exacerbating the issue for women, children and marginalized groups. According to the World Health Organisation (WHO), in Ghana, approximately 12.8 percent of the population lives with disabilities with physical disabilities affecting more than 5.5 percent translating to around 1.65 million people. According to the Ghana Statistical Service, GSS, the Northern region has relatively high prevalence of physical disabilities with approximately 6.3 percent living with physical disabilities. The service, in its latest report, reported that about 69,340 females out of 126,011 individuals with disabilities struggle with various forms of physical disabilities. Of these, 3,186 females live with visual impairments, with 735 experiencing significant difficulties. The Northern Regional Office of the Ghana Federation of Disability Organizations, GFDOs, (2022) reports indicates that out of a total number of 126 persons living with physical disabilities in the Tamale metropolis, about 60 percent of them are females.
Data from the Waste Management Department of the Tamale Metropolitan Assembly, in the Northern region, indicates that there are about 147 public/community toilets in the metropolis, out of which 90 of them are in a compromised state. Some of them have turned into haven for dangerous animals and criminals, while some of them have become death traps. Only seven of these toilets are disability friendly with user friendly accessories. A visit by GBCNews to some of the public/community toilets observed largely that these toilets are in a sorry state and by standard, they do not deem fit for use. The news team also observed that the management of the public/community toilets by party foot soldiers during regimes has created a critical challenge for the Waste Management Department to execute their duty of ensuring clean and accessible toilets for all. The lack of accessible and inclusive facilities exacerbates the plight of persons living with disabilities forcing many to resort to unhygienic and unsafe practices.
Gafaru and Khadija’s Experience
Gafaru Adams, a 35-year-old cobbler from Choggu-Manayili, has lived with a physical disability since age 10. He described the community toilet as “insanitary” and “demeaning.” Due to the filthy conditions, Gafaru resorted to open defecation at a nearby refuse dump. “I stopped using the toilet because it is always dirty, I used to wear tie plastic rubber on my hands and feet before I crawled to the toilet to defecate and sometimes looking on while crawling on fecal matter was sad and demeaning”. He revealed. “I was ridiculed and laughed at in school for not cleaning myself properly after using the toilet. I had to stop attending school in Basic Five.”
Khadija Osman, 22 year old student, living with partial visual impairment, echoed Gafaru’s concerns. She described using public toilets as a “nightmare” due to inadequate lighting and grab bars. “Navigation is difficult, leading to slipping, falling, and injuries, my right leg once slipped into a pit and was stuck and my loud shouts brought people to my rescue. I cried the rest of that day and vowed never to use the public toilet again.” Khadija says she now defecates in a plastic rubber in her room and disposes of it at night.
Both Gafaru and Khadija appealed to authorities to consider persons with disabilities during public toilet construction.
Former Convener of the Northern Regional Chapter of the Ghana Federation of Disability Organisations, GFDOs, Seidu Chentimah, said while the inaccessible state of public toilets have forced many of the PWDs to resort to defecating in their rooms and in plastic bags and disposing them later, others have had to drop out of school particularly females since their dignities were compromised. “I wrote to the then MCE of Tamale during the African Cup of Nations in 2008, when they were constructing public toilets in the metropolis, and we informed them to make them disability friendly for those with physical and visual disability, and all that they did was to construct a steep access ramp at the entrance to few of the facilities. I did visit some of them around Sakasaka, Choggu, and Tishegu around the Pentecost church in 2023 and I suggested to those managing them to create good access because erosion had washed most of the ramps off making it difficult for wheel chair users to access the toilets and as of now, I have not seen any changes”. He intimated. Mr Chentimah emphasized that the absence of ramps or handrails and a lack of grab bars within the toileting area increases health and safety risks such as trips or falls and. The insanitary conditions of public toilets are one of the main means of transmission of many classic diseases and many urinary, vaginal and anal infections.
“Despite our persistence, officials informed us that they were rolling out an initiative to provide toilet facilities to every household”, Mr. Chentimah explained. “We proposed that they offer these facilities to us at a subsidized rate but unfortunately, we were unable to negotiate effectively. We did not even have the opportunity to meet with the funder or discuss the matter further”.
Mr. Chentimah emphasized further that “When we further pushed they said there were rolling an initiative to provide every household a toilet facility so we were on the view that if they could make that facility available to us at a subsidized price but we were not able to negotiate through very well, as we were not able to meet the funder not to talk of having a further discussion”.
Inclusion and WASH Facilities
The Inclusive WASH website states that “People with a disability represent the largest socially excluded group globally and most live without access to basic sanitary services, which can exacerbate impairments and poverty”. The rights of persons with disabilities to accessible WASH facilities are documented in the in Convention of the Rights of Persons with Disabilities (CRPD). The international community also reflects these rights in the Sustainable Development Goals (SDGs).
Sustainable Development Goals (SDG)
Imagine the world in 2030, fully inclusive of persons with disabilities. In September 2015, the UN General Assembly adopted the 2030 Agenda for Sustainable Development that includes 17 Sustainable Development Goals (SDGs). SDG 10 is aimed at reducing inequalities and SDG six is geared towards ensuring access to water and sanitation for all. Building on the principles of “leaving no one behind”, the new Agenda emphasizes a holistic approach to achieving sustainable development for all. The SDGs also explicitly include disability and persons with disabilities 11 times covering access to education and employment, availability of schools that are sensitive to students with disabilities, inclusion and empowerment of persons with disabilities, accessible transport, accessible public and green spaces, and building the capacity of countries to disaggregate data by disability. The 2030 Agenda for Sustainable Development holds a deep promise for persons with disabilities everywhere. But with only six years left to achieve 2030 SDGs, concerns linger about the feasibility of goals 6 and 10 specifically ensuring water and sanitation for persons with disabilities especially in the Northern region. The region, one of the most impoverished regions faces significant challenges in providing accessible and inclusive water and sanitation facilities for persons with disabilities. Therefore, achieving these goals will require a concerted effort from government agencies, civil service organizations and local communities.
Conclusion/Recommendation
The struggles faced by persons with physical disabilities in accessing public/community toilets are a stark reminder of the systemic inequalities that persist in society. The deplorable sanitary conditions and lack of accessibility features in these facilities not only infringe upon their fundamental rights to dignity but also perpetuate social isolation and exclusion. The government is taking a huge risk with the nation’s health in not paying attention to public toilet provision.
It is imperative that we prioritize the needs of the most vulnerable members of the community. Governments, policymakers, and stakeholders must work collaboratively to implement accessibility standards in public toilet infrastructure, ensure regular maintenance and hygiene practices, provide adequate facilities for persons with disabilities, and raise awareness about inclusive development and education on disability rights.
Again, public/community toilets must be managed and supervised by the various assemblies or the Waste Management Department, rather than leaving it in the hands of political foot soldiers whose motive is politically and financially driven. By addressing these challenges, the country can create a more inclusive and equitable society where everyone, regardless of physical ability, can access safe, dignified, and hygienic sanitation facilities.
The time to act is now – let us break down barriers and build a future where every individual can thrive with dignity. Together, we can create a more inclusive world, by constructing one good multifaceted toilet at a time. Judith Heumann, a Renowned Disability Rights Activist in her book (Being Heumann: An Unrepentant Memoir of a Disability Rights Activist, Beacon Press, 2020), once said “Inclusion is not a matter of political correctness, it is a matter of human rights”.
