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This analysis was conducted between April and May 2018 as part of the design process for World Vision Vanuatu’s Water for Women project, Laetem Dak Kona. It seeks to present findings of a study regarding access to Water, Sanitation and Hygiene (WASH) for people with disabilities and women, and recommendations to inform the project design. This analysis was developed following a desk review of literature, a series of key informant interviews and two workshops held in Port Vila in April and May 2018, with a range of stakeholders from national, provincial and communities in Vanuatu. The following summarises the contextual background, key findings and recommendations.
Vanuatu’s National Sustainable Development Plan 2016 – 2030,17 known as Vanuatu 2030: The Peoples Plan, formalises a national commitment to disability inclusion and gender equality through multiple objectives and indicators, which are organised around three main pillars: Society, Environment and Economy. Economy Objective 2.2 mandates the importance of disability inclusive and gender equitable Water, Sanitation and Hygiene (WASH): Ensure all people have reliable access to safe drinking water and sanitation infrastructure.
However, people with disabilities and women in Vanuatu continue to face inequalities in social, cultural, economic and political spheres of life. Vanuatu is a highly traditional society, with customary beliefs (referred to as ‘kastom’ in Bislama), practices, values and structures (including traditional governance) dominating community life.18 There are limits to women’s participation in decisionmaking at all levels, which results in policies and practices that do not account for their particular needs and priorities, and result in inequalities. The risk of violence against women underpins day-today life.
People with disabilities are believed to comprise between five and twelve per cent of Vanuatu’s population, and are more disadvantaged than others.19 People with disabilities are far less likely to have attended primary school than those without disabilities, and are more likely to be in the lowest and next-to-lowest household wealth quintile.20 Commonly reported barriers to participation include stigma, accessibility of the built environment, accessible information, literacy and numeracy, transport, and lack of specific disability support servicessuch as sign language and assistive technology including mobility devices.
People with disabilities and women face many inequalities in accessing safe water, sanitation and hygiene (WASH) facilities, services and practices. While policies exist to support equal access to WASH, implementation has been limited, and the rights and priorities of women and people with disabilities have generally not been considered in practices. Women, people with disabilities and people of diverse sexual orientation and gender identity and expression are typically excluded from national, provincial and community level committees and decision-making structures.21 Over-protectiveness can result in people with disabilities being kept at home “for their own safety”, preventing participation. Sometimes people with disabilities remain at home because their families believe that their participation might create a burden for others. As a result, provincial and national governments and non-government organisations often do not know where people with disabilities are, and what their specific priorities are, which can result in service planning which excludes their needs.
At the household level, women are rarely involved in family and community decision-making, despite women traditionally managing water, sanitation, family health and childcare.22 The barriers to participation experienced by people with disabilities, in particular stigma and discrimination, are likely to result in limited power over decision making at the household and community level.
Women and people with disabilities regularly experience barriers to accessing economic empowerment opportunities. These can include confidence, low community recognition of their ability, limited financial literacy and a lack of specific work skills. Where women with and without disabilities have limited engagement in decision making regarding the use of household income, this can result in limited access to soap, menstrual hygiene management (MHM) and continence products, which impacts on hygiene and health.
Taboos around menstruation can inhibit women and girls’ full participation in daily life. Many girls opt out of school when they have their period, because they lack tools to manage their menstruation and/or lack confidence to continue normal participation in daily activities, including sports.23 Challenges include a lack of information of menstruation and inadequate WASH facilities in schools and public places.24 Male attitudes towards menstruation can be an additional barrier to effective menstrual hygiene management.25 Women with disabilities, especially wheelchair users, frequently have specific menstrual hygiene management needs which are overlooked.
People with disabilities require an accessible built environment to enable access to WASH facilities. This can also benefit older people. People with particular disabilities frequently require access to specific assistive technology to enable safe, hygienic independent toileting. Availability of assistive technology is limited in Vanuatu, especially in rural areas. Caregivers can provide much needed support to people with disabilities as they undertake their activities of daily living, such as showering and toileting. However, caregivers receive little or no training and support. Their caregiving role can mean they are missing paid work opportunities, and may foster resentment. People with disabilities, particularly those with physical disabilities, frequently experience continence management issues, as do older people, and women who have birthed babies. However, continence management strategies such as adult diapers and urine container can be costly, and provoke negative reactions from others, which discourages their use.
Deaf and hard of hearing people, and those with intellectual or communication disabilities may require alternative communication methods to enable them to learn and understand safe and hygienic WASH processes such as handwashing. Low educational attainment, and subsequent limited literacy, further exacerbates the challenges faced by people with disabilities in accessing information about safe and hygienic WASH.
Violence can impact significantly on the access of women and girls, and in some cases boys and men, to adequate water, sanitation and hygiene. Where toileting and bathing facilities are located some distance from the home, women and girls regularly face harassment when accessing these. Given the ‘tabu’ around defecation and menstruation, women and girls often prefer to go to the toilet or use bathing units under the cover of darkness.26 This risk of violence extends to people of diverse sexual orientation and gender identity and expression who may experience bullying and sexual violence when accessing toilets.27 Household disputes can occur between men and women regarding water collection responsibilities and water usage.
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