Bridging the Gap between Cultures of Sanitation and Cultures of Disability

Getting fitted out for a better future, DFID, 2011, Modified.

By Gauri Desai

Published October 24, 2016 This content is archived.

Culture plays a major role in defining disabilities. Concepts and types of disabilities vary widely across cultures, and many societies do not have linguistic equivalences for “disability,” “impairment”, or the now pejorative “handicap" [1]. 

Even within a single culture, a divide exists between the dominant culture of sanitation and an oppressive culture of disability
Gauri Desai, Postdoctoral Student
Epidemiology and Environmental Health

In the Tuareg culture in Mali, having freckles and small buttocks are considered an obstacle to marriage and, therefore, disabilities [2]. Other disability concepts in Tuareg culture include common Western terms, such as deafness, as well as more localized constructs, such as a protruding navel, absentmindedness, ugliness, and illegitimate birth [2].

Culture also determines sanitation and hygiene norms, and, like disability, sanitation and hygiene practices vary immensely. A conundrum, therefore, arises at the intersection of sanitation and disability, where, even within a single culture, a divide exists between the dominant culture of sanitation and an oppressive culture of disability.

In the Western world, researchers, advocacy groups, and government agencies have focused considerable attention on equal access to education, employment, transportation, and housing for people with disabilities. Much less attention, however, has been paid to the rights of people with disabilities in the sanitation sector in low- and middle-income countries. Research is particularly thin. Outside the extensive, though case-based, reports of WaterAid and the Water, Engineering and Development Center (WEDC), much of the literature relies on anecdotal evidence and personal accounts that identify barriers to sanitation access. Moreover, there are few systematic, cross-cultural assessments of sanitation for people with disabilities. One fundamental problem is, given that disability is culturally defined, the lack of global data on the prevalence of disability by type and on the social and environmental barriers people face. A second problem is that documentation of interventions focus largely on reducing physical barriers to access, not on addressing attitudinal and institutional barriers.

Among the Maasai community in Kenya, “disability” refers to a lizard that walks in an awkward manner [2]. This construct equates disability to physical, rather than sensory or cognitive, characteristics, though other more specific terms, such as blind, deaf, epileptic, dwarf, and “unlucky child” exist [2]. More pointedly, in northeast Brazil, women from underserved societies compare babies with congenital defects to crocodile infants, alluding to the stigma and social exclusion that these children face [2].

Despite differences in the objectified terms of disability, there may be thematic relationships between across cultures. Finding these threads, along with parallels between seemingly divergent cultures of sanitation and hygiene, may enable a more robust sharing of information and practices across geographies. A comparative, cross-cultural approach may, then, be leveraged to transform both sanitation practices and disability constructs toward more socially inclusive, cross-sector solutions.


  1. Coleridge, P., Community Based Rehabilitation in a Complex Emergency: Study of Afghanistan. Selected Readings in
    CBR-Series, 2002. 2: p. 35-49.
  2. Ingstad, B., Disability and culture. 1995: Univ of California Press.