Human rights are rights we have simply because we exist as human beings.
According to the Citizens Advice, UK (2020) ‘Human rights are based on important principles like dignity, fairness, respect and equality. They protect you in your everyday life regardless of who you are, where you live and how you chose to live your life.’ They cover everything from the right to life to the rights that make life worth living such as rights to education, food, health and sanitation.
Access to good sanitation worldwide
We know from World Health Organisation (2019) data that there are 4.2 billion people living without access to safely managed sanitation. In 2017 less than half of the global population (45% or 3.4 billion people) used a safely managed sanitation service with only a third having access to private sanitation facilities connected to sewers from which wastewater was treated.
Considering toileting more specifically only 14% of the global population (1.0 billion people) in 2017 used toilets or latrines where excreta were disposed of in situ. With 2.0 billion people still not having basic sanitation facilities such as toilets or latrines and of these, 673 million still defecate in the open, for example in street gutters, behind bushes or into open bodies of water.
Whilst we can look at those figures and for most of us sat in the UK, think they apply to other parts of the world let us just reflect how far our sanitation and toileting systems and habits have evolved over the last 100 years. At the turn of the 20th century chamber pots were the thing and when toilets were initially installed they were predominantly outdoors.
Sanitation & spread of disease.
We are well aware of the link between good sanitation and good health. In fact this last year with the COVID-19 pandemic the UK and the world has seen the increased importance of having sustainable sanitation, alongside access to clean water and hand washing facilities. Sanitation helps protect and maintain our health and stops the spread of infectious diseases.
Other benefits of improved sanitation
However, there are many other benefits of improved sanitation including promoting dignity and safety. A WHO study in 2012 calculated that for every US$ 1.00 invested in sanitation, there was a return of US$ 5.50 in lower health costs, more productivity, and fewer premature deaths. Therefore we can see that there is a clear link between improving sanitation and enabling and promoting individuals participation in community life.
Occupations and participation
According to the Royal College of Occupational Therapists (2019) “Occupation” as a term refers to practical and purposeful activities that allow people to live independently and have a sense of identity. This could be essential day-to-day tasks such as self-care, work or leisure”.
Toileting in itself can be considered an occupation when we consider recognising the need to urinate or defecate, access to the bathroom/toilet, getting on and off the toilet, cleaning ourselves and arranging our clothing.
Equally toileting can be part of other occupations for example considering the need to toilet as part of the routine of getting ready for school or accessing a toilet whilst out shopping or at a restaurant.
However, we are acutely aware that for many toileting is not an easy occupation. Fully accessible toilets and Changing Places are in limited supply across the UK and this lack of access to appropriate facilities makes if difficult for persons with disabilities including and their families to engage in many community based activities or occupations.
This lack of appropriate facilitates can lead to occupational deprivation, which is “a state of prolonged preclusion from engagement in occupations of necessity and/or meaning due to factors which stand outside the control of the individual” (Townsend 1999). We see this when someone stops doing something or is unable to do something because can’t access or use the toilets when out.
This exclusion from participation in valued occupations due to environmental factors can be viewed as occupational marginalisation whereby persons are denied access to their community.
Occupational Justice is “the right of every individual to be able to meet basic needs and to have equal opportunities and life chances to reach toward her or his potential” (Wilcock & Townsend, 2000).
Everyone has occupational rights including access to clean, appropriate toilet and sanitation facilities, which is at the core of the Changing Places Campaign. The Campaign supports the rights of people with profound and multiple learning/or other physical disabilities, to access their community by advocating for facilities that provide more space (minimum of 12sqm) than a normal accessible toilet ensuring that there is adequate room for extra equipment and room for two carers to easily help the user (Changing Places, 2020).
Changing Places Campaign
The principles of the Changing Places Campaign promote occupational justice however, there is still along way to go from moving from fully accessible changing facilities being recommended to compulsory. It is therefore essential that we all get behind the Campaign and advocate for human rights for all including those with disabilities. Access to safe, useable sanitation facilities enables participation not just in the specific activity of toileting but the wider aspect of social participation.
Dignity and rights
An occupationally just society enables participation in both necessary and meaningful occupations, which contribute to health and wellbeing.
“Everyone has the right to use a public toilet when they need to and Changing Places toilets are a lifeline for more than a quarter of a million disabled people across the UK. Having access to one of the 1,534 Changing Places toilets across the country can make a world of difference for people with conditions like muscular dystrophy, ensuring greater independence and making planning days out much easier.” Karen Hoe, Changing Places Development Officer.
- Changing Places. (2020). ‘What are Changing Places toilets?’. Available here
- Citizens Advice. (2020). ‘What are human rights?’. Available here
- Royal College of Occupational Therapists (RCOT). (2019). ‘What is
occupational therapy?’. Available here
- Townsend, E. (1999). “Enabling occupation in the 21st century: Making good
intentions a reality.” Australian Occupational Therapy Journal, 46(4), 147–59.
- UN Water. (2020). World Toilet Day. Fact Sheet. Available here
- Wilcock, A., & Townsend, E. (2000). “Occupational terminology interactive
dialogue: occupational justice.” Journal of Occupational Science, 7(2), 84–86.
- World Health Organization (WHO). (2019). Sanitation. Fact Sheet. WHO,
Geneva. Available here