Incontinence and WASH

Focusing on people in humanitarian and low- and middle-income contexts

 

Incontinence is the involuntary loss of urine and/or faeces

People of any gender, age or ability can experience incontinence: they cannot hold on to their urine and/or faeces (‘the involuntary loss of urine or faeces’), and need to manage their urine and/or faeces leaking out. Leakage can occur at any time, day or night (commonly referred to in children as ‘bedwetting’). Incontinence has a significant impact on the quality of life of those who experience it, and that of their family members and carers:

“The children (in Zaatari refugee camp, Jordon) are really suffering. The problem is that the mothers have been trying to cope for so long that basically they’ve given up. Night after night of urine and they can’t keep them clean. It’s soul-destroying (Venema, 2015)”

Members of an informal email group on incontinence in humanitarian and development settings* have identified a lack of acknowledgement and support for people with incontinence. In response the group has been developing tools and collating resources to enable development and humanitarian professionals to create a supportive environment for people in low- and middle-income countries to manage their incontinence hygienically, safely, in privacy and with dignity.

We have identified that anyone who experiences incontinence has increased water, sanitation and hygiene (WASH) needs compared to the rest of the population. WASH-related tools and resources have been collated on this webpage to help improve the knowledge and practices of the WASH sector. New resources will be added when available. This guidance can be summarised as:

For more information, please see:

*Please note that these documents will be regularly updated as more information becomes available.

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Current projects investigating incontinence in humanitarian and LMIC contexts

Children and their caregivers’ experiences with incontinence (Uganda and Bangladesh): a research and practice partnership to understand and dismantle the barriers to inclusion and well-being that children (aged five to 11), and others living with incontinence, face in humanitarian contexts.

Funder: The Humanitarian Innovation Fund (HIF), Elrha

Partners: University of Leeds, University of York, Plan International UK, Plan International Uganda, UNICEF Bangladesh and World Vision Bangladesh

 

Improving the lives of older people with incontinence (Ethiopia and Malawi): Oxfam and HelpAge International will develop a practical and sensitive methodology to understand the scope and scale of incontinence and how it affects older people living with it and their caregivers in humanitarian contexts.

Funder: The Humanitarian Innovation Fund (HIF), Elrha

Partners: Oxfam, HelpAge International, Dr Sarah House

 

Water, Women and Disability Study Vanuatu: a comprehensive population-based study of disability in Torba and Sanma Provinces, Vanuatu to quantify the prevalence and demographics of disability, and understand access to and experience of water, sanitation and hygiene, menstrual hygiene and incontinence management amongst persons with disabilities, alongside the situation of persons without disabilities.

Funder: The Department of Foreign Affairs and Trade’s Women for Water stream

Partners: London School of Hygiene and Tropical Medicine (LSHTM), World Vision, Vanuatu Society for People with Disability, Vanuatu Disability Promotion and Advocacy Association, Vanuatu National Statistics Office, Ministry of Justice and Community Services, Sally Baker (independent consultant)

 

Dr Amita Bhakta’s work on the perimenopause: conducted at the Water Engineering and Development Centre (WEDC) in the School of Architecture, Building and Civil Engineering with Dr Julie Fisher and Brian Reed at Loughborough University

Opening the doors to the hidden water, sanitation and hygiene needs of women from the onset of the perimenopause in urban Ghana

Cleansing in hidden spaces: the bathing needs of perimenopausal women

It’s time for the water, sanitation and hygiene sector to hear about the perimenopause

 

Other incontinence research being conducted at the University of Leeds

An evidence-based self-management package for urinary incontinence in older women: a mixed methods feasibility study in BMC Urology

Breaking the silence on incontinence

Incontinence affects more than 200m people worldwide, so why isn’t more being done to find a cure? on The Conversation

Multifaceted self-management interventions for older women with urinary incontinence: a systematic review and narrative synthesis in BMJ Open

Technology for incontinence hasn’t developed that much since ancient Egyptian times on The Conversation

Talking to women about urinary incontinence on the BMJ Blog

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Key contacts championing increasing learning on incontinence in humanitarian and LMICs

At the University of Leeds:

Dr Dani Barrington, Visiting Lecturer in Water, Sanitation and Health

Dr Pete Culmer, Associate Professor, School of Mechanical Engineering. Pete is also a member of the IMPRESS initiative of the National Institute for Health Research (NIHR) Surgical MedTech Cooperative which aims to encourage more engineers and scientists to work on researching new technologies for incontinence.

Professor Barbara Evans, Professor of Public Health Engineering

Claire Rosato-Scott PhD Candidate, Emergency sanitation for children aged 5 to 11 with urinary incontinence

External to the University of Leeds:

Dr Amita Bhakta (Freelance consultant on water, sanitation and hygiene) and on Twitter

Larissa Burke (Disability Inclusion Advisor at CBM Australia)

Chelsea Giles-Hansen (Public health and WASH Consultant)

Dr Sarah House (Freelance public health / water, sanitation and hygiene engineer)

Jane Wilbur, Research Fellow Disability, Water, Sanitation and Hygiene at the London School of Hygiene and Tropical Medicine

*If you have any questions or comments about anything on this page, incontinence in general, or if you would like to join the informal email group on incontinence in humanitarian and development settings, please contact  lmic-incontinence+owners@googlegroups.com