The Effects of Climate Hazards on Personal Hygiene Practices among People with Disabilities in Bangladesh: A Qualitative Study

Abstract

People with disabilities experience unique challenges in practising good hygiene, and climate hazards exacerbate those challenges. This study investigates the effects of climate hazards on personal hygiene practices (handwashing, bathing, laundry, and menstrual health) among people with disabilities and their caregivers in cyclone-affected Satkhira and flood-affected Gaibandha of Bangladesh. A phenomenological qualitative study was conducted in rural Satkhira and Gaibandha. We applied purposive sampling to select 39 people with disabilities and 16 caregivers who experienced cyclones or floods between 2018 and 2023. Data were collected through in-depth interviews, photovoice and ranking, and observations. We thematically analysed findings using Nvivo 14. During Cyclone Amphan in Satkhira and recurrent floods in Gaibandha, handwashing practices remained unchanged. However, water-logged muddy paths led participants to refrain from bathing for days in Satkhira, causing dissatisfaction about cleanliness. Flooded water points and surroundings in Gaibandha forced participants to bathe and do laundry in contaminated floodwaters, resulting in people reporting increased rashes, skin infections, and fevers. In both districts, the need for bathing and laundering soiled clothes and bedding among people with disabilities experiencing incontinence remained unmet. Additionally, caregivers struggled to provide dignified hygiene support. Women with disabilities could not wash menstrual materials during cyclone in Satkhira. In Gaibandha, contaminated floodwater was used to wash menstrual materials, and individuals living in temporary shelters expressed privacy concerns. Disposal practices were disrupted, with used materials stored indoors or thrown into floodwaters. These challenges adversely affected the health and well-being of people with disabilities and the emotional well-being of the caregivers. People with disabilities face more complex challenges in maintaining personal hygiene during floods and cyclones due to impairments, gender-specific biological needs, additional health requirements, and dependency on caregivers. To prevent worsening inequalities in a changing climate, it is crucial to systematically include people with disabilities in climate-resilient hygiene initiatives.