Accessible in Theory, Inaccessible in Practice: A User-Centered Evaluation of Disability Inclusion in Humanitarian WASH Facilities in Gaza Displacement Camps

Background Persons with disabilities in displacement settings face persistent barriers to safe, dignified, and independent access to water, sanitation, and hygiene (WASH) facilities. Evidence on functional accessibility in conflict-affected Gaza is limited. This study evaluated the objective and perceived accessibility of humanitarian WASH facilities and examined user experiences in Gaza displacement camps. Methods Between 23 September and 26 December 2025, a mixed-methods study was conducted across six displacement camps. A total of 384 participants, including persons with disabilities and caregivers, were recruited. Data collection included structured facility audits, observations of WASH use, and participatory evaluation sessions. Composite accessibility scores were calculated, and qualitative findings were thematically analyzed. Results Most WASH facilities were nominally “accessible,” but structural, operational, and environmental barriers limited functional use. Ramps, handrails, and widened doors were often inadequate or poorly maintained. Privacy and safety constraints disproportionately affected women, girls, and participants requiring assistance. Over 58% relied on caregivers for facility use, and 39–46% reported delayed or reduced hygiene practices. Composite accessibility scores were low in 61.6% of facilities, with bathing spaces scoring worst. Participants identified priority barriers and suggested low-cost, context-appropriate adaptations, including handrails, non-slip surfaces, improved maneuvering space, and participatory design. Despite awareness of disability-inclusive policies, functional inclusion remained limited. Conclusion Persons with disabilities in Gaza displacement camps experience a persistent gap between theoretical accessibility and practical usability of WASH facilities. Integrating structural improvements, operational reliability, and participatory design is critical to ensure inclusive, safe, and dignified WASH services.