Introduction
Kabale District is a hilly area with steep terrain. Most people in this district live on the steep slopes of hills, although some live in valleys. However, even those who live in valleys have to move up and down the hills in order to access public places such as schools, markets, hospitals and places of work.

The terrain in this area means that people with disabilities are unable to access all facilities necessary for their daily lives. Most mobility-assistive devices such as calipers and wheelchairs are difficult or sometimes impossible to use on steep slopes. Disabled people’s problems of physical accessibility can be improved by building ramps and special toilets, widening and levelling roads, and using recommended, appropriate assistive devices.

Building Ramps
Efforts to improve mobility in Kabale District have greatly improved access for people with disabilities. However, local government authorities should make sure that ramps are built so that people with disabilities can enter buildings easily. For example, most schools, health centres, offices and other public places have steps at the entrance. The exceptions are newly-built school facility grant buildings and health centres, Rukiiko Hall, EARS offices and some public offices. In schools where there are no ramps, children who use wheelchairs have to crawl in order to enter the building. They crawl up the steps and return to the wheelchairs once at the top of steps, although fellow children sometimes help to lift the wheelchair over the steps. This situation can easily be avoided by building ramps using local materials such as sand, stones and cement. Local labour could be employed to build the ramps in order to keep costs down.

Special Toilets
On top of the lack of ramps, there are often no toilet facilities in public places tailored to meet the special needs of people with disabilities. Local government authorities should ensure that special private toilets are availed for each sex so that people with disabilities do not have to crawl in dirty toilets to use them. The authorities could also encourage and sensitise families of people with disabilities to make special latrines, as most people with disabilities find it difficult or are unable to squat on ordinary latrines. Latrines could be built at the same level as the main house so that people with disabilities do not fall over when they are going down steep slopes to and from the toilet. Also, toilets could be built with rails to hold on to, special seats and ramps at the entrance. The lack of these toilet facilities in schools is very serious, even resulting in children with disabilities becoming reluctant to continue with education and dropping out of school.

Appropriate Assistive Devices
Local government authorities should facilitate the acquisition of recommended, appropriate assistive devices so that secondary disabilities are avoided. Some mobility assistive devices such as calipers and wheelchairs are difficult to use on steep slopes but can be used within the compound of the house. Some people with disabilities develop secondary disabilities because they have not been seen and assessed by rehabilitation workers, who could advise on appropriate devices to assist mobility. Others have never been taken to a health facility which has rehabilitation workers. There is a need to train community-based rehabilitation workers so that they can continue with prescribed interventions, follow up and encourage the continuous use of assistive devices. Those already in place can be facilitated to reach those people with disabilities who are far from appropriate health facilities.

Examples of assistive devices include donkeys, which can be used to transport people with disabilities to public places or their gardens. Knee boots can be used by clients who crawl. These devices can be made by orthopaedic technicians or trained artisans.

Wide and Levelled Roads
Local government authorities should encourage the community to dig wide and levelled roads, so that donkeys and people with disabilities using assistive devices can move easily. For example, it is difficult to use crutches on narrow roads. Where possible, graders can be used and roads can be dug from the main road to each and every homestead. This work could be carried out by community participation, including people with disabilities themselves.

Conclusion
People with disabilities cannot reach their maximum potential and increase their independence level in daily activities when they cannot access facilities in their own communities. People with disabilities living in Kabale District have particular issues of accessibility due to the terrain: unless these issues are addressed, we cannot claim to have done much to facilitate increased quality of life for people with disabilities in this and other similar areas.