Consider an ordinary public toilet. A small concrete ridge at the entrance keeps water from flowing into the hallway, while the door opens inward to save corridor space. Most people step over the ridge and enter without thinking about either feature. For a wheelchair user, however, that small threshold can stop the chair’s front wheels, and the inward-opening door can take up the space needed to move. A routine trip to the bathroom suddenly becomes a problem that may require another person’s help.
The difficulties often continue inside. The stall may be narrow, the floor wet and slippery, and the only option a squatting toilet. There may be no grab bars, no proper toilet seat and no clear space in which to position a wheelchair. In that situation, a person may have to struggle, risk falling or depend on someone else for one of the most private parts of daily life. The issue is not simply discomfort; it is the loss of safety, privacy and independence. The hidden problem is not always the absence of a toilet. It is a toilet that exists, looks usable and still excludes the person who needs it.
A ramp at the main entrance does not make an entire building accessible. A student may be able to enter a university but still be unable to remain there for a full day. An employee may reach the office but have no bathroom they can use safely. A family member may attend a wedding but spend the evening worrying about when they will need to leave. If the toilet remains inaccessible, the rest of the building is only partly open to them.
According to the Pakistan Bureau of Statistics’ 2023 census data, Pakistan has 7,448,574 people with disabilities, equal to about 3.1% of the population. The census also recorded 23,170,373 people with functional limitations, or 9.6% of the population. Functional limitations include difficulties with activities such as seeing, hearing, walking, communicating and caring for oneself, so this broader figure should not be confused with the formal disability rate. Together, however, these numbers show that inaccessible design affects a significant part of the population.
Mobility is a major part of the picture. More than 7.49 million people reported difficulty walking or climbing, representing roughly one-third of those recorded as having a functional limitation. Age makes the issue even more urgent. A Gallup Pakistan analysis of census data found that 69.6% of people over 60 reported a functional limitation. Accessible toilets are therefore not needed only by wheelchair users; they also support older adults, people who use walkers, pregnant women, people recovering from injuries and anyone who has difficulty balancing or moving safely.
Reliable nationwide information about the accessibility of Pakistan’s public toilets remains limited, but smaller assessments provide a troubling picture. A Dawn report on research conducted by NED University’s Department of Architecture and Planning examined public-toilet access in five busy parts of Saddar, Karachi. Around Zainab Market and several shopping complexes, researchers found toilets on upper floors, circulation spaces of approximately three feet and stalls containing only squatting toilets. Some better facilities elsewhere in Saddar were restricted to authorised users, available only at certain times or difficult for the wider public to reach. For someone who needs an accessible toilet, knowing that a suitable facility exists behind a locked gate or on an unreachable floor offers little comfort.
The problem also appears in essential government services. A UNFPA-supported assessment of selected facilities found no accessible toilets in five crisis centres and Dar-ul-Aman facilities examined in Islamabad, Punjab and Khyber Pakhtunkhwa. Among four public hospitals assessed, only DHQ Hospital Nowshera had an accessible toilet, and even that facility needed improvement. The police stations and gender-based violence courts included in the assessment also lacked accessible toilets. For a woman seeking protection, medical care or justice, such a barrier can make an already difficult experience even more distressing.
These assessments do not represent every public toilet in Pakistan, but they show the same problem appearing in commercial areas, hospitals and government facilities. A toilet may technically exist while remaining unusable for many of the people who need it. This gap is easy for others to overlook because inaccessible toilets are usually hidden at the end of corridors and discussed only when someone cannot use them. For the person affected, however, the consequences shape the entire day.
When toilet access is uncertain, leaving home requires careful planning. A student may worry about whether the university has a seated toilet, while an employee may wonder if a colleague will have to help with a private task. An older person may leave a family event early because the floor is wet and there is nothing safe to hold. Instead of enjoying the occasion or concentrating on work, they remain aware of the nearest bathroom and whether it will be usable. That constant worry can quietly limit where people go and how long they stay.
Some people may respond by drinking less water or delaying the use of a toilet. This is not a safe or sustainable solution. Medical research published in BMJ Open Quality notes that dehydration may increase the risk of urinary tract infections and acute kidney injury, particularly among older adults. No one should have to choose between protecting their health and avoiding an unsafe bathroom.
The good news is that the necessary improvements are practical. Pakistan already has an Accessibility Code covering public buildings and facilities, including accessible restrooms, grab bars and non-slip surfaces. Raised thresholds can be replaced with proper floor slopes or drainage channels that control water without blocking wheels. Doors can be widened and designed to slide or open outward, leaving more room inside. Pakistan’s code calls for at least 33 inches of clear opening for doors serving accessible spaces.
Inside the toilet, there should be enough clear space for a wheelchair user to enter, turn and approach the toilet without hitting a wall, door or bin. An accessible seated toilet should have a proper seat, reachable controls and enough space beside it for a safe transfer. Secure grab bars can help people sit, stand and maintain their balance without depending on another person. The floor should be non-slip and properly drained, while the washbasin, tap, flush, bidet shower, soap and sanitary bin should be reachable from a seated position.
Design alone is not enough. An accessible toilet stops being accessible when it is locked, broken, covered in water or used to store cleaning supplies. Staff must keep it clean, dry, open and free of obstacles throughout the day. Building owners should also inspect existing toilets with people who use wheelchairs, walkers and other mobility aids, because a plan that looks suitable on paper may still fail in practice.
Architects should include accessible toilets in the original design rather than trying to fit them into whatever space remains. Local authorities should check these facilities during building approval and inspection, while schools, offices, hospitals, mosques and shopping centres should treat toilet access as a basic responsibility. These changes are not acts of charity or special treatment. They allow people to study, work, travel and spend time with their families without fear or embarrassment.
The next time you enter a public toilet, look at the threshold and the direction of the door. Notice whether there is room to turn, a dry floor, something safe to hold and a toilet that can be used without squatting. These details may seem small to someone who has never struggled with them, but they can decide whether another person feels independent or excluded. A truly public toilet is one that every member of the public can use safely, privately and with dignity.
