a case study in ethiopia revealed that the entrances to toilets are often too narrow for wheelchairs forcing individuals to crawl or drag themselves on the floor to reach the toilets wilbur accessibility problems also apply to children chronically ill and older people as facilities may not be within easy and safe reach some illnesses can generate stigmatization such as hivaids and people affected may suffer from exclusion and be denied access to facilities in two out of five people in rural areas had access to piped water supplies a form of improved supply but not necessarily a safely managed supply whereas four out of five people in urban areas had piped supplies