Assessment of Mosques Accessibility for Prayers with Disabilities

Introduction

Disability is part of being human. Almost everyone will temporarily or permanently experience disability at some point in their life. Over one billion people; about 15% of the global population lives with some form of disability and this number is increasing. The term persons with disabilities (PWDs) is used to apply to those who have long-term physical, mental, intellectual or sensory impairments which, in interaction with various attitudinal and environmental barriers, hinders their full and effective participation in society on an equal basis with others [1]. The Americans with Disabilities Act (ADA) defines a person with a disability as a person who has a physical or mental impairment that substantially limits one or more major life activity [2]. Disability has become an issue of humans seeking equal opportunity for all, and its combination with accessibility has recently been highlighted. PWDs are handicapped by barriers that impede their activities of daily living and the focus is no longer on impairment rather PWDs should have access to a barrier-free environment for their daily life without limitation. The theoretical basis of disability legislation is to provide physical, environmental and social accessibility to enable PWDs to move freely and use all the available services on an equal basis with other members of society. The removal of all barriers from the surroundings leading to an accessible environment constitutes the key component of disability law and regulations in all communities [3].

In Saudi Arabia, limited research has been conducted on the prevalence and incidence of disability [4]. More than half a million Saudi citizens (1 out of every 30 individuals) reported the presence of disability during the year 2016 [5]. The 2017 survey results indicated that (2.9%) of Saudi population have disabilities with extreme difficulty [6]. Disability law and regulations in Saudi Arabia are trying to help PWDs to achieve independence and participate actively in society by giving them access to a barrier-free environment. Ensuring physical mobility as well as personal integration towards inclusion in every sphere of the life of PWDs is crucial. However, in practice there have been some reported challenges and cultural barriers in giving equal rights to PWDs or helping them to experience an independent life which has resulted, in some cases, in their further isolation [7, 8]. Saudi Arabia is the heartland of Islam, the birthplace of its history, the site of the two holy mosques and the focus of Islamic devotion and prayer. Praying “Salat” is the second of the Five Pillars of Islam. It is considered one of the most purposeful and meaningful activities of everyday life “occupations” that gives value and meaning to Muslims. Muslims pray  five times each day which allows Muslims to communicate with God “Allah”, listen to God and follow in the footsteps of the prophets [9]. This concurs with the definition of occupations as important aspects of individuals and groups lives for the purpose of active participation in social and spiritual roles and situations in community [10, 11]. The primary purpose of the  mosque  is to serve as a place where  Muslims  can come together for  prayer, as praying together holds great importance in Islam. Saudi Arabia is the country of the two Holy Mosques and Islam is the first to be aware of the issue of disability and the rights of PWDs. There are thousands of mosques in Saudi Arabia. City of Jeddah alone includes more than 2,300 mosques [12].

Rehabilitation and occupational therapy services aim to meet patients’ needs and foster independence in all aspects of their daily life. This includes not only activities of daily living, but also includes encouraging patient re-integration into the community by engaging in social and functional interaction with other people and surrounding environment [13]. Most of these needs are presented under the umbrella term ‘access’ [14]. Restriction of mobility is likely to be the most common handicap amongst PWDs [15]. Accessibility for PWDs is a worldwide concern. Accessibility of built environment is one of the primary concerns of urban planning and design. An urban space can be a successful public place if accessibility is provided. Besides this, a public place should provide accessibility to everyone, regardless physical abilities or financial resources, because ‘accessibility is the freedom and the ease of individuals to decide to participate in different activities [13]. Assessment of building accessibility and public accommodations is the first step in a planning process for readily achievable barrier removal. This assessment is usually done manually which is a source of errors that may affect the reliability of the evaluation results [16]. However, assessments could be done through using some objective outcome measures and checklists that are valid and reliable. These checklists help identify accessibility problems and solutions in existing facilities in order to meet obligations and accessibility universal standards [17]. The goal of such checklists is to study how to make the facilities accessible for PWDs. The Americans with Disabilities Act (ADA) Checklist for Readily Achievable Barrier Removal “Checklist for Existing Facilities-Version 2.1” highlights some of the requirements found in the ADA Standards for buildings accessibility [18, 19]. Only a handful of research studies have focused on measuring accessibility in mosques buildings [20, 21]. Furthermore, no previous studies were identified that examined the degree of accessibility in mosques in the west region in Saudi Arabia. Therefore, the purpose of this study was to examine the degree of accessibility for mosques facilities and buildings for PWDs.

Methods

A team consisted of undergraduate research assistants and occupational therapy students conducted this study. The Americans with Disabilities Act (ADA) Checklist for Readily Achievable Barrier Removal “Checklist for Existing Facilities-Version 2.1” was used to measure accessibility in mosques buildings. The accessibility of a total of 45 mosques was investigated. Our sample included mosques established between the year of (1967) and the year of (2001). Mosques that had more than two constructions/ buildings were excluded due to limitations of time and data collectors. In addition, buildings that yielded missing data due to many non-applicable items in the ADA checklist were also excluded. Of the 45 mosques, 20 mosques met our inclusion criteria and data derived from was included in the final analysis. This study was conducted using the standards derived from the ADA checklist. This checklist is based on four priorities recommended by the Title III regulations for planning readily achievable barrier removal projects: (1) Accessible approach and entrance Priority, (2) Access to goods and services Priority, (3) Access to rest rooms Priority, and (4) Any other measures necessary.

Priority number 4 (any other measures necessary) and some subtitles were removed because most items in this priority were not applicable to the buildings examined (e.g., drinking fountains, public telephones).

The ADA checklist was used to record the data from direct observation and measurement. Priority 1 focuses on that PWDs should be able to arrive on the site, approach the building, and enter as freely as everyone else. At least one route of travel should be safe and accessible for everyone, including PWDs. Priority 2 focuses on that the layout of the building should allow PWDs to obtain materials or services without assistance. Priority 3 focuses on that when rest rooms are open to the public, they should be accessible to PWDs.

Results

Descriptive statistics of simple percentages and means were used to determine the level of accessibility to the surveyed mosques based on the guidelines and standards of the ADA checklist. The scores indicate the number of accessible mosques.

Discussion

Accessibility refers to the degree to which an environment can be approached, entered, operated in, or used safely and with dignity by PWD [22]. As a public building, mosque should be accessible for all and should have no barriers that may confront prayers with disabilities and hinder them from performing their religious rituals. Unfortunately, prayers with disabilities still find difficulties in accessing mosques. For example, the calling to prayer through loudspeakers only could be problematic for persons with hearing loss. Also, prayers with physical disabilities, such as wheelchair users, have difficulties in several areas in the mosque, including the entrance, place of ablution, the lavatories and the area for removing shoes at the entrance to the prayer hall forcing them to pray in isolation in their houses and preventing them from participating in an important part of their faith [20, 21].

In this study a convenience sample of twenty mosques within the northern side of Jeddah city was examined to investigate accessibility. High percentages indicated relatively high compliance and good accessibility while low percentages indicated relatively low compliance and poor accessibility. In the accessible approach and entrance, the highest compliance percentage was in the route of travel section (86%). Most routes did not require the use of stairs, were stable, firm and slip-resistant, and were at least 36 inches wide. The lowest compliance percentage was in the parking and drop-off section (49.45%). Some of them did not have an enforcement procedure to ensure that accessible parking is used only by those who need it, and the accessible spaces were not closest to the accessible entrance. In the access to goods and services, the highest compliance percentage was in the horizontal circulation (94%). Most of their entrance provided direct access to the main floor, lobby, or elevator, and the accessible route to all public spaces was at least 36 inches wide. The lowest compliance percentage was in the signage of goods and services (55%). None of the mosques had raised characters and Braille texts of the pictogram. In the access to rest rooms, the highest compliance percentage was in the lavatories (84%). Most of the mosques had at least one accessible lavatory that had 30 inches wide by 48 inches deep clear space in front, and the lavatory rim was no higher than 34 inches. The lowest compliance percentage was in getting to the rest rooms (45.54%). Most of them did not have at least one rest room fully accessible, and there were no signs at inaccessible rest rooms that give directions to accessible ones.

The current study helped us identify accessibility problems and some possible solutions in the existing mosques in Jeddah city in order to meet obligations and accessibility universal standards. Some possible solutions for Route of travel are to: widen route, move or remove protruding objects, and add a ramp if the route of travel is interrupted by stairs. Some possible solutions for Ramps are to: lengthen ramp to decrease slope, add railings, widen the ramp, and add non-slip surface material. Some possible solutions for Entrance are to: install signs, replace inaccessible knobs with a lever or loop handle, and adjust door closers. Some possible solutions for stairs are to: add non-slip surface to treads, and add or replace handrails if possible within existing floor plan. Some possible solutions for Elevators are to: provide a permanently attached reach stick, and install raised lettering and braille next to buttons.

Saudi Arabia strives to ensure full inclusion of PWDs in different fields and enable them to obtain full rights that ensured their independence and integration in the society. The integration of PWDs into main stream society will require a genuine change in the perception and attitude of the general public towards disability and a shift form the traditional medical model towards the social and integrated models. This can be achieved by educating friends and family and by advocating professionals and policymakers for changes that would help [7, 8]. Through the Quality of Life program, a part of the Vision 2030, the Kingdom sought to ensure the accessible infrastructure throughout the country and was working to create the fully accessible physical environment to enable PWDs to live independently and to integrate into society. As the Custodian of the two Holy Mosques, Saudi Arabia was committed to serving the pilgrims and visitors of all abilities to the holy places in Makkah and Madinah. The Universally Accessible Built Environment Guidelines Manual was developed as part of a larger accessibility initiative within Saudi Arabia. This manual provides technical design guidelines and application criteria as a benchmark for the creation of universally accessible buildings and other built environments and outlines the technical design requirements necessary to achieve universally accessible built environments across Saudi Arabia. Architects, engineers, interior designers, urban planners and others involved in the design of the built environment can use these guidelines for project development, resulting in creation of buildings and other built-environments that accommodate all members of Saudi society including people with disabilities and older persons. The manual includes a whole section related to mosques design considerations, such as but not limited to: access to all areas of worship and other activity areas in the mosque should be provided, access assumes that PWDs may be participants, leaders, staff, or volunteers, places of worship and/or reflection should comply with this section, mosques should comply with applicable design requirements, accessible paths of travel in mosques should be clear of shoes and other obstructions, seating should be provided at entrances and at other locations where people are required to remove their shoes, seating should also be provided within the prayer hall to accommodate people who cannot bend to pray, a designated area to accommodate people using mobility devices should be provided in a location that integrates people with mobility devices into the gathering, and provision should be made to address the potential lack of cleanliness of mobility device wheels where the route to the designated area crosses prayer hall carpeting [12].

This study had some limitations. A convenience sample with a relatively small sample size was used in this study. Our study only included mosques in one city in Saudi Arabia due to limitation of funding grants and data collectors. There were also time limitations for conducting the study due to other workload demands which limited the data collection process. In addition, our study didn’t include all items from the ADA checklist because there were many non- applicable items on most of the studied mosques, such as drinking fountains and public telephones. For future studies, we recommend to use a larger sample through well- funded research and the inclusion of more mosques that are applicable to most of the items on the ADA checklist. The more items we include the more informative data we can obtain. Expanding the timeline to conduct the study and having more data collectors and multiple visits to different mosques to eliminate the effect of missing data is also recommended. Additionally, we recommend conducting qualitative research studies that would measure level of satisfaction of prayers with disabilities and include their very valuable points of view and inputs.

Conclusion

This study has provided useful baseline data for future studies in the mosques of the west region in Saudi Arabia which need to be accessible. The compliance scores for some items such as Getting to the Rest Rooms, Parking and Drop-off Areas, Signage for Goods and Services, Stairs, Elevators, and Entrance for PWDs (prayers) in the examined mosques had the lowest scores among other scores, which means the least accessible items among mosques. This is probably because prayers with disabilities and experts in the area of physical ability management were not consulted and involved in the design and construction of these mosques. International standards should be followed in building new mosques whereas existing mosques can be modified to be accessible. To improve accessibility in mosques buildings, there should be synchronization among prayers, the occupational therapists, physiotherapists, politicians and decision makers, engineers, and architects. Collaborative professional teams need to work together to make mosques buildings more accessible for PWD to meet the needs of this vulnerable population in our community, help achieve independence, and enhance satisfaction and quality of life.

Funding Details: No funding was required.

Acknowledgements: I would like to thank all research assistants and data collectors for their cooperation and support.

Declarations

Ethics Approval: not applicable. Consent to Participate: not applicable. Competing Interests: The author declares no competing interests.