Lawrencia Asante and Akwesi Addai should be considered lucky. The one-room hut in which they live and work mending shoes is directly opposite the public toilets in Sabon Zongo, an Accra slum. As the couple both have difficulty walking, the shorter the journey the better.

But reality is not so easy for Ms Asante, who has to make her way to another neighbourhood whenever nature calls. “That one is not ideal for disabled people,” says Ms Asante, a pretty, plump 45-year-old wrapped in colourful cloth. “You have to squat. But if you cannot bend your knees, what use is it to you? And it is not clean. If you are not extremely careful you could just step on the faeces and slip and fall.”