Persons with Disabilities in Risk Management

 

Key points

• Do not assume that disability is visible. Seek to identify individuals with disabilities proactively, including those with psychosocial and intellectual disabilities.
• Consult persons with disabilities and their families to identify their needs and capacities and understand what barriers impede the effectiveness of protection and assistance programmes.
• Inclusive disability programming is not just about providing ramps and wheelchairs.
• Make sure the language you use to describe persons with disabilities respects their dignity and humanity. (Using the term ‘persons with a disability' rather than ‘the disabled' or ‘handicapped people while speaking to’).
• Consult persons with disabilities when you decide the content of food and non-food assistance packages, to ensure that distribution arrangements are accessible.

1Overview

The Convention on the Rights of Persons with Disabilities and its Optional Protocol (CRPD, 2006, A/RES/61/106) defines persons with disabilities to "include those who have long-term physical, mental, intellectual or sensory impairments which in interaction with various barriers may hinder their full and effective participation in society on an equal basis with others".

In situations of forced displacement, persons with disabilities have the same rights and basic needs as others and face the same challenges. However, they face numerous additional barriers. They face particular protection risks, including a heightened risk of violence, exploitation and abuse, and high levels of stigma. They have difficulties accessing humanitarian assistance, education, livelihoods, health care and other services. They may be denied certain legal rights, and are often excluded from decision-making processes and leadership opportunities.

Persons with disabilities are not a homogenous group. They face multiple and compounding forms of discrimination, on the basis of disability but also on other grounds, which may lead to situations of exclusion.

The World Health Organization estimates that about 15% of the world's population has a disability. In situations of forced displacement, the incidence of disability is usually higher because a larger proportion of people have injuries, lack access to medical services, and face barriers in their environment.

2Protection objectives

• To identify and assess the needs of persons with disabilities, from the start of an emergency and throughout.
• To provide an immediate and adequate response to specific needs and ensure that protection and assistance programmes are accessible to persons with disabilities on an equal footing with other persons of concern.
• To create conditions in which people with disabilities do not suffer discrimination, and participate in decisions that affect them.
• To ensure that all responses take account of and include persons with disabilities, by applying an age, gender and diversity lens and considering their specific needs. Persons with disabilities must be enabled to participate as actors in the protection of their families and communities.
• To ensure that appropriate systems are in place during an emergency to prevent and respond to violence against persons with disabilities and their families, or their exploitation or abuse.

3Underlying principles and standards

UN Convention on the Rights of Persons with Disabilities and its Optional Protocol (2006).
Article 11 of the CRPD refers to the safety and protection of persons with disabilities in conflict and emergency situations.

Handicap International, Disability Checklist for Emergency Response, 2010. In braille and large print.
UNHCR Executive Committee, Conclusion on refugees with disabilities and other persons with disabilities protected and assisted by UNHCR, 2010.
Reaffirms UNHCR's responsibility and commitment to upholding the rights of persons with disabilities in accordance with Executive Committee Conclusions, international conventions, and relevant United Nations General Assembly resolutions. Outlines recommended actions by UNHCR, its partners, and States.

UNHCR, Need to Know Guidance: Working with Persons with Disabilities in Forced Displacement, 2019.
Provides practical guidance on issues that must be considered to ensure that the rights of persons with disabilities of concern to UNHCR are fulfilled without discrimination.

UNHCR, Policy on Age, Gender and Diversity (AGD), 2018.
The policy reinforces UNHCR's commitment to ensure that people are at the centre of all we do. It consolidates commitments to a strong AGD orientation, accountability to affected people (AAP) and commitments to women and girls. It defines six areas of engagement and ten mandatory core actions for all UNHCR operations and headquarters.

4Protection Risks

• Persons with disabilities may experience difficulty in moving, hearing, seeing, communicating or learning. Their disabilities may include injuries or chronic illnesses.
• Persons with disabilities face a variety of barriers: these may be physical and environmental; attitudinal; policy; or in communication.
• Persons with disabilities are more likely to experience violence, including: sexual and domestic abuse; exploitation by family members; discrimination; and exclusion from access to humanitarian assistance, education, livelihoods, health care, a nationality, and other services. Women, older individuals, children, and LGBTI persons who have a disability are doubly exposed to such risks.
• Persons with disabilities are likely to be more at risk in dispersed rural and urban settings and recent displacement sites, because communities in these locations are less cohesive and community protection mechanisms may be weaker.
• Adolescents and youth with disabilities are frequently excluded from peer group activities and social networks that can help to protect them from violence, including sexual and gender-based violence (SGBV).
• Children with disabilities may suffer stigma, bullying or discrimination (including harassment) at the hands of their peers or teachers, harming their educational opportunities.
• Persons with psychosocial and intellectual disabilities tend to be less identifiable than persons with physical and sensory disabilities. As a result, programmes are less likely to address their needs and registration procedures are more likely to overlook them.

5Other risks

• Persons with disabilities will be particularly at risk if UNHCR or its partners fail to protect the security of populations of concern.
• The reputation of UNHCR and its partners will be put at risk if they do not fulfil their responsibility to protect all populations of concern

6Key decision points

• At the start of an emergency, consider disability when designing shelter and settlement options, selecting sites, planning and designing infrastructure, and setting access standards. Make sure that arrangements for emergency aid distribution address the access needs of persons with disabilities.
• Take immediate steps to ensure that the response deals adequately with the specific needs of persons with disabilities.
• Ensure that persons with disabilities are identified and registered and that their needs are assessed.
• Make sure that services and infrastructures take account of and include those with physical, hearing, visual, intellectual and psychosocial disabilities
• Establish referral systems to ensure that persons with disabilities reach relevant service providers.
• Put in place systems to prevent and respond to violence, exploitation and abuse.
• Ensure that programmes include persons with disabilities, and that persons with disabilities have access to information and messaging about programmes that concern them.
• Ensure that staff, partners and local and national authorities recognize and know how to respond to the specific needs of persons with disabilities.
• Ensure persons with disabilities can participate in protecting their families and communities.
• In non-camp settings, take steps to identify potential partners and establish an outreach programme, to ensure that persons with disabilities are identified and receive information they need.

7Key steps

Identification and assessment procedures

• Assign community workers, UNHCR protection staff or community-based protection staff to (pre-)registration points or places of arrivals, to identify and register persons with disabilities.
• Integrate the Washington Group short set of disability questions or other relevant tools in data collection mechanisms to identify persons with disabilities.
• Appoint community workers or partners' staff to identify and register persons with disabilities who may not have been present at (pre-)registration. (This is often due to barriers at access registration points.) Persons with disabilities and their representative organisations may be useful sources of information.
• During rapid and participatory assessments, include specific questions about the experience of persons with disabilities. Do so to identify specific protection risks, specific needs, and barriers that prevent people from obtaining assistance,.
• Consult persons with disabilities to determine which referral mechanisms and which forms of assistance they find most appropriate and accessible.
• Train registration staff and provide guidance on how they should identify and record persons with disabilities who have not yet been registered in ProGres.
• Enter in ProGres the specific needs of persons with disabilities.

Access to services

• Identify families that include persons who have difficulty moving; in consultation with the families, locate them close to facilities and services when assigning plots and shelters.
• Train partners and local service providers in disability inclusion and build their capacity to implement it.
• In consultation with persons with disabilities, adapt medical centres, distribution sites, water sources, latrines, schools, shelters, and other infrastructure, to make them safe, accessible and appropriate for persons with disabilities. (Avoid barriers or tripping hazards, include ramp access, large doorways, handrails on stairs, space to turn a wheelchair, non-slippery floors, etc.).
• Ensure food and other distributions are accessible to persons with disabilities by establishing a distribution monitoring system. Where appropriate, consider separate queues, transport support, smaller parcels, or home delivery systems. Work with health and nutrition partners to identify specific dietary needs of persons with disabilities and people with chronic health issues.
• Consult persons with disabilities to identify what specific protection risks they face, and whether cash-based assistance programmes need to be adapted.
• Consult persons with disabilities when designing new infrastructures and deciding what items distributions should include (for example, lighter jerry cans). Consult early to avoid expensive adjustments later.
• Work with school authorities and communities to improve the inclusion of children with disabilities. Adapt education programmes where necessary. Include children and parents in consultation.
• Consult persons with disabilities to identify barriers they face in accessing health services. (Include public health, sexual and reproductive health, maternal and child health, etc.)

Support services

• Map service providers and potential partners (at community, local and national level, and camp level if applicable) who provide specialized services, such as rehabilitation and assistive devices. Check that their services can be accessed by refugees.
• In consultation with persons with disabilities, identify service providers, agree on coordination mechanisms, and establish referral mechanisms for access to services.
• Prioritize persons with disabilities in reunification efforts. Do not separate persons with disabilities from their family members or support persons, or from their assistive devices, adaptive aids, or medication (for example, during relocation or transport).
• Consult persons with disabilities and the wider community to assess the community's capacity to support persons with disabilities who are alone and need support.
• Identify persons with disabilities who are living in institutions, and ensure that protection staff and partners follow up.

Prevention of abuse and exploitation

• Ensure that all programmes to prevent and respond to sexual exploitation and abuse (PSEA) and sexual and gender-based violence (SGBV) include persons with disabilities.
• Through community workers and other partners, establish systems for monitoring and following up the situation of persons with disabilities who are at heightened risk of abuse or exploitation. Implement appropriate referral mechanisms.
• Train persons with disabilities, their families, SGBV prevention and response partners, and community workers, in how to recognize, prevent, and report instances of violence, exploitation and abuse.

Inclusion and information sharing

• Prepare all key messages to displaced populations in a variety of formats (radio, word of mouth, information booklets in ‘easy to read' format, texts with symbols and images, etc.).
• Make sure your methodologies for consultation include persons with disabilities and their households. Involve them in decision-making and programming, including the design, assessment, monitoring and evaluation of activities.

Awareness-raising and advocacy

• Inform staff and partners of the rights of persons with disabilities. Emphasize that responses need to be designed in consultation with persons with disabilities to ensure they are inclusive and accessible.
• Train UNHCR and partner staff on practical steps they can take to improve accessibility and inclusion. Local organizations of persons with disabilities can be an important training resource. Encourage the authorities to include persons of concern with disabilities in national policies and programmes, including national social protection programmes.

Participation

• Include persons with disabilities in education and livelihood activities. Identify opportunities and training for them, corresponding to their experience and abilities.
• Include persons with disabilities in community-based governance mechanisms, such as refugee committees. Ideally, persons with disabilities should have their own structures and be represented in all community- based structures as well.
• Engage persons with disabilities in leadership roles in the community, as community volunteers, facilitators, etc. To achieve this, you may need to adapt selection criteria and tasks, or provide support.

8Key management considerations

• Put in place enough staff and resources to enable the operation to address the gaps and barriers faced by persons with disabilities.
• Assess programmes regularly and ensure they are AGD-inclusive.
• Establish monitoring mechanisms for all key steps.
• Establish national partnerships to ensure that government services and other national partners are fully engaged. This is essential if programmes and support for persons with disabilities are to be sustainable.

9Resources and partnerships

Staff
Protection; community-based protection; mental health and psychosocial support.

Partners
Partners include UN entities, INGOs, national NGOs including organisations of persons with disabilities (OPDs), and government institutions and ministries that work on disability or provide services to persons with disabilities. The latter are often able to provide mental health and psychosocial support services.

Resources
Financial resources will be required to plan and implement relevant services, interventions and programmes.

End the Poverty in Disability

The 2030 Agenda for Sustainable Development and its 17 SDGs provide a powerful framework to guide local communities, countries and the international community toward the achievement of disability-inclusive development. The 2030 Agenda pledges to leave no one behind, including persons with disabilities and other disadvantaged groups, and recognizes disability as a cross-cutting issue to be considered in the implementation of all of its goals. The Agenda also includes seven targets and 11 indicators explicitly referencing persons with disabilities, covering access to education and employment, availability of schools that are sensitive to students with disabilities, inclusion and empowerment of persons with disabilities, accessible transport, accessible public and green spaces, and building the capacity of countries to disaggregate data by disability.

Persons with disabilities are more likely to live in poverty than persons without disabilities due to barriers in society such as discrimination, limited access to education and employment and lack of inclusion in livelihood and other social programmes. National data on income poverty disaggregated by disability remain scarce, but available data show that the proportion of persons with disabilities living under the national or international poverty line is higher, and in some countries double, than that of persons without disabilities. Regarding food security, in developed countries, available data shows that the average percentage of persons with disabilities who are unable to afford a meal with protein every second day is almost double that of persons without disabilities. More women with disabilities than men with disabilities are in such a situation, and the gender gap between women and men in terms of access to meals with protein is wider among persons with disabilities. In developing countries, data shows that persons with disabilities and their households are more likely to not always have food to eat, than persons without disabilities and their households. While financial inclusion can help persons with disabilities out of poverty, access to financial services such as banks remains restricted by the lack of physical and virtual accessibility of these services. In some countries, persons with disabilities find that more than 30% of banks are not accessible.

Social protection programmes for persons with disabilities, which can be vital in facilitating an escape from poverty, have been adopted in many countries. At least 168 countries have disability schemes that provide periodic cash benefits to persons with disabilities, while lump-sum benefits are provided in 11 countries. In half of the countries with periodic benefits, these benefits cover mainly workers and their families in the formal economy, excluding children with disabilities and persons with disabilities who have not had the opportunity to contribute to social insurance for a sufficient period to be eligible for benefits. In 87 other countries however, schemes are fully or partially financed through taxes and have improved coverage. In only one third of these countries, schemes cover all persons with assessed disabilities regardless of their income status. In the rest of the countries, programmes cover only persons or households whose economic means fall below a certain threshold. Despite their existence, many persons with disabilities are not able to access social protection. In some countries, more than 80% of persons with disabilities who need welfare services cannot receive them. (see the full report: bit.ly/UN-report-disability-sdgs ).

Some actions to be taken to end poverty in disability

1. Design social protection policies and programmes to include persons with disabilities.

2. Remove barriers that persons with disabilities face in accessing and fully benefiting from social protection and employment on an equal basis with others.

3. Sensitize government, NGOs and community members about barriers experiencing by persons with disabilities to access employment opportunities and social protection and approaches to overcome these barriers.

4. Disaggregate data on poverty by disability status.

5. Establish national monitoring and evaluation systems that periodically assess all social protection programmes and employment regarding inclusion and impact on the situation of persons with disabilities.

6. Establish empowerment on enterpreurship and vocational skills as well as employability training skills and job opportunities for both PWDs graduates and non graduates.

Disability and Poverty: Causal Relationship

Disability is both a cause and consequence of poverty.

It is a cause because it can lead to job loss and reduced earnings, barriers to education and skills development, significant additional expenses, and many other challenges that can lead to economic hardship.

It is also a consequence because poverty can limit access to health care and preventive services, and increase the likelihood that a person lives and works in an environment that may adversely affect health.

The result? Poverty and disability go hand in hand. The poverty rate for working-age people with disabilities is nearly two and a half times higher than that for people without disabilities. Indeed, recent research finds that half of all working age adults who experience at least one year of poverty have a disability, and nearly two-thirds of those experiencing longer-term poverty have a disability. People with disabilities are also much more likely to experience material hardships such as food insecurity; inability to pay rent, mortgage, and utilities; or not being able to get needed medical care than people without disabilities at the same income levels. The same goes for families caring for a child with a disability.

In addition to income poverty, individuals with disabilities are also nearly twice as likely to lack even modest precautionary savings in case of an unexpected expense or other financial shock. Fully 70 percent of individuals with disabilities responded that they “certainly” or “probably” could not come up with $100 to meet an unexpected expense, compared to 37 percent of individuals without disabilities.

10 Facts About Disability and Poverty

1. Disability is an umbrella term that covers both the physical and mental conditions that limit a specific person’s senses, activities, movements or ability. According to the World Health Organization (WHO), disability is a human rights issue and is a very complex phenomenon.

2. Disability is both a cause and consequence of poverty. This means that people who experience poverty are more likely to become disabled and people with disabilities are more likely to live in impoverished conditions.

3. It is no surprise that the cost of living for a person with disability is higher than for an average person. people with disabilities in poverty face economic problems due to things like additional medical treatment, rehabilitation and education access. WHO states that people with disabilities are 50 percent more likely to suffer from disruptive health expenditures.

4. Almost half of the persons with disabilities population cannot afford healthcare. It is common that disability is preventable or treatable, but often times people with disabilities in poverty will go their entire lives without proper healthcare. Without treatment, medical conditions can worsen.

5. In additional to overpriced healthcare, there is a lack of qualified healthcare professionals in developing countries. Also, people with disabilities are much more vulnerable to deficiencies in the healthcare system.

6. Assistant devices or rehabilitation allow people with disabilities to be independent. However, disabled people in poverty typically lack access to these medical devices and health treatment. The WHO states that “access to rehabilitation can decrease the consequences of disease or injury, improve health and quality of life and reduce the use of health services.

7. People with disabilities are likely to have very limited education opportunities. For example, a deaf child is likely to be denied access to education because the school does not offer sign language-friendly tuition. This lack of education permanently affects the socioeconomic status of people with disabilities in poverty.

8. For people with disabilities in poverty, securing work is extremely difficult. This can be due to the lack of accessibility in the workplace or discrimination. Only 45 countries have anti-discrimination laws to protect people with disabilities. As a result, treating disability can be very difficult for people with disabilities in poverty because disabled people have a hard time finding a stable job.

9. People with disabilities in poverty often times are put at risk due to impoverished living conditions. Recent research shows that there are alarming health condition trends associated with disability. UNICEF states that disabled people are more likely to contract infectious diseases and injuries. According to the WHO, many people with disabilities experience premature death.

10. UNICEF states that it is important that people with disabilities in poverty gain affordable access to treatment. For some developing countries, global and nonprofit intervention is necessary. According to the World Bank, disability-inclusive development is being made. For example, the United Nations Convention on the Rights of Persons with Disabilities will help countries establish disability discrimination laws and create disability-friendly policies.

Disability and Poverty

Around one billion people or 15% of the world's population live with some form of disability. The prevalence of disability is higher in developing countries. One fifth  of the estimated global total or between 110 million and 190 million people experience significant disabilities (World Report on Disability, 2011).  

Persons with disabilities on average as a group, are more likely to experience adverse socio-economic outcomes such as less education, poorer health care, lower levels of employment and higher poverty rates than persons without disabilities (World Report on Disability, 2011).

Where does the association between poverty and disability come from? It is often stated that disability is "both a cause and consequence of poverty," also poverty and disability "reinforce each other, contributing to increase vulnerability and exclusion ( DFID, 2000)".

Disability accentuates poverty because the systematic institutional, environmental and attitudinal barriers that persons with disabilities encounter in their daily lives result in their entrenched social exclusion in society.

Poverty may increase the risk of disability through discrimination, stigma, social marginalization and isolation, inadequate access to education and health care services, insufficient employment opportunities and exclusion in the workplace, limited access to legal and political processes and increased cost of living with a disability.

Thus, global awareness on disability inclusion need to be continuously delivered so as to end the cycle of poverty and disability. The Inclusion of Persons with disabilities in all aspects of life would be guaranteed through the application of United Nations Convention on the Rights of Persons with Disabilities which incorporates the following:

ARTICLE 5: says that, the State Parties shall prohibit all discrimination on the basis of disability and guarantee to persons with disabilities equal and effective legal protection against discrimination on all grounds. In order to promote equality and eliminate discrimination, State Parties shall take all appropriate steps to ensure that reasonable accommodation is provided.

ARTICLE 9: says that, in order to enable persons with disabilities to live independently and participate fully in all aspects of life, State Parties shall take appropriate measures to ensure persons with disabilities access, on equal basis with others, to the physical environment, to transportation, to information and communication technologies and systems, and to other facilities and services open or provided to the public, both in urban and rural areas. These measures, Include the identification and elimination of obstacles and barriers to accessibility, shall apply to: (a) buildings, roads and other indoor and outdoor facilities, Including schools, housing, hospitals and workplaces, (b) information, communication and other services, including electronic services and emergency services, (c) ensure that private entities that offer facilities and services open or provided to the public take into account all aspects of accessibility for persons with disabilities.

ARTICLE 13: says that, State Parties shall ensure effective access to legal justice for persons with disabilities on an equal basis with others, Including through the provision of procedural and age-appropriate accommodation in order to facilitate their effective role as direct and indirect participants, Including as witness in all legal proceedings, Including at investigative and other preliminary stages.

ARTICLE 24: says that, State Parties shall recognize the rights of persons with disabilities to education, State Parties shall ensure an inclusive education system at all levels and long learning. Persons with disabilities are not excluded from the general education system on the basis of disability, and that children with disabilities are not excluded from free and compulsory primary education and secondary education on the ground of disability. Persons with disabilities can access inclusive and quality education on an equal basis with others in the communities in which they live. Reasonable educational facilities and accommodations of individual's needs and requirements shall be provided.

ARTICLE 25: says that, State Parties shall recognize that person with disabilities have right to the enjoyment of the highest attainable standard of health services without discrimination on the basis of disability. State Parties shall (a) provide persons with disabilities the same range, quality and standard of free or affordable health care and programmes as provided to other persons, (b) provide those health services and programmes needed by persons with disabilities specifically because of their disabilities.

ARTICLE 26: says that, State Parties shall take effective and appropriate measures, Including through peer support, enable persons with disabilities to attain and maintain maximum independence, full physical, mental, social and vocational ability, and full Inclusion and participation in all aspects of life. To that end, State Parties shall organize, strengthen and extend comprehensive habilitation and rehabilitation services and programmes particularly in the areas of health, employment, education and social services to persons with disabilities.

ARTICLE 27: says that, State Parties shall recognize the right of persons with disabilities to work on an equal basis with others; this includes the right to have opportunity to gain a living by work freely chosen or accepted in a market and work environment that is open, inclusive and accessible to persons with disabilities. Also, State Parties shall prohibit discrimination on the basis of disability with regard to all matters concerning all forms of employment, promote employment opportunities and career advancement for persons with disabilities in the labour market as well as Assisting in finding, obtaining and maintaining to employment, promote opportunities for self employment, entrepreneurship, vocational trade and business.

ARTICLE 28: says that, State Parties shall recognize the right of persons with disabilities to an adequate standard of living for themselves and their families, Including adequate food, clothing and housing to the continuous improvement of living conditions.

ARTICLE 29: says that, State Parties shall guarantee to persons with disabilities political rights and the opportunity to enjoy them on an equal basis with others, and shall undertake to:  (a) ensure that persons with disabilities can effectively and fully participate in political and public life on equal basis with others, directly or through freely chosen representatives, Including the right and opportunity for Persons with disabilities to vote and be elected. (a) create an environment in which persons with disabilities can effectively and fully participate in the  public administrative  affairs without discrimination and equal basis with others. Persons with disabilities should have a voice in the decision making that affect their lives.

ARTICLE 31: says that, State Parties shall undertake to collect appropriate and accurate information, Including statistical and research data on persons with disabilities. The evidence-based data on persons with disabilities enable the policy makers to formulate policy, plan services and programmes which would effectively address the exclusion that persons with disabilities face.

In conclusion, disability Inclusion can be promoted and guaranteed by effective application of the United Nations Convention on the Rights of Persons with Disabilities in the following areas:

1- Equality and Non-discrimination.

2- Accessibility.

3- Education.

4- Healthcare.

5- Habilitation and Rehabilitation.

6- Work and Employment.

7- Standard of Living & Social Protection.

8- Participation in Political and Public life.

9- Access to Legal Justices.

10- Statistics and data collection on PWDs.

Therefore, let's join the awareness delivery for disability inclusion and the rights of persons with disabilities in general so as to end the cycle of poverty and disability. 

Persons with disabilities are more likely to experience adverse socioeconomic outcomes such as less education, poorer health outcomes, lower levels of employment, and higher poverty rates.