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COVID-19 in humanitarian contexts: no excuses to leave persons with disabilities behind! Evidence from HI's operations in humanitarian settings

HUMANITY & INCLUSION (HI)
June 2020

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This collection and review of evidence aims to illustrate how the COVID-19 crisis triggers disproportionate risks and barriers for men, women, boys and girls with disabilities living in humanitarian settings. It highlights recommendations for humanitarian actors, to enhance inclusive action, aligned with existing guidance and learnings on disability inclusion. It is based on evidence, including testimonies, collected by HI programs in 19 countries of intervention. Special efforts were made to reflect the voices of persons with different types of disabilities, genders and ages, residing in different geographical areas and living circumstances, including refugee and internally displaced persons’ settlements and host communities.

 

Evidence has been collected through primary data collection among HI teams and partners, working in countries impacted by the COVID-19 pandemic in April/May 2020. Data was extracted from assessments conducted by HI and partners in Bangladesh, Egypt, Haïti, Indonesia, Philippines, Jordan, Lebanon, Somaliland and Togo. Testimonies from affected communities, staff and partners were collected in Kenya, Myanmar, Pakistan, Palestine, Philippines, Somaliland, South Sudan, Rwanda, Thailand, Uganda and Yemen.

 

Inclusion of persons with disabilities in humanitarian action. Case studies collection 2019. 39 examples of field practices, and learnings from 20 countries, for all phases of humanitarian response

PALMER, Tom
et al
December 2019

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Published at the same time as the Inter-Agency Standing Committee (IASC) Guidelines on Inclusion of Persons with Disabilities in Humanitarian Action, this report aims to support their uptake and promote learning by example. This report presents 39 short case studies on inclusive practices for persons with disabilities in humanitarian action and disaster risk reduction (DRR). It is designed for humanitarian stakeholders with limited experience of working with and for persons with disabilities, as well as for organizations of persons with disabilities (OPDs) planning to engage in humanitarian action and DRR. The report draws lessons from field practices, but does not provide technical guidance. The IASC Guidelines are the reference document to seek in-depth theoretical and technical information

 

The case studies focus on:

  • Inclusive disaster risk reduction and preparedness
  • Collecting and using disability disaggregated data for assessments and programming.
  • Participation of persons with disabilities and their representative organizations in humanitarian response and recovery
  • Removing barriers to access humanitarian assistance and protection.
  • Influencing coordination mechanisms and resource mobilization to be inclusive

 

The evidence presented in this report was identified in 2017-2018 through a desk review of publicly available reports and internal documents on projects implemented by CBM, HI and IDA members, as well as their partners and affiliate members. Field visits to Lebanon, Jordan, Kenya, Nepal, and the Philippines conducted in 2018 also informed the case-study collection and documentation

Missing millions: How older people with disabilities are excluded from humanitarian response

SHEPPARD, Phillip
POLACK, Sarah
McGIVERN, Madeleine
July 2018

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The aim of this study was to explore the experiences of older people with disabilities across a range of humanitarian settings, considering:

  • whether older people with disabilities have additional needs and challenges accessing humanitarian assistance and protection
  • what factors facilitate or limit access by older people with disabilities to humanitarian assistance and protection
  • to what extent is humanitarian response inclusive of older people with disabilities

A systematic literature review of published studies was conducted. Key online humanitarian guidelines were explored to review how far they explicitly address older people with disabilities. Data from six population-based disability surveys comparing the living situation of older people with and without disabilities were analysed. These included databases from two crises-affected populations in Haiti (post-earthquake) and Palestine. Data from four non-humanitarian settings was also reviewed to explore more broadly the situation for older people with disabilities – India, Guatemala, Cameroon and Nepal. Interviews were held with older people with disabilities, members of their families and local key informants in two conflict-affected populations in Ndutu and Mtendeli refugee camps in Western Tanzania, and Donetsk and Luhansk regions of Eastern Ukraine to find out about their experiences. Staff of five international agencies working in humanitarian response were also interviewed. 

 

Findings highlight particular issues facing older people with disabilities in humanitarian crises: more risk escaping from danger;  barriers to accessing social protection and work; barriers to accessing health and rehabilitation services; barriers to accessing food and other essentials; unsuitable housing and poor living conditions;  insecurity and discrimination; threats to dignity and independence; social isolation and loneliness; risks to mental health; and missing from humanitarian response.

 

A table brings together the findings from the different components of the research to show the needs, risks, barriers and enablers for older people with disabilities identified in the research. Recommendations are provided to humanitarian donors, policy makers and practitioners

Child health and rehabilitation. Factsheet.

HANDICAP INTERNATIONAL
March 2017

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Child health encompasses physical, mental and social well-being of children under the age of five. The leading causes of under-five deaths are pre-term birth complications, pneumonia, birth asphyxia, diarrhoea and malaria. Malnutrition contributes to nearly half of all under-five deaths. All these conditions contribute hugely to child impairments too. Common impairments and activity limitations related to child health including birth defects, cerebral palsy, developmental delays, burns, falls and injuries and road traffic injuries are outlined and different examples of rehabilitation across the care cycle are given. A case study of cerebral palsy in Haiti is cited. 

Situation of wage employment of people with disabilities (Ten developing countries in focus)

HANDICAP INTERNATIONAL
December 2016

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One of the fundamental rights that is often denied to persons with disabilities is the right to employment. Based on 35 years of work with persons with disabilities in more than 60 developing countries, Handicap International has decided to study this issue of employment and disability. It challenges ten developing country teams to reach out to their local partners to capture the reality of employment today. This qualitative study gives very useful information about country teams’ vision of decent work for persons with disabilities in those environments where specialized resources are rare and inclusive policies remain in their infancy. Despite many obstacles, it identifies some positive promises and future tracks for better practices and efficient services. Many stakeholders, like local business and employment bureaus, are piloting innovative ways to get people to work, and to retain their skills as this positive dynamic evolves. Bringing these experiences to different audiences is the main goal of this document. Hopefully it will be the first piece of a more comprehensive data set and bank of best practices that reinforce access to decent jobs for people with disabilities wherever they happen to live in our global world.

OPERA

Center for Economic and Social Rights
July 2016

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CESR has developed a simple, yet comprehensive four-step framework to analyze various aspects of the obligation to fulfill economic and social rights. Adopting the acronym OPERA, the framework incorporates different measures for specific human rights principles and standards,by framing them around four levels of analysis: Outcomes, Policy Efforts, Resources and Assessment.

A guiding lens for CESR's national enforcement work, the OPERA framework allows an assessment that triangulates outcomes, policies and resources to provide a much fuller picture of what a state is doing to promote the realization of specific rights. Importantly, it traces economic and social deprivations and disparities back to the actions or omissions of the state, to make the case that they constitute an injustice and a violation of human rights.

Participation and quality of life outcomes among individuals with earthquake-related physical disability: A systematic review

NUNNERLEY, Joanne
DUNN, Jennifer
McPHERSON, Kathryn
et al
May 2015

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A literature review to evaluate quality of life and participation outcomes of individuals with earthquake-related physical injury. A systematic review was performed searching MEDLINE, Embase, PsychINFO, CINAHL and AMED electronic databases from 1966 to January 2014. Studies that measured quality of life or participation outcomes among individuals who acquired a physical disability as a result of an earthquake injury were included, with no limits on research design. The search yielded 961 potentially relevant articles after removal of duplicates. Of these, only 8 articles met the inclusion criteria. Seven papers were reviewed from the following 5 earthquakes: 2001 Gujarat earthquake, India; 2008 Wenchuan earthquake, China (also known as the Sichuan earthquake); 2005 Kashmir earthquake, Pakistan (27); 2009 Padang earthquake, Indonesia; 2010 Port-au-Prince earthquake.

Journal of Rehabilitation Medicine, vol.47, no.5, 2015, 385-393

10.2340/16501977-1965

Inclusive disaster and emergency management for persons with disabilities : a review of needs, challenges, effective policies, and practices

RAJA, Deepti Samant
NARASIMHAN, Nirmita
2013

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This report provides an introduction into the needs of persons with disabilities in disasters and emergencies and reviews the challenges, effective policies and practices of inclusive disaster and emergency management.  It compiles international mandates and guidelines, strategies and practices for inclusive disaster management and gives an overview of the disaster and emergency management process and how persons with disabilities can be affected at each stage.  This report highlights the importance of information and communication technologies throughout the process and provides related case studies

Disaster risk management for all : for the inclusion of children, elderly people and people with disabilities

FEDERAL MINISTRY FOR ECONOMIC COOPERATION AND DEVELOPMENT (BMZ)
World Food Programme
GIZ sector programmes
Eds
May 2013

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This publication explains the links between disasters, disaster risk management and particularly vulnerable sections of the population including children, elderly people and people with disabilities.  It gives an overview of the experience to date and provides some practical suggestions on how to meet the needs of all people on an equitable basis through disaster risk management.  Specific activities to strengthen inclusive disaster risk management are provided in this guide for all vulnerable groups

BMZ Information Brochure 1, 2013e

Giving with one hand...evaluation of post-earthquake physical rehabilitation response in Haiti, 2010 : a systems analysis

TATARYN, Myroslava
BLANCHET, Karl
2012

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This report presents the evaluation of the post-emergency rehabilitation response in Haiti in order to assess what had been achieved, to learn from good and not-so-good practice, and to promote the development of an effective rehabilitation sector in the future.This evaluation provides evidence, to inform humanitarian organisations, about what must be done in a post-disaster situation so that people with disabilities have access to relief and protection on an equal basis with others, and what is required in the long-term to develop a good rehabilitation service

Armed violence and disability : the untold story

THAPA, Rashmi
THALER, Kai
2012

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"This study aims to understand the links between armed violence and impairments that can lead to disabilities. It focuses on individuals who sustain impairments resulting from incidents of armed violence. The Disability Creation Process is adapted to analyse the combination of health problems, discrimination and socio- economic exclusion that can lead to disability for people who have sustained serious injury and/or lasting impairments as a result of armed violence...This report is written in a linear progression keeping the research project’s goals, objectives and approach as its backdrop. Chapter 1 (introduction) gives an overview of armed violence along with the justification of this research and its methods. Chapter 2 presents the findings from the four case study regions in countries, situated within its contextual analysis. Each case study draws on its discussion and summary of findings. Chapter 3 presents the discussion and lessons learned from this research, placing assistance and people at the centre of armed violence initiatives. Finally, a glossary, Annexes and references as endnotes are at the end of the report with notes at the end of every page"

A qualitative and quantitative study of the surgical and rehabilitation response to the earthquake in Haiti, January 2010

REDMOND, Anthony
et al
December 2011

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"The disaster response environment in Haiti following the 2010 earthquake represented a complex healthcare challenge. This study was designed to identify challenges during the Haiti disaster response. Qualitative and quantitative study of injured patients carried out six months after the January 2010 earthquake in Haiti to review the surgical inputs of foreign medical teams...This study showed that challenges for emergency medical response during the Haiti Earthquake involved issues of accountability, professional ethics, standards- of care, unmet needs, patient agency and expected outcomes for patients in such settings"
Prehospital and Disaster Medicine, Vol 26, No 6

Disability, displacement and public health : a vision for Haiti

WOLBRING, Gregor
2011

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This article "highlights the situation of people with disabilities displaced by natural disasters, with a particular focus on Haiti which on January 12, 2010 was hit by a catastrophic earthquake of magnitude seven on the Richter scale. The article explores the opportunity for developing a series of best practices with regards to displaced people with disabilities in Haiti - practices that might be applicable to other natural disasters in the future"
Canadian Journal of Public Health, Vol 102, No 2

Toolkit for long term recovery|Haiti : reconstruction for all

GPDD WORKING GROUP ON HAITI RECONSTRUCTION
August 2010

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This toolkit suggests strategies and tools to improve disaster recovery and reconstruction practices for disabled people. It is structured around the following seven major thematic areas related to disability inclusive recovery and reconstruction: physical environment; livelihood, employment and social protection; transportation and communication; education; health; capacity building of disabled people's organisations (DPOs); and organisational and operational issues. This toolkit is useful for humanitarian agencies and NGOs in disasters situations

The IMF, the global crisis and human resources for health : still constraining policy space

LEFRANÇOIS, Fabien
February 2010

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This report "...examines evidence from nine IMF country programmes, chosen based on their HIV prevalence rates, and finds that although the IMF has changed its tune and is talking about greater flexibility, these changes are not enough and are only temporary. "In 2006, the World Health Organisation (WHO) estimated that 57 countries were facing a severe health workforce crisis.... Addressing this shortage, and action alongside it to strengthen health systems around the world, requires substantial, concerted effort from both aid donors and recipient governments. The current global downturn threatens to undermine steps taken in this direction so far and jeopardise progress towards the health-related Millennium Development Goals. "...the IMF has adapted its rhetoric so that it now claims its programmes are more flexible on fiscal and monetary policies, which determine to what extent governments can maintain or increase spending - including of foreign aid - and stimulate economic activity"

Humanitarian response for older people in Haiti : three months on

HELPAGE INTERNATIONAL
2010

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"This review is a snapshot of how the cluster system and individual agencies have supported and integrated older people’s needs into emergency response and relief efforts in the first three months after Haiti’s earthquake. The report provides an overview of what is being done to address older people’s needs; highlights any areas of good practice; assesses challenges; and recommends ways forward to ensure a more comprehensive response to the needs of all vulnerable groups"

Culture and mental health in Haiti : a literature review

WORLD HEALTH ORGANIZATION (WHO)
2010

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"This paper reviews and summarizes the available literature on Haitian mental health and Mental health services. This review was conducted in light of the Haitian earthquake in January 2010. The first part of the review describes historical, economic, sociological and anthropological factors essential to basic understanding of Haiti and its people. This includes discussion of demography, family structure, Haitian economics and religion. The second part of the review focuses on mental health and mental health services. This includes a review of factors such as basic epidemiology of mental illness, common beliefs about mental illness, explanatory models, idioms of distress, help-seeking behavior, configuration of mental health services and the relationship between religion and mental health"

HIV/AIDS in Haiti : key findings of the mortality, morbidity, and utilization of services survey : EMMUS-iv 2005-2006

MEASURE DHS (Demographic Health Surveys)
2008

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This report presents survey findings on HIV prevalence in Haiti and other related results, including knowledge of HIV and AIDS, attitudes toward people living with HIV, and sexual behaviour. The survey was undertaken by the Mortality, Morbidity, and Utilization of Services Assessment Survey (EMMUS-IV) [Enquête Mortalité, Morbidité et Utilisation des Services] conducted between October 2005 and June 2006. The French version of this report follows the English version

Addressing violence against women in HIV testing and counselling

WORLD HEALTH ORGANIZATION (WHO)
2006

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This is a summary and recommendations from an international consultation co-convened by the WHO departments of Gender, Women and Health (GWH) and of HIV & AIDS to identify and review promising strategies or good practices to support women who may fear or experience violence as a consequence of HIV testing and/or HIV status disclosure; and develop recommendations to guide programmes and policies related to HIV testing and counselling, in light of current strategies to expand access to these and related services

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