Life in congested refugee camps is challenging for the 866,457 stateless Rohingya refugees struggling to meet their basic needs (UNHCR 12/2020). For people with disabilities (PwD) and older people1 living in the camps, such challenges are amplified. PwD and older people struggle to access essential services such as latrines, water points, health centres, and aid distributions because of hilly and flood-prone terrain and a lack of adapted facilities and inclusive interventions. Social stigma is a major barrier preventing access to essential services and participation in community activities and decision-making processes. Exclusion and isolation also greatly restrict access to information or feedback and complaint mechanisms. For individuals requiring mental health and psychiatric care, specialised assistance is limited and there are few qualified professionals available to address the scale of these needs in the camps (ISCG 09/19; ADH, CDD, ASB 2017; DFID 01/2019).
Many PwD and older people rely on the support of their caregivers to meet their basic needs. This requirement for around-the-clock care impacts an entire household’s ability to meet its needs. Data collected in 2019 and 2020 indicates that households in the camps with at least one disabled member are among the most economically vulnerable, which has since been worsened by COVID-19 (ISCG 09/19; WFP 04/2020; ACAPS 04/10/2020). Information gaps about disability prevalence and a lack of detailed sex, age, and disability disaggregated data across the humanitarian response impacts the ability to scale up disability-inclusive practices, adjust implementation to support households with PwD and older people, and measure reach and effectiveness.
COVID-19 and the accompanying containment and risk mitigation measures put in place in March 2020 have worsened an already challenging situation. PwD and older people are at greater risk of contracting COVID-19 as they face difficulties in maintaining basic hygiene measures such as handwashing – because of both the lack of accessible handbasins, sinks, or water pumps, as well as the physical constraints of performing the necessary motions for handwashing. Maintaining physical distancing is also difficult because of the additional support needed from caregivers (WHO 03/2020). PwD may also have underlying health conditions that put them at greater risk of experiencing severe symptoms of COVID-19, and older people are an at-risk group for the virus. PwD and older people also face barriers to accessing appropriate healthcare because of difficulties with transportation, disruptions to services, and – in some cases – compounding social stigma attached to disabilities and to contracting COVID-19.
People with vision, hearing, and intellectual impairments face communication difficulties and barriers to accessing public health information, including problems with fully understanding information about COVID-19 (WHO 03/2020; key informant interview 07/2020).
The primary and secondary impacts of COVID-19 and the associated measures on PwD and older people in the camps are still not fully understood, partly because of data collection challenges and restricted camp access. Many planned data collection efforts were put on hold to comply with containment and risk mitigation measures but have since resumed (key informant interview 07/2020). Remote data collection posed challenges related to representativeness, as phone access among the Rohingya is not consistent and those who have phones struggle with poor network connectivity and are unable to charge their phones regularly (Humanitarian Alternatives 11/2020). Access to phones is limited for PwD and older people (especially women), further marginalising them and resulting in inaccurate findings (UN Women, CARE, Oxfam 05/2020; ACAPS 08/06/2020). Data collection via phone also excludes PwD with special communication needs.
This report evaluates existing data on the Rohingya refugee response. It highlights the key challenges and constraints faced by PwD and older people in accessing essential services and explores how COVID-19 and related containment and risk mitigation measures have affected humanitarian programming for PwD and older people. It also identifies information gaps and challenges linked to disability prevalence in the camps.