By: Colette AZZI,
Independant consultant and researcher
I-History of support to PwDs in Lebanon
Support to PwDs in Lebanon has been commonly described as unfair. The Lebanese successive governments do sponsor services to PwDs, but at the same time they hand out the delivery of these services to welfare institutions that were, and still are, linked to religious and sectarian institutions. However the situation started to change in the 1980s with the emergence of several smaller associations, many of which were established and run by PwDs themselves or their families and financed by external donors. Consequently those organizations are considered as Disability Persons Organizations (DPOs) and have played a major role in advancing the situation of PwDs in Lebanon through their continuous and restless efforts to advocate for their rights.
The year 1993 was a turning point as it witnessed the establishing of a National Committee for PwDs (NCPwDs) comprising all disability stakeholders, including DPOs and elected representatives of PwDs, the committee was required to define related policies and to follow-up on the implementation of these policies carried out by the Ministry of Social Affairs (MOSA) in coordination with all concerned public, civil society and private service providers. The Rights and Access Program was the NCPwDs’ first initiative, it provides PwDs in Lebanon with a disability card allowing them access to services provided by the State.
Another important improvement of the disability rights movement in Lebanon was the endorsement of the law 220/2000 which guaranteed PwDs equal rights as any other citizens.
“The law 220 of 2000, in spite of the predominance of the medical approach in its definition of disability (art.1) has gone a little further by taking into consideration the limitation or restriction of participation as one of the indicators that a persons is disabled (art.2). Another important point is that the law 220 classifies (art.3) the disabilities (excluding notably mental and psychosocial disabilities) and states that persons with disability are entitled to a “disability card” that grants them access to social and health services provided by the Lebanese State. Article 4 Paragraph B of law 220 states that the only way to access the disability services and to enjoy the rights stated in the related laws is to hold the disability card according to the conditions stated by law.” – Marie-Noëlle AbiYaghi, Handicap International, 2011.
II-Actual reality of aid targeting PwDs
Internationally, and by the 1980’s, a social approach of understanding disability slowly replaced the dominant medical approach at the time. By 2001, a new definition of disability emerged referring to the negative aspects of the interaction between individuals with a health condition and personal and environmental factors but it missed looking also at the question interaction of PwDs with their respective communities. The social model definition of disability was later on updated to include this aspect with the aim to remove all barriers towards inclusive communities.
All communities coexisting in Lebanon including Lebanese nationals and refugees used to embrace almost the same approach towards disability stemming from a shared “Arab culture”. The ongoing-armed conflicts increased the number of “living martyrs” with disabilities (often males), which helped in putting disability on the political agenda.
The charity approach that was adopted by successive Lebanese governments still considers PwDs as "objects" of charity, favoring special institutions for medical treatment and social protection over encouraging general institutional services to mainstream and adopt inclusive services towards PwDs in Lebanon. Unfortunately, few persons with disabilities in Lebanon have the privilege of being aware of being rights-holders.
The charity approach that is still being adopted by the main duty-bearers is putting all types of barriers in front of the rights-based movement for PwDs. As a result, the development of independent PwDs movement is difficult.
These approaches gave rise to a population of PwDs who lack proper education and basic rights-based services. In 2004, half of the PwDs reported not having received any health care in the previous year despite the establishment of a right-based service program by the Ministry of Social Affairs (MoSA) (UN, 2007). All these barriers increased the vulnerability of PwDs, which is a basic determinant of poverty.
III-National conditions affecting the effectiveness of aid for PwDS in the Lebanese context
The effectiveness principles set by both the Paris Declaration (2005) and Accra Agenda for Action (AAA, 2008), constitute the framework of aid for interventions targeting PwDs. In addition to several complex and interconnected factors, such as the relevance of aid to donors’ policies, national policies, and to the international, regional and national commitments and the relevance of aid to the situation of PwDs and their families in the context of aid. Consequently the results of interventions should be relevant to all these factors.
A-Absence of public plans targeting PwDs
Economic and political reasons are still the pretext behind the Lebanese government reluctance to enforce mechanisms of existing laws such as Law 220/2000 and the ratification of the international Convention on the Rights of Persons with Disabilities (UN CRPD) and its implementation. In the absence of public governmental plans, aid is scattered, lacks focus, strategic orientation and can only reach a segment of PwDs living in Lebanon. Under these circumstances donors and civil society organizations apply their own management to aid interventions.
The lack of a comprehensive vision to all disability issues make the principles of effectiveness inapplicable at the national level and restrict their applicability to the micro level of available funded projects and programs and their respective concerned stakeholders who are mainly donors and civil society organizations. The effectiveness at this restricted level is usually evaluated by donors in referring to their funds pre-set conditions and requirements.
b- Unidentified situation of PwDs and their families
The effectiveness of aid for PwDs should be based on updated situation analysis of PwDs in the context of Lebanon. Many factors contribute to keeping the situation of PwDs and their caregivers unidentified. Among these factors is the incapacity to have a real estimate of PwDs rates in Lebanon. MOSA estimates the number of Personal Disability Identification card holders at 69.953 persons (62.50% men and 37.50% women). The recent approach adopts a restricted definition of disability based on Law 220 that leaves out a lot of PwDs whose disability is not considered at all; it depends on voluntary claiming of individuals with disabilities or their families and lacks national and regular surveys on the living conditions of PwDs and their caregivers.
Similarly, the same obstacles are faced in assessing other PwDs living in Lebanon such as the Palestinian refugees.
c- Accessibility of aid for PwDs and their caregivers in Lebanon
As described earlier, the principles of effectiveness is relative to concerned stakeholders and might be reviewed through the evaluation results of available supported efforts targeting PwDs. Local and national development and relief interventions might consider disability as a cross cutting theme as well as it might target PwDs directly. The decision is left to concerned stakeholders and the participation of PwDs in the aid processes depends on the adopted approaches (aid recipients and donors).
PwDs are only eligible for donors’ funds when they succeed to overcome all the barriers of their living conditions in Lebanon and to organize themselves under a recognized formal organizational form such as a non-governmental organization.
A persisting context of poor governance is threatening the achievements of PwDs rights movement. As the proportion of persons with disabilities have considerably increased over the course of the civil war, the urgent need for an inclusive and comprehensive national development plan becomes crucial.
Yet, the State involvement in the sphere of public affairs has always been minimal. The 2007 Common Country Assessment (CCA) reports a major finding which was precisely mentioned “multi-level governance weaknesses across a range of State sectors”. Amongst the most severe insufficiencies noted was the lack of general regulation enforcement mechanisms and effective allocation of both financial and human resources, especially in poor remote areas. Aid for PwDs risks to be diverted away from the Right Based Approach (RBA). A central dynamic of RBA is about empowering rights-holders to claim their rights and enabling duty-bearers to meet their obligations. RBA should allow a move from aid effectiveness to development effectiveness.