After the typhoon

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Gordon Rattray, Communications Coordinator for CBM’s Emergency Response Unit, reports on rebuilding health services in the Philippines following Typhoon Haiyan and details why people with disabilities must be actively involved at all stages of emergency response.

On 8 November 2013 Typhoon Haiyan, known locally as Yolanda, made landfall on the Philippines and swept west across the centre of the archipelago. It was one of the most powerful storms ever recorded, killing over 6,000 people and affecting more than 14 million. CBM, with its partners, is working to ensure that persons with disabilities are included not only as recipients of relief, recovery and rehabilitation efforts, but as active participants in the recovery process.

Health priorities in the relief effort, led by the Philippines Department of Health and the World Health Organization (WHO), include full re-establishment of health care services, improved health care, strengthening surveillance, as well as outbreak prevention and response.

Four months after the typhoon, more than half of all damaged health facilities were reported as being either partially or fully functional.

A disproportionate hit

However, in any emergency or disaster, people who live with some form of disability (comprising an estimated 15% of the world’s population[1]), are disproportionally affected. Reasons for this include inaccessibility of warning messages and emergency shelters, loss and damage of assistive devices, disruption of support networks and increased difficulty in accessing basic humanitarian needs (food, water, shelter, sanitation and health care services).

At the same time, emergencies can increase the number of people who experience disability, both short and long-term, due to injuries sustained and lack of effective medical services.

Therefore, without proactive efforts to include people with disabilities, a significant proportion of the population will not be able to access health care services. They will be excluded from services they required before the disaster or from support that they now need as a result of the disaster.

Consultation in community DRR plans

To ensure disability inclusion in health care (as in all sectors of emergency response), concerted actions are required, before, during and after emergencies. These must involve stakeholders from local, national and international levels.

Disability inclusion is the intended goal, but – crucially – it will not be reached without practising disability inclusion at every level on the journey there. The voices of people with disabilities must be heard and this knowledge must be used. People with disabilities must be consulted in community Disaster Risk Reduction (DRR) plans and included in all identification procedures, from needs assessments to monitoring and evaluation surveys.

Rebuilding with inclusion in mind

There must also be comprehensive access to mainstream health services. As most people with disabilities have the same health needs as the general population, accessibility has to be a fundamental concept in all rebuilding – from physical structures like clinics and hospitals to production and distribution of health Information, Education and Communication (IEC) materials. There is no point producing information and providing services if it cannot be read or accessed by everyone.

Parallel to this mainstreaming, there will always be essential specific support items that must be maintained during a crisis, including medical equipment (such as catheters) and ongoing medications (for conditions like epilepsy).

CBM and partners’ response to Haiyan

In responding to Typhoon Haiyan, CBM and its partners have been active from the beginning, working to provide emergency relief items with a local disabled persons organisation (DPO), Association of Disabled People Iloilo (ADPI), in Iloilo Province, one of the worst affected areas.

We are looking at long-term recovery. After detailed assessment and expert consultation a Community Mental Health (CMH) pilot project has been started in two provinces, and schools and homes have been repaired. More rebuilding is planned, along accessibility and risk reduction principles.

To ensure mainstreaming and coordinated collaboration between humanitarian actors, including those providing health services, we are integral to an Ageing and Disability Task Force. Also with ADPI, we have started two Ageing and Disability Focal Points (ADFPs). These operate as specialised hubs, identifying community services that exist (including health services), and the people with the needs. They can then assist in referrals.

Benefits for all

As health provision is restored following disasters like Haiyan, facilitating disability inclusion is imperative to ensure that both mainstream and specific forms of support are available and accessible to people with disabilities. Without this, a significant proportion of the population will not benefit. They will be ignored.

But these initiatives will only work to their full potential if people with disabilities are actively engaged. The involvement of persons with disabilities not only brings a range of skills, knowledge and experience to projects but also increases awareness and understanding of their potential among others, reducing negative attitudes. While the focus here is on health, this general principle applies equally to all sectors of emergency response.

For more information, see the Guidance Note on Disability and Emergency Risk Management for Health produced by WHO in consultation with CBM, the International Federation of Red Cross and Red Crescent Societies (IFRC), the International Organization for Migration (IOM), the United Nations Children’s Fund (UNICEF) and the United Nations Office for Disaster Risk Reduction (UNISDR).

References: [1] WHO World report on disability 2011