DTM /HI : Access to Humanitarian Services for People with Disabilities
Executive Summary & Recommendations
In December 2017, an assessment was carried out by Humanity and Inclusion (HI) together with the International Organization for Migration (IOM) in Bentiu Protection of Civilian (PoC) site to increase the understanding of the situation of persons with disabilities in Bentiu PoC, including the barriers and facilitators faced by people with disabilities in accessing needs-based services. Programmatic gaps in the access of people with disabilities to camp management, Water, Sanitation and Hygiene (WASH), Shelter/Non-Food Items (NFI), Health, and Protection services were assessed between December 13 and 20 through ten focus group discussions (FGDs), nine key informant interviews (KIIs), 663 house to house surveys, and 22 direct observations of services.
The assessment targets included not only people with disabilities living within the PoC site, but also their caregivers and families as well as those service providers and protection actors responsible for meeting their basic needs.
A number of barriers to access to services were identified during the assessment, including:
• Gaps in service accessibility are at times exacerbated for those with disabilities as well as among humanitarian aid workers
• Access to information on available services in accessible formats, especially considering high illiteracy rates
• Protection concerns including theft, bribery, robbery and coercion of people with disabilities
• Low participation of people with disabilities in camp coordination, leadership, and management structures
• Obstacles in effective identification of people with disabilities by service providers
Thus, the assessment identified that there is scope for improvement of eff orts to a create respectful and sensitive environment for people with disabilities with the support of the site populations as well as humanitarian aid workers. The assessment took into account men and women, boys and girls, as well as the elderly, all with various disabilities including those with visual, hearing, intellectual and mobility impairments, as well as those with mental health problems.
Through the assessment diff erent priorities were identifi ed, including limited access to health care including access to medication adapted to the needs of people with disabilities, and limited availability of rehabilitation services, including assistive devices.
People with disabilities requested improved safety mechanisms, equal treatment, and less discrimination as they are systematically at risk of violence and theft , and are continually discriminated against.
People with disabilities requested increased participation and a stronger representation in camp management to reduce access barriers and discrimination and to create a two-way dialogue with humanitarian service providers, as people with disabilities are not oɈ en recognized as equal community members, are not oɈ en considered for staff positions, and indicate that they would like to be consulted more extensively by camp management and service providers on decisions that aff ect them.
People with disabilities and their families require more information about the available services, protection mechanisms, and the rights of people with disabilities, and desire more feedback on their concerns raised to camp management.
People with disabilities report that the following actions could make the lives of people with disabilities in the Bentiu PoC site easier:
• Make access to basic services, such as latrines, easier (63%)
• Increase support to family members (45%)
• Increase recreational and cultural activities (26%)
• Provide non-formal education (19%)
As a result of this assessment, recommendations have been made to improve the situation of people with disabilities living within the Bentiu PoC site. These include:
• Donors should promote comprehensive, effective and inclusive actions, through adequate funding and prioritization of programming that takes into consideration issues of inclusion and addresses key identified issues (age, gender, disability). Donor frameworks should include disability rights and access to services.
• Mobilize financial resources to promote inclusive planning and delivery of services (such as establishing disability focal points, training staff on universal accessibility designs, and adding accessibility and disability rights to budget lines).
• Camp coordination mechanisms should deliberately make people with disabilities more visible for all service providers, by systematically capturing disaggregated information about people with disabilities. This can be achieved through the use of the Washington Group Short Set of Questions and through regular participatory situational analyses highlighting the needs of, and challenges faced by, people with disabilities and other vulnerable groups. This data should be presented in assessment reports and the issues identifi ed addressed purposefully in action plans.
• People with disabilities, and other people with functional limitations, should be allocated to accessible and safe environments inside the PoC site and provided with accessible information on their rights, the services they can access, and the assistance they can benefit from.
• Promote and monitor the implementation of inclusive standards through the development of a short, mid and long-term action plan, with dedicated responsibilities and indicators to address the identified challenges. Involve people with disabilities and their representative groups in monitoring the implementation of inclusive standards and in recommending avenues for enhancing equitable service provision.
• All service providers should report on the access and participation of people with disabilities and should consult formal and informal disability representative groups during all programmatic decisions.
• Highlight the exclusion of people with disabilities and any potential violation of rights and due process through advocacy towards service providers, authorities, and donors. Advocate for adapted humanitarian responses, including mobile service provision.
• Setup a network of assistance through trusted community members to provide door-to-door services.
• Continuously strive to adhere to best practices and standards as outlined in guidelines that promote inclusive humanitarian action (such as Sphere standards, protection mainstreaming guidelines,
Humanitarian Inclusion Standards) during all phases of intervention and seek the technical support from international or local mainstreaming actors and representative groups to translate action planning into concrete interventions.
• All humanitarian staff should be sensitized on rights-based approaches to disability and have access to basic training on inclusion and accessibility in order to beɉ er modify the services they off er to equally include people with disabilities.
Promote accessibility and inclusion inside the PoC site:
• Ensure that all service providers use the international defi nition of disability , have the tools necessary to properly identify people with disabilities, and have access to information collected on people with disabilities in the site.
• Support the capturing of disaggregated disability information on beneficiaries, including by facilitating the access of protection actors during registration/verification exercises to assess different protection needs, such as through the use of the Washington Group Short Set of Questions.
• Strengthen formal and informal representative groups, through structural support and through active consultation in decision-making mechanisms, such as joined assessments and humanitarian planning. Two-way communication between humanitarian actors and people with disabilities should also be promoted through these groups.
• At least one focal point per sector of intervention should be trained on right-based programming, including on the issues surrounding disability mainstreaming.
• People with disabilities should have equal employment opportunities, promoting the self-worth, the resilience, and the particular expertise they have.
• Consult people with disabilities throughout all phases of the program cycle in order to take their experiences into consideration and properly address the challenges they might face.
• Conduct regular barriers and facilitators assessments, together with people with disabilities, to beɉ er understand the challenges they face and to address these challenges accordingly.
• Promote safe and accessible infrastructure by ensuring that all new construction works follow the international standards of accessibility and further work to modify an increased number of the existing facilities to the universal accessibility standards.
Promote access to information about services:
• Train camp management, focal points, and key community members on accessible communication methods, and identify focal points trained in sign language in order to involve them to reduce communication barriers.
• Provide information in accessible formats at information desks, at distribution sites and in safe spaces.
• Provide directories of information and mobile services in protection reporting mechanisms and in other services that are available.
• Make information accessible at information desks, at distribution sites, and at safe spaces, and through directories of information/mobile services in protection reporting mechanisms and in other services that are available.
Increase community participation and representation
• Conduct disability awareness raising campaigns and trainings for both humanitarian actors and PoC site community members together with representative groups, in order to reduce violence and discrimination while promoting the rights of people with disabilities and looking at impairments in a positive way.
• People with disabilities should be represented in the camp management coordination and should be supported to form an active disability network. The camp management should be provided a chair at the meetings of the disability network in order to share the networks’ concerns and recommendations with NGOs, and to provide feedback to the network on the concerns those within the network raise
• Strengthen community networking mechanisms, such as the Community Disabled Committee (CDC) and other representative structures, and systematically consult them during all steps of service provision. Develop CDC subcommiɉ ees within each sector to reach more people with disabilities.
Make health services accessible
• Advocate for suffi cient and accessible rehabilitation services, including the provision of assistive devices for people with injuries and functional limitations, and ensure assistive devices can be fi xed in a secure area when needed.
• Develop health policies and an action plan for health staff to deliver and monitor inclusive health service provision.
• Invite disability focal points during staff trainings (e.g. parents, community members, Disabled Persons Organizations - DPOs) to reduce negative attitudes surrounding people with disabilities
• Improve data collection systems at health centers to include the disaggregation of patient data by disability type as well as include disability data in referral tools.
• Facilitate access to health services through accessible infrastructure, and through mobile service provision, outreach clinics, provision of transportation fees or an accessible transportation system, and through general support for family members or caregivers of people with disabilities.
• Adapt recreational and psychosocial support activities to be inclusive of people with disabilities and provide alternative mental health activities such as MHPSS support groups.
• Involve the CDC in all health awareness messaging.
• Provide accessible communication materials on health issues, including on MHPSS and HIV/VCT services.
• Equip counselors with communication skills to beɉ er counsel people with disabilities for MHPSSrelated problems, as well as before, during, and aɈ er HIV testing.
• Train health staff on early detection and prevention programs and disability care (including on serving the needs of people with disabilities who are HIV positive), and on the particular health risks faced by people with disabilities.
• Continue using personal testimonies to reduce stigma surrounding HIV.
Make house conditions safe and accessible
• Ensure that people with functional limitations have appropriate assistance to install and repair their shelter.
• Provide (and monitor the use of) inner-locking mechanisms, a bed, additional blankets, and items based on identified needs (e.g. solar lamps or torches for safety).
• Avoid housing people with disabilities with strangers, or with other people with disabilities.
• People with disabilities should be proportionately represented in shelter committees and in camp management committees
• Perform an assessment to beɉ er identify the shelter needs of people with disabilities and to understand the challenges they face in accessing shelter.
Make WASH facilities accessible
• Modify existing WASH facilities with grab bars, ramps, liɈ ed toilet seats, fi xed handrails, and tactile marking, etc. Provide inner-locks, suffi cient lighting, and protection screens at all facilities.
• Coordinate with health actors to adapt hygiene kit contents (for example by providing assistive devices and adapted sanitation items such as a commode chair or bedpan) and to promote the integration of disability sensitive hygiene messages into WASH activities.
• Ensure that all accessible latrines adhere to the universal accessibility standards for WASH in emergencies.
• Involve people with disabilities in the WASH committees and in all assessment exercises.
Make distribution of food and non-food items accessible
• People with disabilities should not share items (such as radios and torches) with other community members, but rather they should be provided with their own items for use. This ensures that the person with a disability has the use of these items whenever they need them • Set-up door-to-door services, and protection and peer-support networks, to promote safe access to NFIs and food items.
• Improve priority lanes at distribution points for people who have mobility impairments, and systematically monitor the risks of theɈ to people with disabilities. Make wheelbarrows available at all distribution sites to support the transportation of heavy loads as well as provide water containers adapted to be carried by people with mobility impairments.
• Protection actors should monitor violations against people with disabilities and other vulnerable groups, through disability sensitive monitoring systems and through assessment of disabilityspecifi c protection threats.
• Make people with disabilities visible in protection assessments, including GBV assessments (disaggregate data at a minimum of age, gender and disability), and conduct dedicated exercises to understand the specifi c protection risks that people with disabilities face.
• Actively inform people with disabilities, and their representative groups, where and when to report protection incidents and how to get feedback on complaints.
• Inform people with disabilities about their rights as part of awareness campaigns.
• Address situations of abandonment, deprivation, isolation, robbery, and physical and verbal violence against people with disabilities through adequate protection guidelines and operational procedures • Train protection staff in disability protection issues, and train people with disabilities and their caregivers in self-protection.
• Make safe spaces accessible and provide adapted protection kits for people with disabilities.
Additional eff orts should be made to reach out to people who are not able to aɉ end those spaces and off er alternative solutions.
• Increase safe movement inside the site by consulting people with disabilities as to where the safest locations would be, and at what times, for them to receive services. Also consult people with disabilities on what safety mechanisms are needed to be put in place (for example, installing more lightening around key infrastructures and installing inner-locking doors to all shelters and sanitation facilities) in coordination with shelter and WASH actors.
• Implement accessible and inclusive campaigns and community engagement to reduce child protection risks and GBV.
• Improve the inter-cluster information sharing mechanisms to ensure that all service providers are aware of the needs of people with disabilities.
It is hoped that the recommendations resulting from this assessment, which brought to light a number of important issues facing people with disabilities living in the Bentiu PoC site, provide a basis for humanitarian actors to improve the accessibility of their services so that all may benefi t from the protection this site provides civilians.