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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

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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.

“Persons with disabilities are affected psychologically and physically by the COVID-19 crisis. They are negatively impacted by protective measures; they spend all the day at home because some of them, especially children with disabilities, older persons and persons with some physical impairments, have underlying health issues or poor immune systems”, says Reham, HI Rehabilitation Technical Advisor in the Gaza Strip (Palestine).

Reham's account on the situation of persons with disabilities in the midst of the pandemic also highlights the impact on the physical and psychological wellbeing of persons with disabilities as well as their protection, in at-risk countries affected by the COVID-19 pandemic.

“Being at home for a long period of time, unable to access services, can cause stress and depression. Persons with disabilities might feel anxious and fear catching the virus, especially when they cannot afford protective equipment or depend on a support person for daily activities. Children with disabilities who stopped going to schools can face domestic violence at home due to their isolation or change in routine”.

Reham is also witnessing the economic impact of the pandemic on the livelihoods of persons with disabilities:

“Daily workers and those with temporary contracts have lost their source of income. This creates a lot of distress as they do not know how to support their families or buy their medications.”

While persons with disabilities are estimated to represent 15% of the world’s population, in countries where conflicts and humanitarian crises are ongoing, these figures may be much higher. In Syria for instance, this figure doubles as the latest estimates show that 30% of the population aged 12 are persons with disabilities. In Aleppo governorate, 59% of women and 27% of men are persons with disabilities. Across the country, 99% of women and 94% of men over the age of 65 years have a disability

In conflict, disaster affected or fragile countries, the pandemic increases the risks and discrimination against certain groups. The pandemic, including public restriction plans, leads to the collapse of health and social support systems (such as home-based assistance or community support for accessing distributions). Persons with disabilities face additional risks and challenges to access information and assistance. Structural inequalities in interaction with crisis-specific barriers lead to higher risks of contracting the virus and developing severe cases of COVID-19 for certain groups. According to the UN Secretary General, “persons with disabilities generally have more health-care needs than others – both standard needs and needs linked to impairments – and are therefore more vulnerable to the impact of low quality or inaccessible healthcare services than others. Compared to persons without disabilities, persons with disabilities are more likely to have poor health: among 43 countries, 42% of persons with disabilities versus 6% of persons without disabilities perceive their health as poor”.

Moreover, evidence from the Ebola outbreak in 2014 shows that the diversion of resources towards the fight against the epidemic may hamper the provision of critical humanitarian assistance and have negative consequences on public health. The Ebola response, for example, detracted resources dedicated to care for other health issues or diseases such as cholera, malaria or HIV/Aids.

COVID-19 exacerbates barriers faced by the most at risk groups, especially persons with disabilities, to access services, such as health, water, sanitation, shelter and food, and to stay safe. The Global Humanitarian Response Plan on COVID-19 has identified persons with disabilities as the most affected population groups in the 63 countries covered by the plan. Moreover, as a humanitarian organisation engaged in the response in more than 20 countries experiencing humanitarian crises, we often witness that men, women and children with disabilities fall between the cracks of humanitarian response. Multiple risks are created by the intersection of disability, gender and age factors, such as women and girls with disabilities facing particular protection risks or older persons with disabilities facing denial of access to health services. Other risk factors include ethnicity, displacement, access to documentation, or health status.

Various legal instruments and policy frameworks call for humanitarian actors to identify and respond to the needs and rights of persons with disabilities who are particularly at risk of being left behind in humanitarian settings, including during the COVID-19 crisis. Today, these commitments and recommendations must be put into action to scale up an inclusive preparedness and responses to COVID-19, during all stages and at all levels of intervention.