Focus: Risk, resilience and inclusive humanitarian action
By Maria Kett
Assistant Director, Department of Epidemiology and Public Health, Leonard Cheshire Disability and Inclusive Development Centre, University College London
Article 11 of the Convention on the Rights of Persons with Disabilities compels States parties to “ensure the protection and safety of persons with disabilities in situations of risk, including situations of armed conflict, humanitarian emergencies and the occurrence of natural disasters.”
In an emergency – whether armed conflict or a natural or human-made disaster – children are among those most vulnerable to the loss of food, shelter, health care, education and age-appropriate psychosocial support services. This vulnerability can be even more acute for children with disabilities: Even where basic supplies and relief services are available, they may not be inclusive or accessible.
Knowing how many children with disabilities live in an area affected by an emergency is extremely challenging, because accurate numbers may not have existed even before the emergency. Parents or communities may hide such children because of stigma, for example. The resulting exclusion is of particular concern because even the most rudimentary reporting systems can unravel in humanitarian situations, since registration and reporting points or centres may not be accessible.
At the same time, increasing numbers of children may sustain disabling injuries as a result of chronic or sudden emergencies. In an earthquake, children may be disabled by falling objects or when buildings collapse. They may receive crushing injuries and undergo psychological trauma during floods and land- slides. Conflict increases the likelihood that children will become disabled as a result of fighting, because of landmines, or through exposure to other explosive remnants of war (ERW). Because children are smaller and at earlier stages in their development, they often sustain more seriously disabling injuries than adults and require continuing physiotherapy, prostheses and psychological support.
The challenges facing children with disabilities and their families are rarely acknowledged when the impact of an emergency is assessed. These challenges include new environmental barriers such as collapsed ramps; damaged or lost assistive devices; and the loss of previously established services (sign language interpreters or visiting nurses) or support systems (social security payments or social protection schemes).
There are other risks. If family members die, there may be no one left who knows how to care for a child with a physical disability or who can communicate with a child with a sensory impairment. If families are forced to flee, especially if they face a long journey by foot, they may leave behind children who are unable to walk or are in frail health. Families may also leave behind children with disabilities because they fear they will be refused asylum in another country if one of their family members has a disability. Several countries practise such discrimination. Institutions and residential schools may close or be abandoned by staff, leaving few people – or no one – to help the children in their charge.
Children with disabilities, especially those with learning disabilities, can also be directly involved in conflict. They may be pressed into service as fighters, cooks or porters precisely because they are considered to be less valuable, or less likely to resist, than children without disabilities. In theory disarmament, demobilization and reintegration programmes include all child ex-combatants, but resources or programmes for children with disabilities are often non-existent. These children therefore remain marginalized and excluded, leaving them poor, vulnerable and often having to beg, as has been the case in Liberia and Sierra Leone.
The risk of violence, including sexual violence, increases when family protection and social structures break down as they do during conflict and disasters. While girls with disabilities are at particular risk in such situations, boys with disabilities are also at risk and are even less likely to be helped in the aftermath of violence.
Recovery and reconstruction come with their own challenges for children with disabilities. As is the case with all crisis-affected children, those with disabilities require a range of services, including but not limited to targeted ones. Disability-specific needs are extremely important, but they are only part of the picture. During recovery operations after the 2004 Indian Ocean tsunami, for example, one girl with a disability was given five wheel-chairs – but no one asked her if she needed food or clothes.
Resilience and inclusion
Children have repeatedly demonstrated their resilience. Measures can be taken to support their participation and inclusion. These measures should be specific to particular groups and contexts: Boys and girls have different experiences of conflict, as do young children and adolescents. Similarly, emergencies can affect urban and rural areas differently.
As a starting point, children with disabilities should be given the opportunity to take part in the planning and implementation of disaster risk reduction and peace-building strategies as well as in recovery processes. Ignorance and incorrect assumptions that they are unable to contribute have often barred them from doing so, but this has begun to change. In Bangladesh, for example, Plan International learned to challenge such misconceptions through partnerships with disability organizations and by working directly with communities in undertaking child-centred disaster risk reduction.
Similarly, provision for children with disabilities is increasing in disaster response. In Pakistan, Handicap International (HI) and Save the Children built child-friendly inclusive spaces and developed sector-wide guidance on inclusion of persons with disabilities, especially in protection projects. In Haiti, HI and the faith-based development organization CBM lobbied the government to increase the inclusion of persons with disabilities in food distribution and other efforts. The United Nations often uses emergencies as an opportunity to ‘build back better’, an approach that can yield opportunities for children with disabilities because it offers all stakeholders a chance to work together.
Disability is also being mainstreamed in such guidelines as the Sphere Project’s Humanitarian Charter and Minimum Standards in Humanitarian Response, framed by a group of international organizations to improve the quality and accountability of humanitarian response. The availability of emergency guidelines on how to include people with disabilities – and children in particular – is increasing. These gains need to be consolidated and extended to such areas as child nutrition and protection.
Also needed is a unified approach to data collection. Collaboration with local and national disabled people’s organizations should be emphasized, and these groups’ capacity to address issues specific to children should be built up where necessary. And the extent to which children with disabilities are included in humanitarian response must be audited to monitor and improve results.
Clear standards and inclusion checklists that can be applied across the range of emergencies will be essential – but to be put into practice, they must be accompanied by resource allocations.