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"We bear it and accept our fate” Perceptions of healthcare access from people with disabilities in Cox’s Bazar

PANELLA, Amanda
June 2022

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In November and December 2021, Ground Truth Solutions (GTS) and the International Organisation for Migration’s (IOM) Needs and Population Monitoring unit (NPM) conducted qualitative interviews with persons with mobility and vision impairments from Rohingya refugee and host community populations with the aim of better informing and supporting agencies in developing disability-inclusive programmes and engagement activities. These interviews focused on access to health services, aiming to gain insight into how people with disabilities experience engaging with healthcare services – as well as perceived barriers to access. It also looked at health information needs so that the humanitarian community will be better equipped to identify gaps in programming, deliver more equitable services, and build trust with this marginalised group. To weave tangible experiences into the narrative and bring findings to life, this research took a ‘user journey’ approach to create a set of ‘personas’ derived from key informant interviews with Rohingya and Host Community people with disabilities in Cox’s Bazar, resulting in this highly illustrative report.

UNHCR Facilitator’s Guide - Strengthening Protection of Persons

UNITED NATIONS HIGH COMMISSIONER FOR HUMAN RIGHTS (UNHCR)
July 2021

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This guide is designed to support UNHCR staff, partners and other stakeholders at field level to:

  • Recognize the protection concerns and capacities of refugees with disabilities and other persons with disabilities protected and assisted by UNHCR;
  • Apply the principles reflected in the UN Convention on the Rights of Persons with Disabilities (UNCRPD) and UNHCR Guidance on Working with Persons with Disabilities to a range of programs and sectors;
  • Design immediate and long-term strategies to mitigate protection risks and promote the inclusion of persons with disabilities in UNHCR programming.

 

The four modules include:

  • Introductory module - Organizing an accessible and inclusive workshop (Module 1);
  • Promoting a rights-based approach to disability (Module 2);
  • Raising awareness about the impact of forced displacement on persons with disabilities (Module 3);
  • Learning key strategies to foster inclusion of persons with disabilities in forced displacement (Module 4). 

Musculoskeletal impairment among Syrian refugees living in Sultanbeyli, Turkey: prevalence, cause, diagnosis and need for related services and assistive products

BOGGS, Dorothy
ATIJOSAN-AYODELE, Oluwarantim
YONSO, Hisem
et al
April 2021

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Epidemiological data on musculoskeletal impairment (MSI) and related service and assistive product (AP) needs for displaced populations are lacking. This study aimed to estimate the prevalence, aetiology, and specific MSI diagnosis and the need for related services and APs among Syrian refugees living in Sultanbeyli, a district in Istanbul, Turkey.

A population-based survey used probability proportionate to size and compact segment sampling to select 80 clusters (‘street’) of 50 individuals (aged 2+), for total sample size of approximately 4000 participants. An updated version of the Rapid Assessment of MSI tool (RAM) was used to screen all participants using six questions. Any participant who screened positive underwent a standardised examination by a physiotherapist to assess the presence, aetiology, severity and specific diagnosis of MSI and an assessment of need for related services and APs.

 

Conflict and Health volume 15, Article number: 29 (2021)

https://doi.org/10.1186/s13031-021-00362-9

Disability & inclusion survey, Malakal Protection of Civilians site

International Organization for Migration’s Displacement Tracking Matrix (IOM DTM)
February 2021

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The International Organization for Migration’s Displacement Tracking Matrix (IOM DTM), Protection and Mental Health and Psycho-Social Support teams joined efforts with Humanity & Inclusion (HI) to undertake an assessment of the level of access to services and the barriers faced by persons with disabilities within Malakal Protection of Civilian site (PoC site). The United Nations High Commissioner for Refugees (UNHCR) and the Danish Refugee Council (DRC) contributed to the qualitative component of the study as the main Protection and Camp Coordination and Camp Management (CCCM) actors operating within the PoC site. The study, based on data collected between March 2020 and June 2020, aims to improve the knowledge base available to the humanitarian community about access to services by persons with disabilities living in the site. It provides a quantitative estimate of the prevalence of disabilities among the IDP population and an assessment of the barriers faced by persons with disability in accessing humanitarian services across sectors. It also seeks to empower persons with disabilities living within the PoC site, giving them the opportunity to express their concerns and preferences with regards to possible solutions and targeted interventions. It is hoped that the resulting data will help camp management and other service providers operating within Malakal PoC site, including IOM, UNHCR and DRC, to better account for the concerns and needs of persons with disability in humanitarian programming and service delivery. This study builds onto and expands previous studies in Naivasha IDP Camp (formerly Wau PoC AA Site) and Bentiu PoC Site.

Considering age and disability in the Rohingya response

ASSESSMENT CAPACITIES PROJECT (ACAPS)
February 2021

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This report evaluates existing data on the Rohingya refugee response. It highlights the key challenges and constraints faced by persons with disabilities (PwD) and older people in accessing essential services and explores how COVID-19 and related containment and risk mitigation measures have affected humanitarian programming for PwD and older people. It also identifies information gaps and challenges linked to disability prevalence in the camps

 

This secondary data review focuses on the Rohingya refugee camps in Cox’s Bazar and combines publicly available secondary data with 11 key informant interviews conducted with age and disability experts working on the humanitarian response. The interviews took place between 1 July–30 August 2020 with experts from the UN, national NGOs, INGOs, and the International Red Cross and Red Crescent Movement.  

Minimum standards for camp management

CAMP COORDINATION AND CAMP MANAGMENT (CCCM) CLUSTER
2021

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In a humanitarian crisis, camps and camp-like settings are often the only places where internally displaced persons (IDPs) and refugees can seek protection and assistance.


These Minimum Standards for Camp Management describe the minimum actions needed to support meaningful engagement within a site as well as planning and coordination between sectors and agencies. They aim to clarify the role of any site management agency working on a daily basis in humanitarian settings and to set out minimum levels of quality of that work. Although called the Minimum Standards for Camp Management, the standards apply to all contexts where displaced people seek shelter, protection and other support, and the term “site” is used unless a specific camp context is meant.

 

Annex 1 provides a disability inclusion monitoring checklist. This checklist is not exhaustive nor meant to replace participatory approaches but can be used as a complementary tool by site managers willing to assess the overall inclusiveness of a site, or as a tool to support the development of an inclusive strategy for persons with disabilities.

Disability inclusion annual report 2020

UNITED NATIONS RELIEF AND WORKS AGENCY (UNRWA)
December 2020

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The number of Palestine refugees registered by UNRWA recently grew to 5.7 million (from 5.5 million in 2019) in all its five field of operations in Jordan, Lebanon, Syria, Gaza and the West Bank. Among them are Palestine refugees with disabilities, who have long-term impairments, which in interactions with attitudinal, institutional, and environmental barriers prevent their full and effective participation on an equal basis with others in society. Persons with disabilities constitute an estimated 15 per cent of the global population1, and may constitute a higher percentage in humanitarian contexts, such as Syria, the West Bank and Gaza, in particular, which are UNRWA fields of operations.

 

The main actions undertaken in 2020 discussed in the report are:

  • targeted and disability-specific services for persons with disabilities
  • disability inclusion through programmes
  • inter-agency coordination
  • international protection advocacy

Leave no refugee behind - Inclusion and forced migration

LIGHT FOR THE WORLD
October 2020

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By WHO estimates, at least 12 million forcibly displaced people worldwide have a disability. Displaced persons with disabilities face violence, discrimination and barriers to services at a higher rate than other refugees and internally displaced persons (IDPs). Humanitarian actors have to protect the rights of persons with disabilities in contexts of forced migration. This must include accessible services as well as active participation of refugees and IDPs with disabilities in decision-making structures.

 

This Issue Brief covers the situation of forcibly displaced persons with disabilities, policy framework and legal requirements, and the work of Light of the World in this area (mainly in South Sudan). 

How can we ensure the safety and wellbeing of children with disabilities during humanitarian crises? - Evidence brief

QURESHI, Onaiza
September 2020

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This brief reviewed evidence-based recommendations on how to ensure the safety and wellbeing of children with disabilities in humanitarian settings. The right to safety for all is enshrined in Article 11 of the CRPD, yet this population has been consistently neglected in the global literature around children affected by disaster and crises, and as such the recommendations made are limited to specific humanitarian settings (e.g., natural disasters, war and conflict) and towards children with physical and mobility challenges. There is a need to further explore their diverse needs and experiences by recognising them as independent actors who can meaningfully participate in and contribute to the development of services and policies targeted towards them

The digital lives of refugees and Kenyans with disabilities in Nairobi: A human-centred design approach to identifying mobile-enabled opportunities

HAMILTON, Zoe
CASSWELL, Jenny
ALONSO, Aline
July 2020

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This research focuses on disability, using human-centred design methods to better understand how refugees and Kenyans with visual and hearing impairments in Nairobi use mobile technology and potential opportunities that it could provide.

The target populations for the project were urban refugees and host communities with visual or hearing impairments in Nairobi, Kenya. 

 

This report is divided into four main sections, following an introduction, the second section focuses on insights learned from the hearing impaired, the third on the visually impaired and the fourth highlighting issues that were cross-cutting insights across both groups. Sections two and three include insights related to mobile, health and financial services. The fourth section includes insights related to humanitarian and disability support services

 

COVID-19 in humanitarian contexts: no excuses to leave persons with disabilities behind! Evidence from HI's operations in humanitarian settings

HUMANITY & INCLUSION (HI)
June 2020

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This collection and review of evidence aims to illustrate how the COVID-19 crisis triggers disproportionate risks and barriers for persons with disabilities  (men, women, boys and girls) 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 hostcommunities.

 

Evidence has been collected through primary data collection among HI teams and partners, working in countries impacted by the COVID-19 pandemic in April/May 2020. Data was extracted from assessments conducted by HI and partners in Bangladesh, Egypt, Haïti, Indonesia, Philippines, Jordan, Lebanon, Somaliland and Togo. Testimonies from affected communities, staff and partners were collected in Kenya, Myanmar, Pakistan, Palestine, Philippines, Somaliland, South Sudan, Rwanda, Thailand, Uganda and Yemen.  

 

Displaced persons with disabilities face additional challenges to protect themselves and their families and barriers to access services, in camps that were not built for COVID-19

Policy Brief: COVID-19 and People on the Move

UNITED NATIONS
June 2020

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COVID-19 leaves few lives and places untouched. But its impact is harshest for those groups who were already in vulnerable situations before the crisis. This is particularly true for many people on the move, such as migrants in irregular situations, migrant workers with precarious livelihoods, or working in the informal economy, victims of trafficking in persons as well as people fleeing their homes because of persecution, war, violence, human rights violations or disaster, whether within their own countries — internally displaced persons (IDPs) — or across international borders — refugees and asylum-seekers.

 

The disproportionate impact of the COVID19 pandemic on people on the move presents itself as three interlocking crises, exacerbating existing vulnerabilities: a health crisis; a socio-economic crisis and a protection crisis.

 

This Policy Brief offers four basic tenets to guide collective response:

  • Exclusion is costly in the long-run whereas inclusion pays off for everyone
  • The response to COVID-19 and protecting the human rights of people on the move are not mutually exclusive
  • No-one is safe until everyone is safe
  • People on the move are part of the solution

Disability Inclusive Development - Kenya Situational Analysis

ROHWERDER, Brigitte
June 2020

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This situational analysis (SITAN) addresses the question: “what is the current situation for persons with disabilities in Kenya?”. It has been prepared for the Disability Inclusive Development programme (which works on access to education, jobs, healthcare, and reduced stigma and discrimination for persons with disabilities in Bangladesh, Jordan, Kenya, Nepal, Nigeria, and Tanzania), to better understand the current context, including COVID-19, and available evidence in Kenya. It will be helpful for anyone interested in disability inclusion in Kenya, especially in relation to stigma, employment, education, health, and humanitarian issues. This SITAN has been briefly updated from the April 2019 SITAN.

Disability Inclusive Development - Tanzania Situational Analysis

ROHWERDER, Brigitte
June 2020

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This situational analysis (SITAN) addresses the question: “what is the current situation for persons with disabilities in Tanzania?”. It has been prepared for the Disability Inclusive Development programme (which works on access to education, jobs, healthcare, and reduced stigma and discrimination for persons with disabilities in Bangladesh, Jordan, Kenya, Nepal, Nigeria, and Tanzania), to better understand the current context, including COVID-19, and available evidence in Tanzania. It will be helpful for anyone interested in disability inclusion in Tanzania, especially in relation to stigma, employment, education, health, and humanitarian issues. This SITAN has been briefly updated from the April 2019 SITAN.

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