Obindra B. Chand, Kathmandu
22 May 2020
Mass fatality may appear to be the most disturbing impact of the pandemic but it is certainly not the only impact COVID-19 has had on humanity. Almost every aspect of our life has been negatively touched by the worldwide health crisis as every individual on the planet, from presidents to paupers, remains vulnerable to the invisible enemy.
But some groups are more susceptible than the others, such as the People with Disabilities (PwDs). Be it in normal times or during a humanitarian crisis or in any emergency situation, PwDs are always faced with challenges unequally and unfairly for a number of reasons including inaccessible health systems. Not to mention attitudinal. All this could stop PwDs from reporting when they suspect having contracted COVID-19 which in turn could well endanger a wider community transmission. The population of PwDs is substantial, approximately accounting one billion worldwide, 690 million in Asia and the Pacific region, and over half-a-million in Nepal.
PwDs are high-risk groups for COVID-19 due to many underlying reasons. Pre-existing health conditions and poor hygiene practice get compounded with social health indicators. However, the World Health Organization (WHO) has suggested that barriers such as implementing essential hygiene measures including hand-washing could be a challenge as sinks may be physically inaccessible or simply because a person may have physical difficulty rubbing their hands together. They face difficulties while staying in self-isolation to.
Considering the importance and actual need of essential support amid COVID-19, the International Disability Alliance has outlined key challenges that PwDs could face during emergency and crisis. These include information on infection mitigating tips, public restriction plans and PwD-friendly accessibility. Moreover, additional protective measures must be taken for PwDs in accordance with the type of their impairments. Therefore, concerned authorities must design, develop and implement appropriate strategies, plans, programs which are friendly to PwDs during crisis times.
Considering the conditions of PwDs, several policy provisions are in place or are emerging with special provisions for improving the everyday life of PwDs. Their implementation however suggests otherwise. As a result, PwDs are facing challenges and going through hardships and these have been regular norms for their every life. The mental and psychological impact of it on PwDs is unfathomable.
The United Nations Convention on Persons with Disabilities (UNCRPD-2006), Article-11 explicitly states that the State is responsible for taking all necessary measures to ensure the protection and safety of PWDs in the situations of risk, including in humanitarian emergencies and natural disasters. As a signatory country, Nepal is obliged to follow and act on the provisions. Similarly, the Constitution of Nepal 2015, Article-18 declares that everyone is equal, and no discrimination should be made against an individual(s) based on socio-demographic characteristics and physical conditions. The Government of Nepal has also endorsed the Disaster Risk and Management Act (2017). According to the Act, special provisions should be designed and developed owing to the different needs and requirements of particularly for specific groups of people including, PwDs, senior citizens, among others, during the disaster, emergency, and crisis. The Act was developed in Nepal following the Sendai Framework for Disaster Risk Reduction (2015-2030), a comprehensive and inclusive framework for mitigation of the risk during the disaster, emergency, and health crisis.
Realizing the present situation, like IDA, National Federation of Disabled-Nepal (NFDN), an umbrella association of disabled people organizations in Nepal, has drawn the attention of the Government of Nepal at all levels and introduced a guideline ‘A General Guidelines for Persons with Disabilities and All Stakeholders on Disability Inclusive Response Against COVID-19 Pandemic.’
This guideline has clearly focused on the problems and challenges PwDs are facing in the face of COVID-19 and lock-down along with the possible solutions that could address the problems and challenges that PwDs are undergoing. For instance, the Government of Nepal has circulated Information Education and Communication (IEC) materials for promoting information and awareness about the control and prevention of COVID-19, which is crucial for several reasons at the time when the entire world is battling against the virus. Thus, for ensuring accessibility of all the available information, including web/digital materials containing information on prevention and control of COVID-19 for all citizens, appropriate measures should be adopted.
The Government of Nepal recently started using sign language interpreters during its regular COVID-19 briefings. This is undoubtedly a welcome step of the Ministry of Health and Population ensuring crucial information without which a certain section of PwDs may well be caught unawares by coronavirus. However, this is not enough; disability-friendly approach should be extended to and endorsed in many other areas as well. Moreover, the lockdown is even further complicating PwDs of the country. Nepal has been in complete lock-down around two months now and likely to be extended more. This has created complicated situation for PwDs to access essential medicines and medical aid, for instance, accessing urine bags, diapers among others.
The Government has decided to distribute ‘Relief Food Package’ to ease the life of vulnerable groups of people during lock-down. However, considering the everyday needs of the different kinds of PwDs, regular medical aid/medicines or instruments such as regular therapeutic services, catheters, urine bags, diapers, among others, are more essential than ‘Relief Food Package’ for regulating their everyday lives. These instances have evidently exemplified the critical situation that PwDs have been living through pandemic and subsequent lock-down in the country.
This calls for urgent actions to translate policy provisions into concrete actions and implement the provisions effectively, which then would address the unique needs and requirements of particular groups in coordination and support at all three governments along with Disabled People Organizations, NGOs, implementing partners and donors. Collectively identifying the population and problems of PwDs at the community level would be the first step. Then, coordinate and collaborate with different bodies working in both thematic and geographic areas, locally and invite for implementing disability-friendly programs and packages in coordination with local government and local health systems effectively and efficiently would be another step. This could lead to address the regular yet critical needs of PwDs in their homes via communities. If the issues of PwDs are not taken seriously at the moment, it will pose a threat to the community, country that would ultimately risk the entire world. Finally, overcoming the COVID-19 demands collective and collaborative effort from all. Pandemic has not only left differential impact on PwDs but also it has opened an opportunity for building more inclusive and accessible health system that cater the needs and requirements of diverse groups of people including PwDs both in usual situation or an emergency and crisis period.
Obindra B. Chand is a health and social science researcher at HERD International (www.herdint.com), a research and development institute based in Kathmandu.