Analysing risks and barriers to the inclusion of persons with disabilities in humanitarian action

Reducing risk, improving resilience and increasing protection

Persons with disabilities face barriers that increase risk in humanitarian contexts. “Barriers can be either classified as a threat if put in place purposefullyby an actor or as a vulnerability if happening as an inadvertent act. In both cases, these barriers lead to exclusion, which increases the likelihood of personswith disabilities to face threats and vulnerabilities at a higher level than the rest of the crisis-affected population.”41 By making use of enablers (such as support services in camps, facilitated access to food distribution points, or acquisition of assistive devices),persons with disabilities can improve their individual resilience. Falling risk and rising resilience imply improved protection.

What you should know in order to address barriers

This section describes general barriers faced by persons with disabilities during humanitarian crises. Chapters 11 to 18 outlinesector-specific barriers. To identify key actions and measures effectively, and plan and implement accessible and inclusivehumanitarian programmes, it is vital to understand disability, accessibility and the concept of barriers.

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Diagram 3 Barriers and enablers to inclusion of persons with disabilities in humanitarian action

Image Description

Diagram depicting how barriers and enablers impact risk and resilience for persons with disabilities.

Person with impairment + barrier = risk. To reduce risks, you need to eliminate barriers.

Person with impairment + enabler = resilience, safety, protection. Resilience is improved when you identify and use enablers.

Image description end

Persons with disabilities frequently face attitudinal, environmental and institutional barriers in their daily lives. Humanitariancrises exacerbate these and may create new ones, further reducing their access to assistance and protection and hinderingtheir participation in humanitarian action. It is also important to recognize that persons with the same impairment may experiencebarriers differently, for many reasons including their sex, age, culture or socioeconomic status. The complex forms and characterof multiple and intersecting discrimination and disability require a multi-criteria risk assessment.

The left-hand column of the table below lists barriers that occur in humanitarian contexts. The right-hand column describesa disability-inclusive response. The list is not exhaustive; more information on barriers can be found in chapters 11 to 18.

A. Attitudinal barriers in humanitarian contexts. Social misconceptions or prejudices against persons with disabilities may generate incorrect assumptions.

Examples of barriers and misconceptions Examples of enablers and appropriate assumptions
All persons with disabilities died because they were unable to flee. While some persons with disabilities died, many were able to flee. They are disproportionately represented among survivors.
Persons with disabilities are victims who need to be fully assisted. Persons with disabilities need assistance just like any other group in the affected population, but they have capacities, resources and a voice, and many can contribute to humanitarian action.
Persons with disabilities have medical conditions and all need medical care. Persons with disabilities have the same needs as others, and some may require specific medical attention. However, not all persons with disabilities will require medical care.
Health and medical services exclusively meet disability-specific requirements, such as provision of wheelchairs and assistive devices. Humanitarian actors can deliver assistive devices through a range of channels. They must nevertheless understand what types of devices persons with disabilities require to increase their ability to function in the context and increase their capacities and resilience.
Persons with disabilities are unlikely to be able to make decisions; others are likely to need to take decisions for them in their best interest. Persons with disabilities have the right to take decisions on issues that affect them, and most can do so. Some, including those with psychosocial or intellectual disabilities, may require support to understand and make decisions.
Persons with disabilities cannot work and therefore humanitarian organizations do not hire them. Persons with disabilities can work and can make valuable contributions. It is important to discuss with them directly to identify their skills and interests.
Persons with disabilities make people around them uncomfortable. This may be the case, where high levels of stigma and misunderstanding exist. It is important to conduct awareness-raising and sensitization to challenge negative beliefs.
Providing reasonable accommodation for persons with disabilities is too hard, too expensive. It is someone else's responsibility. Accommodating the requirements of persons with disabilities can be easy if you know what they need and how to provide it. Ask them. In most cases, simple low-cost solutions can be found. All humanitarian actors have a responsibility to ensure that their programmes are accessible and to provide accommodations where necessary.
Local culture is often one source of prejudice and stigma against persons with disabilities. Identify cultural and social barriers and address them in a culturally acceptable way.

B. Environmental barriers in humanitarian contexts. Some environmental barriers are likely to be present already. Humanitarian actors and local populations may unintentionallycreate others.

Examples of barriers Examples of enablers
Registration and distribution points are located far away, uphill, across difficult terrain; transport is inaccessible. Place registration and distribution points in locations everyone can access. If this is not possible, provide transport or deliver services to individuals who cannot reach distribution points.
Food packages are too heavy to be carried by persons with disabilities. Identify support people to collect and carry the food packages of persons with disabilities.
The latrine blocks are too narrow to accommodate a wheelchair and support person. Design and procurement documents foresee latrines that are wheelchair accessible.
Tents and temporary shelters have steps and narrow entrances. Design and procurement documents foresee temporary shelters that are wheelchair accessible.
Water points have elevated pumps that are difficult to operate. Design and procurement documents foresee accessible water pumps. (Note that support may be required even for accessible designs.)
Coordination meetings take place in inaccessible buildings that fail the ‘Reach, Enter, Circulate and Use’ principle.42 The response makes sure that coordination meetings are convened in buildings and at sites that are accessible.
Information about humanitarian assistance is provided using only one medium of communication (for example, oral or written messages or posters). Information about humanitarian assistance is provided in multiple accessible formats (oral, print, sign language, easy-to-read/plain language, etc.). Human assistance is provided to those who need it to access information.
Humanitarian frameworks, codes of conduct and other key documents are not available in multiple accessible formats, including easy-to-read/plain language formats. Key documents are made available in multiple accessible formats, including easy-to-read/plain language formats.
Consultations with the community (through focus group discussions, feedback and complaint mechanisms, etc.) are not conducted in multiple formats, and persons with hearing, psychosocial or intellectual disabilities are not supported to understand or participate in them. Consultations are conducted in a range of formats, and persons with hearing, psychosocial or intellectual disabilities are supported to participate in community consultations, focus group discussions, feedback and complaint mechanisms.

C. Institutional barriers and enablers in humanitarian contexts. In many countries, few or no policies promote or ensure the inclusion of persons with disabilities.

Examples of barriers Examples of enablers
Government policies and legal frameworks relevant to humanitarian action and the policies of humanitarian organizations do not promote or ensure the inclusion of persons with disabilities. Government policies support inclusive approaches aligned with the CRPD. Where appropriate, UN entities, UN country teams and UN humanitarian country teams comply with the UN Disability Inclusion Strategy (UNDIS).
Cash-for-work programmes and other employment programmes do not consider the abilities of persons with disabilities and do not employ them. Cash-for-work and other employment programmes consider the abilities of persons with disabilities and support services are respectful of their autonomy (and provide personal assistance or interpretation).
Trained and qualified service providers and skilled staff (such as teachers and physicians) are not available. Recruitment documents consider inclusion and encourage disability-specific experience. Programmes train staff in principles of inclusion and practical ways to promote it.
Inclusion is not a donor requirement. OECD-DAC and a growing number of other donors include disability markers and want to focus more on persons with disabilities.43 UN entities will be obliged to report on their disability performance under the UN Disability Inclusion Strategy.
Recruitment documents for humanitarian posts require applicants to be in ‘good health’ and may exclude persons with disabilities on the grounds that disability is a health issue. Recruitment policies comply with CRPD standards and evaluate candidates based on their capacity to deliver the core functions of the advertised job, with support if required.44
National laws prevent persons with disabilities from opening bank accounts (which can prevent them from accessing cash-based assistance), obtaining loans or credit, or owning land. The response works with the government to develop inclusive policies aligned with the CRPD. It works with financial entities to make it easier for persons with disabilities to obtain cash safely and legally until new laws or the courts allow them to open bank accounts.
The legal capacity of persons with disabilities is restricted,45 reducing their access to legal protection, as well as their authority to take decisions and give free and informed consent. Government supports inclusive policies aligned with the CRPD. Support persons and services are available to support persons with disabilities to make informed decisions, with safeguards to ensure they do not take decisions under duress. The policies of humanitarian organizations do not impose barriers based on legal capacity.
Humanitarian organizations have no disability-inclusive policies and lack accountability mechanisms to measure their performance on disability inclusion. This inhibits the development of an organizational culture that properly supports persons with disabilities. Policies ensure the inclusion of persons with disabilities. Accountability mechanisms measure improvements in performance. The UNDIS guides humanitarian organizations as they develop inclusion frameworks.46
The humanitarian structure has no Area of Responsibility (AoR) for disability. Disability is a standing agenda item in protection and inter-agency meetings. A person is appointed with responsibility for disability.
Needs assessments are not disaggregated by disability. This hinders understanding of the extent to which persons with disabilities experience particular risks. Persons with disabilities are targeted in needs assessments. Data are disaggregated and risks are evaluated in detail.

An inclusive response requires several levels of intervention. Given that persons with disabilities have specific requirements,the CRPD advocates planning on two axes: (i) to progressively develop accessible and inclusive environments and interventions;and (ii) to deliver customized solutions that enable persons with disabilities to participate immediately.

When no mainstream solutions are available, actors should be ready to provide reasonable accommodations to meet the requirementsof persons with disabilities.

To explain how humanitarian actors can balance mainstream or structural solutions and individual accommodations, consideraccessibility. A humanitarian actor that wants to improve accessibility usually does so in steps. It (i) initiates an assessment;(ii) evaluates alternative actions; (iii) prepares a procurement process and documents; (iv) buys or acquires goods, facilities,materials, technologies, etc; and (v) distributes and delivers the chosen goods or services against a planned timetable orschedule. Because denying reasonable accommodation is discrimination, the humanitarian actor also must offer individual solutionson demand.

Bridging the gap between accessibility and individual adjustments

A programme or service is accessible if... Reasonable accommodation is achieved if...
It can be implemented promptly. It can be provided immediately (avoiding discrimination).
It offers a general solution. It is an individual solution.
It is available and accessible regardless of whether it is required. It is delivered when a person with disabilities requires it, and when they cannot otherwise obtain access to it.
It is guided by general principles of universal design. It is tailored to meet the person's requirements and designed together with the person.
It meets accessibility standards. It meets a proportionality test.

A reasonable accommodation is an individual measure that benefits a specific person – but may also bring wider benefits. Forinstance, a path that is made accessible for one person can subsequently be used by many. The same may be true of changingthe procedure for obtaining cash transfers, reorganizing food distribution methods, or reorganizing work to meet the needsof a colleague with a disability. (See Annex 1: Providing reasonable accommodations.)

Accessibility provides just one example of reasonable accommodation. Accountability procedures may be adjusted for certainpersons who cannot maintain their attention for long periods; cash for money programmes might extend the time slots they offerto accommodate the requirements of a person for whom travel is a significant barrier, etc.47