Nabil Eid, Director of Global ICT Accessibility and Inclusion for Ruh Global IMPACT, talks about the ongoing crisis in Syria and the effect it has on people living with disabilities.

People living with disabilities are often excluded, marginalized, and forgotten during times of war. The Syrian civil war, which erupted in 2011, is one of the world’s largest humanitarian crises since World War II. After 10 years of unrest, Syria has the highest recorded prevalence of disability in conflict worldwide.

Syrian men, women, girls, and boys with disabilities, including those in neighboring countries and refugees’ camps, live in highly vulnerable situations: they face multiple and intersecting forms of discrimination, such as increased barriers to accessing support and life-saving services. They often face more protection risks than people without disabilities. At the same time, funding for an inclusive humanitarian response in Syria and for programs that service Syrian refugees with disabilities in neighboring countries is at risk.

People with disabilities often are invisible in programs delivery, ignored in refugee and Internally Displaced Persons (IDPs) assistance programs, and neglected when humanitarian and aid agencies establish targeted services, especially in fragile and conflicted settings. People with disabilities are also often unable to access mainstream assistance programs because of physical or mental barriers.

Adding to this challenging situation, community coping mechanisms, such as extended families and neighbors, are often destroyed during conflict and displacement. This leaves many civilians with disabilities vulnerable and with no assistance. Thousands of people with disabilities across Syria struggle to survive with limited or no access to essential services. 

There is an intersection between humanitarian crises and people with disabilities. People with disabilities and their caregivers are disproportionately affected by conflict and face a specific and aggravated set of challenges due to both discrimination and the barriers that limit their access to essential protection and humanitarian assistance. The intersection between gender, age, and disability can compound exclusion and, in turn, vulnerability.

People with disabilities in Syria are excluded and face psychosocial challenges. They face discrimination and physical barriers to life complicated by war. 

Despite the frequency and familiarity of the vulnerabilities of people with disabilities, international humanitarian interventions still possess a gap in acquiring people with disabilities needs, which makes accessing the much-needed support unapproachable (OCHA, 2019). “These are major and complex challenges, and unfortunately, they are not always present in mainstream humanitarian debates.”

Shocking Numbers: Prevalence Rate of People with Disabilities

Recent evidence suggests that the individual prevalence rate of people with disabilities living in Syria, aged 12 years and above, is 27%, which is almost twice that of the global average (15%).

Based on the World Health Organization and Handicap International report, about 3.7 million people are injured and living with disabilities in Syria. Nearly half of them have permanent disabilities, including 86,000 amputees. More importantly, approximately 30,000 people are added to the disabled community in Syria every month.

The key findings from the National Assessment of Disability in Syria showed that in addition to the provision of medical rehabilitation services, other environmental factors – such as physical and social barriers and the mental health of people with disabilities – are priorities to be addressed and require urgent attention through adopting a comprehensive, integrated, and multidisciplinary approach to disability-inclusive programming.

In response, various international organizations and non-governmental organizations (NGOs) have developed initiatives and established programs to increase access to rehabilitation services for people with disabilities in Syria and other regions where refugees live. However, further effective policies are needed to address the needs of disabled people in this war-torn country.

COVID 19: Risk and Limited Protection

While the COVID-19 pandemic threatens all members of society, people with disabilities are disproportionately impacted due to attitudinal, environmental, and institutional barriers reproduced in the pandemic context. Syria is no exception.

People with disabilities are known to be at an increased risk of protection and transmission of the virus. This is because they can face higher exposure rates due to the need for close contact with personal assistants/caregivers, and they can be more likely to have an underlying health condition, as well as face attitudinal, environmental, and institutional barriers to access services. Inadequate and inaccessible WASH facilities and equipment, such as hand-washing stations and hygiene kits, compounds the risk of exposure to the virus and, therefore, the development of severe illness and complications.

The recent socio-economic impact assessment of COVID-19 highlighted that emergency care services for people with disabilities had been compromised due to limited personal protective equipment and uncertainty about management protocols.

To further strengthen the inclusion of people with disabilities during the pandemic and overall humanitarian response, engagement with humanitarian leaders on practical measures related to the Humanitarian Programme Cycle (HPC) and other strategic coordination processes remains necessary.

People with Disabilities: Higher Risk During Fighting

Situations of armed conflict often force people to flee areas when violence erupts. As a consequence, people with disabilities can have a higher risk of harm.

In refugee situations, people with disabilities are particularly vulnerable. Without independent mobility, families fleeing danger may be forced to abandon their family members with disabilities, exposing them to more health and safety risks and reducing their chances of survival. For those who may manage to reach refugee camps, the situation in the camps gives rise to an increase in causes of impairment through poor nutrition and health conditions, injuries relating to conflict, accidents, burns, torture, and trauma.

Refugees and displaced persons living with disabilities are amongst the most isolated, socially excluded, and marginalized of all displaced populations in refugees camps. Some refugees and displaced persons may have lived their whole lives with a disability, and others may have become disabled during the conflict or natural disaster which led to their flight. They are “Too often invisible and forgotten.” For refugees with disabilities and their families who have fled from conflict in their country, living with physical and mental disabilities poses enormous day-to-day challenges.

“People with disabilities remain among the most hidden, neglected, and socially excluded of all displaced people today,” the Syria Relief report. “As they are often not recognized or calculated in record-keeping and data.

More than 60% of Syrian refugee households include a person with a disability, and 1 in 5 Syrian refugees has a disability, according to a new study by Human Inclusion HI and iMMAP.

Forced displacement disproportionately affects them. People with disabilities are often at higher risk of violence, exploitation, and abuse, face barriers to access basic services, and are often excluded from education and livelihood opportunities.

Disability intersects with other forms of marginalization, including gender, stigma, and abuse, making it even harder for some people with disabilities to access support and services such as food, sanitation, and health care. Children with disabilities in refugees camps are affected by armed conflict and also face severe obstacles to accessing education, support services, and assistive technology devices.

What Is Required?

In line with the principal motivation of humanitarian action, which is to save lives and alleviate suffering in a manner that respects and restores personal dignity, consideration of the specific needs of people with disabilities to services and adaptation is essential during a crises.

Inclusion of people with disabilities in the Syrian humanitarian response and the COVID-19 emergency response must be strengthened, both in terms of protection and assistance, in line with the commitments laid out in the Charter on Inclusion of Persons with Disabilities in Humanitarian Action.

People with disabilities must have equal access to essential services and protection by considering specific needs such as diverse communication methods, personal assistance/care, and individual physical contact to support daily activities and independence with physical accessibility to structures.

We must commit to supporting the needs of people with disabilities by reaching out to as many of them as possible, especially those in remote and hard-to-reach areas, refugees camps, and those who are particularly vulnerable to discrimination, exploitation, and violence, including women and girls with disabilities.

The most crucial topics to work on are accessibility, education, and employment. It is also important to monitor the inclusion of people with disabilities in conflict areas, particularly their specific needs and ability to access services. These things can be the magic turn for people with disabilities in Syria, with capacities and awareness raised.

Final Words

All people with disabilities who live in conflict-affected areas have the same rights, as enshrined in the Convention on the Rights of Persons with Disabilities (CRPD). Refugees with disabilities lack awareness of their rights; many of them are not aware of their rights and are therefore unable to demand them.

As the conflict continues in Syria and the number of injured persons rises, it’s critical to increase the capacity to deliver long-term rehabilitative care.

An inclusive humanitarian response recognizes that there are strategies to address the needs to overcome particular barriers in accessing services for every marginalized or vulnerable group. Inclusion can only be realized by recognizing that it is a core component of moral and practical humanitarian action and requires a commitment at all levels, from the coordination level to service delivery, translated into the provision of dedicated resources, appropriate funding, and deliberate action.

Refugees with disabilities are “forgotten,” “vulnerable,” and “invisible.” We must all work together today to support them.