Features
6 MIN READ
Research shows that disabled people are unequally affected during health emergencies, and this phenomenon is particularly acute in low and middle income countries.
A recent conversation I had with a young visually impaired person left me deeply upset. This young man, who is also an executive member of the Disabled People’s Organization (DPO), told me how most of the time, whenever he is introduced to a new person, he is ridiculed for his physical disability.
Referring to blind street performers as “his friends” is the most common jibe taken at him, he said. The problem he has with such statements is that they not only belittle the people who make a living out of singing at roadsides but also disrespect the hard work disabled people put in to become self-sustainable.
Such instances make it clear that in Nepal, while people’s understanding of the term ‘disability’ has changed over the years, their perception has not. And it should come as no surprise that people with disabilities continue to face extensive exclusion in society. From not getting access to the most basic of human necessities, like education, to not getting access to essential health care services, disabled people are disadvantaged by society itself.
Further, inaccessible structures and inadequate programs for people with disabilities, combined with prejudices and superstitious beliefs, have made it difficult for them to get jobs or engage in entrepreneurship. They do not just undergo challenges in their daily lives but are also unevenly affected during humanitarian crises and health emergencies, such as the current Covid-19 pandemic. For a population that already finds it challenging to make ends meet, the Covid-19 pandemic has only further intensified the challenges they face in Nepal.
According to a 2019 World Health Organisation report, people with disabilities are at a higher risk of contracting Covid-19, primarily because of physical barriers to hygiene facilities; the compulsion to touch things; difficulties in enacting social/physical distancing; and difficulty in accessing information.
Research has consistently shown how disabled people have been unequally affected in past pandemics as well and the situation is not any different this time around. This is particularly acute in Low-and Middle-Income Countries (LMICs) and low-resource settings where 80 percent of the total population of people with disabilities live with minimal facilities to support their daily lives.
Globally, about a billion people with 690 million in Asia and the Pacific and over half a million in Nepal live with different forms of disability. However, the degree of the challenges and exclusion they face varies with culture, context, community, country, and the region where they live.
In Nepal, the Disabled Protection and Welfare Act 1982 has been crucial in terms of addressing the issues and concerns of people with disabilities, with a focus on equal treatment and employment rights. Subsequently, several other policy provisions have been formulated to address the issues and concerns of disabled people. Nepal is also signatory to the United Nations Conventions on Rights of Persons with Disabilities (UNCRPD-2006), under which the government must establish the right to work on equal footing with their non-disabled counterparts.
More recently, the National Employment Policy 2015 too recognized the rights of people to participate in employment, entrepreneurship, and employment‐related training. More recently, the Health Sector Emergency Response Plan for Covid-19 asks that quarantine facilities should ensure the special needs of vulnerable groups, including the disabled. Further, risk communication messages too were advised to be designed and developed in accessible formats suitable to different types of disabled people.
While the country’s policies are very encouraging, the lived experience of disabled people suggests that legal provisions alone are not enough to ensure the livelihood of the target population.
The absence of effective implementation of the legal provisions -- for several reasons such as lack of political commitment, inadequate understanding of the issues coupled with limited allocation of resources (financial or otherwise) -- have led disabled people to face additional challenges to get work.
The limited research that is available suggests that the unemployment rate is higher among people with disabilities. Thus, disabled people are more likely to live in poverty. One can only imagine the hardship that has befallen them during the pandemic.
The situation is more challenging for those who have multiple disabilities along with other intersectional identities. For instance, an uneducated disabled Dalit/Madheshi/indigenous woman from a rural community experiences multiple layers of exclusion.
Experts suggest that Covid-19 poses a double threat to disabled people. Researchers have seen the presence of the virus to be higher in those groups that are on regular medication and need assistance in maintaining personal hygiene and sanitation. The Rapid Needs Assessment by the organization Humanity and Inclusion has shown that the 2020 lockdown in Nepal not only adversely impacted the health of people with disabilities but also negatively influenced their livelihoods at family and individual levels. Further, 76 percent of disabled people who participated in the study reported that their family incomes were negatively influenced by the lockdown while 49 percent mentioned that the lockdown had a negative impact on their own personal income.
Similarly, another report, published last May, shows that over 40 percent of disabled people have lost incomes due to the lockdown in Nepal and over 19 percent think that they are going to lose their jobs. The percentage of the male population was higher than their female counterparts, accounting for over 51 percent and over 48 percent respectively among those who have lost their jobs. Given this situation, eating healthy food to tackle Covid-19 is a distant dream for them.
In addition, much of the information that the government of Nepal has produced for the prevention and control of Covid-19 are not accessible and available for those living across the country. Quarantine and isolation centers have not been developed in a disability-friendly manner.
This calls for a collective effort from the three tiers of government. Further, civil society organizations and external development partners need to work together to strengthen and complement the government and provide disabled people with income-generating opportunities in accessible environments. Also, putting collective efforts into designing and developing disability-inclusive planning and programing in the wake of the second wave of Covid-19 in the country could reduce the unequal burden on disabled people. Doing so would not only contribute to addressing the issues and concerns of disabled people but also work as an impetus towards translating long-term goals set nationally and globally, eventually promoting social justice and allowing everyone to live dignified and respectful lives.
Obindra B. Chand Obindra B. Chand is a health and social science researcher working in the fields of medical anthropology, global health, health systems research, and access to health care services and facilities for various vulnerable and marginalized groups. He is associated with HERD International. Opinions expressed in this piece do not represent the views of HERD International.
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