Following the influx of 745,000 Rohingya refugees into Cox’s Bazar in Bangladesh in late 2017, hundreds of international and national organisations set up operations to provide protection, food, water, shelter, education, health care and other essential assistance. Most initially overlooked the rights and specific requirements of persons with disabilities. Distribution points, safe spaces for women and children and service and sanitation facilities in the camps are difficult to access or operate for people with physical impairments. Buildings have steps and narrow entrances and latrine blocks are too narrow to accommodate a support person. Stigma and discrimination within the Rohingya community mean that persons with disabilities rarely leave their improvised shelters and are in effect invisible, exacerbating their vulnerability and exposing them to increased protection risks, exploitation and abuse.
Against this background, disability-focused organisations play a vital role in promoting the inclusion of persons with disabilities. In the early phase of the crisis, these organisations mainly delivered targeted assistance, for example assistive devices and rehabilitation services. Since 2019, however, cooperation with mainstream organisations has increased; coordination mechanisms include persons with disabilities in their activities, partnerships have been established with UN agencies, and consortia projects with international and national NGOs are building capacity and promoting sustainable changes in organisational practice. In 2018, Humanity & Inclusion (HI), CBM, the Centre for Disability in Development (CDD) and HelpAge International founded the Age and Disability Working Group (ADWG). From this year the ADWG is operating under the Protection Working Group led by the UN High Commissioner for Refugees (UNHCR). A formal collaboration framework specifies the conditions of the cooperation between the working group and the ADWG, and grants the ADWG observer status within the working group task team.
Although it is still too early to evaluate the long-term impact of these partnerships, they have the potential to facilitate the inclusion of persons with disabilities and contribute to change in humanitarian practice. Field research in Cox’s Bazar in 2020 reveals notable progress in data collection and analysis, the removal of physical barriers and the participation of persons with disabilities in the humanitarian response.
Data collection and analysis
In 2020, the protection working group declared the inclusion of older persons and persons with disabilities a core priority. However, important data gaps on disability persist, including disability prevalence and the needs of and barriers faced by persons with disabilities. The 2019 joint government–UNHCR registration exercise, for example, relied on a binary ‘yes-no’ question to estimate the proportion of persons with disabilities in the camps. Not surprisingly, it found that just 1% of refugees have a disability, a figure which clearly contradicts global estimates, according to which persons with disabilities represent 15% of any population 1. Rohingya Refugee Response/Bangladesh: Joint Government of Bangladesh – UNHCR Population Factsheet as of March 15, 2020 (https://reliefweb.int/report/bangladesh/rohingya-refugee-responsebangladesh-joint-government-bangladesh-unhcr-population-0). .
In an effort to address this data gap, the protection working group and the REACH Initiative, 2. The REACH Initiative conducts and facilitates field-based assessments in more than 20 countries to provide timely information and in-depth analysis from contexts of crisis and enable efficient aid planning and response. See www.reach-initiative.org/who-we-are/. in partnership with the ADWG, have prepared a joint needs assessment. Using quantitative and qualitative data collection methods, the assessment aims to identify the specific requirements of persons with disabilities in the camps and capture the voices and experiences of persons with disabilities and older persons in a holistic and dignified fashion. The intent is to further understand the safety and dignity of persons with disabilities across all age groups, ensure meaningful access to multi-sectoral services and assistance and foster participation and empowerment within community and humanitarian spaces. The ADWG will provide training to enumerators and technical support to the project team to ensure that the methodology, tools, data collection process and analysis and use of the data is inclusive of persons with disabilities, including hard-to-reach groups such as deaf persons and persons with autism. The results of the needs assessment are expected in the second half of 2020.
Outside of the ADWG, disability-focused organisations support UN agencies and NGO consortium partners in the collection, analysis and use of disaggregated data. In training sessions, participants from different sectors and levels of the response learn how to apply the Washington Group Short Set of Questions, and how to use this data for inclusive programming.
Removal of barriers
Widespread misconceptions among humanitarian workers in Cox’s Bazar lead to incorrect assumptions about how to remove environmental barriers for persons with disabilities. As one respondent from an international NGO explained:
We always think about someone with a wheelchair. Hence, most of the time, the response is ‘Let’s build a ramp!’ But a ramp will not be helpful for people with different types of disabilities.
To overcome these misconceptions and provide UN agencies, international NGOs and their national and local partners with the necessary skills to address physical barriers, HI, CBM and CDD hold one-day coaching and training sessions for field staff and managers from various sectors of the response, including WASH, protection, nutrition and site management. Facilitators provide participants with a generic orientation on disability inclusion, explain different conceptual models of disability and outline national legislation and policies on disability inclusion. In group work, participants identify barriers and risks for persons with disabilities in their respective programmes, and identify ways to address them. Based on feedback from the facilitators, participants then develop project indicators for continuous monitoring. Subsequently, mainstream organisations establish a disability-inclusive action plan, which ideally reflects these indicators, and partners share their progress and seek advice in regular meetings. Close monitoring of programme indicators and camp visits by experienced project managers and technical officers from disability-focused NGOs minimise implementation gaps and reduce the risk of design errors and construction defects, and in this way help ensure that newly built facilities are accessible for everyone.
Overall, the training sessions and subsequent technical support have been well-received by the project partners, though participants have indicated that the training would be more effective if sessions were longer than a day. While training is often preceded by short site visits, some participants believe that an in-depth pre-assessment by the training facilitators could provide detailed information about inclusion gaps in project activities, which could be integrated into the training.
Besides training and coaching for humanitarian staff from UN agencies and NGOs, the ADWG also raises awareness on contextual factors that can lead to the exclusion of persons with disabilities, and advocates for inclusive humanitarian assistance in coordination and working groups. During the Covid-19 crisis, for example, the ADWG, in partnership with the Protection Working Group, published a joint Covid-19 Guidance Note on making the response age- and disability-inclusive. The Note enumerates the factors making older persons and persons with disabilities more susceptible to the virus, and provides recommendations on how to reduce the risk of infection for these groups 3. ADWG and Protection Working Group, ‘COVID-19 guidance note’, 7 April 2020 (www.humanitarianresponse.info/sites/www.humanitarianresponse.info/files/documents/files/protection_sector_adwg_covid-19_inclusion_guidance_note_12_apirl_2020.pdf) . However, there is no evidence that the humanitarian community in Cox’s Bazar regularly uses the Guidance Note in the response.
Meaningful participation and empowerment of persons with disabilities
The government of Bangladesh treats the crisis as a short-term challenge and does not permit the formation of organised groups in the camps, including organisations of persons with disabilities (OPDs). Persons with disabilities living in host communities have not had the chance to make their views and opinions heard either. According to a representative of an OPD, there are only 12 such bodies in the district and they do not operate in the areas where refugees have settled. OPDs comprise Bangladeshi citizens and do not necessarily reflect the concerns of refugees. Disability-focused NGOs recognise this problem and are trying to support OPDs. The ADWG, for example, invited OPDs to join in 2019. However, until the government allows the Rohingya to fully exercise their rights and permits the establishment of OPDs in the camps, this problem will be very difficult to address.
Humanitarian organisations have become more deliberate in reaching out to persons with disabilities to increase their visibility in the humanitarian response. Thanks to intensive sensitisation efforts on inclusive humanitarian action, more and more organisations involve persons with disabilities in community meetings and focus group discussions. Some respondents indicated that this was resulting in programme adaptations. For example, one organisation had established a women’s committee to encourage the participation of women in the refugee response. Initially, consisting of 100 members, the organisation subsequently expanded the committee to include 10 places for women with disabilities, to give them the chance to address specific issues and report unmet needs.
Remaining challenges and benefits of strategic partnerships
Overall, humanitarian workers have become increasingly aware of the importance of and need to include persons with disabilities in their interventions, in line with human rights approaches and in accordance with international frameworks. At this stage, however, there are still important data gaps on disability, widespread misconceptions among humanitarian staff on how to remove persistent barriers, and a lack of participation of persons with disabilities in the humanitarian response, in the refugee camps and in host communities.
Without a doubt, these challenges are hard to address. Organisations in Cox’s Bazar are grappling with numerous structural challenges, including extremely short funding cycles, frequent staff turnover, restrictive government regulations that also entail a high administrative workload for NGOs and limited information-sharing among organisations and across organisational structures. These challenges prevent organisations from developing holistic, long-term approaches on disability inclusion, impede the effective coordination of disability-inclusive activities, and reduce the time available to humanitarian workers to participate in coaching and training sessions.
Strategic partnerships with disability-focused organisations cannot eliminate the structural challenges inherent to many humanitarian responses. Even so, research in Cox’s Bazar shows that they can contribute to a response that is more disability-inclusive, mainly because they allow disability-focused NGOs to work with a specific set of partners in a structured and coordinated way. Technical assistance and capacity-building at various levels and in different sectors can help mainstream actors absorb any negative effects when staff trained on disability inclusion leave a given location. Strategic partnerships also facilitate regular knowledge exchange between departments and sectors, and thus encourage communication and reduce information silos. They allow disability-focused organisations to closely monitor the implementation of inclusive action plans and help reduce implementation gaps.
The ADWG, in close cooperation with the Protection Working Group, is at the forefront of promoting change in organisational practice. It advocates for equal and safe access to participative processes; facilitates the collection, analysis and use of gender-, age- and disability-disaggregated data throughout the response; raises awareness on contextual factors that can lead to exclusion; and builds capacity for inclusive humanitarian programming among members of coordination and sectoral working groups. In summary, strategic partnerships seem better equipped to meet the growing demands on disability-inclusive humanitarian action than previous ad hoc approaches.
Carolin Funke is a research associate at the Institute for International Law of Peace and Armed Conflict (IFHV) at Ruhr-University Bochum in Germany. Research in Cox’s Bazar was carried out between 12 January and 6 February 2020 under the project ‘Phase 2 – Leave No One Behind! Mainstreaming Disability in Humanitarian Action’. The project is implemented jointly with HI Germany and CBM Germany and funded by the German Federal Foreign Office. The author would like to thank Danielle Richard (HI) for her valuable comments on earlier drafts of this article.