Niamh Ní Hoireabhaird – Around the world, refugees with disabilities face an uphill battle

At higher risk of violence, exploitation and abuse, people with disabilities are among the most vulnerable groups of refugees, according to UNHCR. Elderly migrants as well as women and girls with disabilities are especially at risk

Niamh Ní Hoireabhaird is an Irish disability activist and freelance journalist

Cross-posted from Equal Times

Around the world, refugees with disabilities face an uphill battle

An elderly woman from the Donetsk region arrives at the railway station in Lviv Photo: Adri Salido/Anadolu Agency via AFP

Like thousands of other Zimbabweans, Evelyn fled her country in the 1980s to escape the authoritarian regime of Robert Mugabe, the former president who ruled the country with an iron fist and jailed many human rights defenders, journalists and opposition party activists during his three decades in power. She first escaped to South Africa and then continued on to Ireland in 2019, where she is currently staying in a direct provision centre in the south of the country.

Direct provision centres are the accommodation facilities where asylum seekers wait for their applications to be processed by the Irish authorities. As of February 2021, there were 6,273 asylum seekers living in these reception centres, according to Ireland’s department of equality and integration.

Evelyn – who did not want to be identified with her real name for fear of being targeted by other asylum seekers or the Irish authorities – underwent several complex spinal operations while she lived in South Africa that left her with restricted mobility and chronic pain.

Asylum seekers in Ireland’s direct provision centres receive a medical card that enables them to access doctor appointments, hospital care and prescribed medication while they wait for their applications to be processed. Though she had to contend with Ireland’s long health service waiting lists, Evelyn was nevertheless able to complete physical therapy sessions and given a mobility scooter and a rollator to help her get around.

According to Evelyn, receiving such medical care in her native Zimbabwe or in South Africa would have been impossible. “The medical care in South Africa was terrible,” she explains. Although she has found Ireland more disability-friendly, she nevertheless often has to advocate for herself because the direct provision system does not offer services or support targeted specifically at asylum seekers with disabilities: “I had to do whatever it took by myself to [get] help.”

According to figures from the United Nations High Commissioner on Refugees (UNCHR), the number of refugees fleeing war, persecution and human rights abuses worldwide has more than doubled in the past decade, from 15.2 million in 2011, to 27.1 million in 2021, as conflicts have flared up in Syria, South Sudan and many other places. Russia’s invasion of Ukraine in February of this year has moreover resulted in Europe’s largest and fastest refugee crisis since the Second World War, with over five million Ukrainians now having fled the country.

At higher risk of violence, exploitation and abuse, people with disabilities are among the most vulnerable groups of refugees, according to UNHCR. Elderly migrants as well as women and girls with disabilities are especially at risk. There are no exact figures on how many refugees are disabled, but World Health Organization (WHO) and UN estimates put the number at around 12 million people.

“Depend 100 per cent on themselves”

Malaysia has seen many refugees – particularly members of the persecuted Rohingya minority – arrive from Myanmar in recent years. The military coup in 2021 and the ensuing widespread violence also caused many Myanmar people to flee to the South-East Asian country. Malaysia is not a signatory to the 1951 UN Convention on Refugees or the later protocol that expanded its application, and it does not have an asylum system regulating the status and rights of refugees.

“Refugees in Malaysia have no basic human rights, including access to education, the right to work legally, [to] healthcare, safety and justice,” Hasan Al-Akraa of the NGO Asylum Access Malaysia tells Equal Times. “They have to depend 100 per cent on themselves for basic necessities such accommodation, food and medical care.”

“The struggle is even worse for refugees who are living with disabilities, as they have no access to any support system,” Al-Akraa explains, pointing to the cost of specialised healthcare and mobility aids, as well as the inaccessibility of education.

Along with UNHCR and other local NGOs, Asylum Access Malaysia has advocated for the government to ratify the UN Refugee Convention. Still, Al-Akraa believes that the fight will not end when Malaysia ratifies the key legal document and warns that more support systems and measures need to be put in place to support refugees with disabilities.

Although Kenya is one of the 149 countries that have signed the 1951 refugee convention, this does not mean that refugees with disabilities do not face hurdles there.

David Kaloki is the humanity and inclusion project manager at the Kakuma UNCHR camp in Kenya. “You could talk about persons with disabilities, unaccompanied minors, child-headed families – they present with more vulnerability than just being refugees,” he says.

Established in 1992 by UNHCR, the Kakuma refugee camp is today one of the world’s largest refugee camps and mostly hosts refugees from neighbouring countries South Sudan and Somalia. The camp has 21 inclusive primary schools that are able to accommodate children with disabilities. Initially, that was not the case, Kaloki explains, and children with disabilities were put into ‘special’ schools. “There was a school for the blind, a school for the physically challenged, etc.” he says. But camp staff and volunteers advocated for inclusivity and insisted that all children learn together “in the same class to do away with the issues of stigma and discrimination,” he goes on.

The majority of refugees accessing humanity and inclusion’s services in the Kakuma camp – which range from the provision of mobility assistance and psychosocial support, to rehabilitative therapy services – have a physical disability. The camp has a high prevalence of amputees who were injured in conflict in their countries of origin. This is particularly the case for disabled refugees from South Sudan.

Caring for disabled refugees who need mobility aids or prosthetics comes with many hurdles, Kaloki says. “Number one is the limited resources when it comes to [the] provision of assistive and mobility devices,” he says, adding that that these supports are highly expensive and in short supply at the camp.

Healthcare facilities often targeted in conflict situations

Before Russia’s invasion of Ukraine, Victoria Horodovych used to live with her elderly mother and two children – Julie and Egor – in Kharkiv, a city in the north-east of the country situated close to the Russian border. It was the first Ukrainian city to be invaded by Russian forces. On the first day of the invasion, Horodovych was woken up by the sound of shelling. “I saw the lightning in the sky from my apartment on the fifth floor,” she tells Equal Times. “I woke up my mum and my daughter. I told them: ‘Mum, Julie, the war has started.’”

Horodovych’s teenage son Egor is one of the 2.7 million Ukrainians with a disability. He has epilepsy, autism and muscle weakness and requires specialised medical care, which became impossible to access only a few days after the invasion.

In mid-March and as bombs drew closer to their apartment, a family friend drove Horodovych and her children to the Kharkiv train station, so they could flee to the city of Lviv in western Ukraine. Horodovych’s mother stayed behind. But before the family could board the train, the city was shelled in another artillery attack by the Russian armed forces. The tense situation had a severe impact on Egor. “He was so nervous, he refused to eat, he refused to drink,” his mother says. “It affected him badly.”

After an hour, the train finally set off for Lviv. By this time, Egor was having trouble breathing and Horodovych suspected that he was suffering from pneumonia. When the train arrived in Lviv, a nurse in the small medical centre at the Lviv train station did what she could to keep Egor comfortable before a team of doctors arrived from Poland with more equipment. After observation and tests in Lviv, the doctors sent the family across the border, so Egor could receive additional treatment for his pneumonia symptoms in a Warsaw hospital.

In a survey by the World Humanitarian Summit on disability and forced displacement, 70 per cent of respondents – all of whom were refugees with disabilities – cited access to health services as their primary concern. Such worries are founded – healthcare facilities are often targeted in conflict situations. According to the WHO’s Surveillance System for Attacks on Health Care, there have been 665 attacks on Ukrainian healthcare facilities since the beginning of the war.

Many volunteers and NGOs across Europe have mobilised to provide support to Ukrainian refugees with disabilities like Egor, and social media has been instrumental in these humanitarian efforts.

Pomoc dla Ukrainy (Help for Ukraine), a popular Facebook group for volunteers in Poland, has amassed almost 600,000 members since the beginning of the Russian invasion. “We [saw] a large influx of Ukrainians with disabilities in the last two weeks of March,” group administrator Zofia Jaworowska tells Equal Times, adding that the late arrival of these refugees could be due to “challenges facing them ahead”.

Jaworowska describes the situation for refugees with disabilities as “dire”, particularly when it comes to healthcare and housing. The Polish healthcare system was under strain even before the arrival of thousands of Ukrainian refugees, and housing shortages are a long-standing problem in many Polish cities. Refugees with disabilities, Jaworowska concludes, face “additional difficulties on top of everything else” that the average migrant in Poland faces.

After Egor was released from the hospital, Horodovych and her children travelled on to Austria, so they could stay with her husband’s family and be closer to her husband, who is currently working across the border in Germany.

Horodovych describes her decision to leave everything behind as the one that ultimately saved Egor’s life. “If I had stayed with him in Ukraine, he would have died. His physical condition was really bad,” she says. “I will be grateful to Poles until the end of my life.”

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