Governments in the Middle East and North Africa (MENA) region have rapidly reacted to contain the Coronavirus (COVID-19). With all necessary caution at this stage of the pandemic, contagion seems limited so far, and the public health consequences less severe than expected. However, the pandemic is already causing dramatic economic and social consequences, in particular for the most vulnerable (people with disabilities, older people, refugees).
Despite varying levels of health system preparedness across the region, MENA countries’ overall health management strategies, characterised by strict containment measures implemented in the very early stages of the outbreak, have proved efficient in limiting the spread of the pandemic in the region.
The pandemic is challenging MENA economies’ ability to cope as the virus strains medical systems, some of which are particularly weak and overcrowded. The situation is, obviously, not the same for the Gulf countries, the developing economies in the Levant or North-Africa, or in fragile and conflict-affected countries such as Syria, Iraq, the Gaza Strip, Yemen, and Libya, where the lack of hospital beds and testing capacities is a cause of concern.
The pandemic is already causing a dramatic economic, unemployment rises and wages and remittances fall. The United Nations Economic and Social Commission for West Asia estimates that the economic slowdown caused by the pandemic will cause an additional 8.3 million people to fall into poverty.
CONFLICT AND COVID-19: IMPACT ON MENA REGION
For countries suffering fragility and conflict, the COVID-19 outbreak poses a major challenge given damages to health systems. In emergency settings, where availability of water, sanitation, and hygiene (WASH) services is scarce, applying preventive measures to limit the spread of the disease may prove difficult. Countries, where health care facilities have been partially destroyed during the war and governance, remain extremely fragile and uncoordinated in certain areas, and lack the necessary capacity to respond to the crisis in terms of medical facilities, equipment, and personnel. In Syria, the WHO estimates that 70% of health care workers have left the country as migrants or refugees, while only 64% of hospitals and 52% of primary health care centers remain fully operational.
With the spread of the COVID-19 pandemic, humanitarian and conflict-affected areas are at particular risk. The MENA region has experienced a dramatic flow of refugees and internally displaced persons over the last decade.
Finding ways to integrate migrants and refugees, regardless of their formal status, in national plans for tackling the virus is key to prevent the pandemic from spreading in refugee camps.
In conflict-affected territories and the refugee camps can accentuate the impact of pandemics. Furthermore, confinement measures can result in increased exposure to indoor air pollution, particularly for people relying on polluting fuels for cooking and heating in poorer MENA countries and for buildings lacking, or with poor, ventilation systems, and the pandemic could also bump up the number of undernourished people there by some two million.
Current estimates show that there are some 101.4 million in the region who already live in poverty, according to official criteria, and around 52 million undernourished.
The impact of the COVID-19 outbreak may further exacerbate those regional differences and structural imbalances, in addition to continued political instability as well as fragility in some cases. The outbreak of the virus has indeed impacted political developments within MENA economies.
The COVID-19 pandemic has affected all aspects of life in the Arab region. People with disabilities, older people and, refugees, especially refugees with disabilities, will bear a double burden reflected in the health risks posed by the virus and in weak social protection systems, which leave large groups without protection.
PEOPLE WITH DISABILITIES IN CONFLICT ZONES HARDEST HIT BY COVID-19.
COVID-19 has caused new global changes affecting people’s lives everywhere. These effects are especially felt by people with disabilities as one of the most vulnerable groups impacted by the pandemic. Various social and environmental barriers, discrimination, and inaccessible infrastructure has exacerbated these effects.
COVID-19 can present many additional challenges for refugees with disabilities, including hunger, lack of health information and treatment, depression and anxiety and an increased risk of COVID-19 due to difficult living conditions.
People with disabilities are facing barriers in getting health care. Children with disabilities cannot access remote education on an equal basis with others, and families of children with disabilities do not have the support and services they need to help them cope with the crisis.
This exclusion is robbing people with disabilities of potentially life-saving information and services that they need to weather this crisis.
Private initiatives and international organizations like UNICEF have produced some material about Covid-19 that is accessible for people with disabilities, but many people with disabilities are still not getting life-saving information.
REFUGEES WITH DISABILITIES DURING THE PANDEMIC
The pandemic increases discrimination against certain groups, including people with disabilities and older people.
Refugees with disabilities are often poor, stigmatised, isolated, excluded by their community, and forgotten during an acute crisis like the COVID-19 pandemic.
As the COVID-19 crisis spreads deeper into communities, we see local communities quick to reject refugees, especially when they have a disability. People who live close to refugees tend to avoid them or deny them access to services like healthcare or transportation, fearing that they carry the coronavirus and might put others in danger.
Among 79.5 million people who are forcibly displaced in the world, around 15% have a disability. Globally, an estimated 9.7 million people with disabilities have been forcibly displaced as a result of conflict and persecution.
The world’s refugee camps were not built for COVID-19. They are overcrowded, packed with poor, under-nourished people who settled there in a panic. This environment, with limited access to basic and specialized services, is particularly conducive to virus transmission.
According to a protection assessment by the UN refugee agency, UNHCR, of the Covid-19 impact on refugees in Lebanon in April 2020, 84% of refugees with a disability in Lebanon cited food insecurity.
Public health experts say that the main way to protect yourself from COVID-19 is to socially distance yourself from others, isolate those who become ill, and wash your hands frequently with soap and water. In camps for internally displaced persons or refugees, where so many people seek shelter and protection in armed conflicts or humanitarian crises, this is nearly impossible.
Some refugee camps without ramps, bars, or other supports, some persons with physical disabilities have to crawl to enter toilets. Can you just imagine what that feels like?
Hygiene is one key element of maintaining good health, and so is good information. People with disabilities living in camps for refugees and displaced persons need information in a way that works for them.
How people who are blind or deaf can get information about how to protect themselves from COVID-19. Is the information about this global pandemic presented in a way that makes sense for someone with an intellectual disability?
DISABILITY- INCLUSIVE RESPONSE
Accessibility remains an issue for people with disabilities in the COVID-19 outbreak.
Accessible information on the pandemic is essential for people to make life-saving decisions about how to protect themselves and to get necessities and services during quarantine and self-isolation.
information on protection from the virus and information on how to get testing and treatment needs to be accessible to people with different types of disabilities and older people.
What if the ongoing COVID-19 pandemic served as an opportunity to re-think how emergency planning can be inclusive of people with disabilities? Isn’t this global crisis presenting a unique opportunity to rethink the need for accessible and inclusive during this crisis?
We need to emphasize that people with disabilities receive information about infection mitigating tips, public restriction plans, and the services offered in a diversity of accessible formats, including easy-read format; high contrast print and, where possible, braille; and use of available technologies such as subtitles in verbal messaging.
Physical accessibility to structures (particularly WASH and health) and transportation support. Ensure support during and accessibility for critical counselling and during quarantine/ hospitalization (e.g. sign language interpreters, personal assistants/caregivers), with ensuring that awareness-raising on support to people with disabilities is included in public messaging campaigns.
As well as, students with disabilities have also been disadvantaged by school and institution closures that have mandated online or remote learning without accommodating the needs of children with disabilities in refugee camps, these schools lack reasonable accommodations to help them learn and, teaching method is often not accessible or cannot accommodate the needs of students with disabilities.
So far, mainstream responses for continued learning during the COVID-19 crisis have focused around strategies and solutions deployed during emergencies, A few organisations provided radios to families with students with disabilities to access learning programs. However, this crisis has appeared to rely heavily on education solutions reliant on computers, tablets and online learning portals, virtual lessons, and radio/TV lessons.
The lack of accessibility features may exclude students with disabilities
The lack of accessibility features may exclude students with disabilities, limited internet access hinders learning even further.
Clearly, the COVID-19 global crisis presents a unique opportunity to rethink the need for accessible and inclusive education. See more barriers in accessing information during COVID-19: Stories from the Arab region.
We can and should do more to ensure that people with disabilities are included in all aspects of UN agencies’ work – we cannot wait any longer. This is a matter of life and death. It will be nearly impossible to fight COVID-19 in countries already devastated by conflict unless a concerted response by states and humanitarian organisations is launched immediately.
Displaced people with disabilities remain invisible in so many ways. They are socially isolated and rarely consulted when humanitarian programs are designed and implemented. Many are excluded from or unable to access humanitarian aid programs because of physical and social barriers or because of negative attitudes and biases. As a result, they miss a critical opportunity to contribute their skills, capacities, and ideas to programs and the community.