BOND Disability and Development Group Submission to the UK International Development Committee inquiry on the impact of Covid-19

May 7th 2020

1. The BOND Disability and Development Group (DDG) brings together UK-based mainstream and disability-specific development organisations to ensure that the rights of people with disabilities are included in global development and humanitarian action. The member organisations of the DDG represent a large body of experience based on direct work with people with disabilities, their organisations and the disability movement in developing countries, as well as advocacy and policy engagement with service providers and policymakers globally.

2. We submitted evidence outlining the disproportionate impact of Covid-19 on people with disabilities[1] in response to the IDC’s call for evidence on the current situation and immediate risks and threats in April 2020, and welcome the opportunity to submit evidence on the longer term issues, implications and lessons to be learned.

3. Our first submission highlighted how many of the preventative measures being taken across the world are inaccessible, how physical distancing and self-isolation can disrupt essential daily care, assistance and rehabilitation services, and how the impact of Covid-19 is being exacerbated by inaccessible health facilities and public health messages. We flagged the alarming number of cases of discrimination occurring during the pandemic against people with disabilities and emphasised the critical role the UK – with a stated ambition to be a leader on disability inclusive development[2] – should play in ensuring the rights of people with disabilities are embedded in immediate and long-term responses.

4. This submission focuses specifically on the long-term impact of Covid-19 on people with disabilities and explains why it is vital that the UK and its partners start thinking about how to ensure an inclusive recovery to the pandemic[3].

Summary of Recommendations

5. We recommend the UK Government and its development partners:

1. In line with an effective twin-track approach, ensure all long-term development planning effectively mainstreams disability-inclusion and identifies targeted disability measures where appropriate, in line with DFID’s Strategy for Disability Inclusive Development[4]
2. Ensure any funding that is re-purposed in response to the pandemic is not at the expense of existing disability commitments
3. Ensure current funding invested into the work of Disabled Peoples Organisations (DPOs) and disability-focused organisations is not suspended during the crisis, including funds contributing towards their staff and overhead costs and provide clarity on future funding plans that consider the new challenges we are facing to mitigate the impact of Covid-19 (long and short term) for people with disabilities
4. Ensure effective consultation and engagement with Disabled People’s Organisations
5. Provide funding for and partner with DPOs and disability-focused organisations to build capacity on inclusion during the crisis. Consider intersections between age, gender and disability which may mean people with disabilities are less likely to be included[5].
6. Strengthen health systems to deliver Universal Health Coverage and remove barriers experienced by people with disabilities in accessing affordable, quality health care, water, sanitation and public health information during and after the pandemic, and improve health care coverage, so that people with disabilities receive the health care they need, without incurring financial hardship[6]
7. Ensure all WASH facilities and services including hand-washing facilities, are accessible and gender-sensitive[7]
8. Work with local health partners to ensure decision making is guided by human rights standards and guidance that informs decision making on allocating resources must never be taken based on pre-existing impairments or medical bias against people with disabilities
9. Ensure the principle of leaving no one behind is effectively embedded into DFID’s policy on a global health strategy
10. Ensure all education programmes share accessible learning resources and children with disabilities can access quality education once schools re-open
11. Support people with disabilities’ access to employment and strengthening livelihoods, and provide adequate social protection measures
12. Ensure gender-based violence (GBV) prevention and response services are accessible to and prioritise children and adults with disabilities, including through remote GBV case management support and accessible hotlines; and ensure disability is embedded into DFID’s efforts to eliminate violence against women and girls
13. Ensure that mental health and social support services are maintained and strengthened for people with disabilities during and after the pandemic
14. Adapt responses to contexts, including humanitarian crises, conflict affected areas, and refugee camps
15. Update DFID’s humanitarian response guidelines to include references to the Inter-Agency Standing Committee (IASC) Guidelines on the Inclusion of Persons with Disabilities in Humanitarian Action.[8]
16. Influence the development of partner government’s national development plans to ensure they are disability-inclusive and protect the rights of people with disabilities in emergency response planning and recovery in future[9].
17. Continue to play a leading role in addressing the disability data gap, disaggregating data on Covid-19 by age, sex and disability, and promoting the use of Washington Group Question Sets[10] and the Model Disability Survey[11] as appropriate tools for data collection.

Overview of Current Challenges for People with Disabilities

6. The Secretary of State for International Development has informed the IDC that the pandemic could “threaten to undo 30 years of international development work” and that this “will be felt for years to come for the poorest, most disproportionately affected”[12]. This is highly relevant for people with disabilities in developing countries, who are amongst the poorest people in any society due to widespread discrimination and barriers accessing health care, education and employment.

7. The health systems and social infrastructure in many of the countries our members work in are already under-resourced, and the assertion that the Covid-19 impacts rich and poor people alike is misleading – people who are already excluded are likely to be disproportionately impacted now, and in the long-term[13].

8. The pandemic has also seriously undermined the 2030 Agenda’s central ambition to leave no one behind – people with disabilities and other excluded groups are being disproportionately impacted and discriminated against in multiple contexts[14]. Ensuring development progress that genuinely leaves no one behind is critical – and the UK is well placed to, and should, play a leading role.

9. In order to achieve this, it is important that the UK accounts for the full diversity of disability and applies an intersectional approach in all overseas development assistance (ODA). By this mean we mean taking steps to identify and include the most marginalised people, including people with complex needs and psychosocial disabilities, and accounting for how different factors intersect to shape vulnerability[15].

10. Understanding how gender, age, disability, minority or refugee status, and location – amongst other factors – interact and result in multiple forms of discrimination is vital for developing more effective interventions. For example, it is important to understand how age, disability and gendered roles can make older women with disabilities more vulnerable to the impacts of the Covid-19[16], or how age, disability and family-income can influence whether children with disabilities access or drop-out of school[17]. It is also important to understand how family members and caregivers are being impacted in the long-term. For example, mothers of children with disabilities are often socially and economically marginalised, with high levels of abandonment by their partners, whilst many people with disabilities will now lose their access to personal care, as households lose their incomes.[18]

11. In order to design the most effective immediate and long-term responses to the pandemic, the UK must take steps to account for how different factors interact in different contexts – and ensure ODA is reaching the people who need it most. 

Long-terms Impacts of Covid-19 for People with Disabilities

12. It is vital that children with disabilities can access their right to education during and after the pandemic. Children with disabilities are more likely to drop out of school than their peers, and there is a real risk that many children with disabilities currently out of school due to the pandemic will not return[19]. The closure of schools has also removed a vital channel for many children with disabilities in developing countries in terms of accessing information and school feeding programmes[20].

13. Supporting children with disabilities to access education during the pandemic and beyond is a priority. Many DDG members have reported that resources being used for remote learning are not being made accessible to children with disabilities, their parents are not being appropriately supported and wider communication methods such as TV and radio are not considering the rights of children with multiple or sensory impairments[21].

14. The UK should take additional efforts to ensure all education programmes share accessible learning resources and children with disabilities return to school once they re-open[22].

15. Supporting people with disabilities’ access to employment and strengthening livelihoods should also be a long-term priority. People with disabilities in developing countries are more likely to work in the informal sector, be self-employed, experience discriminatory barriers accessing employment, be denied reasonable accommodations and have lower access to labour protections[23]. Many people with disabilities living in poverty who have lost their jobs as a result of the pandemic will have limited capital to rely on. This has implications for both the immediate crises and in terms of re-establishing their businesses or income generating activities in the long-term.

16. This is particularly relevant for people with disabilities from minority and indigenous communities who may have precarious livelihoods or have had their nomadic cultures severely disrupted by physical distancing and curfews[24]. 

17. This impact on livelihoods could have potentially devastating long-term effects on people with disabilities, who as a result of lost income may struggle to buy food and be impacted by losses in passing trade due to restrictions of movement[25]. Many families of children with disabilities are unable to buy soap, water or face masks being required by governments, and in some cases are on the brink of starvation[26].

18. This dangerously precarious situation will be repeated for families across many developing countries and highlights the importance of ensuring a disability-inclusive approach. This is particularly relevant in terms of ensuring adequate social protection measures that help the poorest people. The inadequacy and inaccessibility of existing social protection schemes in many developing countries is likely to further increase the impact of the pandemic on people with disabilities[27]. In some counties initial consultations on social welfare packages have failed to include DPOs or disability-focused organisations in the conversations meaning considerations of the social-protection needs of people with disabilities has been ignored.[28] It should also be noted that social protection schemes may face increased pressures in the long-term due to the economic impacts caused by the pandemic, which risks causing further exclusion[29].

19. Understanding the impact on the mental health of all people, including people with disabilities, will also be essential in the long-term as the impacts of the immediate crises and disruption to education, the economy, isolation or living in overcrowded environments become apparent[30]. For example, people with psychosocial disabilities may experience increased distress due to anxiety and isolation, whilst people with intellectual disabilities and those on the autism spectrum may be severely impacted by disruption to their daily lives and confusion linked to the reason behind lockdown measures that have not been communicated appropriately[31].

20. Understanding and adapting responses to different contexts, including humanitarian crises, conflict affected areas, and refugee camps is vital. Covid-19 is exacerbating humanitarian needs on countries that are already facing protracted crises. In crisis affected areas populations often live with partly collapsed health systems, whilst many internally displaced people live in overcrowded and inaccessible camps without freedom of movement or proper access to water. Access to health care, emergency relief and sanitation is challenging for people with disabilities in these contexts due to widespread inaccessibility and discrimination[32].

21. The challenges across contexts make the importance of ensuring non-discrimination essential. Long-term responses to the pandemic must protect the rights of people with disabilities to access health care, including in the context of triage[33], on an equal basis as others – in line with the UN Convention on the Rights of Persons with Disabilities[34].

22. Decisions taken on allocating resources must never be taken based on pre-existing impairments or medical bias against people with disabilities of all ages[35]. All forms of public health communications and awareness campaigns must take steps to avoid generating stigma against people with disabilities and reinforcing negative myths and stereotypes[36], and avoid perpetuating harmful assumptions around gender and minority status[37].

23. Addressing discrimination in all forms is essential. Where usual support services have been disrupted, some people with disabilities may face long periods relying on family and household members for assistance. Unfortunately, some families may openly discriminate against family members with disabilities, leaving them at risk of violence, exploitation, abuse and abandonment. People living in institutions are being left highly vulnerable to the impacts of Covid-19 and discrimination[38].

24. People with disabilities, particularly women and girls with disabilities, are also disproportionately vulnerable to gender-based violence. These risks are exacerbated during crises, as households face additional stress and prolonged periods in isolation[39]. Examples of discrimination and violence against people with disabilities are being reported in a number of countries, including deaf people being attacked by police for breaking curfews that they did not know existed as they were not communicated accessibly[40]; backlashes against deaf communities after sign language interpreters appeared on TV; and racism towards minorities being accused of carrying the virus[41].

25. The discriminatory context that exists for people with disabilities –that is being exacerbated by the pandemic – makes ensuring effective safeguarding essential. The pandemic is placing a wide range of people with disabilities at risk. For example, children with disabilities are at a higher risk of abuse, neglect and harm compared to their peers without disabilities. Children with disabilities are most likely to experience abuse or sexual assault in their homes and are more likely to be abused by those who care for them, so the closure of schools has placed many children with disabilities at increased risk of abuse[42].

26. There are increased barriers for vulnerable adults and children with disabilities to gain access to inclusive safeguarding reporting mechanisms. For example, many children with disabilities use peer-reporting with friends or neighbours who they feel safe with or are able to communicate with. Lock down measures have meant safe reporting has become impossible for these groups. DPO’s also play a vital role in providing safeguarding services for people and children with disabilities and if these organisations fail to survive the pandemic this disability-inclusive safeguarding system will disappear[43].

Conclusion and Way Forward

27. A clear implication for the development sector is the need for better data and information to understand impact and allocate resources equitably[44].

28. The impact on people with disabilities in developing countries will be better understood as more information is made available over the coming months. Having up to date, reliable information and data will be key to ensuring interventions are effective, and the Disability Helpdesk within DFID is rightly asking for further information from those working on disability inclusion[45].

29. However, there are currently no examples of disability disaggregated data on mortality rates in the public sphere[46]. It is essential that data is disaggregated by gender, age, location, and other characteristics to enable an intersectional analysis of the impact of COVID-19 to take place. There is little evidence on which to base an effective response – in keeping with the general lack of data on disability in developing countries.

30. Lessons from past epidemics unfortunately demonstrate lessons have not been learned in responses to Covid-19 – for example the importance of ensuring information on disease prevention is made in accessible formats, and how people with disabilities may face worsening deprivation through the impacts on livelihoods and inadequate social protection, which continue after the initial crisis is over[47].

31. The lack of quality data on marginalised groups unfortunately means they are often unaccounted for in both pandemic response and long-term planning[48]. The UK should continue to play a leading role in helping to address the alarming lack of data on disability and other marginalised groups.

32. The scope and gravity of the Covid-19 pandemic requires international cooperation, and a coordinated, ambitious and inclusive response[49]. People with disabilities and their representative organisations must play a vital role in the immediate and long-term response to the pandemic, to ensure the rights of people with disabilities are included in long-term recovery and development planning. DPOs working at grassroots level are currently playing a vital role through keeping their members informed, providing accessible communications and essential services[50].

33. Many DPOs in developing countries are small, and do not have reserves or the immediate fundraising capacity to continue their vital work. Ensuring the international community provides appropriate and flexible funding and support for DPOs and partner organisations – paying particular attention to their diversity to ensure women with disabilities, children and older people are represented – so they can maintain their vital work during the pandemic and beyond is critical[51]. Without this, the voice and participation of people with disabilities will not be realised.

34. It is also important to ensure any funding that is re-purposed in response to the Covid-19 pandemic is not at the expense of existing disability commitments[52]. For example, by preventing a redirection of resources away from services for persons with disabilities, including those related to rehabilitation, provision of assistive technology and sexual and reproductive health and rights[53].

35. The UK has announced unprecedented funding for domestic charities to ensure they can continue their vital work during and after the pandemic, but similar types of support for international development charities is not available. The immediate funding response is mainly being channeled through multilateral institutions and a limited number of large international NGOs. Many international NGOs are already experiencing challenges or disruption to fundraising efforts, including the cancellation and postponement of fundraising activities, which is putting serious strain on unrestricted funds, whilst disruption to ongoing projects, delays in starting new projects and donors postponing decisions on new funding is also impacting core costs[54].

36. Where possible DFID should support international NGOs with core costs otherwise there is a significant risk many will not survive the crisis and be able to help the people who need to access development assistance the most[55]. DFID should also make every effort to ensure all of their partners – at every level of the delivery chain – are considering disability-inclusion in response and recovery[56].

For further information please contact the co-chairs via the Bond DDG website www.bond.org.uk/DDG

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