THE IMPACT OF CORONAVIRUS ON DEVELOPING COUNTRIES AROUND THE WORLD AND THE UK’S RESPONSE
SECOND WRITTEN SUBMISSION BY ADD INTERNATIONAL: FOCUS ON LONGER TERM ISSUES, IMPLICATIONS AND LESSONS TO BE LEARNED
1.1. ADD International is an international disability rights organisation, with its headquarters in the UK, and country programmes in 5 countries in Asia and Africa (Bangladesh, Cambodia, Tanzania, Uganda and Sudan). We fight for the independence, equality and opportunity for persons with disabilities (PWD) living in poverty.
1.2. For more than 30 years, we have been an ally to the global disability movement, working with grassroots activists to advocate for their rights and to build strong and sustainable Disabled Peoples Organisations (DPOs).
1.3. We provide capacity building support to DPOs so that they can secure access to rights and services for their members, challenge discrimination and exclusion at all levels of society, and campaign for policies and services which are inclusive of persons with disabilities (PWD). We also engage with policymakers and development actors to promote approaches which are based on the voice and lived experience of PWD.
1.4. The following written evidence builds on the evidence and recommendations made in our first submission to this inquiry on 17th April 2020. In this second submission we focus in more depth on the challenges and learning in the following areas relevant to ADD’s programmes: the role and capacity of DPOs, PWD Livelihoods, Gender Based Violence (GBV), Inclusive Education, Mental Health, Stigma and Discrimination. The points made previously in ADD’s first submission remain relevant here also.
1.5. ADD International has also contributed to the second submission by the Bond Disability and Development Group (DDG).
1.6. We welcome the opportunity to submit oral evidence as needed.
- The UK response to Coronavirus in developing countries must ensure that it is disability-inclusive in its design and implementation, involving PWD and their representative organisations at every step of the response. The UK response to Coronavirus needs to be in line with DFID’s Disability Inclusion Strategy, particularly on voice and participation of PWD in the response.
- For DFID, it is essential to keep focus and momentum on its world-leading disability inclusion work that it has worked so hard to achieve in the past few years. DFID must not lose ground now against the significant gains that it has already made for disability inclusion. This requires continued political will and leadership and further targeted funding for the disability-iclusive Covid-19 response.
- At ADD International is seeing growing and compelling evidence base coming from our country programmes of the disproportionate and significant impact that COVID-19 is already having on PWD in developing countries – and this submission details a range of specific recommendations that need to be factored in in the response. These are detailed in the sections below.
- At community level, DPOs are providing a lifeline for PWD who are in fragile situations – providing support, advice, life-saving information, access to basic needs, and ensuring they are reached by emergency programmes. But this is only possible where DPOs are already established and have capacity built up previously.
- These are still the early days of the pandemic. There are harder times yet to come in developing countries. The deteriorating pandemic situation in Africa and Asia is a serioius cause for increasing concern. Without urgent and widespread focus and commitment to disability inclusion, millions of PWD will be impacted by the pandemic and at risk of death. Millions of PWD will be left behind – at a time when our collective focus must – now more than ever – be to Leave No One Behind.
3.1. ADD supports the key messages from the disability movement and the community of British INGOs working on disability inclusion: That PWD are disproportionately vulnerable to and impacted by the COVID-19 pandemic, particularly those PWD most excluded because of their gender, age, location and other factors; that UK development assistance efforts should ensure disability focus and inclusion in all COVID-19 responses (as recognised in pillar 4 of the DFID Disability Inclusion Strategy); and that, while the UK government’s commitment to disability inclusion is impressive (as expressed through the DFID Disabiltiy Inclusion Strategy, the 2018 Global Disability Summit London, and other commitments) the COVID-19 crisis will test the application of these commitments on the ground in challenging circumstances.
3.2. ADD welcomes the positive messages coming from DFID on recognising the importance of disability inclusion in the UK government’s support to the COVID-19 response in developing countries, as expressed in a recent letter from DFID to the BOND Disabilty and Development Group (DDG) which stated that ‘There has never been a more important time to deliver our UK aid commitment and … to ensure an inclusive approach is taken as we tackle COVID-19 at home and around the world.’
3.3. Voice and participation of PWD should be a key element of disability inclusion and ADD supports the just published UN recommendations for a disability inclusive response to COVID 19, particularly; ‘Ensure meaningful consultation with and active participation of persons with disabilities and their representative organizations in all stages of the COVID-19 response and recovery’. We believe that engagement with DPOs at all levels (community, national and international) will be an essential channel for PWD participation in COVID 19 responses.
3.4. We are pleased to note that this principle of PWD voice and participation is reflected in the DFID Disability Inclusion Strategy, where ‘Engagement and empowerment of PWD’ is one of five minimum standards. But we need to ensure that this standard is not lost in the crisis response, and that it is done through ongoing, meaningful engagement with PWD, their representative organisations and leaders at all levels to ensure that the crisis response and long term recovery responds effectively to the rapidly changing challenges faced by PWD in different contexts.
3.5. In delivering a disability inclusive COVID-19 reponse it will be important to recognise the interface between humanitarian and longer term development, including: The critical role of DPOs in supporting PWD to access opportunities for re-establishing livelihoods and other development inputs post-crisis, and; The need to strengthen DPOs, the disability movement at all levels, and civil society more broadly, as a strategy for building crisis resilience and response in the long term.
3.6. Recommendations – Policy Environment:
- Ensure that DFID’s minimum standard of ‘engagement and empowerment of PWD’ is applied in the emergency response to COVID-19 as well as in longer term development programmes.
- Recognise the links between long term investment in strengthening PWD voice and representation (through the disability movement), and capacity for delivering a disability inclusive response to crises.
- Recognise the importance of PWD voice and participation at all levels - community, sub-regional, national and international – to support disability inclusive response to COVID-19.
4.1. Where they are well established in their communities, DPOs are providing a lifeline for PWD in the immediate crisis and lockdown: ‘The biggest lesson we are learning, once again, is that disability activists and their organisations are a lifeline for disabled people. Where activists and organisations exist, disabled people are better off. Where they don’t exist, disabled people are left behind and their suffering and isolation compounded’ – Shafiqul Islam, ADD International Country Director in Bangladesh, where so far 41 of our DPO partners across the country have successfully secured emergency support from the government, civil society and their communities for over 5,500 of their members.
4.2. As well as ensuring that PWD get access to survival supplies (food, cash, hygiene supplies), DPOs are taking action to ensure life-saving information reaches isolated PWD: In Bangladesh leaders from 41 DPOs report that the second most frequently used channel among persons with disabilities for COVID-19 information are DPOs and ADD field staff. Some health prevention messages are not accessible or relevant to rural areas, such as adverts showing running water, hand basins and soap, so ADD is translating the COVID-19 pandemic prevention information (from WHO/ UNICEF) into plain local language in accessible formats which are being disseminated by DPOs. In Sudan the Sudan National Society of the Deaf (SNSD) has developed a sign language song on COVID-19 which has been dissiminated to all social media and some TV channels, while DPOs in Khartoum have worked with UNICEF and Save the Children to develop health messages in accessible formats. DPOs are exploring new ways of communicating with their members in the context of social distancing and lockdown; In Tanzania and Uganda DPOs are turning to Instagram and Facebook, and taking part in debates on TV and radio (often the most effective channel in rural areas) to ensure that issues affecting PWD are reflected and communicated in accessible ways.
4.3. The role of DPOs as a trusted source of information is particularly important in contexts where there are increasing doubts about the reliability of official information, including infection rates. One ADD Country Director reported that ‘We hear from our networks that many more people are displaying symptoms than are being officially reported.’
4.4. DPOs represent a key channel for COVID response providers to understand and respond to the needs of PWD: DPOs are engaging with civil society networks and government decisionmaking processes to ensure that the perspectives and needs of PWD are understood and taken on board in planning COVID responses. In Tanzania, for example, the Chair of SHIVYAWATA (the Tanzania Federation of DPOs) has participated in the development of the CSO Directors Forum COVID-19 response plan and position paper, and has also been selected to join the National Disaster Committee which makes decisions on COVID-19 prevention and protection including PPE provision. She liaises with 10 DPOs to inform her work on these groups and to communicate developments back to the wider disability movement so that they can access opportunities for PWD support as they emerge. In Bangladesh, ADD and DPOs have joined other CSOs in the Disability Alliance on SDGs to produce a joint appeal to the government and donor partners to protect PWD from the impact of COVID-19 with 18 specific recommendations on how to do this.
4.5. DPOs need good organisational capacity to fulfil their role in COVID-19 response effectively: As an organisation focusing on long term development we have found ourselves shifting our work overnight to humanitarian response to ensure the survival of PWD in the crisis; we have only been able to do this because our DPO partners are well established within their communities, able to provide guidance and support to their members and engage with local authorities and other actors involved in the Coronavirus response. This has not happened by accident, but results from years of capacity building support to individual organisations and the structures which link the grassroots to regional and national level. In Gedarif State, Sudan, the Cross Disabilty Federation (of DPOs) was set up with ADD’s support and has received capacity building support over several years, including capacity to engage with external organisations: It is now using this capacity to engage with local governmental and non-governmental initiatives to ensure COVID-19 response reaches and includes PWD, such as distribution of basic supplies through the Zakat system (charitable giving through mosques), and hygiene supplies from the Ministry of Health, to the most excluded PWD.
4.6. DFID’s Disability Inclusion Strategy states that empowerment of PWD ‘will be supported by sufficient investments in disabled people’s organisations to promote their meaningful engagement in development policy and programmes and help build the development of a strong disability movement as a key part of accountability mechanisms in developing countries’. This pandemic is teaching us that strong DPOs and disability movements are critical not just for accountability, but also for building resilience among excluded PWD and their families, and providing frontline support in times of crisis.
4.7. Recommendations – DPO role and capacity:
- In the COVID-19 response, DFID should invest in long-term capacity building of national disability movements at all levels, including DPOs and self-help groups at community level, strengthening links with DPO regional and national networks, and wider civil society, so that they are ready to provide the practical support PWD and their families need in this time of crisis.
- In the short-term, DFID should encourage crisis response implementers to provide capacity inputs to DPOs which are engaged in COVID response so that they can be effective and safe, including costs of communication, transport, PPE, and other institutional costs.
5.1. In our first submission we reported that most DPO members rely on informal income generating activities or day-labour which has already been disrupted by social distancing or lockdown. Those who have lost their daily source of income have limited or no capital to fall back on, with many having to sell business assets to meet immediate needs, impacting on their long-term livelihoods. As the lockdown / social distancing continues, the situation is becoming more severe: In Sudan for example, the lockdown of central markets has led to PWD market traders to losing their income as they are unable to travel to smaller markets which are remain open, while the closure of mosques and churches which traditionally provide charitable support, means that PWD who have lost their livelihoods have nowhere to turn for support. In Tanzania, where the spread of COVID-19 is understood by most to be much higher than official figures, our DPO partners report that most of their members who had established small businesses with ‘disability funds’ from district councils, have now closed those businesses because of the difficulties observing social distancing when they don’t have funds to buy personal protective equipment, or communication challenges such as lipreading at distance or when people are wearing masks.
5.2. People who are economically marginalised and dependent on fragile livelihoods are in an impossible bind between physical health and economic ruin and despite lockdown policies, many people have no option but to go out among crowds to shop for basics and to try and earn: in rural areas in Bangladesh our teams report that there is little social distancing - one DPO member who runs a rickshaw taxi and has two disabled people at home, said to us: “if I don’t run my rickshaw how can I keep my family?”.
5.3. In the context of Coronavirus it is proving impossible to implement livelihoods / economic empowerment projects with PWD as planned: Employment placements are frozen as companies have suspended business; it is not possible to deliver vocational training; PWD and their families are using any small business capital accumulated to meet their immediate survival needs. Immediate focus has therefore shifted to accessing survival support in the shape of food distribution or cash transfer programmes. In Bangladesh, DPOs are negotiating with government to get PWD included in cash transfer programmes which allow households to manage expenditure at household level according to their needs, but where these are only one-off or occasional payments it does not allow households to plan ahead and protect the assets they need to re-establish their businesses after the crisis.
5.4. The focus on short term survival means that there is currently little space to engage with powerholders on long term plans for supporting the re-establishment of livelihoods for those who are economically marginalised after the pandemic. National economic responses to date have tended to focus on big business, with little attention paid to the informal sector which the majority of DPO members rely on for their livelihoods. Once governments start turning their attention to longer-term planning it will be important to ensure that PWD and their representative organisations are included in those discussions to ensure that the specific challenges faced by excluded PWD are understood and addressed in government initiatives to rebuild economies. In Tanzania, for example, our DPO partners are planning to write to district councils to ask for the business loans given to PWD to be written off: ‘If the country is asking World Bank to forgive, why not the District Council forgive people with disability in such an emergency condition, so that they can again start afresh?’
5.5. Strengthening social protection systems should be a key element of strategies to protect and support long term livelihood options for PWD. Where we are seeing cash payments provided, this is supporting PWD and their households to survive the crisis where their previous incomes have been lost, allowing them to purchase according to their specific needs, and supporting cash flow in the local economy. Where such payments are regular it would also make it possible for PWD and their households to make long-term decisions such as retaining goods needed for re-starting their businesses, or investing in agricultural activities. DPOs are currently engaging with local authorities and NGOs to provide lists of the most excluded PWD, and where the most vulnerable and excluded have been identified in this way there is now potential for them to be directly targeted in any initiatives for long-term support to re-establish livelihoods.
5.6. Recommendations – PWD livelihoods:
- DFID should invest in social protection systems which provide regular cash payments as a strategy for short term survival and long term re-establishment of livelihoods, and ensure that PWD are prioritised and included in social protection programmes.
- DFID should encourage national governments to write off small business loans previously received by PWD, which have been lost as a result of the pandemic, and make new small business loans and other inputs available to PWD as a priority early in the recovery period
- DFID should encourage national governments to provide businesses with incentives to include PWD in their workforce, particularly where those businesses may have benefitted from government support to stay afloat
6.1. The closure of schools represents the removal of an important channel for support and information to the most excluded and vulnerable children, such as children with disabilities, and their families – and at a time when these families are under huge economic and social pressures. There is currently little information, for example, on children with disabilities out of school who may be vulnerable to exploitation and abuse at this time. In Sudan we have started to gather information about the current status of CWD (and their families) who had been attending schools in our inclusive education project area in Gedarif but this is logistically challenging in the context of lockdown and social distancing. Strategies for taking this work forward include working with local Ministry of Education to encourage them to develop a role for schools at this time as centres for information and advice for families, including information in accessible and appropriate fomats for children with disabilities.
6.2. There have been some efforts to provide out of school education through online learning platforms and virtual libraries as well as TV and radio, but much of this is inaccessible to children with disabilities, particularly in rural areas. In Tanzania the government has given $20 million for education work and ADD is engaging with the Ministry of Education on how this funding can be used to achieve inclusive learning – plans now include printing learning materials for children in hard to reach areas and for students with special educational needs such as visual impairments.
6.3. Recommendations – inclusive education:
- Ensure that out-of-school education provision in lockdown is inclusive of CWD in all locations; Education providers should engage with DPOs for advice and support on reaching and including excluded CWD.
- Explore, develop, and invest in schools’ capacity to provide outreach and support to marginalised children and their families, including CWD, in times of crisis, including identifying and reporting child safeguarding concerns.
- Invest in building capacity of associations of DPOs / parents and carers so that they can provide support, advice and outreach to families of CWD in times of crisis, linking them to emergency response.
7.1. We know from our existing work that gender based violence is an issue of power and control, and that the low economic and social status of women and girls with disabilities makes them more vulnerable to violence and abuse, and less able to seek protection or support. This dynamic is intensified in the context of COVID-19 isolation where economic pressures are increased, where disabled women can no longer contribute their earnings, and where the ‘more powerful’ household members have lost their sense of control.
7.2. There is evidence that levels of violence against women and girls with disabilities has increased as a result of the social and economic impact of Coronavirus. The UNFPA estimates that domestic violence has increased globally by 20% during the COVID-19 pandemic – and we know that an estimated 15% of these cases will be women and girls with disabilities; In Uganda there has been a sharp increase in incidents of domestic violence and violence against women reported to the police (3,200 cases reported in April 2020) and we also know that many cases go unreported. In Bangladesh a survey by the Manusher Jonno Foundation reported 4,249 women faced domestic violence with 1,672 of these being new cases since the start of the lockdown. In Tanzania a recent cross-organisation reflection reported an increase in cases of sexual violence against girls with disabilities who are at home in lockdown. Participants also reported that this situation is exacerbated by difficulties getting access to provide support because of social distancing, and even denial of provision of medical services to women and girls with disabilities.
7.3. Despite widespread recognition of the increase in gender based violence, the main focus of COVID-19 responses has been on immediate survival and provision of basic needs, with less attention to date being given to ensuring that women and girls are protected from violence and can access support. Our own projects on this issue in Cambodia have been adapted to focus on providing emergency survival kits to women and girls with disabilities, but we are including mobile phones, tablets and top-up cards in survival kits so that women and girls who are vulnerable to violence at home can remain in close contact with their peers and DPOs for moral and psychosocial support and for help with referrals to service providers and local authorities if they are experiencing violence.
7.4. Organisations involved in COVID-19 response have a duty to address issues of violence against women and girls as part of their overall safeguarding systems. It is vital that investment in these organisational systems are not compromised as organisations turn their attention to emergency COVID-19 response – in fact they should be strengthened at this time, and publicised. In Uganda we are translating our ‘Safeguarding Pathway’ document into four local languages with culturally appropriate illustrations, including posters, and distributing these through DPO networks. Together with DPOs we are also carrying out radio programmes in rural areas at high risk of COVID-19 to raise awareness of safeguarding for PWD and the pathways for reporting abuses and seeking redress.
7.5. Recommendations: Violence:
- Prioritise support for victims of domestic violence alongside other emergency survival support and strengthen local support and prevention services so that they can be effective during lockdown
- Support DPOs and other civil society organisations to continue to provide frontline outreach and peer support to WAGWD experiencing violence, including provision of life-saving communications devices and signposting to services.
- Support PWD/DPO engagement with local VAWG prevention and support providers to identify and address barriers to WAGWD accessing information and services.
8.1. We are pleased to note that DFID’s Disability Inclusion Strategy recognises the importance of mental health and psychosocial disabilities, including the provision of inclusive and accessible mental health and psychosocial support (MHPSS) in conflict and emergencies. DFID aspires to be a global leader in this area.
8.2. The COVID-19 pandemic is impacting on mental health across populations, and particularly on those people already living with psychosocial disabilities. In Bangladesh, where we have existing projects with DPOs focusing on mental health, we are engaging with the National Mental Health Network to raise their awareness of the issues faced by PWD in relation to mental health, and to reflect this in an online counselling service that is being developed.
8.3. We know from anecdotal evidence that the peer support DPOs provide to their members is an important element in building mental relisience and offering psychosocial support at a time when PWD face even greater isolation, discrimination, and threat to survival than in normal times. We would welcome opportunities to explore and provide evidence of this important value that DPOs provide, so that this can be recognised and invested in as a strategy for future disaster preparedness and response, and built in to future capacity building work with DPOs.
8.4. Recommendations – mental health
- Strengthen mental health service provision in lockdown including targeted outreach which is safe (with PPE provision), and online counselling
- Support DPOs to continue to provide their members with peer support and signposting to services
- invest in gathering evidence of good practice and value of DPOs in this area
9.1. We know that disability stigma and discrimination is a key factor in the social and economic exclusion of PWD in all societies. Anecdotal evidence suggests that stigma and discrimination are intensified in the context of COVID-19, including unfounded fears that PWD are more likely to be carrying COVID-19: As an example, a leading disability activist, who was a partner of ADD International and a prominent disability righst activist, was recently turned away from hospital with pneumonia symptoms and later died. Friends of the activist feel strongly that her disability status was a key factor in the decision to refuse her medical attention.
9.2. DPO members report discriminatory behaviour in practising social distancing and accessing services needed for personal protection: “I was unable to use a new handwashing facility installed close to the Bank ATM in Morogoro. No one was willing to help me” blind DPO member, Morogoro, Tanzania.
9.3. Our DPO partners report fears that superstitions around causes of the pandemic will impact negatively on PWD who may be blamed for family or community misfortune because of their disability status. This is a particular concern for people living with albinism in Tanzania and Uganda who are already vulnerable to kidnap, abuse and murder in association with illegal ‘witchraft’ practices. It will be important to monitor this and gather further evidence.
9.4. Recommendations – stigma and discrimination:
- Support DPOs to continue their work on challenging negative attitudes towards disability, providing support to victims of discrimination and abuse, engaging with service providers to tackle institutional disability discrimination, and with law enforcement services to secure protection for PWD.
For more information, please contact: Jimmy Innes, Chief Executive, ADD International – email@example.com
 Letter from Baroness Sugg to the BOND DDG, 28 April 2020
 UN Policy Brief: A Disability Inclusive Response to COVID 19, May 2020
 DFID Disablity Inclusion Strategy, Minimum Standard 2
 DPO view, as reported by ADD Tanzania Country Director
 UNFPA press release 28.04.2020, citing recent data gathered (link),
 Manusher Jonno Foundation press release 6.05.2020, citing recent data gathered (link)
 Virtual meeting organised by Her-Ability Foundation