Ensuring that Palestine refugees with disabilities are protected and can access services is an essential part of UNRWA’s mandate. The UN General Assembly “has repeatedly encouraged the Agency to work towards addressing the needs, rights and protection of persons with disabilities, in accordance with the UN Convention on the Rights of Persons with Disabilities (CRPD)”. With this in mind, and in view of the challenges and vulnerabilities faced by persons with disabilities, in 2018 UNRWA took further actions to ensure that its programming and services are disability inclusive and in line with the CRPD.
chapter 1: introduction
1.1 Background
There are currently 5.4 million Palestine refugees registered with UNRWA in its five fields of operation (Jordan, Lebanon, Syria, West Bank and the Gaza Strip), and it is estimated that 15 per cent1 or 795,000 of them have a disability. Despite being a significant part of the registered population, there is a lot of stigma related to persons with disabilities and families often hide family members with disabilities from the community or stop them from fully participating in the community’s social activities. Even when there is no shame projected in this way, a commonly held perception is that persons with disabilities are not capable of living a normal life or performing expected social roles. As independence is valued in many societies, those who are highly dependent on family members are seen as incapable and end up being marginalized from society.2 In prolonged conflicts or displacement such as that faced by Palestine refugees, this situation is aggravated since physical structures are often destroyed, public services have been disrupted and the economy is usually deeply affected.
In this sense, Palestine refugees with disabilities can be disproportionally affected by their protracted displacement, facing additional protection concerns as well as barriers to live independently and to be included in their communities.
In addition to facing more barriers to access services and being more vulnerable to poverty and social exclusion, Palestine refugees with disabilities also face additional protection concerns, being exposed to different types of abuse, exploitation, neglect, physical violence and psychological distress. Simultaneously, conflicts can increase the incidence of these protection concerns for Palestine refugees and these factors, may lead to an increase of disability within the affected population. This is particularly in contexts of Syria, Gaza and the West Bank which have seen on-going conflict and armed violence during 2018.
In Syria, according to the World Health Organisation (WHO) and Humanity and Inclusion,3 it was estimated that 1.5 million people have a permanent disability due to the conflict, “including 86,000 people whose injuries have led to amputations” as of December 2017. A similar study4 carried out with Syrian refugees in Lebanon found out that 22.4 per cent had a disability; which is expected to be an analogous reference point for Palestine refugees from Syria, who themselves also generally experience higher poverty rates.
Another aggravating fact is that one third of those injured in the conflict are children. Although UNRWA does not have exact figures, many Palestine refugees have acquired a disability as a result of the conflict which the Agency has addressed through its programmes.
In Gaza, in addition to the violence faced by Palestine refugees during the hostilities in 2014, the ‘Great March of Return’ which started in March 2018 has led to an alarming increase of persons with injuries, including Palestine refugees, resulting from the use of force including live ammunition by Israeli Security Forces (ISF) during the demonstrations which has increased the risk of people developing a permanent disability.
According to WHO’s⁵ figures, from March 30 to November 3, 227 people have been killed and 24,516 people have been injured as a result of the violence –including more than 7,200 of limb related injuries and some 460 injured people who will be in need of limb reconstruction and will require surgeries and extensive rehabilitation and treatment for up to two years. In addition, there have been 94 cases of amputation, 18 cases of paralysis due to spinal cord injuries. Out of the 24,516 people injured, 4,619 cases have been treated in UNRWA health clinics.
WHO and UNRWA have also reported that many patients are being discharged early due to the intense flow of incoming patients, which might lead to post-operative complications, including the development of permanent disabilities. An increase in the number of persons with disabilities has also had several programming implications for UNRWA which will require better planning to ensure: availability of skilled staff, different equipment and specialized services, and adaptation of schools and other UNRWA services.