Refugees and Citizens United by a Tragedy Preceding the War - Children with disabilities in an environment that disregards their needs

The Syrian girl Y.D. (13) lives in a tent with eight other members of her family who are not registered on the lists of the UN High Commissioner for Refugees (UNHCR), the fact that deprives them of the basic assistance on the one hand and refugee status on the other. The family, living in Younine camp in the Beqaa where no one in her family is productive economically, is hunger stricken. As a consequence, her sister M.D. suffers malnutrition.
to download the document click here  
Yasmine suffers severe spine curvature that causes her constant pain and mobility difficulties. She used to be able to stand and walk on her feet to perform domestic chores that were required of her, the fact that exacerbated the curvature in her back. In addition to her stepmother’s mistreatment and verbal abuse, her father prevented her from leaving the tent for «social» reasons, which led to her complete isolation in a corner of the tent, urinary incontinence and shame from her disability.
During a camp field visit, one of the social workers from the «Enabling persons with disabilities to deal with the Syrian crisis project» implemented by the Lebanese Physical Handicapped Union in the Beqaa got to meet the girl. She was referred to one of the international organizations programs to provide her with a medical back brace. The device, however, and after obtaining it, caused her additional pain and turned out to be unsuitable for her. After referring Y. D. again to physical therapy sessions, some progressive improvement was observed but the medical examination revealed that she was in need of prompt intervention. In addition to the brace, she needed an urgent surgical operation without which it is believed she would not be able to walk again. If her disability was to exacerbate, will she be able to be mobile in a wheelchair around the camp? Can the refugee family change its place of residence? And is the surrounding public space for both citizens and refugees and the families that are able to rent apartments any better for children with disabilities?

Figures and needs

The case of Y. D. is one of 306 cases observed by the project implemented by the Lebanese Physical Handicapped Union; the project is involved with 284 of these cases. The project, in its statistical and relief aspects, is an urgent need for a region that houses a very large number of refugees in the absence of scientific statistics. The figures available from UNHCR for the Hermel and Beqaa districts in general reveal the registration of 9,342 persons with disabilities distributed according to type of disability as follows: visual impairment with 1,362 persons (503 females and 859 males), mobility impairment with 1289 persons (621 females and 1,271 males), mental disabilities with 816 persons (346 females and 470 males), auditory and verbal impairments with 1,602 persons (640 females and 962 males), other disabilities with 3,670 persons (1,257 females and 2,413 males). As a result, around 40 percent of refugees with disabilities who have obtained a UNHCR registration card have no specified disability either as a result of absence of a specialized form on the one hand or the narrow local classification of disabilities compared to classifications adopted worldwide in an era following the Convention on the Rights of Persons with Disabilities (CRPD).
Therefore, the no way to reach refugees with disabilities, particularly the children, is by looking for them in refugee camps and centers before determining the needs and intervention possibilities to fulfill their needs. Research has revealed that most of them live in and around Baalbek, Majdel Anjar, Bar Elias and Marj (around 90 percent) while the remaining percentage is spread over the towns of Ali Annahri, Brital, Gazza, Joub Jannine, Hermel, Iaat, Shmustar, Taalbaya, Taanayel and Temnine.
It is evident that the infrastructure in those areas, as in the rest of Lebanon, lacks any architectural amenities that heed the needs of people with disabilities either at its minimum level as provided by section four of the law 220/2000 on the rights of persons with disabilities or in accordance with the comprehensive system imposed by the CRPD and its optional protocol that the Lebanese Parliament has not ratified to this day, nine years after it has been issued.
According to the coordinator Samar Tufayli of the «Enabling persons with disabilities to deal with the Syrian crisis project» implemented by the Lebanese Physical Handicapped Union, «If the infrastructure for public and private use in towns and cities is that way, how could it be otherwise in the refugee camps that virtually don’t have any amenities to aid the mobility of people with disabilities?» Syrians with disabilities have fled to an environment already in a crisis, which does not meet the basic needs of its citizens with disabilities and where legislation on the urgent services is applied arbitrarily, as with the medical and hospital care services where difficulties in obtaining prosthetics and medical devices persist. Moreover, most of the articles of the law 220/2000 relating to educational integration, education, sports, recreation, housing and decent employment have not been applied for 16 years.

Hostages of the place

The project figures show that out of 284 refugees, 161 children were subject to intervention in Middle and North Beqaa (89 percent under the age of 15, 37 percent females), where children make up 57 percent of refugees and are distributed among the four impairment categories (auditory and verbal, visual, mobility and mental), as well as 19 cases of multiple impairments. Moreover, 75 percent of these children live in refugee tents while the rest live in rented apartments or buildings that lack the basic architectural amenities for people with mobility, visual or mental impairments. Thus, they are in fact the hostages of a place that does not heed their needs as well as the needs imposed by displacement on the one hand and their health condition on the other.
Nevertheless, when the intervention with a child with disabilities involves treatment and medical devices, he cannot be isolated from the rest of the children, refugees or other. In spite of the great difficulty of doing so, and according to Tufayli, the project has worked to prevent the isolation of refugee children with disabilities in parallel with working with Lebanese, Syrian, Palestinian and Iraqi children, i.e. four times the number of Syrian children with disabilities, as part of the Emergency Project rehabilitative therapies section that includes physical therapy, speech therapy, occupational therapy and medical devices.
Accurate information has been collected regarding the need of people with disabilities through field assessments and referrals by associations and other parties.
Agreements have been concluded with specialists and the action team has been trained on the standards of referral for each type of therapy and the procedures in place have been organized for each type for best results in the follow up on the progress of each case in addition to equipping the necessary clinics and the mobile clinic. Thus, refugee children have become a part of integrated work that goes beyond relief and therapy to integration in training and recreational activities.
For that purpose, workers in most relief associations and organizations active in the Beqaa had to be trained on how to deal with individuals with disabilities.
In addition, the referral system has been activated to respond to different needs that exceed the project’s capacity relating to mobility aids, health and medical treatments and legal assistance (227 persons have been referred to date and they are being followed up to ensure they receive the required service).
The social and psychological support department has worked on implementing external social activities and social and various psychological support activities for refugees and residents alike in addition to recreational activities for children to help them integrate in the local environment. This was preceded by empowering and training the action team and a team of volunteers who would be carrying out the activities, with special focus on children and adolescents, child protection standards in emergencies, child development stages, communication, providing moral support to a child and his family, disability and integration, and violence survivor care. The social and psychological reality has been assessed in target areas with the help of a rigorous questionnaire (emotional, psychological, social and behavioral) and data analyzed before drafting an action plan.
Difficulties are mainly related to dealing with the society’s received view of children with disabilities and the insistence of some... to download the document click here