Love, war and hope - a year in photos.

2016 will stand in history as a 'critical juncture' with Brexit and a Trump administration, history will be shaped by how we respond as a global community. In 2017 we need to stand together to protect our human rights and work together to battle against this turning political tide. 

Eddie Ndopu, disability activist and inspiration

Source  http://mg.co.za/article/2016-07-11-00-eddie-ndopu-is-ready-willing-and-able

'We fell in love': relationships and people with learning disabilities – in pictures

Source  https://www.theguardian.com/social-care-network/gallery/2016/jun/20/learning-disability-week-relationships-love-friendship 

2016 has been marked with a fundamental change in war and consequently how the international community has responded, this young girl lost both of her legs during the Yemen war.

Source  https://www.icrc.org/en/document/scars-war-yemens-disabled

This year we celebrated the 2016 Paralympics

Source  http://www.telegraph.co.uk/paralympic-sport/2016/08/25/paralympics-2016-jonnie-peacock-insists-rio-should-be-ashamed-of/ 

'We fell in love': relationships and people with learning disabilities – in pictures

Source  https://www.theguardian.com/social-care-network/gallery/2016/jun/20/learning-disability-week-relationships-love-friendship 

Another year plagued with cuts in the UK, protesters in Brighton come to the streets.

Source http://www.disabledgo.com/blog/2016/07/protesters-bring-rotten-pip-message-to-the-core-of-westminster/#.WEx6FqKLSRs 

What we can do for International Day of Persons with Disabilities (IDPD)

Today we mark the International Day of Persons with Disabilities (IDPD). Since 1992, the United Nations of International Day of Persons with Disabilities (IDPD) has been celebrated annually on 3rd December around the world. The theme for this year's International Day is "Achieving 17 Goals for the Future We Want".

This marks the recent adoption of the 17 Sustainable Development Goals (SDGs) and the role of these goals "in building a more inclusive and equitable world for persons with disabilities". The UN state that this year's objectives include assessing the current status and foundation for a future of "greater inclusion for persons with disabilities". 

The message this year from the United Nations General Secretary, Ban Ki Moon, states that the SDG's is based on a pledge that no one is left behind. Achieving this requires the full inclusion and effective participation of persons with disabilities in society development. So what does this mean for us and how can we play a role?

1. Support charities with specific development targets and indicators which assist disabled people. 

Development policy should be inclusive this means including disabled people with development discourse and policy. If you decide to donate to a charity try to investigate if the policy is inclusive of disabled people. Far too often disabled people are neglected from development programmes and are overlooked. 

If we all called for inclusive development policy then perhaps we can make it towards the UN's goal for 2030 and nobody will be left behind. 

2. Ensure access to al mainstream services 

For us to meet the SDG in 2030 every global citizen needs to help bring changes to laws, policies and institutions and society to ensure that disabled people have access to all mainstream education, health, employment, transportation, information/communication and social services equally with dignity. 

3. Empower women and girls with disabilities 

Women and girls are facing double discrimination and this needs to end. Empowering women and girls with information about their rights and how they can claim them are essential for development. They must have access to the legal system and have equal rights to hold property and inherit. We must keep campaigning and working together to ensure women are included, every step of the way. 

4. Employment 

To be an inclusive society, we must promote the employment of disabled people within in all sectors and support entrepreneurship development. The development sector hand in hand with governments should support necessary development initiatives for people with disabilities aimed at overcoming barriers they face in seeking employment, including vocational training. 

5. Health and rehabilitation 

We need to ensure all disabled people have access to health and rehabilitation services that respect their physical and mental integrity and dignity. This includes providing information, services and counselling on sexual and reproductive health issues. 

On this International Day of Persons with Disabilities, we need to urge national and local governments, businesses and everyone in society to maintain efforts to end discrimination against disabled people. By working together, raising awareness and campaigning together we can achieve an inclusive society where no one is left behind. 

This week campaign is dedicated to the children at Thuy An Centre, Viet Nam and the boys at Home of Hope, Cambodia. 

Women and disability

About 650 million people in the world - or 10% of the world's population - live with disabilities, and frequently encounter a myriad of physical and social obstacles. The majority often lack the opportunities of their non-disabled peers and are usually among the most marginalised in society.

A UN report noted, "Girls and women of all ages with any form of disability are among the more vulnerable and marginalised of society". Women and girls with disabilities are subject to double discrimination. Marginalised both on account of their disability and their gender, they face social isolation and rejection and are taught that they are inferior to their peers.  This has a clear impact on both their own aspirations and their family's aspirations for them in the future.

It is estimated over 200 million women with disabilities live below the poverty line. As discussed in this blog, there is no mention of disability in any of the eight Millennium Development Goal (MDG) to promote gender equality and empowerment of women with disabilities. This has significantly held back the progress of disabled women and girls in developing countries.

Due to the double discrimination, they are less likely to receive the health and rehabilitative care they need to remain economically or socially independent and they face reduced access to education, employment or social inclusion compared to both disabled men or non-disabled women. Despite these clear links, gender and disability have persistently been treated separately in development discourse.

Although the UN Convention on the Rights of Persons with Disabilities (CRPD) recognises that women and girls with disabilities are subject to multiple discrimination. However, the CRPD is very unique in recognising women and girls with disabilities as a distinct group. Theoretically, disabled women are in all human rights agreements, the sad reality is that they rarely referenced specifically and are often overlooked in development policy.

This often means disabled women are isolated from educational programmes, healthcare and food during humanitarian crises. Disability causes poverty, and poverty can lead to disability. Women are more likely to have limited resources and are more likely to be deprived of basic necessities and unable to access their rights.

A recent report by Action on disability and development (ADD ) on displaced populations in post-conflict Norther Uganda, a disabled woman describes how "when food is given being given, sometimes persons with disabilities are given what others leave behind on their plates".

The same report found that many disabled women remaining in camps longer after many others have returned home because they are physically and economically unable to leave as a result of their disability. This is yet another example of why governments and all organisations which work in development need to ensure they are focusing on working with, and listening to disabled people. (Human Rights Watch,2010)

 In order to tackle systematic violations of women's human rights more needs to be done to tackle this discrimination throughout the international system. The develop sector needs to develop specific development targets and indicators to measure the impact on women and girls with disabilities. These should be a cross-cutting aspect of all global and national development goals which should be at the top of the development agenda.

If the UN is going to meet the Sustainable Development Goals the development sector, leading international institutions such as the UN and World Health Organisation (WHO) need to work closely with governments to ensure women are included in  all aspects of development policy.

Violation of disabled rights in the UK with government 'reforms'

Austerity policies introduced into welfare and social care by the coalition government amount to “systematic violations” of the rights of people with disabilities, a UN inquiry has concluded.

The report says a range of measures aimed at reducing public spending since 2010, including the controversial changes such as changes to Employment and Support Allowance, the scrapping of the Independent Living Fund, cuts to the Access to Work scheme, the under-occupancy deduction from Housing Benefit or ‘bedroom tax’ and the Benefit Cap.

The highly critical report, published in Geneva on Monday 7th November, says the “rights of disabled people to live independently, to work and achieve an adequate standard of living have been negatively affected by austerity measures”.

It makes eleven recommendations, including a key statement calling on the UK government to carry out a study of the cumulative impact of all spending cuts on disabled people and to ensure the human rights of disabled people are upheld.

The UK government, however, rejected the UN report, the work and pensions secretary Damien Green saying that the report was “patronising and offensive” and presented an outdated view of disability in the UK. He said Britain was “a world leader in disability rights and equality”.

However, disability activists and charities welcomed the report, saying it accurately highlighted the real economic and social pressures faced by disabled people after years of harsh cuts to social security and social care.

The report is damning about the actions in which ministers have conducted welfare and social care reforms, arguing that parliament pushed ahead with changes with the knowledge they would have an extreme impact on disabled people.

The inquiry highlighted that the personal independence payments and the independent living fund had “hindered various aspects of [disabled people’s] right to live independently”, it says making them more reliant on family and carers and in some instances forcing them into institutional care which has also seen significant cuts.

The highly controversial bedroom tax and other housing support such as Disabled Facilities Grants (DFG) had led to debt and eviction. The bill has hit many families as tenants in social housing have their benefits reduced by 14% if they have a spare bedroom, or 25% if they two or more.

The bedroom tax hit families who needed a spare room for an overnight carer, families such as the Rutherford’s. Paul Rutherford, the grandfather of a disabled child from Pembrokeshire has been fighting a legal battle for three years with the government. Warren needs an extra bedroom for an overnight carer. The court appeal ruled that the bedroom tax was discriminatory in the cases of the Rutherfords. However, the Department for Work and Pensions appealed against the decision and the supreme court announced the case of the Rutherfords and several other bedroom tax challenges would be heard. 

Government attempts to decrease the disproportionately high levels of unemployment among disabled people have had little impact. It is highly critical of what is calls the ‘functional assessments’ of disabled people who have applied for social security benefits. The report stresses that their experience tended to be one where they were “merely processed rather than being listened to or understood”.

Alarmingly the report highlighted that disabled people had suffered from a climate in which they were portrayed as “lazy and putting a burden on taxpayers”. The blame game which politicians have relied on to win votes and the Tories election posters with slogans such as ‘Let’s cut benefits for those who refuse work’ have had an extremely negative effect. The report noted that disabled people have continued to experience “increasing hostility, aggressive behaviour and sometimes attacks to their integrity”.

The report, issued by the committee on the rights of persons with disabilities concludes: “There is reliable evidence that the threshold of grave or systematic violations of the rights of persons with disabilities has been met”.

The investigation was instigated by the charity Disabled People Against Cuts (DPAC) who contacted the committee in 2012 – since then other charities have also confirmed that they had contact with the UN. After two years of deliberations, the UN committee on the rights of persons with disabilities gave the green light to the inquiry in May 2014.

After extensive interviews and hearings from the 11-day inquiry tour of the UK undertaken by two UN envoys in October in 2015. The inquiry team met with more than 200 individuals, including officials, MPs, activists and academics.

Disabilities and reproductive rights: radical autonomy and assisted freedom

On the occasion of the International Day of Persons with Disabilities, we turn our attention to reproductive rights.

This is a highly contentious issue, highlighting some of the outdated attitudes that individuals, Governments, and institutions, including care facilities and medical professionals, still hold towards people with disabilities.

Sexuality education and disability: examples from Germany

On average, the hormonal injection only accounts for 1% of the contraceptives in use in Germany, which makes it relatively unpopular. Among women with disabilities, however, the hormonal injection is the most commonly used form of contraception. Unfortunately, this is not always down to a free and informed choice.

In 2008, for example, the case of a woman with an intellectual disability and severe diabetes came before the Higher Regional Court. She lived in a care facility, was sexually active and wished to have children. Her carer however, against her patient’s will, got a doctor involved who restrained the patient and dispensed the hormonal contraceptive injection. When the carer tried to have a follow-up shot dispensed later, the patient managed to reach out to a lawyer and brought her case to court – which ruled that yes, there was no legal basis for the forced use of contraceptives. Interestingly, it remains unclear if criminal charges were pressed – the carer certainly broke the law, so logically she should have been punished.

What may seem like an isolated incident is in fact very common. A 2012 study on the women’s livelihoods health and challenges of people with disabilities in Germany found that 18% of women with disabilities who live independently are sterilised. In care facilities, this figure rises to 30%, with only 53% of these procedures having been consented to. That’s staggering.

Far too many people view people with disabilities as asexual. As if being a sexual being and experiencing one’s sexuality is reserved for able minds and bodies only. In practice, this outdated perception is incredibly harmful. Only 1 in 2 people with intellectual disabilities in care facilities have access to sexual health education. This means that consent to the use of contraceptives is not necessarily informed or based on a comprehensive understanding of how they work.

Furthermore, this often places people with disabilities at a heightened risk of sexual assault and abuse, sadly even at the hands of their carers and doctors.

Disability, Development and sexuality: examples from Vietnam

Blue Dragon Children’s Foundation offers long-term shelter, educational opportunities and escape for Vietnamese children and young adults from their places of slavery. In October 2014, Blue Dragon dealt with “one of the worst cases of sexual exploitation of a vulnerable child we have seen and it shocked us all”. ‘T’, a fourteen year old deaf and intellectually impaired boy from Viet Nam, was savagely beaten and raped by his neighbour.

The Blue Dragon team was able to mobilise legal support, access treatment for ‘T’, gain representation in court, and secure care for the family to recover from their ordeal. The attacker was sentenced to 18 months imprisonment, which is very low by international standards. However, in Viet Nam this is a major achievement as current domestic law does not consider sexually assaulting a boy as a criminal offence.

Sexual assaults of people with disabilities seem to be a widespread problem in developing countries. A 2004 report by Save the Children Norway on sexual abuse and disabilities in Zimbabwe estimates that 87.4% of girls with disabilities have been sexually abused. Of those who had been sexually abused, 52.4% tested positive for HIV. In the developing world, laws, policies and prevailing attitudes do little to protect disabled people’s sexual and reproductive health and rights.

Human Rights and sexuality

The UN declaration on the rights of People with Disabilities takes one of the most radical approaches to disability and reproductive rights. Basically, it states that reproductive rights are a Human Right, including the right to marry and the right to be a parent. For people with disabilities, this means that access must be provided to be comprehensive, appropriate and judgment-free information about contraceptives, safe sex, sexuality and their bodies. In practice, educators, care facilities, medical professionals and social services are required to adjust sexual health education programmes and materials, and to tailor them to the needs and abilities of all people with disabilities.

Ultimately, what heated debates and controversies about sexuality and disabilities come down to are moral arguments about who has the right to be a parent. I’m sure we all know examples of bad parents, who lack much needed support and guidance – regardless of their abilities. Being a good parent is determined by compassion, love and care, not by intellectual and bodily capacities.

Global efforts need to be made at all levels to ensure that disabled people are able to lead a healthy life with regard to sexual and reproductive health. Protecting these rights, and spreading knowledge and information are key to tackling the current discrimination that people with disabilities face.

To learn more about sexual health, head over to http://theintimateinitiative.com/blog/.

Speech therapy in action

Communicating with other people is at the centre of our everyday lives. During my experience working in Cambodia and Viet Nam I met many people who have a communication or swallowing disorder. However, health services for them are nearly non-existent and many people are cut off from their families, friends and the rest of society,

In Cambodia, more than 600,000 people have a communication or swallowing disorder and there are very few places individuals can receive therapy. OIC are working to solve this silent crisis in Cambodia, the small team based in Phnom Penh work towards ensuring people receive the help they need to communicate with those around and lead full and happy lives.

OIC goal is to make speech therapy available to all those who need it in Cambodia. OIC is arguably one of the most sustainable organisations in the development sector, the team have a fourteen-year plan, including an exit strategy, after which OIC will leave Cambodia. The target is for 100 Cambodian speech therapists to be employed by the government by 2030.

Locally trained speech therapists are desperately needed, with no trained speech therapists in the country many children are left isolated or in some cases abandoned. In 2015 alone the social work at Angkor Hospital for Children responded to 20 cases of child abandonment.

Sorya who was born with cerebral palsy was abandoned at Angkor Hospital for Children when he was roughly nine months old. His family left the child due to their lack of confidence to care for him. According to the social work unit lead by, Mr. Sokchea, there are many factors that influence a family to leave their child in the care of another. Reasons include poverty, social norms, lack of information about support services available to the family, violence or the belief that a child born with disabilities will bring bad luck to the family.

Luckily the local team have worked tirelessly with a family who has fostered Sorya. The team have partnered with Safe Haven Medical Outreach, which provides ongoing physical therapy, play therapy and feeding training to Sorya and his foster family.

Speech therapy is so important not just for communication, speech therapy is extremely important and life-saving. When a child has a swallowing disability, common in those with cerebral palsy, food and liquid can go into their lungs. Consequently, they can contract pneumonia and even die.

Ensuring local communities, schools and families are educated means that children with communication or swallowing difficulties can be spotted quicker. Some teachers and parents usually assume their children are 'slow learners'. However with disabled workers heading out to communes and villages working with teachers, government officials and local non-governmental organisations more children will have access to the therapy they need.

Organisations such as Safe Haven Medical Outreach and OIC are working out in the field to ensure children have access to basic speech therapy. OIC go to many rural parts of Cambodia working with children with a range of disabilities ensuring they are able to communicate with their families, have access to education and are able to participate in the local community.

Without their campaigning efforts, advocacy and push for developing and training courses to create jobs for speech therapists many children such as Sorya would be left isolated. 

Please consider supporting OIC.

Queer, black and disabled.

In a recent article published by the Huffington Post, a disabled woman wrote: “disability transcends race, ethnicity, religion, socioeconomic status, sexual orientation, and gender identity”. In other words, people with disabilities are a very diverse group of people.

Eddie Ndopu a 25-year-old black, queer-feminist, disability rights activist from Johannesburg is making history in a big way. He was raised by a single mother who fled apartheid South Africa to self-imposed exile in Namibia. At the age of two, Ndopu was diagnosed with spinal muscular atrophy and given until the age of five to survive.

Since then Ndopu has led an extraordinary life and career. He has held key positions such as Head of Amnesty International’s Youth Engagement Work for Africa, a summa cum laude graduate of Carleton University in Canada, where he served as a research analyst at the World Economic forum.

He is a champion of disability activism or as Ndopu puts it “ I’m the guy on wheels who refuses to rest until every single disabled person in the world until every single beautifully black and brown disabled soul gets a fighting chance at living their best life”.

In his video “In His Own Words” what strikes me about the video is how he challenges the audience to think about their understanding of disability. It’s one of the most inspiring videos I have watched. I hope you enjoy it.

What does a Trump administration mean for disabled people?

Nobody expected Donald Trump to win the election but now with Trump sitting in the Oval office what can disabled people expect? Like many other comments Trump has made during his election marginalized groups, including disabled people, will be watching carefully in 2017.

Although it is impossible to predict what the Trump administration will govern, his campaign platform and the Republican's priorities do not reassure disabled people and their families who rely on support from the Care Act and Medicaid. 

Disabled rights activists have voiced concerns throughout his election campaign, his threats to repeal Obamacare, block granting Medicaid, reducing ADA enforcement and police accountability are just a few concerns. 

Sadly, like many others, their voices have been pushed to the side and the American electorate has voted for an individual who publically mocked a reporter with the joint condition arthrogryposis. An election campaign which has been embodied by hateful messages, misogyny and discriminations will lead many people left with a sense of unease. Below are some of the points which disabled activists are most concerned about. 

Repealing Obamacare 

Throughout his campaign, Donald Trump has repeatedly promised to repeal the Affordable Care Act, also known as "Obamacare". The Republican party has full control of both houses of Congress, meaning Trump will easily be able to fulfil his campaign promise.

However, after his meeting with Mr.Obama on Thursday he has reconsidered his calls for an all-out replacement of the Care act. In a recent interview with the Wall Street Journal, he hints at a possible compromise to keep some aspects of the 2010 law.

In his first interview with since his election earlier this week with the Wall Street Journal, the president-elect said one priority was "moving quickly on President Barack Obama initiative, which Mr.Trump said has become so unworkable and expensive you can't use it".

Trump also comments how Mr.Obama has asked Mr. Trump to reconsider his stance during their first meeting at the White House after the election. Obama's consideration seems to be heard as Donald Trump has said he favours keeping at least two provisions.

President-elect Trump said he favours keeping the prohibition against insurers denying coverage because of patients' existing conditions, and a provision that allows parents to provide years of additional coverage for children on their insurance policies. Saying "he likes those very much".

For now, it seems Trump has done a U-turn on repealing Obamacare altogether. However, the Republican party has never supported the Care act combined with his erratic and inconsistent policy decisions may lead to another rash decision.

Block-Granting Medicaid 

Another of Trump's election campaign promises was to ''block- grant" Medicaid or flat annual funding amount. On Trump's website, he claims that nearly "every state already offers benefits beyond what is required in the current Medicaid structure". As part of the reforms, he pledges that governments can have  more autonomy over the administration of Medicaid. He claims that this gives the states more incentives "to seek out and eliminate fraud, waste and abuse to preserve our precious resources".

Currently, Medicaid functions as a flexible needes-based insurance program designed to provide health care to as many impoverished people as necessary. It is very unclear how Trump would structure his block-granting plan, his proposal was very unclear. The page entitled "Healthcare Reform to make America great again" claims the "American people have had to suffer under the incredible economic burden of the Affordable Care Act- Obamacare". The reforms rely heavily on free market principles that will restore economic freedom.

It is estimated that the proposed 'block-grant' could easily cause some 30 million Americans to lose health insurance, a significant amount of those who are people with disabilities. A healthcare system based on the principles of free the market will hit the most vulnerable. With many Americans falling further into poverty putting healthcare up for sale is not the answer to a more stable and healthy society.

Reducing ADA Enforcement and Police Accountability 

Disability activists have stressed concerned that the next administration could cut back on the civil rights division's resources or change its priorities. The president conducts a significant amount of disability policy through control of various regulatory agencies. The Department of Justice's (DOJ) civil rights division, for example, pursues complaints against employers, business, and other institutions for violating the Americans with Disabilities Act, the 1990 barring discrimination against Americans with disabilities.

Many organisations are sceptical Trump's political appointees to agencies like the Centers for Medicare and Medicaid Services and Department of Labor would be committed to ensuring access to benefits and suitable workplace accommodations for people with disabilities.

A Trump backed DOJ could also progress on police accountability to the detriment of people with disabilities - says David Perry, a leading writer on disability issues. As many as half of all people killed by police are disabled, according to Perry's original research for the Ruderman Family Foundation - including Eric Grabber, who suffered from asthma and heart disease. With the problematic situation of police shootings in the USA, the DOJ needs funding and an administration which will actively support their prosecutions. Therefore the DOJ's pursuit of police accountability is a disability rights issue as well.

Many activists will be waiting in anticipation for the appointee of the DOP who has yet to be named. However, if the current selection has anything to go by he will select a conservative individual who will unlikely maintain and fight for disabled peoples' rights.

Moving forward 

Protecting people with disabilities has traditionally been a cross-party cause in Congress. We hope this will be continued by both parties and the Republican party is able to keep Trump's regressive policies in check. In the words of Stephen W Thrasher " Hold tight to the ones you love who are sick and differently abled."

The singing activist

The World Health Organisation estimates that at least 81 million in Africa have some form of disability. In Nigeria alone it is estimated that 25.5 million people in Nigeria had at least one disability.

Grace Jerry is one of the 25.5 million people who have a disability. In 2002, Grace Jerry was on her way home from choir rehearsal when she was knocked down by a drunk driver and left with paralysis of the lower limbs. After the accident she says music took on a whole new dimension and now she uses music as part of her activism in Nigeria.

The Presidential Precinct Yali video blog, Grace or 'Gracie' eloquently speaks about her experience as a advocate for disability rights in a developing country.

Adaptive design - life made accessible through cardboard.

My last blog explored how to make disabled aides in developing countries. This week's blog will focus on a NGO based in New York who adapt cardboard to make aides for disabled people.

The Adaptive Design association first started out in 1981 when Alex Truesdell, an early childhood teacher from the Perkins School for the Blind in Boston, met Erin, an infant with severe multiple disabilities. A short time after Alex's Aunt Lynn lost the use of her fingers and thumbs following a spinal cord injury. With the help of her Uncle, Alex started to adapt different types of materials to customise solutions for Erin and her Aunt Lynn.

Over the next few years, Alex set up a small workshop in her basement and made many more adaptions for children at the school. Eventually the school hired Alex fulltime to start the Assistive Device Center, a program now in its 28th year.

Image courtesy of Kristen Hastings 

The mission of the Adaptive Design Association  (ADA) is to ensure that people with disabilities are able to fulfil their potential in all spheres of life. ADA help adapt materials for self-care, communication, social activities, academic and vocational potential. Each person receives their own custom adaption to suit their need. The organisation also runs a full range of hands-on education, from basic introduction to apprenticeships, for people wanting to establish Adaptive Design Center's within their schools, organisations and communities across the globe.

Kristen Hastings an occupational therapist from the USA who I met in Viet Nam when she volunteered at a rehabilitation centre I was working with, took the three day course with ADA. Kristen's motivation for embarking on the course was her experience volunteering at a rehabilitation centre in Hanoi, Viet Nam. Throughout her experience Kristen worked endlessly to adapt wheelchairs by using towels, thera-bands and other materials to correctly position each child. The course run in New York offered Kristen a chance to develop new skills when she works overseas in developing countries.

Image courtesy of Kristen Hastings 

The three day course includes the basics such as how to measure accurately, how to cut the cardboard using various power and hand-tools; to more complex tasks such as how to manipulate the cardboard. Kristen choose to learn how to make chair inserts as part of her final task on the last day. The chair inserts fit into a wheelchair which would position children in the most optimal position.

The course has enabled Kristen to develop sustainable solutions to rehabilitation and care in the developing world. Cardboard is a accessible material in many developing countries and with limited access to equipment designed for disabilities, engineering aides from cardboard is a lifeline for developing countries.

This simple idea of manipulating and adapting a low cost material allows more and more people with disabilities to access their world. Kristen Hastings commented 'positioning is key for so many who have a disability. With the proper supports, the body is free to focus more on eating, playing, writing etc. With increased accessibility to engage in your environment comes increased socialisation with others. With increased engagement and participation in one's environment comes increased quality of life."

By enabling a person to draw, play a musical instrument, wash their own hands or improve their communication skills to develop their potential. So often disabled peoples options are very limited due to a lack of accessibility.

Adaptive design provide great solutions for everyday uses. Although the organisation is located in New York they encourage individuals to spread the word and ideas. ADA hope to train other professionals, opening more workshops across the United States as well as other countries. By connecting more people across countries Adaptive Design is leading the way to creating greater accessibility for individuals in multiple communities across the globe.

Please consider supporting this NGO by donating.

How to make disabled aides in developing countries.

Working overseas in a developing country is always challenging whether you are haggling for resources to build a centre to stay on budget for a project or the car breaking down in the middle of nowhere - you have to learn to think on your feet.

Whilst working in Cambodia and Vietnam I spent a vast amount of time trying to find ways of making and adapting equipment which we would be able to find so easily in the developed world. Whether I was trying to fix wheelchairs, improve the level of care the children received or attempting to make toys to help with therapy sessions, everyday was a struggle.

During the month of October I'm going to share some of my ideas, solutions, books, websites and resources to help aid workers, families and therapists from across the world. This week I’m going to focus on making toys and sensory boxes for sensory therapy. 

Sensory bottles 

Pinterest has been my go to place for making sensory bottles for the last two years. Although it has been filled with endless experiments of making sensory bottles in a classroom in Cambodia, the office in Vietnam and many other places! I have finally found the winning solution.

What will you will need? 

Water bottle
Water
Glitter glue (or PVC glitter and glitter)
Glitter
Jewels/Sequins/Buttons etc 

Super glue


How to make it:

Fill the water water bottle up to roughly ⅔
Add a bottle of glitter glue and some extra glitter
Add the jewels,sequins, buttons etc
Finally superglue the top so it doesn’t go everywhere!

Sensory dens 

Ideally every centre will have a sensory room where the children can receive therapy or a place for them to relax. Sadly not every centre has enough space or resources to build a sensory room. In some centres we created ‘sensory dens’ which was a makeshift version! Here are some ideas which we used.

What will you need?

Material
Cardboard/paper

Fairy lights
Cushions
Paint/colouring pencils/felt tips
Art and crafts materials - glitter, sequins, material etc

How to make it: 

Drape the material to make a tent like shape.
Decorate the tent to the children’s need i.e including fairy lights, mobiles and sensory boxes to include for the session.

Sensory boxes

Each box can be designed to each child's or adult's need whether the box can be used to improve fine motor skills, autism or dementia there are lots of possibilities.

Autism Space sensory box:

You can adjust each box to the individual need whether you need a box based around a sense, learning tool each box can be changed!

What will you need?

Black beans or grey sand
Astronauts
Pebbles
Planets made from bouncy balls or cut out circles from cardboard
Stars (glow in the dark if you can source them)

How to make it:

Put it all in the box and create space!

Touchy feely dementia sensory box:

Boxes
Bowl of cold porridge
Ball of cotton wool
Sponge
Polystyrene balls
Banana
Football

How to make it:

With this box you can make a hole in each of the boxes, place the objects in the box and pass the box to the patient to put their hand in and try to guess what the objects are.


Fine motor skill box:

Four small boxes
Paint (green, yellow, red,blue)
Buttons (green, yellow, red,blue)

How to make it:

Paint the boxes the four colours and ask the individual to match the buttons to the box.

These boxes and bottles can be adapted for each person's need but they are cheap and easy to make. There are so many markets across the developing world where you can buy arts and craft materials and are so much fun to make. Enjoy!

Ibrahim Al Hussein inspirational story from the Paralympic games in Rio 2016

Ibrahim Al Hussein represented the Paralympic refugee team in this year's games in Rio. He was named as one-half of the Independent Paralympic Athlete Team representing refugees and asylum seekers.

The inclusion of refugees in the Paralympic and Olympic teams has served to remind a global audience of the plight of those trapped in war-torn countries. As Ollie King highlighted in this blog  'The Syrian Refugee Crisis: Shining a light on the response to impairment, disease, and disability' that levels of conflict-related injuries are notably high in the case of the Syrian conflict. One in 30 refugees that fled to Lebanon, and one in 15 refugees in Jordan were injured as a direct result of the fighting.

Al Hussein story is no different in 2012 a year after the civil war broke out in his country, a bomb went off close to his home. The 27-year-old had taken shelter from the blast inside his house but was alerted when he heard cries for help from his friend. Courageously he ran out of the building and across the street to try and help his friend but was hit by a rocket, injuring his leg.

He managed to crawl away from the scene and was rescued by some of his friends. However the damage to his leg was too severe and doctors had to amputate the limb from the mid-calf down.

After his leg was amputated in Syria Al Hussein fled his hometown and first travelled to Turkey before reaching the Greek island of Samos, travelling on a rubber dinghy, to seek further treatment for his leg.

He was granted asylum in the country in 2014 where he started to swim again. As a child he was a keen athlete who dreamed to one day become an Olympic swimmer. After his leg was amputated he didn't give up on his dream and carried on training.

You can watch his inspiring story to Rio below.

Although Al Hussein didn't win any medals this year at the games he has contributed to changing the face of disability and refugees.

A glimpse of disability care in Tboung Khmum Province in Cambodia.

As we leave Phnom Penh mini vans pass by crammed full of workers, children are litter picking and early morning construction workers head off to work in the unforgiving hot sun. As we leave the city life behind beautiful green rice paddies roll on for miles and miles with palm trees scattered across the horizon.

The team is heading to Tboung Khum province located on the central lowlands of the Mekong river. Before we arrive we stop off for an early lunch at a restaurant in the neighbouring province Kampong Cham. Koy Phallany executive director of Khemara organisation  informs we are stopping off for an early lunch because there is little food and water in Tboung Khum. Initially I think this may be an exaggeration and there must be some access to food and water nearby. But as soon as the drive towards the network of villages begins we see less and less shops, vendors and rows of stilt houses with nothing else around. I realise access to basic necessities is a daily reality for the families who live here. 

Our first few stops are visiting a few families and each house we go to is as heartbreaking as the next. An orphan teenage girl who lives with her Aunt is desperate to go to school but her family are struggling to pay for her school books and uniform. We drive around the corner to visit a Grandmother who lost her daughter and one of her granddaughters a few days after childbirth. She sits cooing the remaining twin sister, the family are struggling to make ends meet even though the father has gone to a nearby province as a labourer sending money when he is able to. With a family of five to feed everyday is a struggle.

Unfortunately neither of these stories are unique with high unemployment rates and the area vulnerable to annual flooding the local people are stuck in a unapologetic cycle of poverty. In Cambodia, as in most parts of the developing world, poverty is recognised to be a major cause of disability. According to a recent DFID report by the age of two, half of all Cambodian children are stunted and malnourishment is a major cause of developmental delay and long-term intellectual disability. The findings are alarming but sadly unsurprising when I visited this rural province the report was contextualised and I realised the harsh reality the people here deal with on a daily basis. 

One of our final stops of the day before visiting Khemara's daycare centres we visited a teenage boy called Sothea. At the age of six Sothea suffered from frequent seizures for a month which has now left him with a permanent physical disability and speech impairment. 

His mother Huy travelled to the capital to see the doctor but could not afford the hospital fees and had to go back to Tboung Kham with her son. This isn't an uncommon problem Cambodians spend a high proportion of their income on health- approximately 10% and health expenditure is a major cause of personal debt. Because poor people lack access to basic healthcare many illnesses and injuries often result in long term disability. 

Grinding poverty is not only a cause of disability - it is also a major consequence of disability. The majority of disabled people are often much poorer than their non-disabled peers. Disability impacts on a person's ability to work and earn a living. In Tboung Kham the majority of families are employed in agricultural activities, and with a mild or moderate physical disability this can limit an individuals capacity to work in the fields which has a consequent impact on the household income. 

As Sothea reaches adulthood he will struggle to find employment in the local area. He has never attended school even though he is a bright young boy with a wicked sense of humour. As part of our visit we asked one of his friends to read to him when she gets home from school. We are looking to build him a Augmentative and Alternative Communication (ACC) device so he is able to communicate with the local people as he is often left alone for long periods of time whilst his family goes to work in the fields. But I leave feeling very defeated I'm unable to do more.

Although there has been some strong developments in disability care in urban areas of Cambodia access to care in rural provinces is still non-existent. There is limited or services provided for children to go to school or a rehabilitation centre often leaving disabled children with no care during the day. Families are far too often stuck in a perpetual cycle of poverty which is exacerbated by their socio-economic position and limited access to healthcare. 

During my short stay in Tboung Kham I realised with disappointment in my heart that the problems of these villages will not be solved in the near future. The socio-economic and environmental issues which plague the local community will need a coordinated response from government organisations and NGO's developing a sustainable and viable plan for the local people. If and when this happens I hope that disabled people are factored into this development plan so young people such as Sothea are able to contribute to the development of this beautiful country. 

If you would like to find out more about Khemara please visit their website and to donate please visit their JustGiving page.

*  Names have been changed.

A glance at disability at Koh Dach island part one

June 2015 was my first trip to Cambodia. From the moment I stepped through the arrivals gate at Phnom Penh airport and was greeted by the warm smile of the pick up guy Piseth Nuth I fell in love with the Kingdom of Cambodia. During my first week I was intoxicated by the city’s chaotic yet charismatic atmosphere and the spirit of the Cambodian people. 

Despite the Khmer’s turbulent history of bloodshed, poverty and political instability the Khmer have still managed to keep a smile on their faces. The happiness and compassion of the local people has resonated so deep within me that I now consider Cambodia to be my home or “phteah” in Khmer. I often tell friends and family or those willing to listen Cambodia stole my heart and when I’m away from the Kingdom of Cambodia I certainly long to be back home. 

An accomplice to stealing my heart is Koy Phallany, executive director of Khemara Organisation. During my short spells in Cambodia I have had the honour of working alongside this fantastic grassroots organisation. Khemara’s work in the local community is endless, from running free daycare centres for disadvantaged children to running AIDS/HIV prevention projects. 

On a Sunday morning Phallany met my boyfriend and I to take us to Koh Dach (Silk Island) located just a short drive away from the capital. After taking a ferry across the Mekong river Koh Dach island is a different pace of life from the capital. With dirt track roads and traditional stilt houses painted in various shades of blue with the Brahman cows munching on hay with their bells gently ringing in the breeze.

Although the island sounds idyllic many of the residents here suffer from high levels of unemployment and poverty. The purpose of our visit was to see the Khan family who were struggling to make ends meet. The mother had just given birth to a baby girl who was just four weeks old and the father who is disabled is unable to find work. 

Before the mother gave birth the parents drove 160 km everyday to pick snails to sell where they roughly earnt $2 per day to feed a family of six. However with a baby to care for their combined wage is limited. The father struggles to find work due to his disability although a decree was signed in 2010 where state-run institutions must employ one disabled person per 50 employees, while private companies are obligated to employ one disabled person per 100. However these quotas are barely filled and disabled people are often subjected to discrimination and are unable to find well - paid secure jobs. If disabled people are able to find jobs it’s often in low-paid and dangerous work. 

Phallany heard about the family through one of Khemara’s daycare centres where two of the children attend whilst their parents are at work. Hagar International kindly donates $50 per month to the family as well as rice to help the family during these desperate times.

Unfortunately stories such as these are far too common in Cambodia. Our next stop was evident of this as we were off to see a family who live five minutes around the corner. Single mother Chenda and her two children who both attend one of the daycare centres run by Khemara on the island. Her youngest child Bopha is disabled when we arrived he had just taken a tumble trying to run around with his friends and was seeking a kiss and cuddle from Mum for his grazed knee.

This courageous little boy aged four was born with a disability, when I ask his mother “What did the doctor’s diagnose him with?” she responded “I don’t know”. Unfortunately services for disabled people are still very limited and the healthcare sector are unable to provide key services such as assistive devices, medical rehabilitation, physiotherapy, education and training. Virtually all services for disabled people in Cambodia are delivered by NGO’s and with the current uncertain funding climate many charities have had to cut back resources leaving many families without access to healthcare services. 

Bopha’s fingers and toes are locked into a fist leaving him some difficulties with his day to day life. Through the Public Health programme run by Khemara in partnership with Projects Abroad Bopha is now able to walk, previously his sister and mother carried him but with encouragement from the staff he is now up and about with his friends causing mischief. The teachers also provide him with basic physiotherapy which means his fingers are still flexible which will be extremely important for the future. 

Stories such as Bopha and the Khan family are just the tip of the iceberg. As in most developing countries, accurate statistics on the number of disabled people in Cambodia are not available. Nevertheless it is estimated that Cambodia has one of the highest rates of disability in the developing world (UN ESCAP 2002). Disability and poverty are inextricably intertwined.It is estimated that 36% of the population in Cambodia live below the poverty line of US $0.40-0.63. Poverty is a significant cause of disability. It is poor people who are often victims of mine and UXOs (unexploded ordnance) as they are forced to live near mine areas and collect food or firewood. They are also unable to access basic healthcare meaning that simple infections, illnesses and injuries often result in permanent disability because they go untreated. For example, untreated childhood ear infections are a major cause of permanent hearing loss in children. 

Although there are some fantastic NGO’s supporting the local community such as Action on Disability and Development (ADD), Handicap International and Khemara (who are looking to extend their services for disabled children) a greater understanding and awareness of disability in Cambodia is needed. 

Throughout my blog I have criticised the development sector for not including disabled people within mainstream development and Cambodia is another prime example. It is critical that organisations engage with the disabled sector, that the government is supported to resume more responsibility for its disabled citizens and that disabled people are empowered. 

If we were to witness changes such as these perhaps little Bopha and the Khan family will be able to lead a life where they have access to a secure job and healthcare. I certainly think they deserve all the happiness in the world and more. 

My next blog will be about my trip to Tboung Khmum Province in Cambodia. 

If you would like to find out more about Khemara please visit their website and to donate please visit their JustGiving page.

* Names have been changed.

The Invisible problem in Development: Part 2

The World Health Organization (WHO) estimates that schizophrenia, bipolar disorder, depression, and alcohol-use disorders affect around 450 million people and account for 12 percent to 14 percent of the global burden of disease, measured in disability-adjusted life years (DALYs) (DALYs represent the total number of years lost to illness, disability, or premature death within a given population). This number doesn’t include the 47.5 million people who have dementia or those who live with social anxiety or obsessive social compulsive disorders.


Although the World Health Organisation estimates that mental and neurological disorders are the leading cause of ill health and disability globally, there is a severe lack of interest from governments and NGO’s.


One of the reasons behind this is a lack of funding in development for mental health initiatives. Due to the market-driven nature of aid, mental health isn’t appealing to donors and projects are strongly correlated to how marketable they are to the general public. Mental health charities struggle to raise money as they are not part of the three big C’s ‘cancer, cats and children’ which tug on heartstrings and consequently purse strings. With mental health it’s harder to generate empathy, mental health problems are not always obvious therefore do not always create the snapshot image for your latest fundraising event.


Social stigma surrounding mental health restricts the formation of any real social pressure to affect governments or individuals into action. A mhGap (Mental Health Gap) report lead by the WHO in 2008 states “The stigma and violations of human rights directed towards people with these disorders compounds the problem, increasing their vulnerability; accelerating and reinforcing their decline into poverty; and hindering care and rehabilitation”.


Research by Christoph Lauber in 2007 shows that comparable to Western countries, there is a widespread tendency to stigmatize and discriminate people with mental illness in Asia. But the problem of social stigma is not just an issue in Asia, Nora Mweemba, who works for the WHO in Zambia, explains that many people suffering from mental health problems don't come forward for treatment because "communities still regard mental health as a misfortune in the family or some sort of punishment [from God]". The pathway to care is often shaped by scepticism towards mental health services and the treatments offered and families tend to turn to traditional healers. There are significant cultural barriers which need to be overcome and further research by organisations to deliver effective mental health policies.


Many of the countries do not have the legal infrastructure to protect those with living disabilities. Although many countries have signed the ‘Convention on the rights of persons with disabilities’ institutions still lack funding, training and the resources to adequately care for their patients. Unfortunately this leads to human rights violations where patients are locked, chained, isolated and denied their basic human rights.


One of the other barriers to the development of mental health services has been the absence of mental health from the public health priority agenda. The report for mhGap launched by the WHO research shows that this has serious implications for financing mental health care, since governments have allocated meagre amounts for mental health within their health budgets. But with so many health concerns facing developing countries mental health is not always top of the agenda.


Although mental health problems account for almost 13% of the world’s total disease burden and costs the world some $ 2.5 trillion per year, yet the amount invested in treating mental health problems is barely a fraction of this. Less than two percent of the health spending in most low and lower-middle income countries.


Gary Belkin, Executive Deputy Commissioner, New York City Department of Health and Mental Hygiene says;

“The challenge is we have in the order of a billion people on the planet who will have a mental health problem in their lifetime and not get evidence based care for it. A response to that sort of problem needs action at a global level. It needs the sorts of global structures we’ve created for malaria and HIV to be created for mental health as well”

However the problem isn’t just a medical concern, in a recent report by the APPG (All-Party Parliamentary Group) highlights how mental health problems are a brake on development as they cause (and are caused by) poverty. This is part of a wider development concern as not addressing mental health fuels social failures including poor parenting and school failure, domestic violence,and toxic stress, preventing people with problems and their families from earning a living.


Although there have been some recent efforts to raise the profile of mental health as a development issue. In 2008 the WHO launched the Mental Health Gap programme and mental health has been included within the SDG’s in 2015 (Sustainable Development Goals) . The mhGap has praised improvements in countries such as Guinea where they are running a services to support ebola survivors and improving care across disaster - affected regions such as the Philippines.


However the response to mental health in the development sector is still severely lacking. There are very few global organisations leading the way for mental health issues. Basic Needs and International Corps are two international charities which are mental health focused and are calling for governments and aid agencies to address the issue.


In order to tackle the growing mental health crises governments and NGO’s need a collective response. Mental health should not be left to the public health or development sector - schools, hospitals, community groups, charity groups and government bodies should work together to tackle mental health at a global level.

Mental Health the invisible problem in international development

Mental Health is the shadow lurking in the corner which nobody wants to talk about in international development. The World Health Organisation estimates that mental and neurological disorders are the leading cause of ill health and disability globally, but there is a severe lack of interest from governments and NGOs.

Below are some images which highlight the state of mental health in the developing world. Due to social stigma, lack of resources and funding for mental health services people are often chained or locked up.

Mental health is not considered a disease by people in Bangladesh. These women are among the estimated 14.5 million adults in Bangladesh receiving limited mental health care.
 Sourced from  The Guardian http://tinyurl.com/qxhgthx, photography by Allison Joyce

Najeebullah has scizophenia and drug induced psychosis.After becoming violent and stabbing one of his family, he has now been chained up in a hospital in Kabul  Sourced from  The Guardian http://tinyurl.com/z5mm459, photography by Magda Rakita

Anne has been locked up for ten years without a window, according to her father she doesn't like to eat much. She used to enjoy running but now she cannot stand.
Sourced from Bored Panda http://tinyurl.com/create.php, photography by Andrea Star Reese

According to a recent study done by The Lancet 173 million Chinese people suffer from mental health problems. Only 158 million of those have never received any professional help. Sourced from  The Guardian http://tinyurl.com/ld5er82, photograph China/photos: Getty images

Due to a lack of understanding and social stigma locking people up is often common practice in Indonesia.

Sourced from Bored Panda http://tinyurl.com/create.php, photography by Andrea Star Reese

After Typhoon Haiyan in the Philippines the true nature of how people are dealt with mental health disorders was revealed. Many people were locked up and left to die after the typhoon hit in 2013. 
Sourced from  The Guardian http://tinyurl.com/ld5er82, clip taken from a video directed by Simon Rawles

The Syrian Refugee Crisis: Shining a light on the response to impairment, disease, and disability

By Ollie King

As of 2014, Syrians constitute the worlds largest refugee population. To most, this comes as no surprise. The media is packed with stories of huge migrations of people fleeing war-torn Syria in search of refuge, a journey beset with danger for even the most able-bodied men, women, and children. Those so often ignored or ill-considered in these circumstances are those who are not able-bodied - refugees suffering injury, impairment, and disability.

The recognition of persons with disabilities is a fairly recent addition to the United Nations (UN) treaty body system. The introduction of the Convention on the Rights of Persons with Disabilities (CRPD) in 2006 is the manifestation of this recognition; a unified document of special clauses and elaborations on previously established rights that serves to shine a light on the needs of people disabled by a society that is unable to cater to their needs. The CRPD is intended to mark the end of a long history of invisibility for disabled people in the eyes of nation-states and the wider international community. However, in the context of human displacement, the promise of recognition and special attention is severely lacking. Article 11 of the CRPD is explicit in committing States Parties to the protection and safety of persons with disabilities in humanitarian emergencies. So where is the international community failing in its mandate to protect refugees with disabilities? What can be done to improve the recognition and response to disabled refugees fleeing conflict?

 Picture sourced from http://www.aljazeera.com/indepth/inpictures/2015/09/window-desperate-journey-150917085100247.html

A rare example of a comprehensive study carried out in this area comes from HelpAge International and Handicap International. Published in 2014, the collaborative study collected data from Syrian refugees in Jordan and Lebanon, seeking to establish their number and their specific needs. Alarmingly, it found that 22% of refugees are affected by an impairment, with 6% affected by an impairment deemed severe (to illustrate how significant this is, the World Report on Disability estimates that 15.3% of the entire world’s population suffers from an impairment). Furthermore, elderly people are disproportionately represented - 70% have at least one impairment, and are twice as likely to suffer intellectual impairments when compared to children.

Levels of conflict-related injuries are notably high in the case of the Syrian conflict - one in 30 refugees that fled to Lebanon, and one in 15 refugees in Jordan were injured as a direct result of the fighting. Working-age men are particularly exposed to the risk of injury; aside from their role in combat, the responsibility for fetching food, water and other provisions often falls to them. Some young men even travel back to Syria to check on their property, contributing further to a life already fraught with danger for Syrian males in particular. Without effective rehabilitation, injury-related health conditions are likely to deteriorate into permanent disability.

Picture sourced from www.http://edition.cnn.com/2012/12/13/opinion/syria-unreported-refugees/

Looking to issues of psychological well-being, half of the refugees affected by impairments, injuries and non-communicable diseases reported at least one sign of recurring psychological distress. These signs include changes in behaviour, emotional state, cognition, and relationships. Once again, the elderly were disproportionately affected, with over 65% reporting one or more of the aforementioned signs.

Crucially, the study found significant difficulties in ‘activities of daily living’ (ADL). ADL is a term used by healthcare professionals to refer to basic self-care activities such as bathing, feeding and dressing oneself. In the general refugee population worldwide, 6% reported difficulties in ADL. Within the Syrian refugee populations in Lebanon and Jordan, 45% of refugees with an impairment, injury or chronic disease had difficulties in ADL; this figure rose to 60% for elderly refugees. This is a staggering increase with severe ramifications. Those struggling with ADL are far less likely to access family and community support strategies, and static and mobile outreach programmes.

As demonstrated, the danger and suffering that disabled people face during humanitarian emergencies is significantly enhanced. The inability of response programmes to tackle the needs of disabled refugees effectively comes down to the lack of a clear picture. Whilst the study conducted by HelpAge International and Handicap International is a step in the right direction, we still lack an understanding of the level and nature of help required within the majority of refugee populations around the world. For this reason governments, national institutions, and NGOs remain profoundly limited in their responses. Injuries become permanent disabilities when they are not treated and rehabilitated, chronic diseases go unchecked and untreated without simple diagnoses and medication, and psychological distress is allowed to fester and endure to become yet another plight for those already impaired.

Picture sourced from http://www.mirror.co.uk/news/world-news/syrian-refugee-carries-disabled-brother-6380968

For those nations receiving refugees, it is essential that they work with dedicated NGOs and healthcare organisations to share information and research for adequate response programmes. Data collection should be inclusive and participatory, allowing all groups an opportunity to engage in focus group discussions so that they can have some input into programme design. Sphere standards must be applied to the collection of data, which should be disaggregated by age and gender (The Sphere Project, launched in 1997, was developed to set minimum standards in the core areas of humanitarian assistance). In addition, data must be further disaggregated by impairment, injury, and chronic disease. Using questions established by the Washington Group, measurements of disability must be incorporated into every statistical survey that concerns refugees. With the collection of refugee statistics remaining constant, the information produced can be compared between different contexts. The accurate collection of data will ultimately contribute to the design and delivery of specific response programmes that are the result of a rigorous analysis of the problems at hand.

Historically, the recognition of the specific needs of people with disabilities has been severely lacking. Left in the dark, they have been overlooked in the formation of policy and the consideration for accessibility in societies worldwide. Today, the CRPD has led the way in providing visibility to people with disabilities. However, consideration for those suffering with a disability within refugee populations is far from adequate. The first step in providing services for this diverse group of suffering people is recognising their size and the diversity of their needs. While HelpAge International and Handicap International have set an important example, we are far from reaching the necessary depth of understanding. Only a deep understanding will allow for a response that is so desperately needed by the most vulnerable of an already vulnerable refugee population.