People with disabilities and older people in Ukraine are facing multiple protection threats, according to a new report from Humanity & Inclusion. Published today, the report includes alarming accounts from Humanity & Inclusion’s Ukraine teams, who are witnessing people with disabilities being disproportionately exposed to violence and abuse and having greater difficulty accessing humanitarian aid and the services they need.
People with disabilities and older people in Ukraine are at direct risk of abandonment, violence, injury and death. Due to all the dangers and challenges of living in a war zone, caregivers of older people and family members with disabilities are making impossible decisions between fleeing and staying to care for their family members.
Some of the situations witnessed by Humanity & Inclusion’s teams in Ukraine include:
- People with disabilities who are unable to move or are confined to their beds are being left behind due to a lack of evacuation support. Many people with disabilities don’t even have access to information on how to evacuate.
- Most of the bomb shelters are not accessible to people who use wheelchairs or have restricted mobility. Consequently, people with disabilities are left behind and are dangerously exposed to explosive weapon attacks.
- Those people with disabilities who are able to flee the violence are particularly vulnerable during the mass movement and displacement of civilians. In the rush to escape, they may lose contact with relatives and caretakers and lose their identification papers. And once they arrive at one of the “collective centers” (schools, gymnasiums etc.) for internally displaced people, people with disabilities often lack the privacy they need for getting dressed or personal hygiene care, exposing them to a high risk of abuse (violence, sexual violence, robbery, etc.)
- People with disabilities and older people are arriving at the borders in very poor condition and there is inadequate provision at the borders for people with disabilities
“In situations of war there are huge changes which can have a significant impact on older people. They are exposed to highly distressing events, often where they had to be urgently evacuated from their homes. In cases of limited mobility, people are sometimes put in blankets to evacuate because they cannot walk on their own. When we go to geriatric collective centers, we see some people in their beds crying due to the high level of distress. What they really need is human connection. They have lost all their community support, which is one of the biggest risk factors of displacement.”
Caglar Tahiroglu, Humanity & Inclusion mental health and psychosocial support specialist in Ukraine.
Institutions operating at triple capacity
The most recent data indicate that people with disabilities, older and chronically ill people make up a high proportion of those who are internally displaced. The most recent data from the International Organization for Migration estimates that 25% of internally displaced families in Ukraine include at least one family member with a disability, 36% include a chronically ill person and 46% a person over 60. In the central and western parts of Ukraine, institutions hosting older people or children with disabilities are often operating at double or triple their capacity. Various reports show children with disabilities to be living in horrendous conditions in some institutions. Humanity & Inclusion staff have witnessed overcrowding, poor hygiene and a lack of technical skills and care in these centers, as well as a loss of contact between the children and their families. These children are also in danger of being abandoned entirely, as many of the center staff have evacuated with their families.
“The medical doctor had a call from the East telling him that they needed to evacuate 42 children with severe disabilities because of the bombardments in the region. The children were put in a bus and arrived in ten hours. This is how little time the center had to prepare for the arrival of these children and we are talking about children with very specific needs. When we saw the needs in the institution, the priority was to save lives with an emergency response. As Humanity & Inclusion, we do not usually work in institutions because, of course, we support a more inclusive approach and the inclusion of persons with disabilities into the community. But this is a war situation. When we entered the institution and saw the state of the children and the staff, with all the team we were clear we had to do something.”
Caglar Tahiroglu, Emergency Mental Health and Psychosocial Support Manager, Humanity & Inclusion Ukraine
Critical lack of rehabilitation and mental health services
Based on Humanity & Inclusion's experience in Iraq, Syria, and Yemen, we know that the number of people with disabilities in Ukraine will increase due to injuries caused by explosive and armed violence. Bombing and shelling cause complex injuries that can lead to amputations or permanent disabilities, requiring long-term rehabilitation care. It is crucial to develop health services adapted to people living with disabilities.
Currently, health services in Ukraine lack rehabilitation capacity. Hospitals are overrun and, in order to cope, they need to shorten the length of stays and are discharging people early. There has been a huge increase in demand for prosthetics & orthotics and rehabilitation services, and there are challenges with under-staffing, inconsistent referral systems and weak data management.
“By providing early rehabilitation, our goal is to prevent further complications. Any one injury will always come with a list of potential problems. So, when you have multiple injuries, they each have their own risks that affect recovery. There is great value in getting people to move safely. It doesn’t take long for the body to start deteriorating, and then recovery can be quite difficult.”
Gaëlle Smith, Humanity & Inclusion emergency rehabilitation specialist
Trauma and mental health problems are among the primary healthcare risks in Ukraine as the population is witnessing highly traumatic events. But despite the huge demand for mental health and psychosocial support there is limited access, due to the high cost and limited availability of services. Humanity & Inclusion teams are also observing strong signs of distress from staff working in hospitals and collective centers due to overwork, the increasing number of people in need, and the lack of resources.
Humanity & Inclusion in Ukraine
Humanity & Inclusion teams in Ukraine are working to support the people most affected by the conflict, including injured people, people with disabilities, older people and those with chronic illnesses. Our activities include emergency rehabilitation care, mental health and psychological support, and risk education sessions to prevent accidents with explosive ordnance.
Overall, teams work to reduce the suffering of conflict-affected populations experiencing the most vulnerability, by delivering an inclusive, immediate and multisectoral humanitarian response. Operations address the protection, health, and basic needs of conflict-affected populations, while reducing the risks caused by explosive ordnance contamination,
facilitating the delivery of aid in Ukraine, and supporting the wider humanitarian response in becoming more inclusive. HI specifically focuses on internally displaced persons, refugees, persons with disabilities, as well as persons with injuries and those with signs of psychological distress. In Ukraine, Humanity & Inclusion works in the eastern and western parts of the country, constantly adapting its approach to the changing context, and in Moldova, in line with the Ukraine Flash Appeal and the Refugee Response Plan.
- Interviews available with Humanity & Inclusion experts in Ukraine
- Published on October 7, Humanity & Inclusion’s new report “War in Ukraine: A focus on people with disabilities and the provision of emergency health services” paints a harrowing picture of the situation for people with disabilities living in the war-torn country. The report is based on data reviews and first-hand observations from Humanity & Inclusion’s teams on the ground who are witnessing people with disabilities being disproportionately exposed to violence and abuse and having more difficulties accessing humanitarian aid and the services they need.
- Mica Bevington | [email protected]