Experiences and Challenges to an Inclusive Response to the COVID-19 Pandemic
Last week I was invited to present via Zoom at a conference in Gaza on the pandemic and the Arab governments’ responses. This blog post is an overview of some of the examples and issues that I discussed in my presentation.
Persons with disabilities are some of the most vulnerable in our societies, facing discrimination and structural barriers to full and active participation even during so-called “normal” times. This position has been clearly revealed, and exacerbated, during the current COVID-19 pandemic, as persons with disabilities face particular hardship due to existing patterns of exclusion and responses that have not been designed to be accessible or inclusive.
During the peaks of the pandemic, in which healthcare systems became overwhelmed and intensive care had to be effectively rationed, persons with disabilities have faced discrimination related to their perceived health status. “Triage” protocols are used in situations when hospitals and care facilities do not have enough resources, such as hospital beds, ventilators, or medical staff, to deal with the influx of those in need. In this triage, medical staff use a number of different criteria to decide who should receive care, such as how much the patient is expected to benefit from treatment. In these decisions, due to the prevailing “medical model” of disability which views disability as an underlying medical condition, there is a risk that persons with disabilities are considered less likely to benefit from treatment and therefore they are de-prioritised during the triage process.
Having a disability does not by itself put someone at higher risk of COVID-19, although some persons with disabilities may have other underlying health conditions that make the disease more dangerous. However, many persons with disabilities do generally have greater healthcare needs than others and are, therefore, more heavily impacted by interruptions to regular healthcare services. Regular medical appointments in hospitals or clinics during the pandemic can also put persons with disabilities at risk of catching the disease. An inclusive healthcare response to COVID-19 must ensure the uninterrupted provision of accessible healthcare to persons with disabilities, with necessary precautions taken to prevent the spread of the disease in these settings.
Across the Arab world, inclusive government responses to the COVID-19 pandemic can be broadly considered across three categories: accessible information, accessible services, and strengthened social security.
Providing information about the pandemic is one of the most important actions governments can take, raising awareness about the disease and informing people of the preventative actions they can take. Most governments have done this through a combination of traditional (TV, radio) and new media (social media, WhatsApp, YouTube). Countries such as Tunisia and Morocco have provided online platforms for integrated information about the pandemic. Some countries have taken extra steps to ensure that the information is accessible. For example, the Egyptian Technical Center for Persons With Disabilities launched an AI-powered chatbot with sign language interpretation, called Wasel. The Palestinian government has a telephone service for persons with disabilities and their families, offering information about the pandemic response including medical care and social services. The Sudanese government has sent letters with information about COVID-19 to all homes, while the Tunisian government has committed to translating all information about the disease from international organisations into Arabic.
Some states have also made efforts to ensure that government services are accessible to persons with disabilities during the pandemic. In Kuwait and Syria, special quarantine centres have been established for persons with disabilities to ensure that those infected with COVID-19 are able to isolate safely. This is particularly important for persons with disabilities, many of whom may find it difficult to “socially distance” due to close interactions with family members and assistants. Beyond healthcare, the shift to distance learning has provided an opportunity to make education more accessible to persons with disabilities, with some experimentation in providing sign-language or other targeted support such as in Morocco.
Most directly however, expanded social security programmes are needed to ensure persons with disabilities do not suffer increased hardship during the pandemic. Persons with disabilities are more likely to face unemployment or the loss of income during the pandemic, starting from a situation in which they were already less likely to be employed and more likely to live in poverty. The Kuwaiti government is providing direct food packages to persons with disabilities, including to the stateless “bidoon” who face extremely high levels of state and social exclusion. The Qatari government is maintaining salaries for persons working in the Shafallah Center for Children with Special Needs even though they are unable to work during the pandemic, while Tunisia and Bahrain have introduced or increased direct payments to persons with disabilities. The Egyptian government is providing increased support to mothers with disabilities, though notably they have not increased support to fathers with disabilities.
Actions for Governments in the Arab World
While many countries in the Arab region have introduced some necessary policies for the protection of persons with disabilities during the pandemic, no one country has introduced them sufficiently. To do so, governments in the region and across the world must involve persons with disabilities when planning and designing their pandemic responses, to ensure that accessibility and inclusivity are maintained throughout. This can help to avoid the unintended consequences of policies such as curfews and lockdowns, which can prevent persons with disabilities from accessing services they need. It should also be possible to coordinate more across countries in the Arab region, for example, in providing information in accessible formats.
Governments and international organisations must also not stop efforts to promote persons with disabilities and remove stigma during this time – persons with disabilities are among the most vulnerable members of society and face increased risk during crises. An inclusive pandemic response that listens to the needs of persons with disabilities on the ground can ensure that this group does not slip even further behind.