New report: People with disabilities in Ukraine facing multiple threats

The most vulnerable people in Ukraine are facing multiple protection threats, according to a new report from the charity Humanity & Inclusion (HI). Published on 7th October, the report includes alarming accounts from HI’s teams on the ground 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. 

Disabled 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 centres” (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.)   

• Disabled 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 centres, 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 disabled, older and chronically ill people make up a high proportion of those who are internally displaced [1]. 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 centres, 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 centre 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 10 hours. This is how little time the centre 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, HI 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. HI teams are also observing strong signs of distress from staff working in hospitals and collective centres due to overwork, the increasing number of people in need, and the lack of resources.   

Humanity & Inclusion’s actions in Ukraine