Cak Fu

Disasters not only have an impact on persons with existing disabilities but may also create a new generation of disabled. Disabled people are recognised in humanitarian assistance as a vulnerable group, together with other vulnerable groups such as women, children, elderly people, and people living with HIV/AIDS (PLWH/A). Each vulnerable group may suffer specific disadvantages in coping with a disaster and may face physical, cultural, and social barrier in accessing the services and support to which they are entitled.

Further, these conditions bring about different characteristics which influence the ways assistance is rendered in a crisis situation. The characteristics of vulnerable groups are often based on their different and specific needs which relate to the context of the local culture, religion and geographical location. Therefore, special care must be taken to protect and provide for all vulnerable groups accordingly.

Specific vulnerabilities influence people’s ability to cope and survive in a disaster, and those most at risk should be identified in each context. Disabled people — both existing disabled survivors and newly disabled survivors — have dissimilar needs based on their level or kind of impairments. Nevertheless, they share the same problem of facing a much harder challenge than other survivors. World Health Organisation (WHO) identifies the consequences of a disaster on disabled people based on two categories of disabled people (an existing disabled people and newly acquired disabilities). The consequences can be listed as the following issues:

Survivors with existing disabilities:

* In comparison with other disabled peer, people with disabilities can be more at risk during the disaster.
* Many persons with disabilities lose their assistive devices during the disasters, including artificial limbs, crutches, hearing aids, and spectacles.
* People with disabilities can have greater difficulties in accessing basic needs including food, water, shelter, latrines and health care services.
* Rehabilitation infrastructures are destroyed and rehabilitation personnel, including caregivers of people with disabilities, may be killed or injured or diverted to other tasks.

Survivors with injuries or/and acquired disabilities:

* Untreated or inadequately treated fractures and infected wounds may lead to severe and long lasting disability.
* Referral of these survivors to appropriate heath facilities often becomes difficult.
* There is a scarcity of rehabilitation personnel and infrastructures to handle a new generation of persons with disabilities.
* Many survivors with newly acquired disabilities will struggle with the loss of their livelihood and other issues for them and their families.

An existing disabled person may suffer more during and after a disaster compared to other survivors. In some cases, people with existing disabilities often need more time than others to make necessary preparations in crisis situation. For example, in instances when people have to be evacuated from a particular city due to an earthquake, existing disabled people (the blind, the deaf, people with mobility problem, and the mentally handicapped) need to be assisted. Special equipments may be needed to help them during the evacuation.

During a disaster, existing disabled people may lose their assistive devices such as spectacles, hearing aids, crutches, wheelchairs, or artificial limbs. In addition, disasters may also destroy the rehabilitation buildings together with all the equipments; rehabilitation staff may be killed during the disasters. This situation causes existing disabled people to suffer more after the disaster because they do not normally get a new assistive device immediately. As a result, they cannot perform their normal tasks like what they can do before the disaster, and this may result in them not being able to access the aids given by humanitarian organisations.
Based on these conditions or facts, some of the needs of both existing disabled survivors and newly disabled survivors in the context of natural disasters are identified, as follows:

Existing disabled survivor:

Notification

Many traditional alarm methods are not accessible to or cannot be used by disabled people. Deaf and blind people are not able to access the alarm systems which are mostly audible and flashing lights. In natural disasters, media such as radio or television are used for communication, which is often not accessible to the disabled due to their already existing impairment. Therefore, existing disabled survivors need an accessible communication media which can notify them in emergency situations.

Evacuation

Existing disabled survivors face a much bigger challenge during an evacuation, especially depending on their level of disabilities. People with mobility impairment may not be able to use the usual means of transportation that they have, such as wheelchairs and crutches. Moreover, it may also not be possible for them to use public transport because during these times, they are usually crowded or the transportation systems may not be working.

Sheltering

When disasters occur, people are often provided with refuge in temporary shelters. Some may be located in schools, office buildings, tents, or other areas. Historically, great attention has been paid to ensuring that those shelters are well stocked with basic necessities such as food, water, and blankets. But many of these shelters have not been accessible to people with disabilities. Individuals using a wheelchair or scooter have often been able somehow to get to the shelter, only to find that there is no accessible entrance, toilet, or shelter area.

Access of food and medical care

Most aid management systems are set up for normal survivors. Medical care is often given in places like medical centres where the refugees are required to visit or go to. It will be a problem for existing disabled survivors who live in refugee camps to have to go to a faraway medical centre and to stay in a queue together with other refugees.
In distributing aids, especially water and food, humanitarian organisations usually only drop the aids in a place. Existing disabled people will face the problem of getting such aids because they have to struggle with other survivors. Sometimes it is difficult to persuade people to be tolerant in receiving aids, and most of the time, they end up fighting with one other to get the aids. In that way, existing survivors are not able to get the aids in equal proportion to other survivors. Therefore, they become second in line in receiving aids and often have to depend on help from their relatives.

Relocation

After staying in refugee camps for a while, most people are willing to return to their former residences. Sometimes, the government and Non Governmental Organisations (NGOs) rebuild houses and infrastructures which are not disabled-friendly. Needs of the disabled are still not being taken into account by policy makers, and this results in policies which do not have a disability perspective.

Newly disabled survivors

Specific Medical Care

Newly disabled survivors need specific medical care and follow-up after medical treatment. Some disabled survivors may need medical treatment due to injuries on some other parts of their body such as eyes or ears after an amputation. In refugee camps where the environment is not clean and where there is the problem of poor sanitation, the circumstances often make health conditions of the newly disabled survivors worse.

Assistive Devices

Newly disabled survivors need assistive devices in order to help them perform their daily activities. Different assistive devices such as wheelchairs, prostheses, crutches, hearing aids, glasses, etc are needed by newly disabled survivors accordingly, depending on their level of disabilities. The problem is that in an emergency situation, these assistive devices are not readily available, so some of the newly disabled survivors do not receive them immediately. Sometimes, even if they are available, the quality is often very poor, so they cannot be used for long by the newly disabled survivors. For example, prostheses which are available in Aceh do not meet international standards.

Special Assistance

After receiving medical treatment and assistive devices, newly disabled survivors still require further regular and special assistance. Such assistance is needed to help these newly disabled survivors cope with their new condition of being disabled. Physical therapies and physical assistance may be needed to make newly disabled survivors get used to using assistive devices like walking aids, wheelchairs and others.
Newly disabled survivors may also need psychological counselling in order to assist them to fully accept their new condition. Most newly disabled survivors reject their condition the first time they realise that their physical condition will be changed. Trauma, frustration, and feeling disadvantaged or valueless mar their psychological condition. Therefore, they need friends to share their feelings with.

Access to public facilities and aid distribution

Due to their disabilities newly disabled survivors are not able to participate fully in social activities. This is because most public facilities in refugee camps are built for normal people. Consequently, there are no public facilities which can be accessible to newly disabled survivors. Newly disabled survivors are mostly not willing to get out from their houses or tents because they know that they will face a much harder problem outside.
Newly disabled survivors have the same rights as other survivors in receiving food, water, and other aids. However, in practice, aids are often distributed collectively at the same time, and not person by person. As a result, aids are not distributed equally among refugees, and disabled people are often neglected and do not get sufficient aids compared to other people.

Preparing for development

Development is a phase when reconstruction of the physical and social aspects of a disaster area is completed and when the people start to lead a normal life. Although, the border line between development and reconstructions are very slightly, but the programs seems to be different. After the disaster, some people may lose their properties and source of income. However, newly disabled survivors may not only lose their properties and families, but obviously they also lose a part of their bodily function which is considered the main human capital for income generation. In a developing country like Indonesia, where social security is not available, disabled survivors face a much bigger challenge when they lose their source of income. Some newly disabled survivors may be discharged from their company due to their disability or because they are considered by a company as being less productive. Therefore, newly disabled survivors need an alternative source of income after the reconstruction phase to ensure their future.

These are ten basic needs of disabled people (existing disabled survivors and newly disabled survivors) which should be fulfilled during an emergency situation after a disaster.