By Nida Qasim Khan

The Covid-19 pandemic has revealed the extent of exclusion that the most marginalized communities in Pakistan experience. Among the most adversely affected groups are Pakistan’s 28 million persons with disabilities (PWDs), who make up 10% to 15% of Pakistan’s population. according to the Special Talent Exchange Program (STEP).

Even under normal circumstances, persons with disabilities are neglected and suffer from reduced access to education, poverty, unemployment, abuse and low rates of participation in the community. According to research done by the United Nations’ Economic and Social Commission for Asia and the Pacific (ESCAP), PWD’s can suffer a difference of up to 20.6% in poverty rates compared to the general population. PWD’s are also 6 times less likely to be employed than those without disabilities, according to STEP. The pandemic has only intensified these inequalities, making PWD’s among the groups hardest hit by the Covid-19 pandemic.

Source: Special Talent Exchange Program

PWDs have to face many social barriers at home too. Most families in Pakistan find dealing with PWD’s a social challenge and a source of shame, resulting in their exclusion from many family events. While in schools, on the roads, or other public spaces like the market, people stare at them or ask intrusive questions leaving them upset. Apart from these issues, there are other challenges that make them even more vulnerable during the Covid-19 pandemic. Some of these challenges include lack of access to public health information, significant barriers to implementing basic hygiene measures, and inaccessible health facilities. These issues are explained below.

1. Difficulty in practicing basic health measures – People with disabilities are usually dependent on their caregivers or others to help them with their basic needs. Since some of this support requires physical closeness, it can be difficult for them to practice social distancing with their caregivers. In terms of practicing basic hygiene, they may face challenges accessing hand basins or even washrooms. Some even have difficulty rubbing their own hands while washing them.
2. Barriers in accessing information & social protection- Most people with disabilities suffer from a lack of access to public health information. For instance, information in sign language or in a way that is more accessible for people with varying disabilities is very limited. Additionally, materials are not translated into local languages, making it difficult for those who do not understand English. Easier formats, language, graphics and videos would help people with disabilities understand public health information better. Additionally, PWD’s often require food, cash and hygiene supplies from the government but face barriers in registration for the supplies online, as the online portals are not accessible nor PWD friendly. The formats are not easy to read and PWD’s often do not have internet access or bank accounts to receive income support, according to the International Disability Alliance (ICRC).
3. Limited personal assistant services – These are extremely scarce due to Covid-19 and social distancing. PWD’s that require personal assistance on a daily basis to carry out their daily activities are intensely affected. For example, a person who uses a wheelchair needs assistance to help load his/her wheelchair onto a vehicle when they need to go to the hospital or elsewhere. Social distancing makes it extremely hard for these people to seek assistance from others. Parents of children also have little to no guidance on how to help their children during the pandemic while avoiding infection, with the lack of personal assistants available, according to the ICRC. 
4. Increased levels of anxiety and depression– People with disabilities are often confined to restrictive and confined environments. Due to the pandemic, their living environments have become even more restricted, leading to more isolation. For example, if someone had been confined to a room due to their disability before the pandemic, they are often now even more restricted in their movement during the pandemic due to lockdowns. This isolation causes many people with disabilities to experience increased levels of depression and anxiety.
5. Socio-economic insecurities– Even before the pandemic, people with disabilities struggled to achieve economic security and independence. With the outbreak of the coronavirus, they are at heightened risk of unemployment, which makes it even harder for them to have economic security. The stigma and misconceptions attached to the capabilities of people with disabilities have also been exacerbated by the pandemic. People with disabilities additionally do not have access to social protection and relief programs as their needs are not being prioritized. 

How has Pakistan assisted people with disabilities during the pandemic? 

Pakistan has started to turn to more online mediums during the pandemic. One good move has been the introduction of telemedicine platforms like Sehat Kahani, which connects patients to female doctors using chat, audio, and video mediums 24/7. This makes health services more accessible for PWD’s, who can get a consultations from home. The Sehat Kahani initiative is seen as part of community-based rehabilitation, “a multi-sectoral approach working to improve the equalization of opportunities and social inclusion of people with disabilities while combating the perpetual cycle of poverty and disability.” Various organizations working with PWDs have made several efforts to aid them and create more awareness around their challenges during the pandemic including the key organizations like STEP,the  Network of Organizations Working with Persons with Disabilities Pakistan (NOWPDP) and the ICRC. 

The government has also provided relief packages. These include:

1. Ehsaas Kafaalat for Special Persons Policy – under which an estimated 2 million families with at least one disabled person can benefit from a stipend of Rs.2000 a month. Eligible persons are validated through NADRA’s database. 
2. Ehsaas Emergency Cash Programme – under which 12 million families (72 million individuals) received Rs.12,000 each during the pandemic. 
3. Ehsaas Rashan Programme – where individuals in need of food rations and those willing to donate were able to register. 
4. Sehat Sahulat Programme – where the underprivileged citizens could get access to their medical healthcare in an efficient and easy manner.

What major actions can be taken to help people with disabilities during the pandemic?

The World Health Organization (WHO) recommends that people with disabilities to practice the following actions to protect themselves from Covid-19: 

Avoid crowded places, reduce physical contact with others, stock ample food, medicines, and hygiene items to cover your needs for at least 2 weeks; opt for online purchases and ask family, friends or caregivers for help. Also, make sure to regularly disinfect any assistive products you use such as wheelchairs, canes, and hearing aids. Identify relevant helplines that you can reach out in case of emergencies or assistance, and put a plan in place to ensure continuity of care and support. These actions taken in coordination with the caregivers can provide a level of protection to people with disabilities (World Health Organization). 

How governments can help people with disabilities 

The World Health Organization (WHO) recommends that governments  take the following actions to help people with disabilities: ensure that all healthcare facilities for Covid-19 are accessible and inclusive; make public health information accessible for people facing all kinds of disabilities; engage people with disabilities in the Covid-19 response process to address their needs as well; ensure that disabled people are part of the financial compensation schemes created during the pandemic and ensure continuity of services and support where the number of caregivers has been reduced due to the pandemic. They are also advised to fast-track the training of a  new workforce; provide hotline numbers in various formats to make the numbers accessible such as via telephone, SMS, language apps, video calls, or other accessible formats; and ensure caregivers and service providers of people with disabilities receive no-cost personal protective equipment and access to Covid-19 testing (World Health Organization).