Handicap International: Study on Disability Inclusion in Emergency Response

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While natural disasters affect a large number of individuals, People with Disabilites (PWDs) tend to be more affected than others during such situations and often face bigger challenges in order to cope with the situation and survive. Due to their specific situations, they risk being excluded and invisible during response activities, and they often face additional barriers in accessing support and relief efforts. In an emergency context, their original vulnerability is greatly compounded, bringing about the risk of their vulnerability increasing.

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Handicap International: Study on Disability Inclusion in Emergency Response

  1. 1. A STUDY ON THE DISABILITY INCLUSION PROCESS IN THE EMERGENCY RESPONSE TO TROPICAL STORM WASHI
  2. 2. A Study on the Disability Inclusion Process in the Emergency Response to Tropical Storm WASHI Published by Handicap International – Philippines program under its project ‘Emergency response to improve the living condition of WASHI affected vulnerable families in Cagayan De Oro and Iligan City’, funded by Australian Agency for International Development (AusAID). Study conducted by Camilla Reyes Pante, assisted by MItzie Santiago Written by Camilla Reyes Pante, with contributions from Satish Mishra and Catherine Vasseur © Handicap International – Philippines program, 2012 Photo Credits Handicap International – Philippines program This publication is the property of Handicap International. It has been produced with the financial assistance of the AusAID. The views expressed herein should not be taken, in any way, to reflect the official opinion of the AusAID. For more information and www.handicapinternational.ph to download a copy of this publication please visit
  3. 3. About Handicap International Handicap International is an independent international aid organization working in situation of poverty and exclusion, conflict and disaster. Working alongside persons with disabilities and other vulnerable groups throughout the world, our action and testimony are focused on responding to their essential needs, improving their living conditions and promoting respect for their dignity and their fundamentals rights. With a network of eight national association (USA, Belgium, Canada, France, Germany, Luxembourg, Switzerland and UK), Handicap International, founded in 1982 and co-recipient of the Nobel Prize in 1997, has program in 60 countries and acts in both emergency and development situations. Handicap International in the Philippines has been operational since 1985 and is one of the key organizations in the disability sector in the country. It has wide range of complimentary projects which assists to promote inclusion of persons with disabilities and their issues in development policies and actions, build capacities of key local stakeholders and reduce the impact of natural disasters and conflicts. Handicap International in the Philippines is committed to enhances persons with disabilities access to services, promote their active participation and social inclusion, developing partnerships at all levels, in the frame of the national and international policies on disability. AusAID is the Australian Government agency responsible for managing Australia’s overseas aid program. The fundamental purpose of the Australian aid program is to help people overcome poverty. In the Philippines, Australia’s aid program focuses on: basic education, local service delivery, disaster risk reduction and climate change, peace and development in Mindanao, and governance. About the Project Handicap International WASHI Project: “Emergency response to improve the living condition of WASHI affected vulnerable families in Cagayan De Oro and Iligan City” was implemented from February 2012 to September 2012. Working with partners and community the project aims to ensure that vulnerable groups have access to relief services and are better equipped to cope with the crisis with a specific focus on persons with disabilities, persons with severe or chronic medical condition, children, expectant mothers, mothers with young children, and female heads of household and older persons.
  4. 4. ACKNOWLEDGEMENTS Handicap International would like to thank the following for their valuable participation and contributions to the study Action Contre la Faim Australian Agency International Develpment The Camp Coordination and Camp Management Cluster, Health Cluster, Protection Cluster, and WASH Cluster in Cagayan de Oro City and Iligan City Catholic Relief Services Community and Family Services International Department of Social Welfare and Development - Region X Department of Health - Region X Cagayan de Oro City Social Welfare and Development Office Cagayan de Oro City Disaster Risk Reduction and Management Council Camp Managers in Cagayan de Oro City and Iligan City Iligan City - District 7 Social Welfare and Development Office Iligan City Administrator Iligan City Health Office International Organization for Migration Philippine National Red Cross Save the Children UN High Commissioner for Refugees UN Office for the Coordination of Humanitarian Affairs World Food Programme World Health Organization Xavier University - Lumbia Ecoville
  5. 5. TABLE OF CONTENTS LIST OF ABBREVIATIONS .............................................................................................. 8 1. INTRODUCTION ..................................................................................................... 9 2. OBJECTIVE AND RESEARCH QUESTIONS ............................................................... 10 3. SCOPE AND LIMITATIONS .................................................................................... 10 4. RESEARCH METHODOLOGY ................................................................................. 11 4.1. KEY INFORMANT INTERVIEWS ........................................................................................... 11 4.2. SURVEYS ........................................................................................................................... 11 4.2.1. Survey of Camp Managers .............................................................................................. 11 4.2.2. Survey of Washi-affected population ............................................................................. 12 4.3. FOCUS GROUP DISCUSSION WITH HANDICAP INTERNATIONAL........................................... 12 5. POLICY REVIEW ................................................................................................... 13 5.1. KEY NATIONAL POLICIES .................................................................................................... 13 5.1.1. Republic Act 7277: Magna Carta for Disabled Persons ................................................... 13 5.1.2. Republic Act 10121: The Philippine Disaster Risk Reduction and Management Act of 2010................................................................................................................................. 14 5.1.3. Other disability laws ........................................................................................................ 15 5.2. INTERNATIONAL CONVENTIONS AND FRAMEWORKS ......................................................... 15 5.2.1. United Nations Convention on the Rights of Persons with Disabilities (UNCRPD) ......... 15 5.2.2. Biwako Millenium Framework ........................................................................................ 16 5.2.3. Other international conventions ..................................................................................... 17 5.3. HUMANITARIAN GUIDELINES AND STANDARDS ................................................................. 17 5.3.1. The Sphere Handbook ..................................................................................................... 17 5.3.2. Other humanitarian standards and guidelines ............................................................... 18 6. RESULTS .............................................................................................................. 19 6.1. KEY INFORMANT INTERVIEWS ........................................................................................... 19 6.1.1. Disability in general ......................................................................................................... 19 6.1.2. Relevant laws, conventions, and guidelines ................................................................... 19 6.1.3. Disability in the delivery of emergency relief and services ............................................. 20 6.1.4. Disability in monitoring and reporting ............................................................................ 21
  6. 6. 6.1.5. 6.1.6. 6.1.7. 6.1.8. Existing attitudes and assumptions regarding disability and emergency response ....... 21 Opportunities for disability inclusion in emergency response ....................................... 22 Challenges and difficulties to disability inclusion in emergency response ..................... 23 Recommendations for disability inclusion in emergency response................................ 25 6.2. SURVEY OF CAMP MANAGERS ........................................................................................... 26 6.2.1. General Information........................................................................................................ 26 6.2.2. Knowledge and attitudes of respondents towards disability ......................................... 27 6.2.3. Perceptions on inclusive and targeted emergency relief for PWD ................................. 32 6.2.4. Respondents’ confidence and perceived challenges in including PWD in camp activities .......................................................................................................................... 38 6.3. FOCUS GROUP DISCCUSION WITH HANDICAP INTERNATIONAL EMERGENCY RESPONSE TEAM ............................................................................................................................... 40 6.3.1. Beneficiary Identification ................................................................................................ 40 6.3.2. General emergency relief activities ................................................................................ 40 6.3.3. Physical accessibility........................................................................................................ 42 6.3.4. Support to specific needs ................................................................................................ 43 6.3.5. Observations regarding coordination and other emergency response actors ............... 43 6.4. SURVEY OF AFECTED HOUSEHOLDS ................................................................................... 43 6.4.1. General Information........................................................................................................ 44 6.4.2. Effects of Tropical Storm Washi on affected households ............................................... 45 6.4.3. Search, rescue, and evacuation....................................................................................... 46 6.4.4. Immediate needs of affected households and assistance received ............................... 46 6.4.5. Access to emergency relief and support ......................................................................... 50 6.4.6. Physical accessibility of camp structures ........................................................................ 51 6.4.7. Disability and access to emergency relief and support................................................... 52 7. ANALYSIS ............................................................................................................ 53 7.1. CONSIDERATION AND IDENTIFICATION OF PWD NEEDS BY THE RESPONSE ......................... 53 7.2. MECHANISMS FOR THE INCLUSION OF PWD IN EMERGENCY RESPONSE ............................. 55 7.2.1. Beneficiary identification ................................................................................................ 55 7.2.2. Communication and information dissemination ............................................................ 56 7.2.3. Special arrangements for PWD during distributions and relief activities ....................... 56 7.2.4. Identification and consideration of the specific needs of PWD ...................................... 57 7.2.5. Coordination.................................................................................................................... 57 7.3. PREVAILING ATTITUDES AND PERCEPTIONS OF DISABILITY IN DISASTER RESPONSE ............ 57 7.3.1. Inclusion is automatic through a blanket approach and through PWD caregivers ........ 58 7.3.2. Disability inclusion requires special and technical skills ................................................. 58 7.3.3. Disability inclusion will divert resources from the affected population ......................... 59
  7. 7. 7.3.4. PWD cannot participate in camp and community activities ........................................... 59 8. CONCLUSION ....................................................................................................... 60 9. RECOMMENDATIONS .......................................................................................... 61 9.1. GENERAL RECOMMENDATIONS ......................................................................................... 61 9.1.1. RECOMMENDATION 1: Improve awareness and understanding of disability ................ 61 9.1.2. RECOMMENDATION 2: Increase capacities for disability inclusive emergency response .......................................................................................................................... 62 9.1.3. RECOMMENDATION 3: Improve data collection on disability ........................................ 62 9.1.4. RECOMMENDATION 4: Involve PWD .............................................................................. 63 9.1.5. RECOMMENDATION 5: Create referral systems for the specific needs of PWD ........... 63 9.1.6. RECOMMENDATION 6: Regulate and monitor disability inclusion ................................ 63 9.1.7. RECOMMENDATION 7: Increase advocacy at all levels .................................................. 64 9.2. RECOMMENDATIONS FOR FURTHER STUDY ....................................................................... 64 ANNEX 1: List of Key Informants ............................................................................... 66 ANNEX 2: Guide Questions to Key Informant Interviews ........................................... 67 ANNEX 3: Survey Questionnaire for Camp Managers ................................................ 68 ANNEX 4: Survey Questionnaire for Washi-Affected Households............................... 71 ANNEX 5: Guide Questions to Focus Group Discussion with Handicap International Field Teams ............................................................................................... 74
  8. 8. LIST OF ABBREVIATIONS CCCM Camp coordination and camp management CDO Cagayan de Oro City CSO Civil society organization CSWDO City Social Welfare and Development Office DPO Disabled people's organization DSWD Department of Social Welfare and Development FGD Focus group discussion IASC Inter-Agency Standing Committee IOM International Organization for Migration NGO Non-governmental organization PWD Persons with disabilities SRE Search, rescue, and evacuation UN United Nations UNCRPD United Nations Convention on the Rights of Persons with Disabilities UNHCR United Nations High Commissioner for Refugees IDP Internally displaced person LGU Local government unit NFI Non-food items WASH Water, sanitation, and hygiene 8|P a g e
  9. 9. 1. INTRODUCTION The World Health Organization estimates that 15% of any given population lives with some type of impairment1. For the Philippines, it would translate into over 12 million persons with disabilities (PWD) however there is no available comprehensive and accurate data at national, regional nor provincial levels. In the Philippines, disability is more common among women, elderly and poor households and majority of PWD live in rural areas where social exclusion and isolation are part of their daily lives and experience. Tropical Storm Washi swept across the Mindanao region of Philippines from 16 to 18 December 2011, bringing strong winds and heavy rains that caused massive flooding, flash floods, and landslides. As the storm left Mindanao in the early hours of 17 December, rain-swollen rivers surged down the steep volcanic hills and mountains surrounding the cities of Cagayan de Oro (CDO) and Iligan flooding the Cagayan, Agus and Mandulog rivers. In some places, the mud-clogged rivers rose by over 3 meters in less than an hour, causing devastation more common with tsunamis, with entire neighborhoods and villages swept away. The flash floods struck in the early hours of the morning, giving residents little warning and killing many people as they slept. According to the Philippine National Disaster Risk Reduction and Management Council (NDRRMC), the tropical storm and its accompanying floods killed over 1,200 people, with almost 200 reported missing and 6,000 injured. Tropical Storm Washi was estimated to have affected 1,114,229 individuals (120,800 households).2 While natural disasters affect a large number of individuals, PWD tend to be more affected than others during such situations and often face bigger challenges in order to cope with the situation and survive. Due to their specific situations, they risk being excluded and invisible during response activities, and they often face additional barriers in accessing support and relief efforts. In an emergency context, their original vulnerability is greatly compounded, bringing about the risk of their vulnerability increasing. Factors that may make PWD more vulnerable in emergencies include the following3:   PWD are particularly affected by changes in terrain resulting from disaster  Because of limited physical accessibility, the loss or lack of mobility aids, or the lack of appropriate assistance, PWD may be deprived of rescue and evacuation services, relief access, safe location and adequate shelter, water and sanitation, and other services.  2 PWD may not be aware of what is happening, and therefore not comprehend the situation and its consequences  1 PWD tend to be missed by emergency registration systems Emotional distress and trauma caused by a disaster may have long-term consequences on PWD Word Disability Report (2011) National Disaster Risk Reduction and Management Council, SitRep No. 46 re Effects of Tropical Storm “SENDONG” (Washi) and Status of Emergency Response Operations (January 2012), p. 1 <http://www.ndrrmc.gov.ph/attachments/article/358/NDRRMC%20Update%20Sitrep%20No.46%20re%20Effects %20of%20TS%20SENDONG%20as%20of%2025%20Jan%202012,%208AM.pdf> [accessed 13 June 2012] 3 Handicap International, Including Disability Issues in Disaster Management (Bangladesh: Handicap International, 2005), p. 7 9|P a g e
  10. 10.  PWD may misinterpret the situation, and communication difficulties make PWDs more vulnerable in disaster situations  PWD may be separated from their families or caregivers who serve as their support system. These individuals may also be affected by the disaster, with their capacity to support the PWD diminished. PWD also have specific needs that are not always taken into account by response activities. Although they have the very same basic needs as everyone else, meeting these specific needs may be critical to prevent their condition from deteriorating and allow them equal access to basic emergency relief. Examples of specific needs can include the need for assistive devices or technical aids, additional nutrition requirements, medical care specific to certain conditions, adapted physical environments, and the like. This study seeks to provide a broad picture of what the disability inclusion process was like in the Washi response, examining how the immediate response took into account the specific situation and needs of PWD as well as the current attitudes and perceptions surrounding disability inclusion in emergencies. The results gleaned from the study and their analysis will be utilized to formulate recommendations towards the improved inclusion of disability in subsequent disaster response. 2. OBJECTIVE AND RESEARCH QUESTIONS The objective of this study is to provide an analysis of the immediate response to Tropical Storm Washi, and provide recommendations for the inclusion of PWD in the disaster response of disaster management stakeholders in the Philippines. This will be done through answering the following research questions: a. Were the needs of PWD considered in identifying and providing immediate emergency assistance? b. What formal mechanisms are in place for the inclusion of PWD in disaster management, in particular in the immediate emergency response phase? c. What are the prevailing attitudes and perceptions of disaster management stakeholders towards mainstreaming disability in disaster response? 3. SCOPE AND LIMITATIONS Disability inclusion in emergency response is a broad subject, while the time and resources allotted for the study are limited. Given this, the following scope and limitations were established to delimit the study boundaries: a. The study shall cover the emergency response stage of the Washi response, from the onset of the disaster to three months after. b. The study will focus geographically on Washi-affected areas of Cagayan de Oro City, Misamis Oriental and Iligan City, Lanao del Norte, including evacuation centers, transitional sites, relocation sites, and affected communities. 10 | P a g e
  11. 11. c. 4. While the researchers recognize that other factors aside from disability may impact on the inclusion of individuals in emergency response, an in depth analysis is not within the scope of the study. These factors, such as gender, age, ethnicity, religion, etc., will however be acknowledged where relevant. RESEARCH METHODOLOGY The study utilized mixed methodology for data collection, including both quantitative and qualitative methods covering a wide range of stakeholders. This section shall discuss each of the methods used and their respective samples. 4.1. KEY INFORMANT INTERVIEWS In-depth key informant interviews were conducted with representatives of NGOs, UN agencies, coordinating bodies, government offices and agencies, and local civil society organizations with Washiresponse activities. These organizations, offices, and agencies were not selected at random but were selected through information collected from the contact lists of various coordinating bodies and from feedback provided by the Handicap International Washi-response team. They were all present from the onset of the disaster and, at the time of data collection, continued to be present in the Washi-affected areas within the scope of the study. The target participants for the interviews were coordinators, managers, or heads of office. A total of 22 key informant interviews were conducted. (See Annex 1 for a list of participating organizations, offices and agencies.) The interviews followed a semi-structured format, framed by an interview guide made up of openended questions (Annex 2). Information was collected on their knowledge, attitudes, and perceptions on disability and inclusion, their respective organizations’, offices’ or agencies’ current efforts at inclusion at the field level, challenges and limitations faced in including PWD in their activities, and recommendations for strengthening disability inclusion. 4.2. SURVEYS 4.2.1. Survey of Camp Managers A survey was conducted for camp managers of evacuation centers, transitional sites, and relocation sites in Cagayan de Oro City and Iligan City. All camp managers were targeted for the survey, conducted during the regular camp manager meetings in both cities. A total of 69 camp managers participated in the survey, representing 86% of all 80 camp managers. The tool utilized for this survey was a self-administered questionnaire (Annex 3), with closed questions aimed to gather information on the respondents’ knowledge and attitudes towards disability, and their perceptions of disability inclusion in their respective sites. 11 | P a g e
  12. 12. 4.2.2. Survey of Washi-affected population A second survey was conducted for Washi-affected households. The sample included both households with PWD and those without PWD, providing a basis for comparison to help identify cases where reported non-inclusion or accessibility issues are due to disability as opposed to factors that also affect the access to relief of households with no PWD. For example, if households with and without PWD in one site provide reports about not being able to access relief services, this may more likely reflect issues in the general availability or accessibility of relief in their area rather than issues due to disability. The survey covered evacuation centers, transitional sites, relocation sites, and communities in Cagayan de Oro City and Iligan City chosen by the Handicap International Washi-response team. Given the study limitations in terms of time, the areas chosen were those where information already existed on affected households with PWD. Households with PWD were selected based on this information, while households with no PWD were selected at random. The survey had a total of 166 respondents. The tool utilized for the survey of Washi-affected households was a questionnaire administered by of Handicap International community workers (Annex 4). The questionnaire is made up of both closed and open-ended questions on the sample’s experience of the immediate response, their perceptions of the assistance they have received, and of their access to available relief and services. Households with PWD were asked additional questions on how their specific needs were met by the response and their perceptions on how their disabilities affected their access to emergency relief and services. 4.3. FOCUS GROUP DISCUSSION WITH HANDICAP INTERNATIONAL A focus group discussion was held with representatives of the Handicap International Washi-response team to discuss their various observations on inclusion and accessibility in the different sites covered by their activities. Participants included staff from the teams in Cagayan de Oro City and Iligan City. The discussion was semi-structured, framed by open-ended guide questions (Annex 5) covering various aspects of the emergency response. 12 | P a g e
  13. 13. 5. POLICY REVIEW There exists a range of national laws, and international conventions and frameworks that include provisions for the mainstreaming of disability in disaster management. This section will explore the key provisions of these laws, conventions, and frameworks relating to disability mainstreaming in emergency response. 5.1. KEY NATIONAL POLICIES 5.1.1. Republic Act 7277: Magna Carta for Disabled Persons Republic Act 7277, entitled an Act Providing for the Rehabilitation, Self -Development and Self-Reliance of Disabled Persons and their Integration into the Mainstream of Society and for Other Purposes, is the central disability legislation in the Philippines. Also known as the Magna Carta for Disabled Persons, the act was ratified in 1991 with amendments following in 2007 and 2010. PWD are defined by the Magna Carta as ‘those suffering from restriction of different abilities, as a result of a mental, physical or sensory impairment, to perform an activity in the manner or within the range considered normal for a human being’; with impairment being defined as ‘any loss, diminution or aberration of psychological, physiological, or anatomical structure of function’. 4 The Magna Carta covers the rights and privileges of PWD to employment, health, education, social services, telecommunications, accessibility, and political and civil rights. Some of the key provisions of this act and its amendments include the following:  Establishment of a national mandate for the elimination of discrimination against PWD  Rehabilitation, development, and provision of opportunities towards self-reliance of PWD and their integration into mainstream of society  Establishment of the National Council on Disability Affairs (NCDA) whose task is to monitor and coordinate the efforts of government agencies  Granting of privileges to PWD in all public and private establishments offering direct services such as hotels or accommodations, transportation, health services, and other related services.  Granting of incentives to those caring and living with PWD.  Penalties for the verbal, non-verbal ridicule and vilification against PWD.  Establishment of a Persons with Disabilities Affairs Office (PDAO)in every province, city and municipality Republic Act 7277 does not include any provisions for PWD in case of emergencies such as natural disasters. 4 Philippines, Republic Act No. 727 (1991), Chapter I, Section 4 <www.ncda.gov.ph/disability-laws/republic-acts/republic-act-7277> [accessed 12 June 2012] 13 | P a g e
  14. 14. 5.1.2. Republic Act 10121: The Philippine Disaster Risk Reduction and Management Act of 2010 Passed into law in 2010, the DRRM Act seeks to adopt a disaster risk reduction and management approach that is holistic, comprehensive, integrated, and proactive in lessening the socio-economic and environmental impacts of disasters including climate change, and promote the involvement and participation of all sectors and all stakeholders concerned, at 5 all levels, especially the local community. The scope of the act, as specified in Section 4, is ‘the development of policies and plans and the implementation of actions and measures pertaining to all aspects of disaster risk reduction and management.’6 Its key provisions include the following:  The renaming of the National Disaster Coordinating Council to the National Disaster Risk Reduction and Management Council, as well as the organization, membership, powers, and function of this council  The establishment and organization of Disaster Risk Reduction and Management Councils at the regional, provincial, municipal, and local levels  The establishment of Local Disaster Risk Reduction and Management Offices in every province, city, and municipality; and the establishment of Barangay Risk Reduction and Management Committees in every barangay  The integration of DRR education in school curricula and mandatory training for public sector employees  Mechanisms for the declaration of state of calamity  Coordination during emergencies of the various DRRM councils and offices  Mechanisms for international humanitarian assistance There are no specific provisions for PWD in the act. PWD are included in what the act refers to as ‘Vulnerable and Marginalized Groups’, defined in Paragraph oo of Section 3 as ‘those that face higher exposure to disaster risk and poverty including, but not limited to, women, children, elderly, differentlyabled people, and ethnic minorities.’7 Throughout the act, these groups are made mention of thrice:  Under Section 2 – Declaration of Policy: ‘It shall be the policy of the state to… [d]evelop and strengthen the capacities of vulnerable and marginalized groups to mitigate, prepare for, respond to, and 8 recover from the effects of disasters.’  Under Section 3 – Definition of Terms: DRRM Information System is defined as a specialized database that includes information on vulnerable groups, together with information on ‘disasters and their human 9 material, economic and environmental impact, risk assessment and mapping.’ 5 National Disaster Risk Reduction and Management Council, National Risk Reduction and Management Framework (2011), p.5 < http://www.ndrrmc.gov.ph/attachments/article/227/NDRRMFramework.pdf> [accessed 12 June 2012] 6 Philippines, Republic Act 10121 (2009), p.12 < http://www.ndrrmc.gov.ph/attachments/045_RA%2010121.pdf> [accessed 12 June 2012] 7 Ibid, p. 12 8 Ibid, p. 4 9 Ibid, p. 7 14 | P a g e
  15. 15.  Under Section 12 - The LDRRMO: The act states that the head of the barangay should facilitate and ensure the participation of ‘at least two CSO representatives from existing and active community-based 10 people’s organizations representing the most vulnerable and marginalized groups in the barangay.’ 5.1.3. Other disability laws There are several other disability laws or laws that include provisions for PWD in addition to the Magna Carta for PWD, including the following:  Commonwealth Act 3203: Care and Protection of Disabled Children (1935)  Republic Act 3562: An act to promote the education of the blind in the Philippines (1963)  Presidential Decree 603: Child and Youth Welfare Code (1974)  Batas Pambansa Bilang 344: Accessibility Law (1982)  Senate Bill 1730: The Economic Independence of Disabled Persons Act (1999) 5.2. INTERNATIONAL CONVENTIONS AND FRAMEWORKS 5.2.1. United Nations Convention on the Rights of Persons with Disabilities (UNCRPD) The UNCRPD was adopted on December 2006, and the convention and its Optional Protocol opened for signature by all states and by regional integration organizations on March 2007. The UNCRPD had 153 signatories with 114 ratifications, while the Optional Protocol had 90 signatories with 65 ratifications.11 The Philippines signed and ratified the convention, but is not a signatory to the protocol. The purpose of the UNCRPD, as specified in Article 1, is ‘to promote, protect and ensure the full and equal enjoyment of all human rights and fundamental freedoms by all persons with disabilities, and to promote respect for their inherent dignity.’12 PWD are defined by the convention as ‘those who have long-term physical, mental, intellectual or sensory impairments which in interaction with various barriers may hinder their full and effective participation in society on an equal basis with others.’13 The convention, seen as ‘mark[ing] a shift in thinking about disability from a social welfare concern, to a human rights issue’,14 covers areas including accessibility, personal mobility, health, education, employment, rehabilitation, participation in political life, and equality and non-discrimination. In terms of emergencies, Article 11 of the UNCRPD deals with Situations of Risk and Humanitarian Emergencies, and calls for State Parties to take ‘all necessary measures to ensure the protection and 10 Ibid, p. 25 United Nations Enable, Convention and Optional Protocol Signatures and Ratifications <http://www.un.org/disabilities/countries.asp?navid=17&pid=166> [accessed 14 June 2012] 12 United Nations, Convention on the Rights of Persons with Disabilities (2006), Article 1 <http://www.un.org/disabilities/default.asp?id=259> [accessed 14 June 2012] 13 Ibid. 14 United Nations, Why a Convention? <http://www.un.org/disabilities/convention/questions.shtml#three> [accessed 14 June 2012] 11 15 | P a g e
  16. 16. safety of persons with disabilities in situations of risk, including situations of armed conflict, humanitarian emergencies and the occurrence of natural disasters.’15 However, how this translates in practice is not defined by the convention. A paper published by the Conflict and Emergencies Task Group of the International Disability and Development Consortium defines what Article 11 can mean in practice for emergency response actors:  PWD are considered as a key target group across all intervention processes, including identification, assessment, planning, delivery of support, and monitoring and evaluation  Local organizations of PWD and their caregivers, and NGOs working in the disability field should be involved and consulted by humanitarian agencies to ensure the needs of PWD are recognized  Action and care is needed by humanitarian agencies to pro-actively seek out PWD to ensure they are registered and supported  Funding guidelines of donor agencies should include information on universal design for camps and shelters to ensure comprehensive accessibility  Sectoral agencies must include the needs of PWD, including with regard to disability access in their operations  Funding for post-conflict and post-disaster interventions needs to include PWD in a tailored way, supporting PWD as beneficiaries whilst enabling them to be included as part of the community response 16 to the disaster or emergency 5.2.2. Biwako Millennium Framework The Biwako Millennium Framework is a policy framework for the Asian and Pacific Region, for States to work towards an inclusive, barrier-free and rights-based society for PWD. Covering the period from 2003 to 2012, the framework identified seven priority areas for action:  Self-help organizations of persons with disabilities and related family and parent associations  Women with disabilities  Early detection, intervention and education  Training and employment  Access to built environment and public transportation  Access to information and communication  Poverty alleviation through capacity-building, social security and sustainable livelihood programs During its mid-term review in 2007, an explicit strategy recognizing the importance of disability-inclusive disaster management was introduced: 15 United Nations, Convention on the Rights of Persons with Disabilities (2006), Article 11 <http://www.un.org/disabilities/default.asp?id=259> [accessed 14 June 2012] 16 Emergency & Humanitarian Assistance and the UN Convention on the Protection and Promotion of the Rights and Dignity of Persons with Disabilities, p. 2 16 | P a g e
  17. 17. Disability-inclusive disaster management should be promoted. Disability perspectives should be duly included in the implementation of policies and initiatives in this area, including the Hyogo Framework for Action 2005-2015…. Universal design concepts should be integrated into infrastructure development in disaster-preparedness and post-disaster reconstruction activities.17 5.2.3. Other international conventions Other international instruments with provisions for PWD include the following:  Universal Declaration of Human Rights (1948): Articles 3, 21, 23 and 25  International Covenant on Civil and Political Rights (1966): Article 26  International Covenant on Economic, Social and Cultural Rights (1966): Article 2  The Declaration on the Rights of the Disabled Persons (1975)  Convention on the Rights of the Child (1989): Articles 2 and 23 5.3. HUMANITARIAN GUIDELINES AND STANDARDS 5.3.1. The Sphere Handbook The Sphere Handbook is a widely accepted and recognized set of standards for humanitarian response, utilized by local and international humanitarian actors, donors, and UN agencies alike. Its creation was based on two core beliefs: ‘that those affected by disaster or conflict have a right to life with dignity and, therefore, a right to assistance; and… that all possible steps should be taken to alleviate human suffering.’18 Unlike the UNCRPD and other international conventions, the Sphere standards are selfregulatory, with no compliance mechanism for humanitarian actors. Two components make up the handbook: the humanitarian charter and the minimum standards. The humanitarian charter provides the ethical and legal background to the subsequent components of the handbook. Aside from establishing legal rights and obligations, the charter ‘attempts to capture a consensus among Humanitarian agencies as to the principles which should govern the response to disaster or conflict.’19 The standards ‘describe conditions that must be achieved in any humanitarian response in order for disaster-affected populations to survive and recover in stable conditions and with dignity’.20 These 17 United Nations Economic and Social Council, Biwako Plus Five: Further Efforts Towards an Inclusive, Barrier-Free and Rights-Based Society for Persons With Disabilities in Asia and the Pacific (2007), p. 14 <http://www.ncda.gov.ph/international-conventions-and-commitments/other-internationalcommitments/biwako-plus-five/> [accessed 15 June 2012] 18 The Sphere Project, Humanitarian Charter and Minimum Standards in Humanitarian Response (The Sphere Project, 2011), p.4 19 Ibid., p. 20 20 Ibid., p. 4 17 | P a g e
  18. 18. standards cover four sets of activities: water supply, sanitation and hygiene promotion; food security and nutrition; shelter, settlement and non-food items; and health action. The handbook takes into account a number of cross-cutting themes, including disability. The other themes are children, DRR, environment, gender, HIV/AIDS, older people, and psychosocial support. For themes dealing with an affected population’s particular vulnerabilities and capabilities, the handbook further recognizes that ‘treating these people as a long list of “vulnerable groups” can lead to fragmented and ineffective interventions, which ignore overlapping vulnerabilities and the changing nature of vulnerabilities over time, even during one specific crisis.’21 The definition of disability provided by the UNCRPD is utilized by the handbook and it states that: Persons with disabilities face disproportionate risks in disaster situations and are often excluded from relief and rehabilitation processes… [They] are a diverse population including children and older people, whose needs cannot be addressed in a ‘one size fits all’ approach. Humanitarian responses, therefore, must take into consideration the particular abilities, skills, resources and knowledge of individuals with different types and degrees of impairments... It is essential, therefore, to include persons with disabilities in all aspects of relief and recovery. This requires both mainstreamed and targeted responses.22 Given this, the handbook makes mention of disability - either directly or through reference to ‘vulnerable people’23 - throughout its sections, from the Humanitarian Charter, the Protection Principles, the Core Standards, and the technical chapters on minimum standards. 5.3.2. Other humanitarian standards and guidelines In addition to the Sphere standards, other examples of standards and guidelines for humanitarian response that integrate disability include the following:  IASC: The Operational Guidelines on the Protection of Persons in Situations of Natural Disasters of the IASC acknowledges that certain persons are particularly vulnerable during disasters, including PWD. These guidelines include the specific human rights concerns that PWD may face and practical steps towards their protection in situations of natural disasters. The IASC Guidelines on Mental Health and Psychosocial Support in Emergency Settings also includes provisions for persons with severe mental disorders or disabilities.  UNHCR: The Handbook for the Protection of Internally Displaced Persons, published by the Global Protection Cluster led by UNHCR, utilizes an age, gender, and diversity approach, with diversity defined as ‘other factors [that] might lead to significant inequalities and place persons at risk… includ[ing] ethnicity, 21 Ibid., p. 11 Ibid., p. 17 23 The handbook defines vulnerable people as ‘people who are especially susceptible to the effects of natural or man-made disasters or of conflict… due to a combination of physical, social, environmental and political factors… marginalized by their society due to their ethnicity, age, sex, disability, class or caste, political affiliations or religion.’ 22 18 | P a g e
  19. 19. 24 language, culture, religion, disability, family status and socio-economic status.’ UNHCR have also published a guide entitled Working with Persons with Disabilities in Forced Displacement.  Other guidelines or toolkits published by NGOs working in disability also exist, such as Handicap International and Christian Blind Mission 6. RESULTS After discussing laws, conventions, guidelines, and standards relevant to disability inclusion in emergency response, this section will look at the research findings collected through the methodology and data collection tools described in Section 4. 6.1. KEY INFORMANT INTERVIEWS Twenty-two interviews were conducted with various actors from NGOs, UN agencies, government offices and agencies, and civil society organizations (see Annex 1). The discussion of the results of these interviews will be structured by the main themes covered, focusing on responses shared by all or the majority of the informants, as well as statements that express important existing assumptions and attitudes towards disability. 6.1.1. Disability in general The informants and the bodies they represented took PWD as part of a broader grouping, referred to alternatively by the various actors interviewed as ‘most vulnerable’, ‘vulnerable groups’, and ‘persons with special needs’. Other groups commonly included under this umbrella term are women, children, older persons, persons with chronic illnesses, single-headed households including those headed by children, women, older persons or PWD, among others. PWD and the other groups mentioned were seen as needing special attention and prioritization in all emergency response activities. In general, the informants felt that to deal with disability required technical and medical expertise. Several informants also seemed to feel that disability was to be taken solely as a specialized sector, in a way disconnected from the mainstream. Many informants said that to work with disability required specialized teams or focal points which focused only on disability. A concrete manifestation of this is how a number of individuals targeted for the interviews refused or delegated the interviews to disability focal points, despite explanations that the interviews would cover the entire emergency response. This was especially noticeable for government offices and agencies participating in the response. Some informants also carried the assumption that PWD are not numerous in society, and that the exclusion of PWD is not an issue for the Philippines when compared to other places. These assumptions on disability together with others are explored further in Sub-Section 6.1.5. 6.1.2. Relevant laws, conventions, and guidelines 24 Global Protection Cluster, Handbook for the Protection of Internally Displaced Persons (2010), p. 14 19 | P a g e
  20. 20. Official references regarding disability mainstreaming differed depending on the type of organization or office being interviewed. Government offices and agencies referred mostly to the DRRM Law of 2010 as their reference for disability inclusion in disaster response, while only a minority of NGOs, UN agencies, and civil society organizations mentioned the law. On the other hand, interviewees from the latter groups all mentioned the Sphere standards which were not mentioned by the government offices or agencies. A common reference mentioned by the informants was their own internal guidelines and mandates, ranging from organizational strategies, mission vision statements, to technical guides for emergency response. One important observation is that none of the informants mentioned the Magna Carta for PWD, the centerpiece legislation for disability in the country, or provided additional details on provisions specific for PWD in the DRRM law or the Sphere standards. 6.1.3. Disability in the delivery of emergency relief and services The activities of the informants took a general or blanket approach to emergency response, with the exception of some activities specifically targeting women and children, and activities where beneficiary selection is necessary. Informants noted that where selection is done, disability is always part of the criteria. The identification of beneficiaries as described by the informants is largely dependent on DSWD, CSWD, and the barangay. In some cases, additional information is also collected from or provided by the communities. Some organizations also conduct independent validation of the information they receive. Of the 22 informants, there were three25 with activities specifically targeting PWD through the provision of assistive devices, technical aids, and medicines. For the other informants, their means of including PWD was generally through addressing the issue of access to emergency relief and support. One informant described this approach as increasing PWD access to relief, or increasing their access to the PWD. The most common examples provided by the informants included special distribution arrangements such as special lanes and assistance in carrying relief items, providing additional support for certain activities such as shelter repair or construction, building of accessible facilities, increased monitoring of PWD for psychosocial and nutrition activities, among others. It was commonly acknowledged by the informants, and demonstrated by the above examples, that while disability changes the mode of delivery of relief or the frequency and intensity of monitoring for some activities, it does not change the actual service or support being provided. This was seen to be true even in cases where selection criteria included disability. As one informant observed, PWD are always part of the criteria but no specific interventions or adaptations to interventions follow for them. When asked about addressing the specific needs of PWD, the approaches described by the informants were largely ad hoc in nature. No mechanisms were mentioned for the systematic identification and 25 Specifically, CFSI Cagayan de Oro, CFSI Iligan, and UNHCR in partnership with CFSI 20 | P a g e
  21. 21. referral of these needs. Where these special needs were identified, this was often through PWD or their families asking emergency actors directly for support. Informants representing clusters and coordination bodies were also asked to speak about how they monitor disability inclusion in their members’ activities. With the exception of the Displacement Tracking Matrix of the CCCM cluster which includes the number of PWD per site, it would seem that no systematic monitoring of disability is being done by the clusters or coordinating bodies. The discussion of disability issues during cluster or coordination meetings is largely ad hoc, brought up only when there are specific issues. Global indicators, the main monitoring mechanism of the clusters made up of three to five indicators selected by cluster members, also did not include disability. The terms of reference for the provincial clusters were not yet available at the time of the study, and were therefore not checked for the inclusion of disability. The informants had mixed responses when asked if they felt the emergency response was sufficiently inclusive for PWD, although it was commonly acknowledged that improvements can still be made. Despite this, informants felt that they did what they could, given their capacity and the challenges to the inclusion of PWD in emergency response they described (see Section 6.1.7.). 6.1.4. Disability in monitoring and reporting Apart from those conducting activities directed at PWD, the informants said their organization or office does not collect information on their beneficiaries with disabilities. Disaggregation of beneficiary data for monitoring and reporting is limited to gender and age, with other vulnerability factors not included. A few organizations collect disability information at the individual or household level but the data is not consolidated and therefore not reported. Examples include family access cards and individual nutrition screening forms. 6.1.5. Existing attitudes and assumptions regarding disability and emergency response Several existing assumptions, perceptions, and attitudes towards disability and emergency response emerged during the interviews. A number of informants were of the assumption that PWD and their needs were automatically being included in the emergency response. A statement repeated in a number of interviews was that because activities were implemented using a general or blanket approach26, PWD were automatically being covered. Although less common than this, some informants were also of the thinking that mainstreaming disability was something more or less automatic for international organizations. Voucher systems for distributions were also seen as a way to ensure that PWD needs were being covered. Only a minority of the informants said that increasing access of PWD to relief does not necessarily mean meeting their needs. 26 Approach where the entire population in a certain area such as an evacuation center, relocation site, or affected community is included in an activity, with no beneficiary targeting 21 | P a g e
  22. 22. There were also assumptions that all PWD are able to access relief or have someone to access relief for them. When cases were mentioned where PWD reportedly were not able to receive relief goods, a number of informants said that this was the fault of the PWD themselves. For example, one informant said that if they really needed the items, they would come to the distributions. That they did not come meant it was really not essential to them. Another informant said that it is the responsibility of the PWD to find someone to collect relief for them, adding that all PWD have family. For these informants, there was very little acknowledgement of the possibility that some PWD may be living on their own and had no capacity to reach distributions or access information. Many of the informants were also of the opinion that making emergency response activities inclusive or accessible was significantly more costly than activities that were non-inclusive or accessible. This assumption has resulted to the opinion that considering PWD needs somehow reduces the resources available for the general affected population, with a number of informants saying they needed to think of the greater number before considering the few. This assumption can be linked to the thinking mentioned earlier that PWD are not numerous in society, which can lead to questions from actors on why they need to be considered in the response. A number of informants were also of the opinion that responding to disability equates to a long-term, sustainable response, showing some confusion in distinguishing between the emergency needs and the long-term needs of PWD. In some examples provided by the informants, it could also be seen that PWD were thought of as a generally homogeneous group. Their individual abilities were not always considered in the implementation of activities. A good example of this would be cash-for-work or food-for-work activities, where it is almost automatically assumed that all PWD will not be able to participate due to the nature of the work required, and alternatives such as cash vouchers or the direct provision of items are provided to them before an actual assessment of their capacity and willingness to participate. However, some informants also stated that while PWD need special attention, their capacities also need to be considered; that they have special needs, but this does not automatically imply that they are different from others. For a number of informants, this realization came after PWD in various sites expressed their willingness and determination to participate in cash-for-work and food-for-work activities despite alternatives being made available to them. 6.1.6. Opportunities for disability inclusion in emergency response The informants were asked to identify factors that facilitated or could facilitate the inclusion of PWD in their activities. Many of the respondents said that there already was a general consciousness and awareness of disability and the need to include PWD, that there was little question that disability was a relevant crosscutting issue that needed to be mainstreamed. However, capitalizing on this awareness is limited by their lack of capacity for disability inclusion. 22 | P a g e
  23. 23. Informants also pointed out that there is some data on PWD such as existing databases or registries, and that communities are able to provide valuable information that is sometimes missed by barangays, the CSWD, or the DSWD. However, when asked further about the actual utilization of available information, there did not seem to be any systematic or clear manner in which the data is being used. Internal factors that can facilitate the inclusion of PWD include the mandate and nature of the informants’ respective organizations and offices, as well as having staff who are already experienced and exposed to disability and other cross-cutting issues. Another opportunity identified by the informants was the building of partnerships and coordination between actors, seen as contributing to a systematic referral system for PWD. The informants conducting activities targeting PWD and whose approach can be considered inclusive towards disability provided the following additional factors that they considered key to their being able to implement such activities:  Presence in the areas before the disaster  Existing partnerships with donors and local organizations  Their team already had experience with PWD  Inclusion was already being emphasized before Washi  Some information on PWD was already collected before Washi  Their activities took an individual, targeted approach  There were existing tools and capacity for the identification of PWD as similar emergency projects had already been implemented elsewhere before Washi 6.1.7. Challenges and difficulties to disability inclusion in emergency response When asked about the main challenges to disability inclusion in emergency response, the various responses given by the informants can be divided into four main themes: information, resources, knowledge and capacity, and representation and participation. Information was emphasized by almost all informants as the most significant challenge in making emergency response activities more inclusive. This was often the first answer provided by the informants. The informants noted a lack of information about PWD and disability in general, both before and after the disaster. There was no available census data on PWD from before Washi, and information on the affected population afterwards did not include disability. In cases where information is or was being collected, informants noted that there was still very little in terms of the actual utilization of data. They also noted issues in the consistency and reliability of data. For example, informants reported cases where information was not up to date or where various sources provided conflicting information on PWD numbers. 23 | P a g e
  24. 24. Following information issues, limitations in terms of resources was the most common answer. These limitations were often attributed to the nature of emergency response, where time is limited and activities are implemented rapidly. Informants mentioned being stretched to capacity in terms of human resources given the emergency context. For example, most informants from government offices or agencies mentioned having no one to dedicate for PWD or having to divert their PWD focal point. This underscores two key assumptions: firstly, that disability inclusion requires additional human resources; and secondly, that it requires the dedication of a focal point or team, as mentioned earlier. Budgetary limitations to including disability and making accessibility considerations were also mentioned by informants, implying a common perception that disability inclusion is expensive and costly. Some informants mentioned there being no specific funding for disability. Also included in these limitations are external conditions such as the land contour in relocation sites and limited space in camps, seen to make accessibility modifications more challenging to implement. Another challenge mentioned by most informants was the lack of knowledge and capacity on disability. In a number of interviews, informants expressed confusion as to who is considered as a PWD and what disability is. Some informants admitted to understanding disability as something that can be visibly seen, an obvious physical condition of a person. Emergency field teams do not receive training on disability. For example, it was mentioned during the interviews that camp managers did not receive any training on dealing with disability in either Cagayan de Oro or Iligan. This lack of knowledge and understanding as to what constitutes disability can be directly linked to difficulties expressed by informants in identifying PWD, saying they are more difficult to identify and therefore more complex to include in activities compared to other vulnerable groups. Informants also expressed a lack of knowledge on what constitutes mainstreaming and inclusion, and on accessibility and minimum accessibility standards. Given the perception mentioned earlier of disability requiring specialized skills, informants mentioned their lack of technical or medical skills as another difficulty. In one case, this perception actually led to an organization choosing not to deal with PWD saying they did not have the medical capacity to do so. The low participation and representation of the disability sector in coordination meetings and emergency activities was also seen as a difficulty, with disability issues getting lost amongst other competing concerns. Informants expressed the need for constant presence from the sector for it to be included and to ensure existing policies are being implemented. A few informants also mentioned cases where PWD were being hidden by their families, making it difficult to identify them and ensure their needs are being considered. For some informants, PWD and disability inclusion were seen as unnecessary, additional work. One informant mentioned the additional assistance they needed to provide PWD as a challenge while another informant thought that the monitoring of disability inclusion was ‘too detailed’. A number of 24 | P a g e
  25. 25. informants were also of the opinion that PWD were generally more emotional and sensitive, and therefore always required extra care from their teams during communication or activities. In the most extreme case encountered throughout the interviews, one informant said that the challenge was the persons themselves, referring to PWD as problematic because they can disrupt activities when they are ‘weird’ or ‘noisy’. The same informant said they were hesitant to include PWD because it will become their responsibility or add to their work if the PWD are left alone or in case there is an emergency. This thinking ultimately led them to impose more requirements for PWD to meet before being allowed to benefit from their activities, including a medical exam and an additional waiver. 6.1.8. Recommendations for disability inclusion in emergency response To address the challenges and difficulties identified, informants said that general information management on disability should be improved. Disaggregated data should be available from early on in the emergency, before the actual implementation of activities for inclusion to take on a less ad hoc approach. Emergency actors also need to systematically monitor and document data themselves. Lastly, the actual utilization of available data also needs to be improved. Many informants mentioned the need for information on accessibility and mainstreaming needs to be made available before disasters, during the preparedness phase. Disability inclusion should also be covered in the contingency plans of emergency actors, clusters, and coordinating bodies. The need for training and capacity-building was also a common recommendation, with informants saying this is needed at various levels for it to be effective, covering key actors, the community, the household-level, and the individual level of PWD themselves. For the organizations and offices of the key informants, technical support and advice on disability inclusion needs to be provided. However, almost all these actors expressed the condition that support and advice be feasible, user-friendly, practical, simple, and not too burdensome. All actors agree that the post-emergency stage of Washi or the subsequent preparedness phase would be a good time for these efforts to be done. Advocacy efforts also need to be intensified at both national and local levels, with representation from local and international disability-focused organizations. Advocacy should take a bottom-up and topdown approach, engaging leadership while building the capacity of local disability organizations as well. Informants also mentioned the need for disability inclusion to be made systematic rather than the current ad hoc approach being taken. Suggestions on how to do this include the putting in place and tracking of monitoring mechanisms for inclusiveness and accessibility, as well as the improvement of referral pathways and systems between disability-focused organizations, specialized service providers, and other actors. The possibility of complementary activities between these actors should also be explored. Informants also thought that increased donor support for disability inclusion was an important means towards the actual practice of inclusive approaches by NGOs and other actors. 25 | P a g e
  26. 26. 6.2. SURVEY OF CAMP MANAGERS 6.2.1. General Information A total of 69 camp managers were included in the survey. Of this number, 56 camp managers or 81% worked in sites located in Cagayan de Oro City, while the remaining 13 camp managers or 19% were covering sites in Iligan City. The majority of the camp managers surveyed were under the DSWD management, with 52 respondents or 75%. The remaining 17 respondents or 25% were IOM camp managers. The camp managers who responded to the survey covered 42 sites in Cagayan de Oro and 10 sites in Iligan. Figure 1 shows the percentage breakdown of all 69 respondents by city and by affiliation to either DSWD or IOM. Of the 69 respondents, 10 were camp managers in more than one site, with 6 respondents handling two sites each, 2 respondents handling three sites each, and another 2 respondents handling four sites each. All of these 10 respondents were IOM camp managers. Table 1 below lists the sites covered by the respondents by city. 56% 26 | P a g e
  27. 27. TABLE 1 Sites covered by camp manager respondents CAGAYAN DE ORO SITES Agusan Elementary School Camaman-an Covered Court Lumbia Central Elementary School Amakan 1 Canitoan Elementary School Macasandig Covered Court Amakan 2 Carmen Zone 6 Mandumol Transitional Site Amakan 3 Carmen Zone 8 Mt. Carmel Parish Barangay 24 Covered Court Carmen Zone 10 Nazareth Multi-Purpose Hall Buena Oro Covered Court City Central School North City Central School Bugo Elementary School Consolacion Covered Court Patag Covered Court Bulua Elementary School Cugman Elementary School Provincial Capitol Grounds Bulua Covered Court Gusa Regional Science High School Puerto Elementary School Calaanan 1 Indahag 1 Sto. Niňo Parish Church, Tablon Calaanan 2 Indahag 2 Tibasak Covered Court Calaanan 4 Iponan Multi-Purpose Hall Xavier University - Ecoville Calaanan 5 KM 5 Elementary School Xavier Heights Covered Court ILIGAN SITES Luinab Diocesan Malta San Roque Tent City Sta Elena Luinab Gym 1 Tambacan Elementary School Tambo Tent City Madrasah Siao Shelter Box Upper Hinaplanon Elementary School Order of Malta On average, the total duration the respondents had spent as camp managers was 11 weeks, with answers ranging from 1 to 16 weeks. The majority of respondents, at 80% or 55 out of the 69 respondents, had been in their positions for between 9 to 12 weeks. 9 respondents or 13% did not provide an answer to this question. Figure 2 demonstrates the length of time the respondents had spent as camp managers at the time of the survey. 6.2.2. Knowledge and attitudes of respondents towards disability A number of questions to measure respondent knowledge and attitudes towards disability were included in the survey questionnaire. For some questions, there was a noticeable difference in answers between camp managers working under IOM and those under DSWD. This information will be presented where the difference can be considered significant. 27 | P a g e
  28. 28. When asked about factors affecting disability, the majority of respondents (69% or 36 respondents) thought that socioeconomic, environmental, and economic factors all impact a temporary or permanent impairment and result to disability. The remaining 33 respondents thought that only economic (13% or 7 respondents), environment (12% of 6 respondents), or socio-cultural (2% or one respondent) factors affected disability, with 2 respondents not answering this question. The camp manager respondents were asked what means should be taken to ensure that emergency relief and support in the camps are inclusive of PWD. Of the 69 respondents, the majority at 58% (40 respondents) answered ‘integrate and include them and their needs in all camp planning and activities’. This response was followed by ‘allot a separate area in the camp for them so we can easily identify and meet their needs’, at 30% (21 respondents). 10 percent (7 respondents) said that they would ‘depend on disability-focused organizations to help them’. When the results are disaggregated between the respondents from IOM and DSWD, a stark difference can be noticed, as shown by Figure 5. While 88% of IOM camp managers chose integration and inclusion as the best response, only 48% of DSWD camp managers chose the same response. More importantly, the disaggregation shows that 37% of all DSWD camp managers thought that separation and isolation of PWD was the best answer. Although this is not the majority, it is still a high number representing 19 camp managers working in 19 camps. 28 | P a g e
  29. 29. A question regarding children with disabilities asked respondents to choose the statement they thought the most true between four different possibilities. The option with the most respondents, at 40% (21 respondents) was that ‘activities in child-friendly spaces can be adapted for children with disabilities if we are familiar with their needs and abilities’. This was followed by ‘it is the parents’ responsibility to make their children participate in childfriendly spaces and community activities’, with 31% (16 respondents). The remaining two options - ‘children with disabilities need special activities, so we cannot make them participate in child-friendly spaces’ and ‘referring a child with disability to a disabilityfocused organization means we do not need to worry about them accessing support anymore’ had 17% (9 respondents) and 7% (4 respondents) respectively. Disaggregating responses further shows that answers from DSWD camp managers are more distributed than those provided by IOM camp managers. This is especially true for respondents choosing the statement on adapted activities and those choosing the statement on children with disabilities being their parents’ responsibility. While 65% of IOM respondents chose the previous statement, only 40% of DSWD respondents chose the same. On the other hand, while only 6% of respondents from IOM chose the latter statement, this number is 31% for DSWD. For both organizations, more than 10% thought that children with disability need specialized activities and therefore cannot be made to participate in activities. 29 | P a g e
  30. 30. When asked to choose the statement they thought the most true regarding the physical accessibility of camp structures, the large majority at 75% (52 respondents) said that ‘Using minimum accessibility standards can create structures that are safe and functional for all users while promoting the selfreliance and ease of living of persons with disabilities.’ The remaining 25% of respondents were relatively spread out between the three remaining options, with 10% stating that ‘designing a structure to be more physically accessible is a lot more expensive than one without accessibility features’; 7% stating that ‘only people specialized in disability can design physically accessible structures’; and 6% stating that ‘only persons with disabilities will benefit from physically accessible structures’. Disaggregation of results between DSWD and IOM did not show any significant differences. Asked about means of communication with persons who have difficulties hearing and speaking, 80% (55 respondents) of all respondents said that they ‘can use gestures, body language, picture messages, and written text while I’m speaking to help them understand’. 14% (10 respondents) said that they ‘should just speak directly to and get information from their caregiver because these persons will not be able to express themselves’; while the remaining 6% (4 respondents) said that ‘if I speak louder and shout, the person will understand me’. Statements regarding disability were also included in the questionnaire, and the camp manager respondents were asked to indicate whether they thought these were true or false. 30 | P a g e
  31. 31. The first statement provided was ‘If there are not many persons with disabilities in the site, we don’t need to consider their needs in relief efforts and camp activities’. A large majority of respondents, at 90% (62 respondents) disagreed with the statement, with 9% (6 respondents) agreeing with it. As Figure 10 shows, there was not a lot of variation between IOM and DSWD responses. For the next statement, ‘It is the sole responsibility of the caregivers of persons with disabilities to make sure they get any information we disseminate in the camp about relief or activities’, respondents were more evenly divided with 55% (38 respondents) considering the statement as true and 43% (30 respondents) considering it as false. However, a disaggregation of this result shows a large difference between IOM and DSWD responses. The majority of IOM respondents, at 76%, thought the statement is false, while the majority of DSWD respondents, at 65%, thought the statement is true The next statement was ‘Persons with disabilities cannot be active participants in camp and community activities because of their disabilities’. The majority of all respondents, at 74% (51 respondents), considered the statement false; with the remaining 26% (18 respondents) considered it to be true. Although the majority of responses indicate a belief that PWD can be active participants in camps and communities, the number of camp managers believing the contrary is still large enough to cause concern. This 26% represents 18 camp managers responsible for 20 different sites in both of the studies target cities. 31 | P a g e
  32. 32. 6.2.3. Perceptions on inclusive and targeted emergency relief for PWD Following the questions on knowledge and attitudes towards disability, the respondents were asked questions regarding the emergency relief and assistance being provided to PWD in evacuation centers, transitional sites, and relocation sites, ranging from the identification of PWD to specific sectoral activities. The respondents were asked to base their answers on their actual observations and experiences from their respective camps. Unlike the data covered by the previous sections, results under this section are disaggregated by city to allow for a comparison between the emergency response provided in Cagayan de Oro and Iligan. When respondents were asked if children with disabilities in their sites attended activities in child-friendly spaces, the majority said yes with 59% (41 respondents). However, the disaggregation of results by city shows that while 66% of respondents from Cagayan de Oro agree with the statement, only 31% of camp managers from Iligan said the same. Perceptions regarding the access of PWD to communal facilities in the camps are almost evenly split, with 48% agreeing with the statement that ‘PWD are located close to and can easily access the camp’s communal facilities’, and 49% disagreeing. Results from Cagayan de Oro follow this pattern, with 50% of respondents agreeing and 46% disagreeing; while results from Iligan show more variation, with the majority disagreeing at 62% and the remaining 38% agreeing. With regards to food and nutrition programs, 65% of respondents (45 respondents) agreed that ‘programs take into account the additional nutritional requirements of PWD’ and that they are included in feeding programs. When the results were differentiated by city, this percentage was higher for Cagayan de Oro, with 85% of respondents agreeing as opposed to 61% for Iligan. 32 | P a g e
  33. 33. The majority of respondents, at 70% (48 respondents), said that there were no special food, NFI and water distribution arrangements for PWD in their camps, with only 26% (18 respondents) saying that these arrangements were available. This pattern is also true for the disaggregated results, with 66% of camp managers in Cagayan de Oro and 85% of camp managers in Iligan saying that these arrangements were not put in place for PWD. For those saying that special arrangements were made for PWD, the following are the examples they provided:  Items were provided directly to the PWD  PWD are given priority  Specific NFIs were provided to PWD such as wheelchairs, mattresses, crutches, and catheters When asked about the means of communication utilized to disseminate information in camps regarding distributions and services, the answers were evenly split with 45% of respondents (31 respondents) agreeing with the statement that more than one means of communication is utilized and the same number disagreeing. This pattern holds true for respondents in Cagayan de Oro, with 41% agreeing and 46% disagreeing; while for respondents in Iligan, the majority agreed with the statement at 62% with 38% disagreeing. Compared to other questions, more respondents left this question blank, with 7 respondents (10%) not providing any answer. Examples of the different means of communication used in the camps included:  Through camp leaders who will disseminate information to vulnerable groups  Utilization of megaphones and microphones  Person-to-person information dissemination  Tent-to-tent information dissemination  Through camp information committees and camp public information officers  Neighbors pass the information 33 | P a g e
  34. 34.  Announcements posted on bulletin boards and other written notices  Basic sign language  Through word of mouth  Through meetings where one member per family is present When asked whether ‘targeted, case-to-case assistance is sufficiently being provided to PWD by NGOs, LGU, and other actors’, the majority of respondents at 64% (44 respondents) said yes while the remaining 36% (25 respondents) said no. Results from Cagayan de Oro are similar to this, with 68% saying yes and 32% saying no. On the other hand, a lower percentage of respondents in Iligan said yes, with only 46%; while 54% said no. The respondents were also asked to judge how specific activities for PWD were being implemented through a scale with five options: poor, needs improvement, average, good, or very good. For efforts to locate, identify, and register PWD and their specific needs, the respondents were almost evenly spread out between those that thought these efforts needed improvement, were average, and were good, with 23% (16 respondents), 22% (15 respondents), and 28% (19 respondents) respectively. 10% of the remaining respondents judged these efforts to be poor, while 16% said they were very good. When comparing the results from the two cities, it can be seen that there is less variation in the responses from Iligan, with the clear majority saying these efforts were good. On the other hand, respondents from Cagayan de Oro were spread out between needs improvement (27%), average (21%), and good (23%). 34 | P a g e
  35. 35. When asked about efforts of camp health services to address the prevention of disability or the deterioration of an existing impairment through the provision of appropriate drugs and assistive devices, 30% of respondents (21 respondents) said these needed to be improved. This was closely followed by respondents saying these efforts were average and poor, with 25% (17 respondents) and 23% (16 respondents) respectively. For camp managers coming from Iligan, the clear majority responded that these efforts needing improvement, with 62%. For Cagayan de Oro, respondents were evenly spread out between poor, needs improvement and average, with 27%, 23%, and 25% respectively. Given the additional vulnerabilities of and protection risks to women and girls with disabilities, the respondents were asked if these were taken into consideration by protection activities for women in their respective sites. The largest number of respondents said this needed improvement, with 29% (20 respondents). Following closely were respondents who thought the inclusion of women and girls with disabilities in protection activities was either average or good, with 23% (16 respondents) and 22% (15 respondents) respectively. In Cagayan de Oro, 34% of the respondents said this needed improvement, followed by 21% saying this was average and 20% saying this was good. Respondents in Iligan City were evenly spread out between average, good, and very good, each with 31% of respondents. 35 | P a g e
  36. 36. The respondents were asked about the representation of PWD in camp management activities including in planning, decision-making, sector-specific camp committees, and coordination. 28% of respondents (19 respondents) said PWD representation was average, followed by those saying that representation was good and needing improvement, with 25% (17 respondents) and 17% (12 respondents) respectively. The largest number of respondents from Cagayan de Oro at 30% said PWD representation was average, while in Iligan 31% said this was very good. Respondents were of the opinion that the referral of the needs of PWD to specialized service providers such as hospitals, rehabilitation centers, and disability-focused groups was either average, good, or needing improvement, with 29% (20 respondents), 28% (19 respondents), and 26% (18 respondents) respectively. Responses from Cagayan de Oro were spread out between needs improvement with 30%, average with 27%, and good with 29%. In Iligan, the largest number of respondents at 38% said referrals to specialized service providers was average, followed by good and poor, each with 23% of respondents. 36 | P a g e
  37. 37. When asked about the inclusion of PWD in relief activities conducted by government agencies and offices in their camps, the respondents were evenly distributed between those that thought this needs improvement, was average, or was good, with 28% (19 respondents) and 26% (18 respondents) each respectively. In Cagayan de Oro, an almost equal number of respondents said inclusion in government activities needed improvement or was good, with 30% and 29% each respectively. In Iligan, 31% of respondents said this was average, followed by those saying this was poor at 23%. When asked about PWD inclusion in activities conducted by NGOs, civil society organizations and religious groups, 29% of respondents (20 respondents) said this needed improvement. This was followed by respondents who said this was average and good, each with 23% (16 respondents). In Cagayan de Oro, the largest number of respondents at 32% said inclusion by NGOs, civil society organizations and religious groups needed improvement, followed by 27% thinking this was already good. In Iligan, 38% of respondents said inclusion was currently average, followed by those thinking this was very good with 23%. 37 | P a g e
  38. 38. 6.2.4. Respondents’ confidence and perceived challenges in including PWD in camp activities In the survey questionnaire, two questions were asked to look at how the respondents perceived their own capacity to include PWD in camp activities. One question asked about their confidence in working with PWD, and another one asked what they felt were the main challenges to the inclusion of PWD in their respective sites. Of all the respondents, majority said that their confidence to identify and integrate PWD and their needs in camp activities was either average or good, with 30% (21 respondents) and 29% (20 respondents) respectively. Seventeen percent (12 respondents) felt that their confidence needed improvement, 14% (10 respondents) said their confidence was very good, while 7% (five respondents) said this was poor. A larger percentage of respondents from Iligan, at 46%, felt their confidence to be average; whereas in Cagayan de Oro, respondents were mostly split between those feeling their confidence was average (27%) to those saying it was good (32%). None of the respondents from Iligan judged their confidence to be poor, compared to 9% for Cagayan de Oro. The percentage of those saying their confidence level was very good was also very different for both cities, with 31% of respondents from Iligan and only 11% from Cagayan de Oro. There are also some differences between the responses provided by camp managers from DSWD and IOM. The majority of DSWD respondents (31%) felt that their confidence level is good, whereas most respondents from IOM (41%) judged their confidence to be average. Almost the same percentage of respondents for IOM and DSWD judged their confidence level to be on the lower end of the scale, with 10% of respondents from DSWD judging their confidence to be poor and 15% saying it needs improvement; while 24% of IOM respondents said it needed improvement. A higher percentage of respondents from 38 | P a g e
  39. 39. DSWD judged their confidence to be good or very good, with 31% and 15% respectively; as opposed to 24% and 12% respectively for IOM. Regarding the challenges or limitations in including PWD in camp activities, of the 69 respondents, 42% (29 respondents) thought that ‘only persons specialized in disability are capable of doing this’. This was followed by ‘I have no training on how to include disability in camp management’ with 30% (21 respondents); ‘it costs too much to include them in camp activities’ with 13% (9 respondents); and ‘there are no persons with disabilities in the camp’ with 8% (6 respondents). The pattern of the overall results is followed comparing responses provided by camp managers from Cagayan de Oro and Iligan, with the majority for both cities saying that only specialized persons are capable of including PWD in activities, followed by those saying they have no training. There is a more visible difference in responses when comparing between DSWD and IOM respondents, with the majority of DSWD respondents saying that inclusion needs people specialized in disability, and the majority of IOM respondents saying they have no training. It should be noted that, as mentioned in under the results of the key informant interviews, neither sets of camp managers received specific training on dealing with PWD. In Iligan, there was no training on this at all; while in Cagayan de Oro, disability was taken as a protection issue during trainings. It is also interesting to compare the responses to this question to those provided by respondents when asked about their confidence to identify and include PWD. 43% of all respondents said that their confidence level was good or very good. However, when asked about challenges, almost the same percentage said they felt that only persons specialized in disability are capable of inclusion. 39 | P a g e
  40. 40. Other challenges indicated by respondents included:  PWD are sometimes passive participants in camp activities  There are no programs or activities planned for PWD  Some PWD are not capable of doing camp activities  PWD cannot participate in activities due to work 6.3. FOCUS GROUP DISCCUSION EMERGENCY RESPONSE TEAM WITH HANDICAP INTERNATIONAL A focus group discussion (FGD) was held with members of the Handicap International emergency response team from Cagayan de Oro and Iligan covering their observations of the emergency response. They were also asked to give specific examples for the different topics covered by the discussion, which included beneficiary identification, general emergency response activities, support to specific needs, physical accessibility, coordination, and general observations on other actors. 6.3.1. Beneficiary Identification To identify beneficiaries for activities targeting PWD and other persons with specific needs, the first stop for the field teams of Handicap International are camp managers for evacuation centers, transitional sites, and relocation sites. In affected communities, the teams go through barangay officials and barangay health workers or through DPOs where present. Participants in the discussion observed that while many areas have data available, information is almost always not complete. After collecting information from the sources mentioned above, the teams conduct tent-to-tent or house-to-house visits, and collect information from the community. They estimate that the data provided by camp managers and barangay officials miss out 20% to 30% of PWD in a given area. They also observed that information tended to be available in barangays where there is an active DPO, but usually not in others. The participants said that there is a tendency in camps and in communities to identify only those PWD with physical, visible disabilities. In some cases, even when camp managers are able to identify PWD, they have difficulties categorizing those falling under other kinds of disability. The same observation was made in the communities, where only a few categories of PWD are being counted. The participants also cited cases where families reject or hide the presence of PWD in their household, even from neighbors or other members of the community. A number of cases of this were uncovered in areas covered by the team, mostly of children with disabilities hidden by their parents. Another challenge in the identification of PWD noted by the participants is that some PWD move from camps to communities, thereby not being included in data collected in either area. Renters who are PWD are also not always included by barangays in data collection. 6.3.2. General emergency relief activities 40 | P a g e
  41. 41. Participants were asked to describe their observations regarding the inclusion of PWD in emergency relief activities being implemented in the various areas they cover, and some reports coming from PWD that they have spoken with and assessed. Observations were shared for activities such as distributions, health services, education, and psychosocial support activities. The participants shared that a number of PWD reported difficulties in accessing relief goods. There were cases where PWD were unable to collect goods themselves and had no one to get the goods for them. Having non-PWD family members, attend distributions is also not an assurance that their households will receive relief, as these household representatives will not fall under prioritization criteria. A number of cases were reported where relief goods had run out before PWD or their households’ representative could receive any. There were also distributions where stubs or tickets were given with numbers and the numbers were applied for PWD as well. Prioritization was not practiced. Of all the PWD assessed, the FGD participants estimated that around 20% are unaccompanied. This implies that there is a possibility that these individuals are not receiving relief and are being missed by emergency actors. The participants observed that whoever comes to the distributions get served, but there is little or no effort to look for those that may especially need assistance. They lamented that even where data is available to direct relief to these individuals, the information is not being utilized. Another observation was that existing efforts at disability inclusion tended to be biased towards those with physical disabilities, those that are easy to identify as PWD, similar to the situation described in the previous section on beneficiary identification. Individuals with physical disabilities may be prioritized or be included in activities because of their appearance, while a person who may have severe hearing or visual impairments may not receive the same attention. An example was provided where one organization adjusted their criteria for distributions to include one PWD with a physical impairment seen by their project team. This individual was included in distributions normally intended for children. This example shows efforts at disability inclusion, but it also shows how inclusion was done in an ad hoc approach and in a way that was triggered solely by the visual recognition of the person as a PWD. The participants perceived access to water as something more equitable than other assistance provided, saying that having little or no water access in a site is something that affects everyone, not just PWD. For healthcare activities, the participants did not notice any prioritization given for PWD. Medical missions to sites as well as site health facilities more often than not do not have the capacity to deal with complex cases that PWD and other persons with specific needs may present. In addition to this, they observed that many IDPs were not aware that they could avail of services in the health centers of the barangays where their sites are located. One organization willing to cater to PWD referred by Handicap International was mentioned by the participants. For children with disabilities issues shared by the participants included disrupted access to special education schools due to displacement. Disruption of schooling was also raised as an issue for children in general due to loss of financial capacity and of supplies for schooling, in addition to displacement. 41 | P a g e
  42. 42. The participants also shared their observations of activities conducted in child-friendly spaces. They noted that they have not seen any child with disability in the child-friendly spaces they have visited, and that facilitators are not trained at all on dealing with children with disability. They observed that communication regarding such activities is mostly through announcements, and there is little or no effort to seek out children who are not participating. They added, however, that the issue of participation sometimes also lies with parents who are either too protective or embarrassed of their child’s disability, or who are unable to accompany their child to the child-friendly space. Similar observations were made for psychosocial support activities targeted at adults, as facilitators did not always reach PWD who may have difficulties or apprehensions about participating in such activities and in camp activities in general. However, the participants shared an example of one site in Iligan where clear efforts were made by the camp manager to ensure PWD participated in all activities; and of one NGO where some community workers were able to communicate with PWD with hearing and speaking impairments through sign language. In addition to the above issues specific to PWD, the participants identified more general issues in terms of access to relief. These issues include inequitable relief within some sites, with organizations targeting one section of residents and not others; and inequitable relief due to ethnicity, religion, or political ties. Geographically isolated areas affected by Washi received noticeably less support than other more accessible areas, with a concentration of relief in camps compared to communities. 6.3.3. Physical accessibility The FGD participants were asked about their views on the physical accessibility of the different sites. For WASH facilities, the group generally agreed that there are efforts towards accessibility although these differ from site to site. They also agreed that these can still be technically improved. For instance, in some latrines fitted with ramps, the ramps are too steep to be used. The participants were of the opinion that a factor that tends to be neglected is the location of the latrines. For some of them, this posed a more significant barrier than how the latrines are designed. Designs may be accessible but if the site is not accessible itself, for instance there are barriers on the path to the facilities it will still be difficult for PWD or other residents to access. Distance to the facilities is also an issue. One example was given where a PWD who, in addition to not being able to access water, had to dig a whole just outside his shelter to use as a toilet. For shelter designs, participants noted that some accessible designs were already being implemented. They expressed concern that proposing design changes at the time of the focus group discussion would be difficult as the bulk of shelter activities were already planned. Regarding the possibility of specific designs for PWD, participants said that this was challenging as there was no pre-identification of which lot or house is for PWD beforehand, nor information on which PWD goes to which site. 42 | P a g e
  43. 43. Efforts of other actors at improving disability inclusion were also shared such as the mapping of PWD in sites and the tracking PWD movement from site to site. However, there were also cases of segregation in some sites where PWD were all placed in separate blocks. Participants noted that in addition to PWD in evacuation centers, transitional sites, or relocation sites needing prioritization, universally accessible designs as well as the location of facilities also need to be considered. They observed that it was rare that these three were considered all together by emergency actors. For example, PWD may be prioritized in terms of the provision of shelters, but then they are placed far from a site’s WASH facilities, as was the case for the PWD described above. Although they acknowledged how challenging it is to consider all factors, participants noted that site planning needs to be improved in a way that not only places PWD as a priority but also considers their needs in terms of access to facilities, design-wise as well as location-wise. 6.3.4. Support to specific needs When asked about support being provided for the specific needs of PWD, the participants were of the opinion that no significant adaptation of relief or specific support was being given. They observed that there were some specialized programs that could meet the needs of PWD, but these are focused only on specific groups such as children, and pregnant and lactating women. They noted that voucher systems being implemented may provide a way through which PWD can get exactly what they needed. Participants mentioned that there were some organizations which provided items responding to specific needs such as assistive devices or technical aids, but their assessments show that some of these items are not appropriate to the needs of the PWD. For example, there were a number of cases where another device would have been more appropriate to the beneficiary. There were also cases where devices were not fitted correctly, such as adult wheelchairs being provided to children. 6.3.5. Observations regarding coordination and other emergency response actors The participants observed that other emergency actors knew they needed to consider and include PWD in their activities, but they did not know how to go about this. They noted that when these actors came across Handicap International teams, they began to reconsider their concerns and sought help. Barangay officials with whom the team worked with were also willing to learn. The biggest need of these stakeholders observed by the Handicap International team was for information and support to be provided to them, on PWD and on disability inclusion. In terms of clusters and coordination, no other organizations focused on disability are represented. FGD participants who attended various cluster meetings mentioned that how disability is discussed is quite variable from cluster to cluster, observing that this is person-dependent, depending on the cluster leader. 6.4. SURVEY OF AFFECTED HOUSEHOLDS 43 | P a g e

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