Desk - IASC



Desk Review on Humanitarian Action Inclusive of Persons with DisabilitiesPrepared for the IASC Task Team on Inclusion of Persons with Disabilities in Humanitarian ActionMarch 1, 2018Prepared by Janet E. Lord in consultation with IASC Task Team co-chairs and membersContents TOC \o "1-3" \h \z \u Draft Desk Review on Humanitarian Action Inclusive of Persons with Disabilities PAGEREF _Toc494145034 \h 1Acronyms PAGEREF _Toc494145035 \h 5List of Tables, Figures & Text Boxes PAGEREF _Toc494145036 \h 6I.Introduction PAGEREF _Toc494145037 \h 7A.Background to Desk Review PAGEREF _Toc494145038 \h 7B.Purpose of IASC Task Team on Humanitarian Action Inclusive of Persons with Disabilities PAGEREF _Toc494145039 \h 7C.Objective and Focus of Desk Review PAGEREF _Toc494145040 \h 8D.Methodology for Desk Review PAGEREF _Toc494145041 \h 8II.Starting Points for Considering Persons with Disabilities in Humanitarian Action PAGEREF _Toc494145042 \h 10A.Conceptual Foundations for Inclusive Humanitarian Action PAGEREF _Toc494145043 \h 10B.Responsible Humanitarian Actors PAGEREF _Toc494145044 \h 17III.Normative Landscape: Overview of the Law & Policy Framework PAGEREF _Toc494145045 \h 19A.International Human Rights Law PAGEREF _Toc494145046 \h 21B.International Humanitarian Law PAGEREF _Toc494145047 \h 24C.Refugee Law PAGEREF _Toc494145048 \h 27IV.Assessment of the Needs of Persons with Disabilities in Humanitarian Crises PAGEREF _Toc494145049 \h 331.Identification of Barriers PAGEREF _Toc494145050 \h 352.Review of International Law PAGEREF _Toc494145051 \h 363.Operational Guidance & Good Practices PAGEREF _Toc494145052 \h 364.Key Points PAGEREF _Toc494145053 \h 37B.Personal Safety PAGEREF _Toc494145054 \h 381.Identification of Risks PAGEREF _Toc494145055 \h 382.Review of International Law PAGEREF _Toc494145056 \h 403.Operational Guidance & Good Practices PAGEREF _Toc494145057 \h 414.Key points PAGEREF _Toc494145058 \h 41C.Maintenance of Family and Caregiver Links PAGEREF _Toc494145059 \h 411.Identification of Barriers PAGEREF _Toc494145060 \h 412.Review of International Law PAGEREF _Toc494145061 \h 423.Operational Guidance & Good Practices PAGEREF _Toc494145062 \h 434.Key Points PAGEREF _Toc494145063 \h 43D.Access to Water, Food and Sanitation PAGEREF _Toc494145064 \h 431.Identification of Barriers PAGEREF _Toc494145065 \h 433.Operational Guidance & Good Practices PAGEREF _Toc494145066 \h 464.Key Points PAGEREF _Toc494145067 \h 47E.Access to Shelter PAGEREF _Toc494145068 \h 471.Identification of Barriers PAGEREF _Toc494145069 \h 472.Review of International Law PAGEREF _Toc494145070 \h 483.Operational Guidance & Good Practices PAGEREF _Toc494145071 \h 494.Key Points PAGEREF _Toc494145072 \h 50F.Health and Rehabilitation Services PAGEREF _Toc494145073 \h 501.Identification of Barriers PAGEREF _Toc494145074 \h 502.Review of International Law PAGEREF _Toc494145075 \h 523.Operational Guidance & Good Practices PAGEREF _Toc494145076 \h 534.Key Points PAGEREF _Toc494145077 \h 55G.Education PAGEREF _Toc494145078 \h 551.Identification of Barriers PAGEREF _Toc494145079 \h 552.Review of International Law PAGEREF _Toc494145080 \h 564.Key Points PAGEREF _Toc494145081 \h 58H.Livelihoods PAGEREF _Toc494145082 \h 581.Identification of Barriers PAGEREF _Toc494145083 \h 582.Review of International Law PAGEREF _Toc494145084 \h 603.Operational Guidance & Good Practices PAGEREF _Toc494145085 \h 60I.Access to Justice and Effective Remedies PAGEREF _Toc494145086 \h 621.Identification of Barriers PAGEREF _Toc494145087 \h 622.Review of International Law PAGEREF _Toc494145088 \h 633.Operational Guidance & Good Practices PAGEREF _Toc494145089 \h 644.Key Points PAGEREF _Toc494145090 \h 65V.Analysis of Existing Resources Most Relevant to Disability Inclusion in Humanitarian Action PAGEREF _Toc494145091 \h 66A.United Nations System Practice PAGEREF _Toc494145092 \h 661.CRPD Committee Practice PAGEREF _Toc494145093 \h 66B.IASC Guidelines PAGEREF _Toc494145094 \h 682.UN Agency Guidance PAGEREF _Toc494145095 \h 69C.DPO & NGO Guidance PAGEREF _Toc494145096 \h 70D.Other Supporting Resources PAGEREF _Toc494145097 \h 72VI.Conclusions, Recommendations & Suggested Approach PAGEREF _Toc494145098 \h 72VII.Annexes – PAGEREF _Toc494145099 \h 79A.Bibliography PAGEREF _Toc494145100 \h 79B.Glossary PAGEREF _Toc494145101 \h 79C.Table of CRPD Article 11 CRPD Committee Concluding Observations & Recommendations PAGEREF _Toc494145102 \h 79D.Principles that Inform Inclusive Humanitarian Action PAGEREF _Toc494145103 \h 79E.Table of Standards and Guidelines that Inform Inclusive Humanitarian Action PAGEREF _Toc494145104 \h 79F.Matrix of Key Legal Obligations Mapped Against Humanitarian Action Sectors PAGEREF _Toc494145105 \h 79AcronymsCOSP Conference of States PartiesCRC Convention on the Rights of the ChildCRPD Convention on the Rights of Persons with DisabilitiesDPO Disabled peoples’ organizationGBV Gender-Based ViolenceHI Handicap InternationalIASC Inter-Agency Standing CommitteeIDA International Disability AllianceINEE Inter-Agency Network for Education in EmergenciesIHL International humanitarian lawMHPSS Mental Health and Psychosocial SupportUNHCR United Nations High Commissioner for Human RightsUNICEF United Nations Children’s FundWHO World Health OrganizationList of Tables, Figures & Text BoxesTablesTable 1. General Lines of Inquiry for Desk ReviewTable 2. Global Landscape of Norms and Standards Relating to the Inclusion of Persons with Disabilities in Humanitarian ActionTable 3. Key Elements for Inclusive Dispute SettlementTable 4. Gaps in Accounting for Persons with Disabilities in Humanitarian ActionTable 5. Outline of Options for Structuring IASC Guidelines on the Inclusion of Persons with Disabilities in Humanitarian ActionFiguresFigure 1. Inter-relationship between the CRPD and Other General Bodies of LawFigure 2. CRPD Article 11 and Inclusive Humanitarian ActionFigure 3. Terminology PyramidText BoxesText Box 1. Risk Factors Contributing to Disproportionate Disadvantage for Persons with Disabilities in EmergenciesText Box 2. Key Stakeholders in Livelihoods Programs Text Box 3. Summary of Key CRPD Committee Recommendations (Article 11)Introduction“Disability inclusion encompasses the capacities, rights, and requirements of persons with disabilities. But beyond disability, inclusive humanitarian action will benefit society as a whole…” —Committee on the Rights of Persons with Disabilities, Statement of the Committee on the Rights of Persons with Disabilities on Disability Inclusion for the World Humanitarian Summit (2015). Background to Desk Review In July 2016, the Inter-Agency Standing Committee (IASC) agreed to establish a Task Team for the period January 2017 - December 2018) mandated to works towards the development of guidelines to assist humanitarian actors, governments and affected communities to coordinate, plan, implement, monitor and evaluate essential actions that foster the effectiveness and efficiency of humanitarian action, resulting in the full and effective participation and inclusion of persons with disabilities and changing practice across all sectors and in all phases of humanitarian action. The decision was taken to adopt a tripartite co-chairing agreement comprising UNICEF, the International Disability Alliance, and Handicap International. Membership in the Task Team is composed of disabled peoples’ organizations (DPOs), NGOs, UN Agencies, the International Committee of the Red Cross (ICRC) the International Migration Organization (IOM); Governments; ECHO; the IASC Secretariat; and the IASC Mental Health and Psychosocial Support (MHPSS) Reference Group. Purpose of IASC Task Team on Humanitarian Action Inclusive of Persons with Disabilities The work of the IASC Task Team on the Inclusion of Persons with Disabilities in Humanitarian Action (Task Team) is directly responsive to the call in the Charter on Inclusion of Persons with Disabilities in Humanitarian Action, launched during the World Humanitarian Summit, for system-wide guidelines on the inclusion of persons with disabilities in humanitarian action. The primary remit of the Task Team is the creation and endorsement of IASC Guidelines on Inclusion of Persons with Disabilities in Humanitarian Action. The proposed Guidelines aim to alert stakeholders sensitive to the discrete needs of persons with disabilities and to improve the quality of assistance and protection activities carried out with the participation of and for the benefit of persons with disabilities. To that end, the Desk Review is being undertaken for the purpose of informing the formulation of guidelines and associated instruments that can help to (1) to raise awareness of the way in which persons with disabilities, are affected by humanitarian crises and how States and organizations respond; (2) inform the development of guidelines and recommendations as to how to ensure the most appropriate responses to meet the needs of persons with disabilities are met in such contexts, bearing in mind the existing humanitarian architecture within which such responses can be effectuated; (3) identify good practices that can help inform those who operate in situations of risk and lessons learned in instances where there are direct examples (or analogous ones in the context of other groups requiring specific protection); and (4) provoke critical reflection and analysis for those stakeholders engaged in the development of the Guidelines. Objective and Focus of Desk Review The objective of this study is intended to inform the development of the Guidelines by providing an overview and analysis of the current landscape. In order to better inform Task Team participants of existing resources pertinent to the development of disability-specific Guidelines, identify their application to disability inclusive humanitarian activities and chart the relevance of existing international standards - those general and specific to persons with disabilities - the focus of the Desk Review is on: identifying and analyzing the differentiated needs of persons with disabilities in humanitarian crises; analyzing human rights law, international humanitarian law, refugees and IDP law and other relevant bodies of international law with a view to assessing the extent to which they provide adequate coverage of the needs identified; mapping the range of activities/sectors within which humanitarian actors work to assist and protect persons with disabilities in risk situations; mapping key actors and their responsibilities across the programme cycle of humanitarian action; and developing key recommendations and an outline to inform the formulation of Guidelines. Methodology for Desk ReviewThe foregoing approach seeks to identify the ways in which persons with disabilities are affected by humanitarian crises, explore their assistance and protection needs and thereby help provide baseline information to improve quality, relevance and impact of humanitarian assistance and protection. The methodology is qualitative in nature, encompassing a review of the existing literature, reporting and operational guidance pertinent to the inclusion of persons with disabilities in humanitarian action. A structured approach was employed in conducting the Desk Review in order to determine the source of materials for review. Both peer-reviewed literature as well as grey literature was consulted. Searches for peer-reviewed journal articles and law journals were conducted using online databases accessed via the University of Maryland and Harvard Law School. In addition, the Google Scholar search engine was used to complete more generalized searches on disability inclusion in humanitarian action. Inclusion criteria consisted of documents that discussed persons with disabilities in humanitarian action and situations of risk and related categories (e.g., persons with disabilities and conflict). Documents excluded were those that were not published in English. Preference was given to documents published since 2000, but relevant documents were not excluded on the basis of earlier publication. Importantly, key informants within the membership of the Task Team provided a wealth of information, including academic research, practice-based literature and links to useful websites. A further source included articles and reports reviewed for important references that may have been missed in the initial survey. Finally, additional searches were conducted for information from Internet websites, especially those of humanitarian actors.A further component of the methodology consisted of a legal analysis directed towards a summary outline of the extensive general and specific protections to which persons with disabilities affected by humanitarian crises are entitled under international law, including international humanitarian law, human rights law, refugee law, among others. The legal review included not only legally binding instruments and customary international law, but also soft-law sources that, while not binding, are nonetheless reflective of international policy and can, in time, contribute to the development of international law or be utilized in its interpretation. The emerging jurisprudence of the CRPD Committee was likewise canvassed, along with States Parties’ reporting on Article 11. For a glossary of key terms, see Annex B.General lines of inquiry are set out in Table 1.Table 1 General Lines of Inquiry for Desk ReviewHow are persons with disabilities particularly affected (and in relation to different sectors) by a given humanitarian crisis and how are they affected in different ways from their non-disabled counterparts?How do the effects of humanitarian crises impact differently on persons with disabilities and, further, how do these effects vary depending upon other identity characteristics (gender, age, ethnicity and the like) (e.g., the humanitarian impact on women and girls with disabilities is rooted not simply in biological differences, but in factors related to their roles in society)? What needs are specific to persons with disabilities or particular sub-groups of persons with disabilities? What are the core principles that must inform a disability-inclusive approach to humanitarian action?What is the legal basis for addressing the needs of persons with disabilities in humanitarian crisis? Using the methodology referenced above, the review and analysis of the resulting inventory was conducted placing emphasis on the following sources, in order of highest priority:Examples of policies or guidance that specifically pertain to persons with disabilities in situations of risk (e.g., especially guidance reflecting the consensus of a coalition of humanitarian actors or that of an agency but also with regard to an individual organization’s specific policy on the inclusion of persons with disabilities in humanitarian action); Reports, studies addressing persons with disabilities in situations of risk and the barriers they experience (e.g., a specific organization’s assessment or evaluation/lessons learned on inclusion of persons with disabilities in humanitarian action);Examples of guidance that addresses disability within the broader context of a sector specific issue or group at risk, especially focused on how to include persons with disabilities (e.g. IASC Guidelines; INEE Guidelines, UNICEF Guidelines); and Academic literature addressing persons with disabilities in situations of risk (e.g., literature addressing the needs of persons with disabilities or legal analyses).Limitations of StudyWhile the Desk Review does canvass the whole spectrum of issues tied to disability inclusive humanitarian response, it seeks to convey the breadth of issues at stake and identify where there is existing practice or guidance upon which to draw in the formulation of the guidelines by the Task Team. It also attempts to identify salient issues where the evidence base and good practice is under-developed, with a view to informing the Task Team on gaps. That said, the assessment was constrained, to a degree, by the following limitations:Narrow time frame within which to complete the desk review given the comprehensive scope of the Task Team’s Terms of Reference; andLimited window of opportunity for data collection likely limited the number of one-on-one interviews that could be scheduled with Task Team participants. This was offset somewhat by the convening of Task Team participants during the UN Conference of States Parties in New York.Starting Points for Considering Persons with Disabilities in Humanitarian Action Conceptual Foundations for Inclusive Humanitarian ActionThe point of departure for the work of the Task Team is recognition that persons with disabilities experience enhanced risk in humanitarian crises. This understanding is reflected in the acknowledgement by the Secretary-General on the occasion of the 2016 World Humanitarian Summit (WHS) that persons with disabilities are among the most marginalized population in any community experiencing humanitarian crisis. International standards on the rights of persons with disabilities as set forth in the Convention on the Rights of Persons with Disabilities (CRPD) constitute the conceptual foundation for this study and its recommendations. Its principles serve as the benchmark for the Desk Review analysis and conceptual framing of issues for informing the development of IASC Guidelines on Humanitarian Action Inclusive of Persons with Disabilities. This approach aligns with the work of the IASC’s Task Force on Human Rights and Humanitarian Action. The discussion that follows introduces key concepts and principles that frame the consideration of persons with disabilities in humanitarian crises.Humanitarian Crises and Situations of Risk. As defined by UNICEF in its 2017 Guidance: Including Children with Disabilities in Humanitarian Action, humanitarian situations can be understood broadly, as including: (1) rapid-onset disasters, such as floods, earthquakes, typhoons or tsunamis; (2) slow-onset disasters, such as drought or families; (3) health emergencies, such as the Ebola epidemic; (4) forced displacement, including refugees and internally displaced persons; and (5) armed conflicts, including protracted crises. This is consistent with the broad conception of “situations of risk” in Article 11 of the CRPD.Disability-specific focus. The CRPD understands that “persons with disabilities” applies to all persons “who have long-term physical, mental, intellectual or sensory impairments which, in interaction with various attitudinal and environmental barriers, hinders their full and effective participation in society on an equal basis with others.” One who is disabled under this understanding experiences disadvantage as a consequence of environmental factors in relation to an impairment, or condition creating or likely to create loss or difference in functioning. In framing disability within a socio-contextual model of disability, the CRPD compels the identification of specific barriers that persons with disabilities face in times of peace and in times of humanitarian crisis and situations of risk. Further, it requires positive measures, where required, to eliminate barriers (prospectively and retroactively). The CRPD implicitly recognizes that individuals with disabilities represent a highly diverse, heterogeneous population whilst also recognizing the common experience of stigma and discrimination. Persons may have a disability which is apparent or may have a non-apparent or invisible disability. Likewise, persons with disabilities may belong to more than one category of disability type. Some are born with a disability while others acquire a disability. Understanding the diversity of disability is essential to understanding how to accommodate persons with disabilities in humanitarian action to avoid discrimination and mitigate risk during emergencies.Characterizing risk, vulnerability and disadvantage in relation to persons with disabilities. Existing IASC Guidelines emphasize that “pre-existing vulnerabilities and patterns of discrimination usually become exacerbated in situations of natural disasters.” While persons with disabilities should be no more vulnerable than others in situations of risk such as armed conflict or natural disaster, it is well recognized in the CRPD and in research that persons with disabilities are more susceptible to poverty, marginalization, exclusion and general suffering resulting from crises, particularly insofar as they are already subject to discrimination in non-risk situations. In order to move beyond the casting of persons with disabilities in the generic assemblage that so often characterizes references to “vulnerability,” the drafters of the CRPD deliberately avoided using the term and instead, opted for language in Article 11 referencing “situations of risk.” Thus, the approach taken in the CRPD tracks with the social model of disability which pivots away from medicalized and individually-oriented characterization of disability (i.e., the person is deficient/vulnerable/helpless) toward an approach focusing on danger and risks presented by the environment (i.e., attitudinal, physical, legal, communications). This is the perspective emphasized by the Office of the High Commissioner for Human Rights in its Thematic Study on Article 11 where it noted that IHL was “codified under previously dominant understandings of disability, notably the medical model of disability, which focuses exclusively on the impairment of the person and reflects a paternalistic approach to persons with disabilities” and, further, that “[t]hese concepts have been superseded by the human rights-based approach to disability framed in the Convention.” Further, the definition provided in both the Hyogo Framework and the Sendai Framework for Disaster Risk Reduction reflect a notion of vulnerability that is exogenous to the individual, constituted by “[t]he conditions determined by physical, social, economic and environmental factors or processes, which increase the susceptibility of a community to the impact of hazards.”Disabling consequences of emergencies. The disabling consequences of emergencies run in several directions. They may result in newly acquired impairments and therefore the emergence of a new generation of individuals experiencing disability, whether due to injuries, poor basic surgical and medical care, lack of rehabilitative care, or emergency-induced mental health and psychological conditions. It is reported that for every individual killed in a disaster, another three are injured or left with a long-lasting impairment.For individuals with disabilities prior to the onset of a crisis, they may experience additional disadvantage and risk, leading often to secondary or aggravated health conditions due to, abandonment, breakdown in support structures and health and rehabilitation systems, and separation from caregivers. Intersectionality. Persons with disabilities are one category of at-risk population whose needs must be specifically accounted for in humanitarian action. It must be recognized that persons with disabilities may belong to more than one group requiring specific support (e.g., girl child refugee with disability). Accordingly, persons with disabilities, as with other groups experiencing disadvantage, have overlapping identities. The interrelationship between these identities can create multiple and multi-dimensional disadvantage. The CRPD acknowledges this concern in noting the “difficult conditions faced by persons with disabilities who are subject to multiple or aggravated forms of discrimination on the basis of race, colour, sex, language, religion, political or other opinion, national, ethnic, indigenous or social origin, property, birth, age or other status.” Thus, for instance, women and girls with disabilities are known to face barriers that are different from and disproportionate to, their male counterparts, including enhanced risk to sexual violence. Some data suggests also that access to primary education in refugee camps is more compromised for girls with disabilities than for their non-disabled peers and boys with disabilities. To cite another example of intersectional identity producing enhanced risk, the CRPD Committee has urged that the safety of all children with disabilities in conflict-affected areas be ensured and prioritized, in particular children living in institutions.The foregoing suggests that, more often than not, persons with disabilities experience multidimensional disadvantage in situations of risks, whether armed conflict, natural disaster or other emergency, in combination with other vulnerable status based on gender, poverty, ethnicity, sexual orientation and gender identity and the like. The Charter on Inclusion of Persons with Disabilities in Humanitarian Action highlights this intersectionality in recognizing “the multiple and intersecting forms of discrimination that further exacerbate the exclusion of all persons with disabilities in situations of risk and humanitarian emergencies and whether they are living in urban, rural or remote areas, in poverty, in isolation or in institutions, and regardless of their status, including migrants, refugees or other displaced persons, and that crisis often leads to further impairment.”Accessibility of ICTs as a cross-cutting issue. Information and communication technology (ICT) is increasingly driving access to public and private emergency and other services, information and networking, and pathways to full social, economic, and civic participation. Communicating and disaster warning information is critical for persons with disabilities, making accessibility of ICTs essential. Emergency communications for persons with disabilities can include, for instance: (1) emergency information provided to the public available in alternative accessible formats such as text messages on mobile phones; (2) sign language and closed captions for the deaf and hard of hearing; and (3) audio messages for those with visual disabilities on emergency television broadcasts. Accessible mobile emergency services includes the ability to send texts and or video relay. Accessibility of ICTs is cross-cutting at every stage of emergency and impacting all sectors. Ensuring the accessibility of ICTs can facilitate multiple modes of communication and access to a wide array of vital information regarding emergencies. It should be noted that accessible information and communications technology during emergencies is a cross-cutting issue and has been consistently highlighted in the disability work of the UN, especially in relation to ensuring that emergency call lines are accessible to all. Providing information through media in a manner that is more understandable to all means that protective actions such as evacuation can be taken more effectively and by a broader range of the population. New technologies and modifications of assistive technology devices, including wheelchairs, hearing aids, Braille, and communication boards, have historically been used to level the field for persons with disabilities. Design of accessible ICTs technology has the potential to similarly provide equitable access to protection and assistance in situations of risk. Survivor assistance and mine action as a cross-cutting issue. Humanitarian mine action, concerning landmines and all explosive remnants of war (ERW) such as cluster munitions and unexploded ordinance, addresses civilian safety and mine risk education, together with recovery and inclusion of survivors, who become part of the larger group of persons with disabilities, and indirect victims. The UN’s policy on victim assistance situates assistance to mine/ERW victims within IHL and human rights law, and underscores the principles of IHL together with the CRPD as conceptual underpinning of mine action. Elements of victim assistance as determined by the Mine Ban Treaty and the Convention on Cluster Munitions include: (1) emergency and continued medical care; (2) rehabilitation (including ortho-prosthetic services); (3) psychosocial support; (4) socio - economic inclusion (including the right to work and employment, and the right to an adequate standard of living, education and cultural life and sports); (5) laws and policies. Victim assistance should be guided by the principle of non-discrimination as it is defined in the CRPD. Accountability to affected populations of persons with disabilities. The IASC Principals adopted five principles of accountability in relation to affected persons. Persons with disabilities are specifically referenced among those affected populations for whom accountability is required. It goes without saying, one hopes, that accountability is required of humanitarian actors to persons with disabilities among affected populations. Guidance is needed, however, on the approach to accountability in relation to persons with disabilities. This ought to include, and specify, meeting the discrete needs of individuals with disabilities and doing so through the provision of reasonable accommodation and other measures such as accessibility measures, universal design and the like. Non-discrimination and the duty to provide reasonable accommodation. Humanitarian law requires that assistance and protection be provided to all victims of conflict or violence without discrimination and in accordance with their needs (the principle of adverse distinction). Accordingly, it follows that the identification of the specific needs and vulnerabilities of each category of affected population group is essential in order to be able to reach, assist and protect affected populations appropriately. As discussed in following sections of this Desk Review, non-discrimination within the specific context of disability-based discrimination appears first in an international treaty in the CRPD. It should be noted, however, that disability as a specifically prohibited ground of discrimination appeared first in the non-discrimination clause of the Convention on the Rights of the Child (CRC). The CRPD goes much farther and prohibits not only disability-based discrimination but also requires the provision of reasonable accommodation in order to ensure that discrimination, whether direct or indirect, does not occur. In the humanitarian action realm, therefore, it is not enough to apply (in policy or in practice) a generic non-discrimination standard. Rather, the CRPD requires that persons with disabilities must be provided reasonable accommodation in order to access their rights on an equal basis with others. Participation and inclusion. Ensuring the participation of affected populations in decision-making in humanitarian action is one of the principles of accountability to affected people adopted by the IASC and makes reference to affected persons with disabilities. Studies regarding humanitarian action and guidelines that inform humanitarian response in relation to highly vulnerable groups (e.g., children, women, IDPs) emphasize the imperative of including affected communities in the design, implementation, and monitoring of assistance. For Sharma, inclusion in disaster risk management is “about equality of rights and opportunities, dignity of the individual, acknowledging diversity, and contributing to resilience for everyone.” Likewise, principles of participation and inclusion are central concepts in the CRPD framework reflected in Articles 3 and 4(3) and in the Sendai Framework. As a general obligation, the UN CRPD provides in Article 4(3) requires States Parties to “closely consult with and actively involve persons with disabilities, including children with disabilities, through their representative organizations” including “in the development and implementation of legislation and policies to implement [the UN CRPD], and in other decision-making processes concerning issues relating to persons with disabilities.” It would be difficult to overstate the imperative of the participation and inclusion of persons with disabilities and their representative organizations in driving disability law, policy and programming, including in humanitarian action. The following guidance from UNHCR captures the recurrent call for participation in risk situations:Achieving a high standard of protection is only possible if an inclusive and participatory approach is adopted. The inclusion of persons with disabilities in policy formulation and consultation processes is key to developing and implementing appropriate solutions to the problems they face. Consultation and participation throughout all phases of crises and protracted situations is essential. UNHCR should make sure that persons with disabilities are able to apply their skills and capacities to benefit themselves, their families and their communities.Accessibility and universal design. The CRPD emphasizes the principle of accessibility and lays out obligations to address the numerous barriers that persons with disabilities experience, all of which are germane to understanding the discrete needs of persons with disabilities in situations of risk. Universal design is an approach to achieving accessibility and means “the design of products, environments, programmes and services to be usable by all people, to the greatest extent possible, without the need for adaptation or specialized design.” It does not preclude the need for assistive devices for particular groups of persons with disabilities where this is needed. Accessibility includes access to the physical environment, to transportation, to information and communications, including information and communications technologies and systems, and to other facilities and services open or provided to the public. Also relevant to understanding accessibility in humanitarian crises are specific barriers to food distribution sites, schools, and sanitation facilities. Limited access to assistive devices is likewise an important dimension of accessibility in this context. Accessibility must be taken into account in both urban and rural areas. Conceptualizing barriers using the lens of accessibility is a central component of ensuring that the proposed IASC Guidelines reflect accessibility mandates across all sectors of humanitarian assistance. Other principles. Other principles are sometimes emphasized in policies and operational guidance on the inclusion of persons with disabilities in humanitarian action. Some of these are reflected in the CRPD and in other human rights instruments. Of particular note are human dignity (recognizing that very often persons with disabilities are not accorded respect and human dignity), autonomy and independence (recognizing that individuals with disabilities have the right to live independently, within the community, and that such rights are at great risk during crises). Cities not necessarily camps. Research discloses that the majority of refugees fleeing conflict reside in urban environments, not camps. UNHCR’s publication, Global Trends in Forced Displacement 2015, indicates that 60% of refugees are residing in cities. IASC Guidelines developed on the inclusion of persons with disabilities in humanitarian action should take into account the diverse settings within which displaced persons with disabilities are located. Disability Data. Ensuring non-discrimination or persons with disabilities in humanitarian action requires data collection in order to understand needs, identify possible harms and ensure appropriate inclusion. As emphasized by UNICEF, “[b]y collecting data on children with disabilities, it is possible to identify them, assess their needs and monitor the outcomes of humanitarian intervention.” This is a recurring theme in the literature. For humanitarian actors, this entails collecting specific data on disability and ensuring that the collection and use of such data that is disaggregated by disability, as well as sex, age and other characteristic depending on content. Examples of such data includes disability prevalence, impairment types, participation restrictions (in law, policy and practice), and barriers to inclusion experienced by persons with disabilities.Obligations to collect data and statistics on disability is affirmed in Article 31 of the CRPD. It requires the collection of appropriate statistical and research data at national level to facilitate the formulation and implement policies to achieve the Convention’s objective. It should be noted that in countries where there is a lack of quantitative data on disability, a more heavy reliance on qualitative information may be required. This underscores stakeholder engagement as an essential part of the process.When humanitarian actors are assessing the situation of disability within a country, it may be difficult to obtain or rely on the accuracy of quantitative data. For example, disability is often not included within a government’s census. As a result, it is often difficult to know the accurate numbers of men and women with disabilities within a country. In education, for example, a government may not have accurate data on the enrolment of children with disabilities at any level of education. Due to social stigmatization, many individuals with disabilities may be reluctant to self-identify as someone with a disability, further skewing statistics within a country. Likewise, many disabilities are “hidden” (such as developmental disabilities or many psychosocial disabilities) and the determination of disability cannot be ascertained through simple observation. Humanitarian actors will want to uncover and highlight trends and disparities between people with disabilities and people without disabilities in humanitarian contexts. Where focus-group discussions are being undertaken in the affected communities to identify risks and needs, persons with disabilities should be included in those consulted, along with their representative organizations, Disability data for collection and analysis includes information on such matters as the number of people with disabilities in the population (ideally disaggregated as to disability type, gender, age), the main causes of impairment (disaggregated by age and gender), and data on the extent to which participation is restricted for persons with disabilities e.g., , in accessing food and water, hygiene and sanitation facilities, services in camps or urban areas for refugees and displaced persons or safe spaces for women and children). At the country level, it is important for humanitarian actors to consider the country’s status in signing and ratifying the UN CRPD and governance, which includes the Government office responsible for disability policy and cross-ministerial coordination, the policy framework and budget, and the monitoring mechanisms in place. There are tools available to assist in the systematic disaggregation of data by disability. These include the UN’s Washington Group on Disability Statistics which developed the Washington Group Questions that aim to identify limitations in areas of basic activity functioning that are found universally, are most closely associated with social exclusion among persons with disabilities, and which occur most frequently. A ‘Short Set’ of six questions seek to identify in people with functional limitations that have the potential to limit their independent participation in society. Responses are categorized on a scale of severity of the difficulty experienced (i.e. no difficulty, some difficulty, a lot of difficulty, and cannot do at all). Other tools that may be helpful resources in capturing data on disability include the Washington Group/UNICEF Survey Module on Child Functioning, together with the Washington Group “Short Set” – short set of questions on disability prevalence. Also of note are the Australian Information Matrix, the UNHCR Heightened Risk Identification Tool, and the WHO’s Model Disability Survey..Key PointsThe conceptual point of departure for considering the inclusion of persons with disabilities in humanitarian action is a socio-contextual and rights-based understanding of disability. Principles of IHL and human rights law, in particular Article 3 of the CRPD, form the conceptual underpinning for disability inclusion in humanitarian action.Ensuring the participation of persons with disabilities and their representative organizations in design, implementation and monitoring of humanitarian action is a pre-condition to inclusion in situations of risk.Persons with disabilities are not a homogenous group and have diverse and discrete needs that must be accommodated on an individualized basis.Persons with disabilities, as with other groups experiencing disadvantage, have overlapping identities and the interrelationship between these identities can create multiple and multi-dimensional disadvantage that should be accounted for in humanitarian action.Collection of disability data, both qualitative and quantitative, is essential in humanitarian assessment, monitoring and evaluation in order to appropriately identify the discrete needs of persons with disabilities in situations of risk.The obligation to collect disability data is recognized in Article 31 of the CRPD, together with obligations to observe human rights in the collection, use, dissemination and storage of such data.Responsible Humanitarian ActorsResponsible humanitarian actors are key to ensuring the utilization and implementation of IASC Guidelines. An inclusive humanitarian response relies heavily on the positive reception and proactive dissemination and use of tools to guide action. Disability is recognized as a multi-faceted, cross-cutting, and inter-sectoral issue and, as such, a mapping of where disability expertise may reside, both within government and within and across the humanitarian sector is likely warranted.The IASC Policy on Protection in Humanitarian Action emphasize the roles that actors beyond the principal humanitarian actors must play in continuing to protection, among them: national state authorities; armed forces and armed groups; individual commanders and fighters; diverse groups of affected persons, their institutions and leaders; national and local organizations; national human rights institutions; political and peacekeeping missions; other States and permanent missions; private sector entities; donors; advocacy organizations, academic and think tanks.Existing IASC Guidelines provide coverage of key actors in various ways. The most detailed is that provided in the IASC Guidelines for Gender-based Violence Interventions in Humanitarian Settings: Focusing on Prevention of and Response to Sexual Violence in Emergencies (GBV Guidelines) set forth essential actions to be undertaken by key humanitarian actors: While the Guidelines orient action to be undertaken by a specific sub-set of humanitarian actors, they nonetheless underscore the broad range of stakeholders in humanitarian action, both national and international. The key stakeholders for whom the GBV Guidelines are addressed include:These include:GovernmentHumanitarian CoordinatorsHumanitarian Country Teams/Inter-Cluster Working GroupsCluster/Sector Lead AgenciesCluster/Sector CoordinatorsGBV Coordination mechanismsThe GBV Guidelines provide a detailed matrix of actions to be taken, disaggregated as to responsible humanitarian actor and arranged in accordance with the program cycle, and across two stages of emergency: (1) pre-emergency/preparedness; and (2) emergency/stabilized stage.By contrast, the IASC Guidelines, Addressing HIV in Humanitarian Settings, provide a brief narrative of the key actors and structure of humanitarian action in the context of HIV. They identify target audience as follows:Mid-level programme planners and implementers from agencies involved in providing humanitarian assistance. Some agencies may specialize in HIV programme implementation, while others may integrate elements of HIV programming into their humanitarian assistance activities. Not all organizations may be implementing activities within all sectors. These guidelines have been designed in order that the user can refer to sectoral responses as well as relevant actions that should be addressed across all sectors.Finally, in relation to humanitarian standards, the Guidelines on Mental Health and Psychosocial Support in Emergency Settings (MHPSS Guidelines) provide coverage of responsible humanitarian actors in the discussion of coordination and identify key government ministries, including ministries of health, social welfare and education), UN agencies, and NGOs and other organizations (professional associations, universities, religious or community based organizations) active in MHPSS. Humanitarian actors essential to the successful implementation of IASC Guidelines on the inclusion of persons with disabilities in humanitarian action are persons with disabilities and organizations representing persons with disabilities. In addition, NGOs active in the inclusion of persons with disabilities in humanitarian action are also relevant stakeholders and should be identified as such in resulting IASC Guidelines. Likewise, government institutions, particularly those designated as implementing focal points and/or coordinating entities under the CRPD, are relevant but rarely if ever cited as stakeholders, nor are independent national human rights institutions and/or national disability commissions.Key PointsPast practice in the development of IASC Guidelines includes the identification, in greater or lesser detail, of key responsible humanitarian actors in relation to the implementation of the Guidelines. Consistent with CRPD principles and the development of international standards on disability generally, it is important that affected populations of persons with disabilities be consulted in the course of the development of IASC Guidelines, particularly through representative organizations of DPOs, along with NGOs working in the area of inclusive humanitarian action.Disability inclusive stakeholder mapping requires the identification of CRPD Article 33 governmental and independent national monitoring mechanisms tasked with CRPD implementation oversight. Existing IASC Guidelines identify the key humanitarian actors and also seek to identify issue-specific actors with responsibility for (or interest in) implementing the Guidelines in question.Normative Landscape: Overview of the Law & Policy FrameworkThere are several domains of law applicable to situations of risk and germane to humanitarian action inclusive of persons with disabilities. International humanitarian law (IHL) covers the regulation of armed conflict within which much, though not all, humanitarian action takes place. Human rights law and refugee law are important as they are applicable equally in armed conflict as well as other types of humanitarian crises, such as natural disasters. The CRPD is of greatest relevance among human rights instruments as it places international human rights law within the context of disability and, further, expressly references the application of its principles to persons with disabilities in situations of risk, including protections under IHL. Finally, it should be noted that domestic law continues to be applicable during times of armed conflict or other crises. The discussion that follows identifies both general and specific rules that pertain to persons with disabilities during humanitarian crises. The inter-relationship between the CRPD and general bodies of law pertinent to protection in situations of risk is depicted visually in Figure 1. The figure represents a hierarchy in which the CRPD, in a vertical orientation, informs four bodies of law, IHL, human rights, refugee law and international criminal law.Figure 1. Interrelationship between Relevant Bodies of LawAccounting for the rights of persons with disabilities and the responsibilities of humanitarian actors in situations of risk is informed by a growing body of general and disability-specific global norms and standards. Standards, in this context, refer to universally or widely accepted, agreed upon, or established means of determining what inclusive humanitarian action ought to be, to be distinguished from guidelines or guidance which, under existing IASC protocols, set out detailed steps and make specific recommendations on how to address a certain topic in humanitarian action. Table 2, below, provides a summary of this global landscape of norms and standards, placed within the context of respecting and protecting persons with disabilities in humanitarian action:Table 2. Global Landscape of Norms and Standards Relative to Persons with Disabilities in Humanitarian ActionInternational human rights law and human rights principlesConvention on the Rights of Persons with Disabilities, Convention on the Rights of the Child Dignity, non-discrimination, participation and inclusion, accessibility, dignity, age and gender equalityInternational humanitarian lawGeneva Conventions & Additional Protocols, Mine Ban Treaty, Cluster Munitions ConventionHumanitarian principlesHumanity, impartiality, neutralityExisting and emerging global humanitarian standardsHumanitarian Charter and Minimum Standards in Disaster Response (Sphere Standards)Inter-Agency Network for Education in Emergencies (INEE) Minimum StandardsMinimum Standards for Age and Disability Inclusion in Humanitarian ActionMinimum Standards for Child Protection in Humanitarian Action (CPMS).For a table of standards and guidelines that inform humanitarian action, see Annex E. International Human Rights LawInternational human rights law applies during times of peace and in armed conflict. While the International Bill of Rights comprising the Universal Declaration of Human Rights and the two Covenants are applicable to all human beings, and thus apply to persons with disabilities the Ad Hoc Committee that negotiated the first legally binding international treaty on the rights of persons with disabilities recognized the disjuncture between the human rights system and its application to persons with disabilities. The impetus for the drafting of the CRPD was the realization that the existing framework had not elevated persons with disabilities as equal rights holders in practice and, further, had not applied existing human rights standards to the specific situation of persons with disabilities. A core mandate of the CRPD is to clarify and make applicable existing general human rights obligations to the context of the lived experiences of persons with disabilities, including the application of these principles in peace and in times of conflict and other crises. Its specific obligations add disability-specific content to well-established human rights obligations (for example requiring non-discrimination in relation to health care access or mandating rehabilitation) and thereby contribute to the interpretation of other instruments, including IHL. A visual representation of the interrelationship between inclusive humanitarian action for persons with disabilities and the framework of the CRPD is provided in Figure 2. It depicts the inclusion of persons with disabilities under the CRPD as a central core (circle) with a ring of overlapping circles around the core comprising the social model, general principles, general obligations, specific obligations and monitoring and implementation measures. Figure 2. CRPD Article 11 and Inclusive Humanitarian ActionCRPD principles. As noted above, the CRPD principles of dignity, autonomy and independence, non-discrimination, inclusion, participation and accessibility (among others) offer a framework within which humanitarian action can be applied to better serve persons with disabilities in programming. Further, they are to be used to inform IHL and humanitarian action inasmuch as they are intended to be applied transversally across the treaty and used to inform the interpretation of all of its provisions, including, for instance, Article 11 on the protection of persons with disabilities in humanitarian risk situations. Many of these principles are also reflected in conceptual frameworks developed specifically within the context of humanitarian action. Others are not, such as accessibility (as a guiding principle) and reasonable accommodation, a core element of non-discrimination on the basis of disability. These principles should inform the approach taken to disability inclusive humanitarian action and be made explicit in IASC Guidelines not only as a conceptual tool, but as an element of humanitarian action operations. For a Table of principles that inform inclusive humanitarian action, see Annex D.Social model of disability. The emergence of disability rights standards as set forth in the CRPD, is contributing to a shift in the conceptualization of disability as a narrow, medical issue or charitable concern limited to beneficent ideas about caring for wounded soldiers or civilians. It reflects instead a more broadly (and socially) constructed human rights issue that seeks to dismantle barriers for all persons with disabilities. The social model of disability “focuses on barriers posed to persons with impairments by their environment, rather than their bodily impairment” and, further, such barriers “include the attitudes and prejudices of society, policies and practices of governments, and the structures of the health, welfare, education and other systems.” The social model conception of disability is a precondition to understanding disability within a human rights frame and, as such, must be clearly reflected in future IASC Guidelines on disability. Protection in situations of risk. Article 11 of the CRPD, more specifically, requires positive measures of protection and safety by States Parties for persons with disabilities affected by situations of humanitarian emergencies and risk. The necessity of such protection is recognized overtly in the CRPD’s preamble which affirms that “the observance of applicable human rights instruments are indispensable for the full protection of persons with disabilities, in particular during armed conflicts and foreign occupation.” The implications of Article 11 for the elaboration of IASC Guidelines is clear: Specific and positive measures must be undertaken in order to achieve access to relief and protection. Non-discrimination and the duty to accommodate. In emphasizing the implications of Article 11, the OHCHR has underscored that it requires full implementation of other CRPD provisions, including non-discrimination and the duty to accommodate and, further, that Article 5 “is crucial in forming inclusive policies on emergency situations, including through the provision of reasonable accommodation.” Current guidance is not always attendant to the requirements of non-discrimination insofar as the failure to provide reasonable accommodation under the CRPD constitutes discrimination. What is reasonable in the initial phase of an emergency may well be different during recovery, however, as positives measures that with the specific measures taken to protect and assist other vulnerable groups, such as women, there are a range of positive measures that can be taken even in the context of an emergency.Participation and inclusion. A recurrent obligation in international disability law is the participation and inclusion of persons with disabilities, including the broad general obligations set out in Article 4(3) requiring States to ensure close consultation with, and the active involvement of, organizations of persons with disabilities in decision-making. As outlined by the Office of the High Commissioner for Human Rights (OHCHR), this includes participation “in the development, implementation and monitoring of emergency-related legislation and policies.” Further, and of note in the context of humanitarian action, the CRPD Committee stressed in a statement on natural disasters affecting Peru, Ecuador and Colombia: “[I]t is imperative that States and all humanitarian and emergency prevention and response actors include persons with disabilities and their representative organisations in the design, implementation, monitoring and evaluation of disaster risk preparedness, resilience, reduction and recovery policies and strategies and to ensure inclusive, accessible and non-discriminatory participation in decision-making in this respect.” Participation and inclusion, therefore, are principles to guide the elaboration of IASC Guidelines and are also substantive norms to be specifically operationalized in humanitarian action. Personhood and recognition before the law. The notion of personhood reflected in the CRPD underscores that specific rights are to be applied in a way that preserves the dignity, autonomy and independence of persons with disabilities. This signals that segregation, isolation, quarantine or other such measures are impermissible and are not protective of persons with disabilities. This includes recognition of personhood and legal capacity to take decisions. Article 12 of the CRPD specifically affirms equal recognition of persons with disabilities before the law and specifically recognizes their legal capacity, on an equal basis with others, together with the duty on the part of States to provide measures to support the exercise of legal capacity where needed. This has deep implications in the context of humanitarian action with regard to decision-making, property rights, legal claims, registration and documentation, among others. Humanitarian action must be sensitive to and reflective of these principles. Guidance must clearly articulate how these principles are to be applied in specific sectors, for instance in shelter, education and livelihoods where independence and autonomy militate against segregated solutions.Accessibility. Accessibility as a principle of the CRPD and as a general obligation in Article 9 is central to ensuring that persons with disabilities are not excluded during situations of risk and humanitarian emergency, including in providing access to information and alert mechanisms (and ensuring that information and communication technology utilized during emergencies is accessible), in advancing physical access and the promotion of universal design in shelter and settlement responses and during recovery, to harness opportunities to build a more inclusive society. These provisions speak also to important role of private actors, such as humanitarian organizations, in ensuring the implementation of Article 9.Protection from violence. The CRPD emphasizes prohibitions against violence and abuse and recognizes the right of persons with disabilities to mental and physical integrity and the right to life. These provisions affirm protections set forth in other human rights conventions but do so within the context of disability. This requires, for instance, the provision of reasonable accommodations and accessibility measures, among other, to ensure protection against physical and mental harm. Monitoring & Implementation Measures. The CRPD requires state reporting on implementation progress, together with governance requirements to facilitate implementation, including the designation or establishment of a government focal point and an independent motoring mechanism. A coordination mechanism within government is suggested which could have important implications for humanitarian action, such as including emergency management agencies within CRPD coordinating mechanisms. An Optional Protocol to the CRPD is generating jurisprudence by the Committee that addresses, both directly and indirectly, humanitarian action. The monitoring system of the CRPD provides clear entry points for humanitarian actors to engage with governmental and non-governmental stakeholders with responsibility for CRPD implementation. For an illustrative matrix (non-exhaustive) of legal obligations of persons with disabilities mapped against humanitarian sectors, see Annex F. International Humanitarian LawInternational humanitarian law (IHL) accords both general and specific protections to persons with disabilities. General protections of IHL aim to shield all persons not actively engaged in hostilities from harm. Second, IHL sets forth specific rules of protection on account of disability, as for other populations deemed particularly at risk on account of a given characteristic. General protection. The prohibition against adverse distinction in the treatment of civilians and persons rendered hors de combat is set forth in common Article 3 of the Geneva Conventions, in the Third and Fourth Geneva Conventions and is also recognized as a fundamental guarantee by Additional Protocols I and II.? Adverse distinction, referring to differential treatment in the application of IHL on account of “race, colour, sex, language, religion or belief, political or other opinion, national or social origin, wealth, birth or other status,” is prohibited. While disability is not specifically mentioned as a prohibited ground of adverse distinction, it would be covered under “other status” and in the light of developments in international law that amplify disability status as worthy of protection against discrimination.Thus, persons with disabilities are entitled to the same general protection afforded to all persons under both the rules pertaining to treatment and protection as well as the rules relating to the means and methods of warfare. Further, adverse distinction in IHL implies that while discrimination between persons is prohibited, a distinction is permissible to give priority to those in most urgent need of care. As an application of this principle in IHL, no distinction may be made among the wounded, sick and shipwrecked on any grounds other than medical. Another illustration is provided in the Third Geneva Convention: Article 16 of that treaty holds that all prisoners of war must be treated alike, however, allows for the possibility of preferential treatment to be accorded to them by reason of their state of health, age or professional qualifications.?Positive duties to distinguish amongst individuals who are hors de combat include the right of seriously wounded prisoners of war to be repatriated during hostilities. This duty ought to apply in respect of prisoners of war who, though perhaps not requiring the kind of urgent medical assistance of seriously wounded prisoners, have disability accommodation needs warranting prioritization for repatriation.The idea of adverse distinction tracks with the notion of positive discrimination in contemporary human rights law. Positive discrimination holds that specific measures necessary to advance or achieve de facto equality of historically marginalized groups, such as persons with disabilities, women or racial minorities, shall not be considered discrimination. Obligations in respect of disability accommodations and accessibility measures fall within this category of permissible distinction. For instance, the Second Geneva Convention, at Article 30, requires specific facilities to be provided for the care and rehabilitation of prisoners of war with disabilities. This tracks with the concepts of reasonable accommodation as well as accessibility measures in the CRPD. This is a salient example of how the CRPD gives texture to IHL rules and operational guidance consistent with the needs of persons with disabilities.The principle of humanity in IHL gives rise to formulation of a wide range of both general and particular rules. Rules relating to the humane treatment of civilians and those who have laid down their find expression in a number of IHL provisions applicable in both international and non-international conflicts. Common Article 3 of the Geneva Conventions, for example, is rooted in the principle of humanity and gives rise to specific applications of the notion in its articulation of rules proscribing violence to life and person, including murder, cruel treatment and torture as well as outrages upon personal dignity, in particular, humiliating and degrading treatment, among other acts. Notably, in its contemporary interpretation under IHL, the principle of humane treatment includes environmental factors. Assessing risk and vulnerability therefore compels the identification of barriers that enhance risk for persons with disabilities and the dismantling of those barriers to meet the standard of humane treatment. General protection against the effects of armed conflict for non-combatants is recognized as a fundamental axiom of IHL. The principle of distinction is paramount and holds that parties to an armed conflict are required to distinguish between civilians and combatants and must not direct attacks against civilians and the civilian population. Notably, such protection also applies to attacks, though not directed or targeted at civilians, of a nature to strike military objectives and civilians (or civilian objects) without distinction. The principle of distinction thus requires differentiation and protection in respect of civilians who do not take part in hostilities and in respect of combatants who no longer take part in hostilities on account of falling into the power of the enemy, if wounded, sick or shipwrecked, or if parachuting out of an aircraft. Persons with disabilities enjoy this general protection either on account of their civilian, non-combatant status or because they fall within the category of a combatant rendered hors de combat. Specific Protection of Persons with Disabilities in IHL. In addition to the general protection accorded to persons with disabilities to which all persons are entitled, IHL recognizes that persons with disabilities have specific needs and are thus entitled to special protection for their benefit in the context of armed conflict. The nature and precise scope of this protection is less developed than under international human rights law. Thus, a number of IHL instruments recognize that special respect and protection are to be accorded to persons with disabilities (and others whose status may render them, in IHL terms, vulnerable or disadvantaged, such as children or older persons) without necessarily articulating the parameters of such protection. That said, they provide clear and unequivocal entry points for understanding protection in a contemporary context and in the light of the CRPD. These protections are best illustrated by?Article 16 of Geneva Convention IV?and?Article 8(a) of Additional Protocol I of the Geneva Conventions, both of which consider the need to care for and protect those civilians who are wounded, sick, disabled, and in need of medical assistance. A further example is Article 17 of Geneva Convention IV providing for the prioritization of persons with disabilities in local agreements concluded for evacuation of protected persons from besieged and encircled areas. Article 70 of Additional Protocol I provides for prioritization in the distribution of humanitarian relief to persons with disabilities insofar as it explicitly recognizes those groups enjoying specific protection under Geneva Convention IV. The right of persons with disabilities to protection and care is also recognized in IHL instruments covering non-international armed conflicts. It should be noted that the language used to describe disadvantage on the basis of disability is not uniform, nor does it correspond to rights-based understandings of disability, as noted in the literature and by the OHCHR in its study on Article 11. Persons with disabilities are variously captured in IHL provisions referencing the “infirm,” “wounded,” “sick,” and “disabled.” Certain categories of individuals with disabilities are sometimes specifically referenced in IHL provisions, in particular persons with “mental disease” or individuals who are “blind,” “maimed,” or “disfigured.” While terms are an indicator of disability, they clearly do not correspond to the disability rights paradigm captured in the CRPD. Additional Protocol I, adopted in 1977 and thus at a much later date than other core IHL instruments, supports a broad-based approach and lends some definition to these various terms associated with disability: Article Convention (IV) relative to the Protection of Civilian Persons in Time of War, Geneva, 12 August 1949, Article 17.Convention (III) relative to the Treatment of Prisoners of War, Geneva, 12 August 1949, Articles 16, 44, 45 and 49; Convention (IV) relative to the Protection of Civilian Persons in Time of War, Geneva, 12 August 1949, Articles 27, 85 and 119.8(a) provides that the terms “‘wounded’ and ‘sick’ mean persons … who, because of … physical or mental disability, are in need of medical assistance or care … and other persons who may be in need of immediate medical assistance or care, such as the infirm.” This evokes an understanding of disability more in the direction of the CRPD.While much of the terminology reflects a medicalized approach to disability, when filtered through a disability rights lens, IHL terminology may be reinterpreted to cover both the sense of disability covering wounded soldiers and civilians in need of medical attention, as well as persons who, on account of their disability, may require specific forms of assistance or protection, though not medical care (e.g. Deaf persons who are unable to access radio messaging; older civilians with mobility restrictions; persons with intellectual disabilities who have difficulties reading or following complex instructions). The conclusion to be drawn from the foregoing is that the CRPD and its disability rights principles are capable of informing the multitude of rules in IHL designed to protect persons with disabilities through general and specific forms of protection. And indeed IHL offers multiple entry points in its existing framework for ensuring respect for the rights of persons with disabilities. In that sense, IHL and human rights law may be seen as mutually reinforcing and constitutive of each other in terms of protecting, respecting and fulfilling the rights of persons with disabilities in international and non-international armed conflict. Refugee LawThe international refugee law framework emerged in its modern form as a result of the massive refugee flows of World War II and its aftermath. Its subsequent extension beyond that particular crisis underscores the ongoing need for a framework of protection for refugees (and internally displaced persons) around the world. While the 1951 Convention Relating to the Status of Refugees (1951 Convention) and the 1967 Protocol to the Convention reflect an ancient practice of providing safe passage and sanctuary to persons at risk and in need of protection, those standards and their application continue to evolve as a consequence of rapidly evolving humanitarian challenges. The 1951 Convention sets out the rights to which individuals are entitled once they have been recognized as refugees. It references disability only in the context of a provision on labor legislation and social security, and simply affirms that refugees are entitled to the same social-security rights as citizens of the country. Disability is not an explicitly recognized ground of persecution in the 1951 Convention that gives rise to refugee status assuming other conditions are met. Article I applies the term “refugee,” among other things, to a person who:owing to well-founded fear of being persecuted for reasons of race, religion, nationality, membership of a particular social group or political opinion, is outside the country of his nationality and is unable or, owing to such fear, is unwilling to avail himself of the protection of that country; or who, not having a nationality and being outside the country of his former habitual residence as a result of such events, is unable or, owing to such fear, is unwilling to return to it.Under the existing definition, a person with a disability can claim refugee status on the basis of disability-related persecution by falling within the category of “social group.” A successful claim depends upon an understanding of the socially constructed nature of disability, a perspective that is not always evident among immigration officials and judges, nor within refugee assistance agencies. While the refugee definition can and should encompass disability-based claims of persecution, the literature points to the need for enhanced awareness of how disability can influence the type of persecution or harm experienced and the reasons for this treatment. Accordingly, a precondition to improving refugee and IDP response for persons with disabilities is enhancing awareness of disability rights and the specific needs of refugees and IDPs with disabilities.The 1951 Convention provides that all refugees must be granted identity papers and travel documents that allow them to travel outside the country, a right that may be compromised for refugees with disabilities because they may have no birth registration or other documentation or because they are denied the right to obtain travel documentation on account of their disabilities. While the Convention requires that refugees must receive the same treatment as nationals of the receiving country with regard to a range of rights—such as free access to the courts, including legal assistance; access to elementary education, and access to public relief and assistance—in practice, multiple barriers prevent persons with disabilities access to these rights generally, irrespective of their immigration status.Likewise, the emerging protection regime for IDPs, including the Guiding Principles on Internal Displacement (Guiding Principles), is not particularly disability inclusive. The Guiding Principles do recognize that persons with disabilities are entitled to protection and assistance. Further, IHL rules provide that forcible displacement is prohibited. Where not prohibited, all possible measures must be taken to ensure that civilians are received under satisfactory conditions of shelter, hygiene, health, safety and nutrition and that members of the same family are not separated.Relatedly, Article 9 of the African Union Convention for the Protection and Assistance of Internally Displaced Persons in Africa (Kampala Convention) likewise calls on States Parties to accord specific protection to internally displaced persons with disabilities. It requires States parties to respect and protect the human rights of internally displaced persons, including the rights to non-discrimination, equality and equal protection of the law and, specifically provides that persons with disabilities be accorded special protection and assistance. Other components of the evolving protection framework for IDPs also make reference to persons with disabilities, including the revised Framework on Durable Solutions and the Inter-Agency Standing Committee’s Operational Guidelines on Protection of Persons in Natural Disasters. These documents emphasize the principle of non-discrimination in relation to persons with disabilities and highlight the need to take specific protection measures in respect of IDPs with disabilities.International criminal lawHuman rights law establishes State responsibility for violations of human rights, meaning that States are obliged to observe human rights standards and prevent and respond to human rights violations. Implementation of these obligations requires various measures such as ensuring criminalization of conduct such as violence and abuse against persons with disabilities. While not specifically referenced in human rights law, crimes against persons with disabilities can constitute a subset of hate crimes, defined variously in domestic law frameworks as encompassing crimes motivated by the offender’s animus against victims on the basis of membership in a particular group, such as persons with disabilities. Further, States are require under human rights law to prevent and punish human rights violations by private actors. IHL affirms the responsibility of States to prosecute or extradite person suspected of having committed grave breaches of the Conventions. The establishment in 1993 and 1994 of two ad hoc international criminal tribunals to prosecute serious violations of IHL committed in the former Yugoslavia and in Rwanda and later, the establishment in July 1998 of the Statute of the International Criminal Court have led to the progressive development of international criminal law, including in the prosecution of gender-based violence. These developments have not yet resulted in interpretations germane to addressing disability-based persecution. That said, international criminal law does recognize that humiliating and degrading treatment as a war crime does not require the personal awareness of the victim as regards the nature of the conduct as humiliating. This can accommodate, for instance, victims with intellectual or psycho-social disability. Further, in the law pertaining to sexual violence, the incapacity to give genuine consent is a factor in the assessment of whether there was an element of coercion attached to an act of sexual nature such as to constitute sexual violence. The CRPD reinforces State obligations in respect of human rights violations against persons with disabilities, whether in armed conflict or in peacetime.Emerging research discloses instances of crimes against humanity perpetrated against persons with disabilities in humanitarian contexts and include murder, enslavement, imprisonment, torture, rape, sexual slavery, forced sterilization, and related egregious acts of persecution. Increased attention to the human rights situation of persons with disabilities is filling the reporting gaps apparent in decades of human rights reporting. The implications of such reporting for international criminal law and process has yet to be realized as emerging legal work in this realm argues. The implications of the CRPD for international criminal law (and for domestic mechanisms holding perpetrators to account for war crimes) are clear. The application of disability rights principles in international criminal law and process is required in order to ensure that accountability for violations committed during situations of risk against persons with disabilities. Much like the failure to tailor international criminal proceedings early on before the two ad hoc criminal tribunals of former Yugoslavia and Rwanda to the needs and circumstances of women victims, the CRPD contemplates positive measures in order to ensure access to justice. The additional element of non-discrimination in the CRPD, namely the requirement of reasonable accommodation, affords persons with disabilities with protection in all stages of legal process. Together with Article 13, addressing State obligations in respect of ensuring the accessibility of all aspects of the justice system for persons with disabilities, non-discrimination and the duty to provide reasonable accommodation must inform international criminal proceedings. The failure to do so can result in impunity, re-victimization of survivors and an undermining of the legitimacy of criminal process.Other Instruments and Policy FrameworksOther soft-law and policy instruments adopted internationally and regionally increasingly account for persons with disabilities and their rights in humanitarian crises, either within mainstream or in disability-specific instruments. Those referenced in this section are limited to instruments with the greatest relevance to disability inclusion in humanitarian action and are thus not exhaustive of all disability-related international policies.The Charter on Inclusion of Persons with Disabilities in Humanitarian Action. As part of the work surrounding the World Humanitarian Summit held between 23 and 24 May 2016 in Istanbul, the Charter on Inclusion of Persons with Disabilities in Humanitarian Action?was developed and reflects the consensus of more than 70 stakeholders from States, UN agencies, the international civil society community and global, regional and national organizations of persons with disabilities, including, for instance, the ICRC and the International Federation of Red Cross and Red Crescent Societies. The Charter emphasizes the need for the removal of barriers faced by persons with disabilities in accessing relief, protection and recovery support in humanitarian crises and the participation of persons with disabilities in the development, planning and implementation humanitarian programs. The Charter conceptualizes the inclusion of persons with disabilities in humanitarian crises consistent with “the humanitarian principles of humanity and impartiality, and the human rights principles of inherent dignity, equality and non-discrimination.” Sendai Framework for Disaster Risk Reduction. The Sendai Framework for Disaster Risk Reduction 2015-2030 adopts a rights-based sustainable development agenda that calls for accessibility and the inclusion of persons with disabilities. The Framework provides that:Persons with disabilities and their organizations have a critical role to play at all stages of disaster risk reduction planning. All disaster risk reduction policies should integrate a disability perspective. Inclusive risk-informed decision-making must be based on the dissemination of information disaggregated by, among other factors, disability. Sustainable Development Goals. The Sustainable Development Goals (SDGs) reflect disability inclusion in four dimensions of the framework. First, the SDGs contain 7 targets that address with specificity persons with disabilities in terms of education, accessible schools, employment, accessible public spaces and transport, empowerment and inclusion, and data disaggregation. Second, six SDG targets refer to persons in vulnerable situations, which are understood to include persons with disabilities. Third, universal targets are inclusive of all persons and therefore must also be achieved for persons with disabilities. In addition, two other targets address discrimination, a major cause of inequality and unequal access to opportunities and services for persons with disabilities. Of particular relevance to ensuring disability inclusion in humanitarian action, Goal 16 underscores the need to promote peaceful and inclusive societies for sustainable development, provide access to justice for all and build effective, accountable and inclusive institutions at all levels. Goal 9 concerns building sound infrastructure and particularly in areas affected by disasters. Goals 11 and 13 reflect the position that no issue can be viewed in complete isolation, including disaster prevention and relief.Further, for many of the targets there is need for urgent action for persons with disabilities, for instance in focus areas of poverty, social protection, health coverage, violence against women, sexual and reproductive health, access to water and sanitation, resilience to disasters, and birth registration. At the national level, additional indicators may be needed to implement the disability-related SDG targets and should accordingly be part of law and policy assessments undertaken in the context of humanitarian action.World Bank Group. The World Bank’s (draft) Disability Inclusion Framework emphasizes disability inclusion in the area of resilience and disaster management, and underscores the need to implement accessibility principles into disaster risk reduction processes. It further states that disability should be considered as an integral part of inclusive community resilience and should guide regulatory frameworks and universal design standards. Second, in the context of the Bank’s work on fragility, conflict and violence, the draft Framework recognizes the vulnerability of persons with disabilities in situations of conflict and violence, including its gender dimension that requires discrete attention. Regional instruments and mechanisms. Also of note are regional mechanisms that in some instances compliment, reinforce or further elaborate protection in the context of humanitarian risk situations. The Verona Charter on the Rescue of Persons with Disabilities in Case of Disasters Further, the newly adopted Draft African Protocol to the African Charter on Human and Peoples’ Rights on the Rights of Persons with Disabilities in Africa specifically references in Article 7 “the protection and safety of persons with disabilities in situations of risk” and further requires that States “[e]nsure, that persons with disabilities are consulted in all aspects of planning and implementation of post-conflict reconstruction and rehabilitation.”In 2012, governments of the ESCAP region adopted the Incheon Strategy. This sets the first regionally-agreed disability-inclusive development goals, comprising 10 goals, 27 targets and 62 indicators. Goal 7 of the Incheon Strategy addresses disability-inclusion in disaster risk reduction and addresses the need for governments to develop disability-inclusive disaster risk reduction plans, train for disaster organizations to ensure accessible facilities and information, and to collect, analyze and disseminate disability-aggregated disaster statistics.Other instruments. Instruments complementary to IHL protections appear in a range of international documents. The ICRC Plan of Action adopted by the 31st International Conference of the Red Cross and Red Crescent recognizes the necessity of humanitarian assistance efforts to be accessible to persons with disabilities, including their access to shelter, water, sanitation, food distribution, education, medical care, physical rehabilitation, transportation, communication and socio-economic inclusion. It further recognizes the need to ensure the effective participation of persons with disabilities all stages of humanitarian assistance.? Likewise, the Vienna Declaration and Programme of Action, adopted by the World Conference on Human Rights, calls upon States and parties to armed conflicts to observe IHL rules based on concern for violations impacting civilians, in particular persons with disabilities.?As noted previously, disability-specific instruments antecedent to the CRPD also reflect recognition that person with disabilities experience risk during armed conflict and other emergencies and require protection specific to their needs.Assessment of the Needs of Persons with Disabilities in Humanitarian Crises The recognition that persons with disabilities are disproportionately affected in situations of risk and humanitarian emergencies and experience multiple barriers in accessing protection and humanitarian assistance, including relief and recovery support, is reflected in the Charter on Inclusion of Persons with Disabilities in Humanitarian Action. The understanding that persons with disabilities are among the most marginalized sectors of the population in a crisis is increasingly supported by field-based evidence that identifies a range of risk factors that contribute to disproportionate disadvantage. At the same time, it is important to recognize that persons with disabilities are not and should not be characterized as hapless victims without agency in humanitarian action. They are resilient and possess unique problem-solving skills as affected populations. Moreover, they are also experts and humanitarian actors involved in all cycles of an emergency and should not be seen or characterized only as individuals at risk.A summary of these factors is listed in Text Box 1. First, persons with disabilities are stigmatized and face discrimination and exclusion. This results in restricted access to education, employment, transportation and health care and often live in isolation from the wider community. As a consequence, as reflected in the 2011 World Report on Disability, persons with disabilities are over-represented among those living in poverty. Text Box 1 Risk Factors Contributing to Disproportionate Disadvantage for Persons with Disabilities in EmergenciesLack of inclusion in community consultations with affected populations and disempowerment generally of persons with disabilities;Breakdown of protective peer networks in the community raises risk of violence, abuse and exploitation, especially for women and girls with disabilities, and persons with intellectual disabilities;Lack of safety and security, especially due to abandonment or separation from family/caregivers; Disability-based persecution and gender-based violence; Inequality of access to assistance, basic goods and services and discrimination in aid provision including failure to provide reasonable accommodation; Lack of access to information about available services in accessible formats;Inaccessibility or absence of specific services including health, functional rehabilitation, mental health services;Abuse, neglect and exploitation, including disability-based persecution;Lack of documentation due to discriminatory birth registration practices;Inequality of access to justice mechanisms including law enforcement;Inaccessible or absence of effective feedback and complaint mechanisms; Inequality of access to assistance (for example cash assistance, employment and livelihood opportunities); Forced relocation, segregation, institutionalization, or abandonment; Unsafe or involuntary return or resettlement of persons displaced by the disaster; andLack of property restitution and access to land.Like other at-risk groups, persons with disabilities are therefore already disadvantaged prior to the onset of an emergency. The onset of violence or disaster very often reinforces disadvantage and exclusion. This risk is further acknowledged in an emerging academic literature on persons with disabilities in situations of risk. The phenomenon has been recognized in the past, although it is under-reported: egregious violations against persons with disabilities during World War II amounted to war crimes. The sections that follow address issue-specific barriers, legal standards and existing guidance pertaining to persons with disabilities and their protection and access to assistance in times of crisis. Protection and access to assistanceIdentification of BarriersBarriers in the access to assistance and protection for persons with disabilities in situations of risk is a recurrent theme in law, policy and practice. Existing evidence on the right of persons with disabilities to assistance and protection in humanitarian response points to a range of barriers and the fact that persons with disabilities tend to be among the least accessible, and least visible members of the community. When in need of assistance, persons with disabilities face numerous obstacles, such as physical and infrastructure barriers; lack of resources and accessible transport which restricts freedom of movement; lack of accessible information about assistance and protection; communication barriers; attitudinal barriers, among others. The CRPD Committee, in the context of its work on Article 11 implementation, has highlighted lack of accessible formats in information about risk reduction strategies during emergencies, leading to enhanced risk; lack of information about accessibility of shelters and evacuation routes; absence of information on the situation of refugee persons with disabilities and how they are included in disaster risk reduction strategies. This is strongly supported by field work undertaken by humanitarian organizations.Child protection and children with disabilities. Child protection in humanitarian action reflects the recognition that threats to the safety and well-being of children are ever-present in all crises at all phases of humanitarian action. At the stage of initial humanitarian response, urgent child protection risks for children with disabilities, as for all children, include separation/abandonment from family members or caregivers, exposure to mental and psychosocial health risks, violence and abuse, sexual violence and other forms of exploitation. For children with disabilities they face additional challenges: children with disabilities may be unable to escape due to inaccessible evacuation routes; lose access to support services and assistive technology; lose an assistive devise and/or caregiver and thus be extremely vulnerable to physical violence, and to sexual, emotional and verbal abuse; be invisible in registration, data collection or needs assessments; be excluded from or unable to access mainstream assistance programmes such as health centre or food distribution due both to physical barriers (i.e. lack of accessible buildings) or to the struggle against negative attitudes and uncompromising environments.?Humanitarian crises may result in life-long injuries for children.?Humanitarian action for child protection also involves preparedness, including the strengthening of inclusive child protection systems before, during and after an emergency, to increase state, community, family and child resilience to the emergency and mitigate its effects.Older Persons. There is an interrelationship between disability and aging in that persons with disabilities age and older persons are more likely to acquire disability as they age. The unique experience of older persons with disabilities – both in terms of risk in emergencies and resilience – is increasingly understood. Research in this context points to the important role that older persons play as caregivers for grandchildren, for instance, and in rebuilding, but also notes the risks their exposure to emergencies can bring. Review of International LawStates are under humanitarian law obligations to ensure that their citizens are protected. Of greatest relevance is the Fourth Geneva Convention that provides that protected persons (e.g., civilians with disabilities) must have the opportunity to access relief efforts such as making application to the ICRC and national organizations. Where the population in a conflict affected area does not have adequate access to food, medical supplies or other essential commodities, the power in control must agree to and help facilitate relief. This would include rehabilitation supplies, assistive devices, and the like. Humanitarian relief must be impartial and conducted without adverse distinction. This means, for instances, that relief and assistance for persons with disabilities must be consistent with this principle and the principle of humanity. Segregation or isolation as a means of assisting or providing relief would not align with these principles. Article 11 of the CRPD requires positive measures of protection and safety for people with disabilities affected by situations of humanitarian emergencies and risk. The importance of such protection is underscored in the CRPD’s preamble which affirms that applicability of human rights in the “full protection of persons with disabilities, in particular during armed conflicts and foreign occupation.” The CRPD has implications for the important role of private actors, such as humanitarian organizations, in ensuring the implementation of the Convention. This is particularly important given the role that such actors play in providing assistance and protection during and in the aftermath of conflict or other humanitarian crisis. It is also relevant for bodies engaged in the investigation of serious violations of IHL and gross violations of human rights, for international criminal tribunals and commissions of inquiry and other bodies seeking to hold perpetrators of abuse to account. Likewise, it speaks to the importance of imparting an inclusive lens on humanitarian action, underscored as a major priority at the 2016 World Humanitarian Summit under the directive of “leaving no one behind.” Both human rights and IHL recognize the protection that must be accorded on the basis of age in humanitarian situations, with the Convention on the Rights of the Child underscoring that children are protected under IHL. While there is as yet no legally binding human rights treaty on the rights of older persons, they too are specifically identified within IHL as a specially protected group and, in addition, international, policy documents likewise specify their needs in all contexts, including situations of risk.Operational Guidance & Good PracticesGuidance places emphasis on ensuring that persons with disabilities are able to access assistance and protection in view of the enhanced risk that they often experience in humanitarian crises. Much of this underscores the need for undertaking specific measures to identify persons with disabilities in the context of needs assessments in recognition of the difficulty of ascertaining who among affected populations has a disability. In a growing number of cases, localized guidance was developed, for instance in assessments and other types of reporting which has contributed to greater awareness and localized change. Drawing on this knowledge and extrapolating it to generate guidance applicable to broad humanitarian contexts is an important dimension of the development of new IASC Guidelines.IASC Guidelines on Psychosocial and Mental Health Support (MPHSS) provide guidance on meeting the needs of persons with psychosocial disabilities in humanitarian action and in that regard are fundamentally important to the formulation of IASC Guidelines on the inclusion of persons with disabilities in humanitarian action. First, they provide coverage of a sub-group of persons with disabilities who are recognized to be highly marginalized even within the disability sector. Second, some of the general guidance provided is relevant not only to persons with psycho-social disabilities but for all persons with disabilities. Further, insofar as the MPHSS Guidelines reflect IASC consensus, it will be important to ensure alignment between them and the forthcoming guidelines on the inclusion of persons with disabilities broadly. Cross-referencing will likely be an important tool for the IASC especially with the MHPSS Guidelines.The IASC GBV Guidelines provide important guidance on GBV in the context of persons with disabilities, as a cross-cutting issue, underscoring the need for complementarity between and among IASC existing and new guidelines. The GBV Guidelines are inclusive of persons with disabilities and specifically identify persons with disabilities as a particularly at risk population.Also of particular note is forthcoming guidance from UNICEF on the protection of children with disabilities in humanitarian crises as parts of its series on the protection of persons with disabilities in humanitarian emergencies. Key PointsPersons with disabilities experience multiple barriers in seeking assistance and protection in humanitarian crises, on account of their marginalization in society. A lack of empowerment among refugees with disabilities reinforces barriers and there is a need for interventions that provide awareness of their rights and facilitate their participation and advocate for more inclusive and meaningfully engagement in humanitarian assistance and protection.Humanitarian assistance organizations must take into account the consequences of marginalization in identifying and reaching persons with disabilities who may require assistance and protection.IHL and human rights law emphasize the importance of protecting persons with disabilities in humanitarian crises as part of general protection to which all civilian are entitled and specific protection accounting for the unique risks that persons with disabilities experience during crises. Existing IASC Guidelines provide important points of departure for addressing protection needs of persons with disabilities. Personal SafetyIdentification of RisksA growing body of evidence that details the particular risks to personal safety that persons with disabilities face at all stages of a humanitarian crisis. This evidence has led to reporting on these risks and the development of guidance directed specifically to ensuring the safety of persons with disabilities in humanitarian action. Information and communication. Risks posed by inaccessible information and communication during humanitarian crises have likewise been underscored by the CRPD Committee in numerous concluding observations pursuant to the State reporting system. Further, the Committee, together with G3ict, have emphasized the importance of ensuring that where information and communication technology are used during the course of emergencies, that they are accessible to persons with disabilities. Examples of information considered essential for mitigating risks to the safety of persons with disabilities include information on safe and accessible modes and means of evacuation, accessible shelter options, and information on military operations in the area.Personal safety & violence. Personal safety may be defined as safety from dangers, violent acts, or threats of violence. In an armed conflict context, personal safety is to be accorded to civilians or to those no longer taking part in a conflict (e.g., disabled combatants). Violence in this context includes physical and mental harm, and may manifest in killings, summary and arbitrary executions, torture and other cruel, inhuman or degrading treatment or punishment, rape, forced prostitution, forced impregnation, forced termination of pregnancy and sterilization, and other forms of sexual violence. Other threats to personal safety in armed conflict and in other emergencies include ethnic cleansing, forced displacement, abduction, shielding from attack (using persons with disabilities as human shields or using their places of residence) and hostage taking, arbitrary detention, forced disappearances, trafficking, slavery, persecution, harassment, discrimination, and the deliberate spread of infectious diseases. These gross violations of IHL and human rights regarding personal safety impact persons with disabilities and are increasingly documented. This is no doubt due in part to an increased understanding and awareness of disability-based persecution, rooted in stigma, and manifesting in abuses such as hate crimes, discrimination brought about by gross failures to provide needed accommodations, and other experiences of persons with disabilities in risk situations.Personal safety and gender-based violence. Physical insecurity is further amplified in emergencies on account of stereotypes casting persons with disabilities as weak and vulnerable, which enhances the likelihood of exploitation. Sexual violence—a prevalent problem for displaced women and girls generally—may become even more of a threat for women and girls with disabilities because of overall insecurity in displacement camps. Human Rights Watch, for instance, in reporting on persons with disabilities in Northern Uganda documented instances of physical and sexual violence against women refugees with disabilities. Recent publications by the Women’s Refugee Commission underscore the risks associated with GBV against children with disabilities and risks to living in urban environments that is an under-examined phenomenon. Abandonment. Abandonment is a major risk to persons with disabilities in humanitarian crises. UNICEF points to the enhanced risk that children with disabilities face in crises and the likelihood of them being left behind, abandoned or neglected. Numerous reports point to this reality and resulting consequences of abandonment, for instance in New Orleans during Hurricane Katrina, where many disabled persons were left behind and died, and in Northern Uganda, where Human Rights Watch reported that women with disabilities who were unable to flee rebel forces were subjected to disability-based abuse and persecution. More recently, documentation on human rights conditions of conflict-affected persons with disabilities in Central African Republic points to the problem of abandonment and the horrific choice confronting family members who must decide between fleeing in the face of imminent danger or staying behind with a family member with a disability and facing certain death A report issued jointly by Human Rights Watch and the OHCHR addresses the impact of the ongoing conflict in South Sudan on persons with disabilities.Arbitrary displacement. Restrictions on movement, for example, arbitrarily and unlawfully imposed detention, can disproportionately impact persons with disabilities for whom access to necessary support and accommodations is crucial to well-being and may not be provided in detention situations. It should be noted that existing research specifically on the detention of persons in humanitarian crises and the needs of detainees with disabilities in such contexts is limited.Segregation and quarantine. Weakened support systems during emergencies further compound freedom of movement for persons with disabilities. For those already segregated in institutions, risks may increase where staff flee and already poor living conditions may worsen during emergencies. In other instances, inappropriate segregation and/or quarantine may occur, very often based on wrong-headed attitudes towards disability or on false notions of promoting safety and protection in the name of segregation. Further, as emphasized by the UN Committee on the Rights of Persons with Disabilities in its reporting on CRPD implementation, there are enhanced risks of trafficking, sexual abuse and exploitation of women and children with disabilities in institutions during conflict.?Review of International LawA primary aim of IHL is to protect civilians from the effects of armed conflict. General IHL principles are applicable to ensuring the safety of persons with disabilities who are civilians. IHL protects civilians from the effects of armed conflict through regulation of the means and methods of warfare and, further, it prohibits specific acts of violence by parties to the conflict, especially when persons are under their power, including through detention, surrender, wounding or sickness. The requirements that parties to an armed conflict must adhere to the principle of humane treatment is also applicable and, when read against the requirements of the CRPD, humane treatment requires protection of life and persons together with judicial guarantees, including the provision of reasonable accommodation where required. Specific protection is also accorded to person with disabilities in IHL as a manifestation of the understanding that persons with disabilities face disproportionate risk in crises. Human rights law places major emphasis on ensuring the protection of persons from violence and abuse. The CRPD guarantees the right to life, the right to be free from torture or other inhuman and degrading treatment or punishment, the right to be free from exploitation and abuse and the right to physical and mental integrity. These protections are complementary to the mandate to protect persons with disabilities in humanitarian crises set forth as a general obligation in Article 11.Operational Guidance & Good PracticesOperational guidance and good practices that focus on the impact of emergencies on persons with disabilities uniformly recognize the risks associated with such crises and the protection needs that too often have gone unmet. General guidance issued by UNICEF in 2017, Guidance: Including Children with Disabilities in Humanitarian Action emphasizes the array of protection needs of children with disabilities in crises. A subsequent publication in the series will focus exclusively on protection issues.IASC Guidelines on GBV include within their guidance protection issues of persons with disabilities, epically women and girls and their protection needs. Finally, IASC Guidelines on Psychosocial and Mental Health Support provide detailed guidance on the risks to personal safety experienced by persons with psychosocial and mental health conditions and strategies to integrate protection measures in different phases of recovery. Key pointsPersons with disabilities face enhanced and disproportionate risk in humanitarian crises, on account of attitudinal barriers (e.g., disability-based stigma), physical and communication barriers, among other risks.IHL and human rights recognize the protection risks and consequent need for protection measures associated with emergencies for person with disabilities. CRPD provides further interpretive guidance.Existing IASC Guidelines, anticipated UNICEF Guidelines on the protection of children in humanitarian action and field based evidence acknowledge the personal safety risks to persons with disabilities in times of conflict, including gender-based violence.Maintenance of Family and Caregiver Links Identification of BarriersHumanitarian emergencies pose considerable risks for the maintenance of family units. As a consequence, they may in some instances greatly enhance risks for those reliant on family members for assistance essential to safety or survival. These include, for instance, infants and children or persons with disabilities who rely on family or caregiver support. For children with disabilities, as for all children, maintaining the family unit is important for reasons of caregiving, support and nurturing, assistance, education, and protection, among others. Accordingly, the breakdown of traditional family and community supports during crises poses considerable risks for men, women and children with disabilities who require supports for daily activities.Especially where flight is involved, persons with disabilities are at high risk of losing their support systems when families are broken up, resulting in separation from caregivers. Subsequent reunification with family members and friends at borders and at refugee and IDP camps is made difficult for persons with mobility and visual disabilities because of physical barriers. Communication barriers similarly cause difficulties for individuals with intellectual disabilities and deaf persons to make their needs known as they endeavor to locate caregivers. Heightened stress or lack of psychological support or medication also can be difficult for all persons during crises and may disproportionately impact persons with psychosocial disabilities, resulting in social stigma that bars effective assistance. Review of International LawIHL has a specific focus on maintenance of family ties for the obvious reason that those most at risk during humanitarian crises are those individuals who rely upon caregivers such as women, children, older persons, and persons with disabilities. As a result of the specific protection categories that have emerged within IHL, as well as population-based human rights conventions (e.g., CRC, CRPD, CEDAW), standards for recognition of the family unit and its protective role are a salient feature of the humanitarian action landscape.IHL prohibits the involuntary separation of families and, where families are separated, it requires the adoptions of specific measures to support reunification (in particular registration). Finally, if separation occurs, it specifies measures that must be undertaken to reestablish family ties and bring family units back together. Most relevant are those provision found in the Fourth Geneva Convention recognizes and protecting family life. Additional measures are specified to preserve to identity of children and to register their parentage, protections that clearly apply to children with disabilities.International human rights law recognizes the right to respect for family life including, for instance, in the Convention on the Rights of the Child (CRC). In the CRC, children have the right to an identity and family relations, prohibits their arbitrary separation, and sets froth provisions concerning the maintenance of contact with parents and measures to promote family life. While the CRPD expressly acknowledges the inherent risks of humanitarian crises for persons with disabilities and the need for their protection, a rights-based, social model understanding of disability cautions against conceptualizing the maintenance of family unit and caregiving supports in paternalistic terms. Thus, the operationalization of IHL in this context, and informed by the CRPD, should emphasize (1) participation and inclusion of person with disabilities in humanitarian action programming; (2) recognition of the legal capacity of person with disabilities and their ability to voice their own will and preferences, with support as needed; (3) CRPD principles and avoidance of characterizations that make assumptions about individuals with disabilities and their need for family and/or caregiving supports and/or reinforce paternalistic and pejorative views about individuals with disabilities.Operational Guidance & Good PracticesOperational guidance in the context of the family unit tends to focus on children and women. Emerging research and guidance emphasizes the connection between enhanced risk and loss of the family unit for individuals with disabilities. The OHCHR, in its Article 11 study, underscores the efforts required by States in order to foster reunification as rapidly as possible:States and non-State actors should intensify their efforts to facilitate, by every means available, the reunion of persons with disabilities with their families in accordance with their wishes. Service providers should consider the support required by some persons with disabilities in this regard. Personnel involved in these processes should be aware of the psychological impact on persons with disabilities and the potential distress caused by abandonment and violence. In addition, attention should be paid to the particular needs of unaccompanied boys and girls with disabilities, particularly those subjected to torture or trauma, and to the needs of older persons. Lastly, personnel should be aware of gender and cultural issues that could affect the process of family tracking and reunification; for example, those subjected to rape can experience shame upon reuniting with their families owing to cultural prejudices.Key PointsWhile not all persons with disabilities are reliant on family or caregivers for support, some are. The disruption in family and caregiving through separation and other consequences of emergency constitute risks that must be accounted for in developing guidelines for humanitarian assistance inclusive of person with disabilities. The legal capacity of person with disabilities and their ability to voice their own will and preferences, with support as needed, is important in the context of humanitarian action where separation from family and/or caregivers has occurred.References to maintenance of family and support linkages must be characterized consistent with principles of the CRPD and thereby avoid paternalistic or stereotypical renderings of individuals with disabilities as passive and helpless victims in humanitarian contexts. Access to Water, Food and SanitationIdentification of BarriersAround the world, clean water and safe sanitation may be generally accessible to the public, but not to persons with disabilities. This circumstance is compounded for disabled refugees and IDPs, particularly for those living in a camp setting. Numerous obstacles prevent ready access to clean water and sanitation facilities. Physical barriers include the placement of latrines at considerable distance from camp living spaces, and infrastructure with narrow entrances or steps, slippery floors, lack of inside space, and an absence of grab bars to assist with balance. Even when camp sanitation facilities are constructed to be accessible for persons with disabilities and older person, uneven, rocky terrain and long distances to facilities may prevent persons with disabilities from using them. Latrine locations pose security risks and physical dangers where not constructed accessibly. Likewise, the positioning of clean water distribution centers impacts women and girls with disabilities whose family task it is to carry water. Research and policy developments in this realm focus outlining the social and economic benefits of WASH. A 2015 UNICEF study reviewed existing literature and good practices and concluded that the following were most relevant in tackling the inaccessibility of WASH programming for persons with disabilities: (1) Addressing stigma and limited understandings of the rights of persons with disabilities; (2) Defining entry points for engaging with DPOs and disability rights activism in sub-national, national, regional and global contexts; (3) Equipping country and regional offices with tools/guidance on inclusive and accessible WASH; (4) Confronting gaps in global data/evidence gathering for inclusive and accessible WASH; (5) Providing country offices information about the bottom line on the costs of accessible WASH; and (6) Strengthening knowledge-sharing and communities of practice across country, regional, and global offices.The provision of adequate food is clearly a major component of ensuring that the basic needs of persons with disabilities are met in humanitarian response. Insofar as children and adults with disabilities very often do not enjoy equal access to services in their own communities, due to factors such as inaccessible premises and professionals that are not able to communicate adequately with persons with disabilities, access to sufficient nutritious food is often an issue of concern to families having a member with disabilities. Poverty as well as unequal distribution of resources within the household often impact access to adequate nutrition for household members with disabilities. Access to nutritious food for women with disabilities and their children is unaccounted for in both the nutrition and disability sectors, placing those women and children at increased risk. UNICEF points to research disclosing a heightened risk of undernutrition for girls with disabilities compared with boys.In emergency settings, according to a report from the Women’s Commission for Refugees: “In all the refugee camps, participants in the field studies pointed out that the food distribution systems were not suited to refugees with disabilities. Food distribution points were frequently far from refugees’ homes and they had to line up for long periods, or try to push their way through large crowds, to receive their food—which was difficult for many.” These prospects are riskier and often impossible when people with disabilities are separated from family and peer support who would otherwise perform important roles in food preparation and other tasks. Gendered expectations for women to feed and care for their families present additional obstacles for women with disabilities. Review of International LawHumanitarian law places limits on the permissible methods and means of warfare with the aim of preventing severe food shortages or denials of access to food in armed conflict contexts. Most relevant in the current context are rules prohibiting the starvation of the civilian population. Further, it is prohibited to attack and destroy objects indispensable to the survival of the civilian population. Where relief to the population is required, humanitarian law contains provisions to ensure that persons in need and at risk receive humanitarian assistance. IHL also prioritizes the distribution of humanitarian relief for those accorded specific protection.Human rights law guarantees access to an adequate standards of living for persons with disabilities on an equal basis with others. Under the CRPD, Article 28, Adequate standard of living, guarantees non-discrimination in access to clean water, food, and other necessities. In Article 25, Health, the CRPD obligates States to “[p]revent discriminatory denial of health care or health services or food and fluids on the basis of disability.” Part of non-discrimination is taking positive measures, including reasonable accommodation and other accessibility measures to facilitate access and thus prevent discriminatory results. The CRPD principles of accessibility and promotion of universal design principles—the concept expressing the idea that the design of products, environments, programs, and services should be usable by all, to the greatest degree possible, without adaptation or specialized design—have clear application to making water and sanitation facilities more accessible and of benefit to everyone in a refugee community, including elderly persons, youth, and persons who are ill. The SDGs affirms the importance of accessible WASH. Thus, SDG Targets 6.1 and 6.2 mandate inclusive and accessible WASH in in specifying the achievement of “universal and equitable access to safe and affordable drinking water for all” and “access to adequate and equitable sanitation and hygiene for all and end open defecation, paying special attention to the needs of women and girls and those in vulnerable situations.” SDG 4, on ending hunger, achieving food security and improved nutrition and promoting sustainable agriculture is also of direct relevance to persons with disabilities. Target 2.1 calls for ending hunger and ensuring access by all people, in particular the poor and people in vulnerable situations, including infants, to safe, nutritious and sufficient food all year round by 2030. Target 2.2 addresses ending all forms of malnutrition, including achieving, by 2025, the internationally agreed targets on stunting and wasting in children under 5 years of age, and addressing the nutritional needs of adolescent girls, pregnant and lactating women and older persons.?Operational Guidance & Good PracticesWithin humanitarian action, access to food, water and sanitation is divided into discrete areas of humanitarian operation: Water, Sanitation and Hygiene, otherwise referred to as “WASH”; (2) Food security and agriculture; and (3) Nutrition. Existing guidance specifically on disability inclusion in humanitarian action, such as the UNICEF series, Including Children with Disabilities in Humanitarian Action, addresses WASH and Nutrition in two separate booklets. The IASC MHPSS Guidelines address these in two sections, one on WASH and another on Food Security & Nutrition. Water & Sanitation. Guidance, often very detailed, and collected good practices have been developed to ensure that water and sanitation providers reduce physical and infrastructural barriers that present barriers to water and sanitation service provisioning. Such guidance focuses on improving accessibility to sanitation facilities for persons with disabilities through low-cost changes and disability awareness training. Evidence based research emphasizes consideration of the complete domestic water cycle (drawing transporting, and storing water, and household use for bathing, and washing clothes and dishes) along with access and entry, support railing, seating, and usability, as well as the service delivery components of ensuring access, is essential in order to arrive at an inclusive response. UNICEF has also published guidance on inclusive good practices in the WASH context. The most recent and comprehensive work on the topic, including but going beyond water and sanitation in humanitarian action, is the publication of the World Bank Group, Including Persons with Disabilities in Water Sector Operations.Food Security and Nutrition. Guidance emerging on addressing the food security and nutrition needs of persons takes various forms, including additional or targeted and prioritized rations. Nutrition in this context also includes important initiatives from children under age 5 as well as pregnant and breastfeeding women. Activities in this context include, for instance, accessing emergency micronutrients, complementary and supplementary foods, care practices, and skilled breastfeeding counselling for children below age 5, pregnant and breastfeeding women with disabilities.In some instances, the United Nations High Commissioner for Refugees (UNHCR) has worked to broker arrangements with the World Food Programme to prioritize food distribution to persons with disabilities. Another strategy is to use mobile units to distribute food to individuals who are unable to collect the rations themselves, thereby responding to transport and other barriers for disabled people, older persons, and others. Specific guidance on Nutrition will appear in UNICEF’s Guidance: Including children in humanitarian action.Key PointsThe provision of adequate water and food and access to water, sanitation and hygiene facilities is a major component of ensuring that the basic needs of persons with disabilities are met in humanitarian response.International law places limits on the means and methods of warfare so as to ensure the provision to the civilian population of food, water and other necessities. Human rights law provide further legal protection specifically addressing the rights of person with disabilities in these contexts. The principle of non-discrimination and the duty to provide reasonable accommodation, along with the principle of accessibility are especially important in this context.There is ample research and guidance on inclusive design for water, sanitation and hygiene and forthcoming guidelines from UNICEF on the topic for children with disabilities which provide detailed information.Emerging research is beginning to focus on the food security and nutrition needs of persons with disabilities in humanitarian action and a forthcoming guidance publication from UNICEF will address nutrition in the context of children with disabilities.Access to ShelterIdentification of BarriersThe experience of Hurricanes Katrina and Rita in the United States disclosed the inadequacy of accessible shelter for persons with disabilities when it was discovered that trailers provided by the Federal Emergency Management Agency were inaccessible. Similarly, studies of shelter provided for survivors of the Asian tsunami revealed similar problems. These failures clearly illustrate the need to take accessibility into account during emergency preparedness and underscore the importance of including DPOs organizations in such processes so that access is seamlessly woven into the design phase.Accessible shelter during times of humanitarian crises is often hard to come by and presents serious challenges for displaced persons, especially for persons with physical disabilities. Post-disaster shelter and settlement responses have been shown to be deficient in addressing the potential barriers faced by persons with disabilities. Further, shelter needs and programs are very different in camps versus urban settings. In urban settings, refugees usually have access to multi-purpose cash and then must find their own shelter which may require negotiations with private sector landlords. Shelter actors may, however, play a role in negotiating temporary shelters with landlords. Themes emerging from the review of resources addressing shelter and settlements include the following barriers for persons with disabilities in emergency settings:Safety. Shelters raise concerns about safety for persons with disabilities who are already at higher risk of violence and abuse. In such settings the lack of private spaces for those who require assistance with personal hygiene presents privacy and also safety concerns. Over-crowding in both camp and urban settings where families pool funds to rent over-crowded living spaces is problematic. In such contexts domestic violence is a concern as is the possibility of restraints for persons with disabilities.Risks to those in institutional settings. For persons with disabilities housed in institutional settings during emergencies, whether hospitals, social care homes, orphanages, nursing homes or places of detention, they are at the mercy of the facility and its planning for emergency response, as amply demonstrated by the abysmal failure to makes plans for evacuation of nursing homes during extended power outages in Hurricane Harvey.Physical: Man-made barriers such as staircases, narrow doors, level changes and thresholds, inaccessible public transportation, lack of accessible public toilets. During times of natural disasters such as earthquakes or floods as well as armed conflict such as destruction of infrastructure create new physical barriers. Shelter and settlement interventions may contain barriers in themselves, such as steps at the entrance to shelters or latrines, lack of information in accessible formats and household items that are not suitable for persons with different types of rmation: Barriers to information or communication regarding shelter and settlement responses including, for example, inaccessible early warning systems and evacuation, and information about relief operations and access to aid. Most persons with disabilities rely heavily on caregivers and support networks for access to information. Review of International LawInternational humanitarian law reflects the importance of shelter in providing protection for civilians in armed conflict. Various rules account for the provision of adequate shelter. These include rules regarding the protection of civilian dwellings and prohibitions against forced displacement. They also include protections for civilians who have been displaced, providing that they must be given adequate shelter during the period of their displacement.In humanitarian action, while shelter and settlement are the dominant terms, human rights law provides protections in relation to shelter and settlements under provisions protecting the rights to property and the right to be free from arbitrary interference with one’s home. Protections also fall within the scope of the right to adequate housing. Everyone has a right to adequate housing, and this right is recognized in key international legal instruments, including in Article 28 of the CRPD. Human rights law recognizes that adequate housing entails protection from the climate, structural hazards and risks to health, access to essential services and facilities, and appropriateness. A further element relates to accessibility, in terms of the physical location of the dwelling or accommodation and the ease with which the space itself can be used by the affected individuals. Operational Guidance & Good PracticesThe operational focus of shelter responses early on in humanitarian crisis is protection against the elements and, later, ensuring that reconstruction occurs within the framework of accessibility standards and principles of universal design. Existing guidance on accessibility in the emergency shelter context includes UNICEF’s Accessible Components for the Built Environment: Technical cards embracing universal design. This resource provides technical guidance on accessible infrastructure and its surroundings and identifies the following four areas where barriers commonly arise for persons with disabilities: (1) movement in the outdoor environment and reaching the buildings; (2) entering, exiting and evacuating buildings; (3) movement within a building; and (4) use of individual rooms and facilities. Also of note are Handicap International’s Accessibility for All in an Emergency Context the IFRC, CBM and HI’s All Under One Roof Disability: Inclusive shelter and settlements in emergencies and the publication by Sightsavers and DRRA, Disability, Disasters and Empowerment . Guidance also exists that focuses on post-crisis reconstruction and “building back better.” Key PointsThe rights of persons with disabilities to shelter are negatively impacted by physical, information, attitudinal and organizational barriers as a result of crises or in the context of humanitarian response.International law addresses accessible shelter and settlement response in IHL provisions protecting civilian dwellings and prohibiting forced displacement and in human rights law under provisions on the protection of property rights and the right to be free from arbitrary displacement. Existing guidance provides direction on the construction of emergency shelter in accordance with accessibility standards and the opportunity for ensuring that reconstruction efforts are accessible to persons with disabilities, underscoring the need for the participation of the disability community in such efforts.Health and Rehabilitation ServicesIdentification of BarriersThe many obstacles faced by individuals with disabilities when accessing health and rehabilitation services are intensified during times of humanitarian crisis, as amply documented, for instance, in relation to the ongoing Syrian conflict. These barriers relate to inaccessibility of services, lack of availability, inappropriate services and lack of quality care and present even more challenges in humanitarian contexts.General public health access. Accident prevention and public health promotion through mine clearance, inoculation, better health care and/or nutrition are important components of equal access to health care for persons with disabilities. They should be considered as important general public safety and health matters for which persons with disabilities must have access and must benefit.Accessibility. Physical barriers to service facilities exclude users of wheelchairs and other mobility/assistive device users, the absence of facilitators can preclude persons with intellectual or psychosocial disabilities from receiving treatment, public health education campaigns are often visual and thus not accessible to blind people, and radio-based education campaigns do not reach deaf individuals. Financial barriers to adequate health and rehabilitation services are intensified during crises and the specific needs that persons with disabilities may have for functional rehabilitation or mental health supports for those with chronic conditions may be prohibitive. Sexual and reproductive health. False assumptions about the needs of persons with disabilities, especially in relation to sexual and reproductive health result in the exclusion of persons with disabilities from sexual and reproductive health information and interventions and this may hinder access to life-saving services in an emergency. HIV/AIDS research suggests that persons with disabilities are likewise neglected in HIV and AIDS programming because of false assumptions of sexual inactivity and wholly incorrect beliefs their low risk for sexual abuse or drug usage. In consequence of these unfounded notions and despite contrary empirical evidence, public sexual and reproductive health programs for refugees and IDPs have disregarded disabled populations. This exclusion has had a severely disparate impact on women and adolescent girls with disabilities.Mental Health and Psychosocial Supports. Persons with pre-existing mental health and psycho-social disability are at risk of exclusion from humanitarian assistance and healthcare due to stigma or lack of available services in a crisis. Additional risks include disruption in medical treatment or medications during emergencies. The onset of humanitarian crises itself brings about mental health and psycho-social disability requiring specific supports, including depression, anxiety, and post-traumatic stress. We note an increasing involvement of international and national stakeholders for the integration of MH in Primary Health Care.Victim Assistance in Mine Action. Survivors of landmines, explosive remnants of war (ERW), and improvised explosive devices (IEDs) very often acquire disabling conditions and thus must have access to emergency health/trauma care and evaluation, psychosocial support, access to adequate temporary water, shelter, and hygiene during recovery, adequate protection, among other support services. Gender and age related aspects of victim assistance must also be considered when addressing barriers, including, for instance, risk of abandonment and/or isolation for female survivors and loss of familial supports and ongoing and frequent rehabilitation needs for children survivors (e.g., prosthetic replacements).Disability specific health services. Persons with disabilities may, depending on their needs, need additional support and resources to fulfil their potential including rehabilitative care, surgical intervention, assistive devices such as crutches or wheelchairs, or environmental modifications like ramps and accessible transport. Appropriate Services. A dimension of disadvantage too often experienced by survivors of crises is the risk of further harm due to wrong-headed approaches to recovery, hence the principle “Do No Harm.”. In some communities certain disabling conditions may be regarded as a curse or ill omen. Bogus remedies thought to “cure” disability are also commonly peddled and lead to inappropriate or dangerous treatments. In the context of psycho-social disability, this may take the form of culturally inappropriate recovery models or bogus customary approaches to healing. For those with traumatic injury resulting in physical disability, this may take the form of inappropriate rehabilitation or limited access to rehabilitation services. A disability rights frame understands health and rehabilitation in emergencies as entailing a broad array of rehabilitative options and health in keeping with the WHO paradigm of physical, mental and social well-being as opposed to the absence of disease and infirmity. Because humanitarian health access programming historically has not been disability inclusive, the specific health and rehabilitation needs of refugees and IDPs with disabilities are especially challenging. In sum, ,Review of International LawHuman rights law protects the right of all persons to the highest attainable standard of health and prohibits discrimination on the basis of health status. The CRPD adds significantly to the understanding of disability in the context of health. It emphasizes that persons with disabilities have the right to non-discriminatory access to health services which includes the duty to accommodate individuals with disabilities where required. It recognizes: (i) the right to sexual and reproductive health services; (ii) access to population-based public health programs; (iii) services provided as close as possible to people’s communities; (iv) provision of disability-specific health services, including prevention of further disabilities; (v) autonomy and independence in health care decisions, on the basis of free and informed consent; (vi) non-discrimination in access to health insurance and life insurance; and (vii) prohibiting the denial of care, including food and fluids, on the basis of disability. Article 26 of the CRPD recognizes the right, broadly construed, to rehabilitation. When read together with Article 11, the CRPD requires that the provision of health and rehabilitation services, especially support for psychosocial recovery, must align with CRPD Articles 25 and 26. Also underscored are respect for autonomy and respect for free and informed consent, peer support, community-based services support where needed for individuals in decision-making. Medical personnel should respect the right of every person to accept or refuse medical treatment, including mental health treatment. In addition, as highlighted by the OHCHR, the prevention of primary impairments is not a disability-related policy and should not be referenced as such (signaling the longstanding tendency to conflate prevention of disability with protecting the rights of persons with disabilities). The Committee on the Rights of the Child, in its General Comment No. 9, stated that States parties must ensure access to adequate health and social services, including psychosocial recovery and social reintegration, to children with disabilities affected by an armed conflict.Unlike its earlier instruments, IHL treaties placing limitations on the means and methods of warfare that couple prohibitions with protections and support for survivors, along with access to information (e.g. mine risk education) that can prevent traumatic injury. Thus for instance the ban on anti-personnel landmines in the Mine Ban Treaty is coupled with obligations for States Parties to provide assistance to victims by providing medical care and rehabilitation, as well as ensuring the social and economic reintegration of landmine survivors. More expansively, and notably after the negotiation of the CRPD, the Cluster Munitions Convention (CMC) obliges States to provide for the medical care, rehabilitation, psychological support, and social and economic inclusion of cluster munitions victims in areas under its jurisdiction or control. The intention was not to create a privileged group of survivors nor indeed a privileged sub-group of persons with disabilities, as the CMC includes non-discrimination protections and takes into account, as does the CRPD, intersectional discrimination. Such provisions are complemented and reinforced by human rights treaties that recognize the rights of trauma survivors and survivors of various human rights abuses to certain protections. The UN Mine Action Service has adopted a policy in recent years that squarely places victim assistance within the CRPD framework.Operational Guidance & Good PracticesWHO, in collaboration with CBM, the International Federation of Red Cross and Red Crescent Societies (IFRC), the International Organization for Migration (IOM), the United Nations Children’s Fund (UNICEF) and the United Nations Office for Disaster Risk Reduction (UNISDR), promulgated Guidance Note on Disability and Emergency Risk Management for Health (2013). The Note (1) provides an overview of the impact of emergencies on people with disabilities and sets out principles that should underpin practical action related to emergencies; (2) outlines the minimum actions required across sectors/clusters and specific disability-related actions that can be undertaken by health actors working in different areas of health care provision such as injury prevention and trauma care, mental health and psychosocial support, and child health to ensure inclusion of disability; and (3) provides various annexes that provide further details and checklists to assist actors in conducting assessments and in the design and delivery of programmes and services that address the needs of people with disabilities who are at risk of emergencies. UNICEF has a forthcoming publication providing guidance on health in the context of inclusive humanitarian action for children with disabilities. The IASC Guidelines on HIV and those on MHPSS address health within the context of their respective thematic focus. This guidance should be reflected in forthcoming IASC guidelines on disability inclusion. Guidelines on wheelchairs.; this innovative product is specifically designed to be appropriate and supplied quickly.Added Value:?This product will enable a significant shift in international practice as it complements existing activities in the field.Innovation Phases Description:A major challenge in emergencies is the provision of appropriate wheelchairs (and other assistive devices) to persons who need them quickly. The WHO and Handicap International, among others, have documented that during emergencies, very often wheelchairs are slow to arrive, are second hand, hospital chairs which rarely meet international standards and are not designed for the challenging environments typical of emergencies. Work has been undertaken to innovate in this context to design a wheelchair meeting the specific requirements of emergency situations. Innovative approaches include model programs that provide training in emergency wheelchair response procedures; integrate wheelchairs into emergency preparedness programmes; implement emergency wheelchair response; and evaluate and disseminate emergency wheelchair response packages. The impact of this unavailability is significant and can lead to life threatening situations for injured and disabled people and exclusion from accessing emergency relief efforts. Guidance on Mental HealthWhile there IASC has, as noted, promulgated guidelines XXX, other guidance compliments these guidelines. These include, especially, publications by the WHO in the context of addressing mental health in low resource settings. Other works focus on promoting rights-based approaches to mental health in legislation. Guidance on HIV and DisabilityHIV is recognized as a cross-cutting issue in humanitarian assistance (and development programing. Persons with disabilities are as likely as other members of society to become infected with HIV and, as studies suggest, in certain situations they may be at higher risk of infection than others. HIV infection is a disabling condition and requires domestic laws and institutions such as legislatures, AIDS councils and national human rights institutions to ensure that HIV/AIDS and disability responses are mutually reinforcing. Research shows that marginalized and socially isolated groups who experience discrimination and other human rights violations in society are far more likely to face barriers in their access to HIV prevention, treatment, care and support than other populations and this is especially the case during emergencies. HIV-related laws, policies, programmes and institutional frameworks all too often fail to take their needs into account. Existing guidance helps to identify potential risk factors and to provide guidance on how HIV services can be made accessible to persons with disabilities. In the context of IASC Guidelines, HIV is a cross-cutting issue and should thus be reflected as such in forthcoming disability-specific guidance. Community-based Rehabilitation Guidelines.Also of note in relation to access to rehabilitation services are the WHO Community-based Rehabilitation Guidelines (CBR Guidelines). These provide guidance on the development and strengthening of CBR programs; advance CBR as a strategy for community-based development involving people with disabilities; provide guidance on how to support stakeholders to meet the basic needs and enhance the quality of life of people with disabilities and their families; and also advance the empowerment of people with disabilities and their families. The CBR Guidelines address the following five sectors: health, education, livelihood, social, and empowerment. The broad context of establishing CBR programs is perhaps most relevant to the post-crisis recovery but the principles and approach together with guidance offered are pertinent to facilitating access to quality rehabilitation any stage of a crisis.Key PointsPersons with disabilities are known to be highly vulnerable to health-related risks during humanitarian crises, including barriers in accessing health as well as rehabilitation services.Persons with disabilities require access to sexual and reproductive health care services and the discrete needs of women and girls with disabilities, often overlooked, should be addressed. International law provides protection to persons with disabilities in accessing health and rehabilitation services without discrimination and during times of humanitarian crises. Existing guidance underscores the risks that persons with disabilities face during humanitarian crises and specify measures to ensure their inclusion in HIV/AIDS interventions, and emphasizes principles of non-discrimination, accessibility, participation and dignity, and resourcefulness and capacity.EducationIdentification of BarriersDuring humanitarian emergencies, education is one of the first services to be disrupted. Education is restricted for children with disabilities even in non-emergencies. People with disabilities are far less likely to be literate than their non-disabled peers; they face numerous barriers in accessing mainstream education systems and, as a result, very often have little or no education. Obstacles experienced by people with disabilities in accessing their right to education include physical, information, and communication barriers, and attitudes. Barriers are also structural in nature and may be embedded in institutional structures. Deeply entrenched misperceptions about persons with disabilities and their alleged limitations are difficult to displace, even among educators and policy makers in this field. Exclusion from education results in life-long hindrances to meaningful employment, health, civic, and political participation and many other spheres of life. The barriers to education that persist throughout the world present challenges for children and adult refugees and IDPs with disabilities. There is some evidence to suggest that efforts to introduce inclusive education in refugee settings can take hold, even in the face of major barriers.Studies suggest that persons with disabilities have difficulty accessing education, with only 10% of children with disabilities in school and indicate that their global literacy rate is as low as three percent, and for women with disabilities, it is as low as one percent. The gender dimension is profound, as girls with disabilities are even less likely than their male peers to attend school, often on account of parental fears or assumptions that they will not be able to obtain employment and thus do not need to be educated. Also of note, there is evidence that adolescent girls who have siblings with disabilities may be pulled out of school to assume care-giving roles. Research undertaken by Human Rights Watch suggests that Syrian refugee children with disabilities in Jordan and Lebanon have been largely excluded from efforts to provide access to education. In Lebanon, thirteen humanitarian and disabilities organizations working told Human Rights Watch that little or nothing had been done to ensure that children with disabilities can enroll in schools. Research undertaken in Sierra Leone and Sudan emphasizes the enhanced risk to children with disabilities who are out of school and the limited attention by donors to emergency education generally. Access to education for children with disabilities living in crisis-affected environments enables not only the acquisition of basic education skills such as literacy and numeracy, but also skills associated with well-being and survival such mine awareness, HIV and AIDS education and other health education programs.Review of International LawIHL provides some, though limited, coverage on education, primarily in the context of ensuring that children separated from their families are able to access education. An Occupying Power is mandated to promote the operation of national and local services for the care and education of children.Human rights law affirms the right to education and, for persons with disabilities, the right to an inclusive education. The CRPD Committee has underscored the elements of inclusive education which include availability, accessibility (including non-discriminatory access and the provision of reasonable disability accommodations), acceptability, and adaptability, with the aim of full participation and inclusion, on an equal basis with others. The CRPD Committee in its draft General Comment on Article 24, Education, acknowledges that situations of armed conflict, humanitarian emergencies and natural disasters disproportionately impact the right to inclusive education. To that end the Committee calls on States to adopt inclusive Disaster Risk Reduction strategies for comprehensive school safety and security in emergencies, which are sensitive to learners with disabilities. The Committee further underscores that temporary learning environments in situations of risk must ensure the right of persons, and particularly children, with disabilities to education on the basis of equality with others, including accessible educational materials, school facilities, counselling, or access to training in local sign language for deaf learners. The Committee recognizes the heightened risk of sexual violence in emergencies, especially for women and girls with disabilities. Finally, the Committee holds that learners with disabilities must not be excluded from access to education on the basis that their evacuation in emergency situations would be impossible, and that reasonable accommodation must be provided in such contexts.Operational Guidance & Good PracticesHumanitarian guidelines emphasize that the return of children, whether displaced or not, to schooling should be facilitated as early and as quickly as possible after a humanitarian crisis. Access to education must observe the principle of non-discrimination; children with disabilities are entitled to equal access to education. UNICEF’s Core Commitments for Children in Humanitarian Action outline commitments on education (Education Commitment 2) providing that “all children, including pre-school-aged children, girls and other excluded children, access quality education.” UNICEF’s Guidance: Including children in humanitarian action will set out more detailed guidance in a forthcoming publication that specifically addresses the inclusion of children with disabilities in humanitarian action. Operational guidance developed through consultations with numerous humanitarian actors provides helpful, evidence-based perspectives on the barriers that children with disabilities face in accessing inclusive education in humanitarian settings. The International Network for Education in Emergencies (INEE) has published several resources providing guidance on accommodating children with disabilities and other at risk populations in education in emergency settings, of particular note are the INEE publications, Pocket Guide to Supporting Learners with Disabilities (2010) and Education in Emergencies: Including Everyone. These resources identify common challenges and barriers to inclusion for learners with disabilities in emergencies, practical strategies for overcoming such issues, and resources for further guidance. Measures include ensuring school buildings are physically accessible (e.g., new schools and schools under reconstruction); providing training and support to teachers on disability inclusion; raising disability rights awareness among teachers, parents, other children, communities, humanitarian actors and policy makers; life skills training; and capacity building of the wider community on disability rights and awareness.The Minimum Standards for Age and Disability Inclusion in Humanitarian Action, developed by the Age and Disability Consortium, devote a chapter to inclusive education in emergencies and set out four standards for implementation by humanitarian action addressing inclusive education for girls and boys with disabilities as well as adults with disabilities and older people, drawing attention to the need for access to vocational training, skills training and adult literacy.Key PointsPersons with disabilities are uniformly and disproportionately denied to right to an education in developing countries and their risk of being left out of education interventions during humanitarian crises is high.Human rights law protects the right of children with disabilities to an inclusive education, including in times of humanitarian crises.Guidance reflecting a consensus among many humanitarian actors as part of the INEE provides important inputs on making education interventions inclusive for students with disabilities during emergencies, with UNICEF also in the process of formulating specific guidance.Livelihoods Humanitarian emergencies pose serious economic hardships for all and disproportionately impact persons with disabilities on account of their general economic marginalization in society. Identifying barriers to accessing livelihoods for persons with disabilities and working to eliminate them is an important component of mitigating risk for persons with disabilities in humanitarian action. Moreover, where livelihood programs integrate sustainability throughout the design, implementation and evaluation of the program, they may facilitate improved economic circumstances for persons with disabilities and their families during recovery. The transition to cash based assistance, poised to double in the next several years, presents opportunities for all persons affected by crisis and displacement to make their own choices about their basic needs. The implementation of cased-based assistance, and the growing utilization of technology-based systems of transfer, poses potential problems to persons with disabilities unless their design and implementation is planned with their inclusion.Identification of BarriersWhile meaningful and non-exploitative work and resources to maintain an adequate qualify of life is difficult to attain for persons with disabilities in any context, the barriers are magnified during situations of risk: “In conflict or crisis situations, where displacement, theft, looting, and the destruction of property are commonplace, households no longer have the necessary means of production to be self-sufficient.” In developing countries, eighty to ninety percent of persons with disabilities of working age are unemployed, compared with fifty to seventy percent in industrialized countries. World Bank estimates disclose that “leaving people with disabilities outside the economy translates into loss of GDP of about 5–7 percent annually.” Employment schemes frequently are inaccessible, with barriers as to information about employment opportunities in accessible formats, failure to provide reasonable accommodations to make employment programmes accessible. Access to the finance needed to start a business is severely restricted for persons with disabilities generally, with studies suggesting that a substantial percentage of the unbanked poor are persons with disabilities. Microfinance initiatives historically have neglected persons with disabilities as potential participants. These barriers are more pronounced for refugees with disabilities as well as IDPs. Refugees and IDPs often find their movement restricted to camps as a consequence of local laws that limit the movement of refugees outside of the camps and for persons with disabilities, a multitude of disability related barriers serve to limit engagement in livelihood opportunities and thus impact economic opportunity. Text Box 2. Key Stakeholders in Inclusive Livelihoods ProgramsPersons with disabilities and families/caregiversGovernments, including ministerial focal points on disability and government-run livelihood/economic development programs All mainstream livelihood and vocational training service providers (for example, INGOs, local NGOs, MFIs, financial service providers, vocational training centers,) National disability commission/councilsNational human rights commissions (including disability focal point)Public and private financial institutionsDisabled peoples organizationsDisability service providersLocal disability advocate leadersBusiness groups (especially those engaged in networks on disability inclusive employment)Other barriers impacting inclusion in livelihoods programs include widespread discrimination and stigma, especially the belief that persons with disabilities cannot work due to their disability among livelihood actors/stakeholders and resulting exclusion of persons with disabilities from all mainstream livelihood service provision. Further, the lack of sign language interpreters/captioning services/written communication materials for Deaf people, lack of adapted tools for persons with physical disabilities, inaccessible accessible toilets in vocational training centers, potential workplaces, inaccessible transport and lack of Braille materials for blind persons or the existence of supported employment models all limit access to livelihoods programs. Legal limits on the right to work, rooted in stigma and the false belief that persons with disabilities are incapable of work or financial decision-making reinforce, disadvantage. Non-recognition of the legal capacity of persons with disabilities can impact access to livelihood programs in humanitarian action. Notably, recent research suggests that persons with disabilities are very often the last to be resettled in part due to barriers. Review of International LawIHL and human rights law prohibit starvation and the destruction of property that is indispensable for civilian survival. IHL rules place restrictions on the methods of warfare (e.g. poisoning of wells is prohibited; destroying agricultural areas for the production of foodstuffs, crops and livestock essential for survival of the civilian population) and the use of certain weapons, such as anti-personnel mines. Further, IHL provides for socio-economic inclusion for survivors and assistance measures. The CRPD likewise prohibits the withholding of food or fluids and recognizes the right of persons with disabilities to an adequate standard of living and the right of persons with disabilities to work. Human rights law reorganizes the right of property, elements of which are expressly referenced in the CRPD, and the prohibition of discrimination against persons with disabilities in the enjoyment of property rights. Equality in rights to property is recognized in the CRPD on the basis that persons with disabilities are recognized as possessing legal capacity and the rights to exercise that capacity, including property rights. Operational Guidance & Good PracticesOperational guidance and good practice on the inclusion of persons with disabilities in livelihood projects in humanitarian crises responses is starting to emerge, with examples in the mine action realm tracing back more than ten years. While opportunities for refugees with disabilities to earn a living is severely restricted in many settings, good practices overwhelmingly emphasize partnerships with DPOs and persons with disabilities as experts. The Minimum Standards for Age and Disability Inclusion in Humanitarian Action, developed by the Age and Disability Consortium, devote a chapter to food security and livelihoods. Four standards address the inclusion of persons with disabilities and older people in food security programs and livelihood programs. The standards emphasize accessible information on food assistance and food security programs, accessibility in relation to food distribution and cash and voucher transfers and including persons with disabilities and older persons in food-for-work, cash-for-work and livelihood programs.As noted above, the increased reliance on cash assistance to allow for affected communities to make their own decisions about what they need may pose additional barriers for persons with disabilities. This is especially so if the differentiated needs of persons with disabilities are not taken into account and if specific outreach to ensure persons with disabilities are reach in cash assistance programing is undertaken. Technology-based cash transfers – implemented by humanitarian actors working in collaboration with financial institutions – must take accessibility into account. Text Box 3 Text Box 3: Measures to Ensure Equal Access to Financial ServicesAustralian Banking Services Access: In compliance with the Disability Discrimination Act (1992) the Australian Bankers’ Association (ABA) through facilitation by the Australian Human Rights Commission and in consultation with disability organisations developed and adopted the following Guiding Principles for Accessible Authentication to ensure secure access to financial for people with disabilities.The Guiding PrinciplesPrinciple 1: Accessibility of authentication technologiesFinancial institutions should ensure that authentication technologies are accessible to all customers, or where this is not possible, a human-based alternative authentication system needs to provide equivalent amenity and convenience.Principle 2: Customer convenienceAll customers should be able to undertake their personal and business financial activities conveniently and safely.Principle 3: Authentication planningFinancial institutions should consider the accessibility needs of customers with disabilities and older customers as part of authentication technology planning.Principle 4: Authentication testingFinancial institutions should consult customers with disabilities and older customers as part of planning and testing accessibility of authentication technologies.Principle 5: Registration, login and transaction proceduresFinancial institutions should ensure that registration, login and transaction procedures are as accessible as possible to all customers.Principle 6: Messages and error recoveryFinancial institutions should ensure that online messages are unambiguous and written in “plain English” and that error recovery processes are efficient and accessible.Principle 7: Staff and customer trainingFinancial institutions should provide relevant customer support staff with appropriate disability awareness training so they are aware of the needs of customers with disabilities and older customers. In addition, financial institutions should provide customers with information and training in the use of available authentication technologies.Principle 8: Raising staff, business and customer awarenessFinancial institutions should develop a strategy for enabling relevant management and staff awareness of these Guiding Principles. In addition, financial institutions should promote the availability of alternative accessible authentication technologies with their customers.Principle 9: Confidentiality of customer informationFinancial institutions must ensure the confidentiality of information of customers with disabilities and older customers.Principle 10: Security of transactions and transaction feesFinancial institutions should ensure customers with disabilities and older customers are not exposed to higher financial risks or costs as a result of the deployment of authentication technologies.Source: Australian Banking Association, Guiding Principles for Accessible Authentication (Dec. 2006).Key PointsWhere policies are being formulated that are relevant to livelihood, it is important to identify and dismantle law and policy barriers that impact access to all components of livelihoods activities.Persons with disabilities must be engaged as staff and participants in livelihood programming from the beginning of all livelihood programs.Persons with disabilities must be consulted to ensure that specific risks (e.g., exclusion from programming, barriers and risks in program implementation) are addressed.Inclusive budgeting should be followed that accounts for reasonable accommodations and other supports within all livelihood programs, mainstreamed and targeted. As with other sectors, inclusive livelihood programming is integrally connected to, among other things, accessible transportation, legal guarantees on the right to work, sustainable livelihoods (i.e. climate resilient and disaster resilient). Access to Justice and Effective RemediesIdentification of BarriersLegal barriers frequently inhibit access to redress where the rights of persons with disabilities have been violated, including in humanitarian crises. Persons with disabilities face numerous barriers in seeking access to justice for the vindication of their rights. Some of these barriers are generally experienced by all marginalized groups and contribute equally toward disempowerment. Other barriers are more specific to the experience of individuals with disabilities. Lack of recognition of legal capacity. Persons with disabilities are frequently denied their right to legal recognition in law or practice. This impacts formal and informal rights of decision-making, and may also impact a range of issues pertinent to accessing services during or after humanitarian crises.Personal documentation. Personal identification and registration documents are important means of freedom of movement, access to social assistance, and recognition of legal capacity. Because records are lost or abandoned during flight, refugees and IDPs frequently require assistance in obtaining documentation needed to claim refugee status, receive humanitarian assistance, access government services such as health care and education, find employment, and realize other fundamental human rights such as the right to participate in political affairs (e.g., the right to vote). For individuals with disabilities, cultural stereotypes often add additional barriers to acquiring official records. Documentation may be denied on the basis of non-recognition of legal capacity rooted in disability-based discrimination. They may never have had documentation in the first place due to poverty, illiteracy, or social stigma resulting in either not being registered at birth or being denied documentation later on in life. Or, they may have once had such documentation, but absent appropriate accommodations cannot communicate sufficient information to receive meaningful assistance. For women and children with disabilities, lack of personal documentation may disproportionately impact them on account of their age and gender. Many of these barriers were documented in a recent report by Human Rights Watch on the failure of the registration process to identify persons with disabilities who were refugees seeking protection in Greece.Access to remedies. Access to remedies for egregious human rights violations, including those falling within the purview of IHL and international criminal law, is influenced by disability-related factors and barriers, including stigma, inaccessible procedures, lack of accessible information about grievance and justice mechanisms, failure to provide accommodation to person with disabilities in terms of facilities and procedures, and barriers to information and communication technology.Review of International LawUnder Article 4 of the CRPD, States Parties must adopt legislative, administrative and other measures to implement enumerated rights. In the realm of ensuring access to justice, this might include, for example, ensuring that criminal procedures recognize the right of persons with disabilities to serve as witnesses, making disability-based persecution an aggravated offense, or specifically addressing the accessibility of criminal process and victim reparation procedures. States must abolish or amend existing laws, regulations, customs and practices that discriminate against persons with disabilities, for instance redressing laws that deny legal capacity to persons with disabilities. Fundamental to the development of inclusive and accessible law, policy and programming is the CRPD requirement in Article 4(3) that States Parties “closely consult with and actively involve persons with disabilities, including children with disabilities, through their representative organizations.” The implications of the CRPD for international criminal law bodies, transitional justice mechanisms and other processes, such as resettlement, is that such mechanisms must be inclusive of persons with disabilities not only in terms of their operation and accounting for violations, but also in their design. The CRPD provides fairly detailed provisions to address accessibility in connection with justice sector mechanisms. Accessibility is a core principle of the treaty, expressed in Article 3 (General principles) and is also the subject of a general provision, applicable across the treaty, Article 9 (Accessibility) which to identify and eliminate “obstacles and barriers to accessibility.” Article 13 explicitly recognizes that States must undertake measures to ensure the accessibility of justice mechanisms to persons with disabilities, on an equal basis with others. Procedural accommodations are specifically referenced and are to be directed towards ensuring that person with disabilities may participate, directly or indirectly, in “all legal proceedings” including as witnesses and including investigative (fact-finding) or other preliminary stages. These accordingly implicate a range of measures, some of which are detailed in the CRPD. Article 13(2), for instance, requires States to promote training for those working in the field of administration of justice. Further, in order “to promote equality and eliminate discrimination,” States Parties are required to “take all appropriate steps to ensure that reasonable accommodation is provided.” This accommodation duty applies equally to all rights and applies in all contexts. Finally, Article 12 of the CRPD affirms – and explicitly presumes - the legal capacity of persons with disabilities. it follows that the exercise of legal capacity must be appropriately facilitated, for instance in terms of providing accessible court processes, providing plain language materials for individuals seeking access to justice or benefits. Article 12 is directly responsive to firmly held and discriminatory presumptions – in law and practice - as to the legal incapacity of individuals with disabilities and their unreliability and credibility as witnesses. Operational Guidance & Good PracticesOperational guidance and good practice is still emerging on legal issues and access barriers relating specifically to persons with disabilities in humanitarian action. Little attention is given to the specific barriers that limit access to legal redress such as reparations whether in the literature or in existing guidance. Existing guidance tends to underscore broad principles of participation, inclusion and accessibility in a generalized way, without, however, providing detailed attention to identifying and dismantling barriers to legal access. The IASC Best Practice Guide Inter-Agency Community-Based Complaint Mechanisms Protection against Sexual Exploitation and Abuse, for instance, does make passing reference to the need to ensure that persons with disabilities are included in complaint mechanisms, but do not address in any detail the many barriers that they may experience and how such barrier could be overcome.The CRPD Committee has, to some extent, highlighted the impact that lack of legal recognition can have on persons with disabilities without detailing the application of this issue to humanitarian action. Illustrations include, for instance, failing to include disability-specific standards into legislation and action plans on humanitarian action; disability-specific guidelines within procedures for registrations during humanitarian crises; victim reparation programs that do not include accessible procedures; incorporation of accessibility standards into the framework of humanitarian law, policy and guidance; procedures for asylum that fail to incorporate accessibility and reasonable accommodation requirements. The World Bank Group, in its new Environmental and Social Safeguard Framework, however, places major emphasis on grievance resolution mechanisms in the context of World Bank Projects, and the accessibility of those mechanisms to stakeholders, including persons with disabilities. More attention is needed to address access barriers in the context of legal and grievance mechanisms s in the context of humanitarian action. What may be gleaned from existing practice is that persons with disabilities must have access to grievance mechanisms within the context of humanitarian action, on an equal basis with others. This requires undertaking specific measures to ensure that persons with disabilities can receive information about grievance mechanisms, obtain a response in a timely manner, and receive impartial treatment within a system that resolves problems in a consistent manner. The Table below provides a framework for key elements necessary to ensure access to grievance and other dispute settlement mechanisms for persons with disabilities that may be applied to the humanitarian context and its aftermath.Table 3: Key Elements for Inclusive Dispute SettlementReceive: Receiving information about grievance mechanisms in an accessible format. Investigate: The duty to investigate concerns and grievances of stakeholders with disabilities must be undertaken on the same basis as others. Part of this duty is the provision of reasonable accommodations where required such as ensuring that persons with disabilities can impart information about their concerns in their own language, such as Sign Language, and/or through the use of auxiliary aids and services, such Sign Language interpreters.Respond: The duty to respond to concerns and grievances raised by individuals, including persons with disabilities, must likewise ensure accessibility in relation to the information provided in the response. Further, responses must avoid arbitrary decision-making rooted in stereotypes about disability.Timeliness: Grievance mechanisms must respond in a timely manner to concerns and grievances raised by stakeholders. Non-discrimination and equality of access requires Borrowers to ensure that persons with disabilities have access to all phases of the grievance basis in a timely fashion. It further requires that such access not be disproportionately delayed relative to others, for instance in order to receive reasonable accommodations. Consistency: Grievance mechanisms require consistency in the process by which they operate and their procedures. Borrowers must ensure that there is a coherent, consistently applied procedure in place to provide reasonable accommodations for persons with disabilities to access the grievance process. Arbitrariness or inconsistency in the provision of reasonable disability accommodations can be avoided by the development of clear procedures and guidelines. The failure to provide reasonable accommodations where required to access grievance mechanisms constitutes discrimination. Key PointsPersonal documentation is a key factor in obtaining access to assistance and persons with disabilities often face numerous barriers in obtaining such documentation.Legal mechanisms must be inclusive of persons with disabilities and accessible to them in their design and operation.Actions against persons with disabilities constituting violations of international human rights, humanitarian, international criminal law, and/or refugee law incur State responsibility and must be addressed by justice mechanisms.Analysis of Existing Resources Most Relevant to Disability Inclusion in Humanitarian ActionAn emerging literature and guidance on the inclusion of persons with disabilities in humanitarian action should figure heavily in the formulation of IASC Guidelines on the Inclusion of Persons with Disabilities in Humanitarian Action. Of particular note are those resources that address disability inclusion in the context of risk situations (whether manmade or naturally occurring) and that reflect the principles in the CRPD. Also of major consequence are existing IASC Guidelines which offer several distinct models for the formulation of IASC Guidelines, all of which have merit, engage disability inclusion issues and should be given careful consideration in decision-making on the scope, content and format of the proposed IASC Guidelines. Finally, privilege is given to guidance documents reflecting the consensus of more than one organization. Particular attention is owed, for instance, to the concluding observations of the CRPD Committee in relation to Article 11 implementation, as this is a body tasked with knowing implementation of the CRPD and is comprised of 18 members. Similarly, existing IASC guidelines and other resources developed in a collaborative process of more than one humanitarian organizations and that accordingly reflect the consensus of a more than one, and in some instances many, humanitarian actors and therefore merit special consideration. This is not at all to suggest that guidance prepared by a single organization is without merit; indeed, such work very often feeds into a broader consensus document. Rather, the scope of this Desk Review requires a limiting criterion and an analysis that focuses on resources developed in a partnership is consistent with the board principles of humanitarian action as well as guidance offered by the CRPD Committee. The discussion that follows provides a summary analysis of these resources – not an exhaustive accounting – for the specific purpose of devising recommendations to the Task Team on the merits and shortcomings and/or gaps in existing resources.United Nations SystemCRPD Committee Practice The CRPD Committee, in its Reporting Guidelines for States Parties, specifies the following required information when reporting on Article 11: This article obliges States Parties to ensure the protection and safety of persons with disabilities in situations of risk, such as situations resulting from armed conflicts, humanitarian emergencies or natural disasters.States Parties should report on any measures taken to ensure their protection and safety including measures taken to include persons with disabilities in national emergency protocols.States Parties should report on measures taken to ensure that humanitarian aid relief is distributed in an accessible way to people with disabilities caught in humanitarian emergency, in particular measures taken to ensure that sanitation and latrine facilities in emergency shelters and refugee camps are available and accessible for persons with disabilities.Key dimensions emphasized by the CRPD Committee in its guidance to States include:The importance of measures to ensure “protection and safety of persons with disabilities in situations of risk” The application of protection measures in any type of humanitarian crisis, be it armed conflict, natural disaster or other humanitarian emergency. The necessity of ensuring that humanitarian assistance is distributed in accordance with accessibility, with illustrative measures that should be taken to facilitate access in the sanitation context.In reviewing States reports pursuant to the reporting obligations of the CRPD, the Committee has consistently raised concerns and put forth recommendations regarding shortcomings in the implementation of Article 11. To date, under the Optional Protocol, the CRPD Committee has not had occasion to consider the application of Article 11, nor are pending communications before the Committee alleging violations of Article 11. This provides a growing evidence base on which to draw in the formulation of Guidelines. A comprehensive table of CRPD Committee conclusions and observations in relation to Article 11 in responding to reporting by States may be found at Annex C. A short summary of key findings and recommendations is provided in Text Box 4. Text Box 4 Summary of CRPD Committee Recommendations on the Inclusion of Persons with Disabilities in Situations of RiskEndorsement of the Charter on Inclusion of Persons with Disabilities in Humanitarian Action and the Sendai Framework for Disaster Risk Reduction.Ensuring the inclusion of a disability-specific lens in all legislation and national plans relating to situations of risk and humanitarian action.Establishment of national emergency management standards for implementation across all levels of government, inclusive of diverse disabilities and covering all phases of emergency management preparation, early warning, evacuation, interim housing and support, recovery and rebuilding.Ensuring that disaster risk reduction plans and strategies provide for accessibility and inclusion of persons with disabilities, in all situations of risk, that are comprehensive, accessible and disability-inclusive, in line with the Sendai Framework for Disaster Risk Reduction.Development of plans for evacuation of persons with disabilities in consultation with DPOs, by all public services.Provision of information about risk reduction strategies during emergencies in accessible formats and information about accessibility of shelters and evacuation routes, including ensuring that telephone-based emergency services and public broadcasting of warnings are accessible. Design accessible early-warning systems that incorporate sign language and Braille, focusing also on persons with disabilities in rural and remote areas.Ensuring the inclusion of refugees with disabilities in disaster risk reduction.Mainstream disability in refugee policies and adherence to CRPD in instances where persons with disabilities seeking asylum are detained.Ensure the accessibility of and inclusion of persons with disabilities in victim reparation and assistance programs.Undertake measures to facilitate the protection of persons with disabilities in refugee camps, such as accessible shelters, water and sanitation, education and health, evacuation during emergencies and rehabilitation.Identify places of refuge and shelters accessible to persons with disabilities in urban and rural areas.Ensure the accessibility of information and communication technology used in emergency services to persons with disabilities.Undertake capacity building among humanitarian assistance providers on the rights of persons with disabilities, including civilian protection personnel. Provide disaggregated information about the situation of asylum seekers and refugee persons with disabilities within the State’s territory.Ensure systematic registration of internally displaced persons with disabilities to facilitate access to assistance.Take measures for monitoring the situation of persons with disabilities in refugee camps and internally displaced persons with mittee Practice Key Points:The CRPD Committee places emphasis on the endorsement of the Charter on Inclusion of Persons with Disabilities in Humanitarian Action by States (and other actors); promotes disaster risk reduction planning in accordance with the Sendai Framework; emphasizes the application of CRPD principles to ensure accessibility of shelters, water and sanitation, education and health, evacuation, accessible information and communication technology used in emergencies; accessibility of victim assistance and reparations; and stresses disaggregation of data in refugee procedures.OHCHR and Article 11e Office of the High Commissioner for Human Rights (OHCHR), as part of its CRPD mandate, conducted a thematic study in order to clarify the scope of the CRPD in the context of disasters and humanitarian emergencies, to identify good practices, and to make recommendations. Notably, the Human Rights Council requested that contributions by stakeholders be submitted in an accessible format and that the report include an easy-to-read-version on the OHCHR website prior to the thirty-first session of the Council.Many of the conclusions of the study are reflected in sections of this Desk Review. Most salient for the purposes of the IASC Guidelines are the following points reflected in the OHCHR study:The CRPD draws together IHL and human rights obligations in guaranteeing the protection of persons with disabilities in situations of risk.All principles and obligations set forth in the CRPD are relevant for understanding the scope of protections and the content of State obligations in relation to the protection of persons with disabilities during emergencies. Key PointsWhile the development of IASC Guidelines are intended to be operationally directed, the work of the OHCHR together with the CRPD Committee can help to orient the conceptual approach and principles that should inform the development of the Guidelines.IASC GuidelinesExisting IASC Guidelines have been referenced in other parts of this study. They should clearly inform the development of the proposed new Guidelines, especially insofar as they address disability inclusion but also in how they structure and format their content.IASC Guidelines on Mental Health and Psychosocial Support. The IASC Guidelines on Mental Health and Psychosocial Support aim to promote full and inclusive participation of people with disabilities in decision-making, planning, design, management and implementation of camp activities as a key strategy toward ensuring psychosocial well-being. These Guidelines are more modest in scope than other examples (especially the revised version of the GBV Guidelines), although they contain many of the same types of elements (e.g., matrix approach, sectoral/thematic approach, examples of good practices, key resources). Of particular note, each Action Sheet provides essential background, providing context for gaps and barriers to accessing mental health and psychosocial supports in a given context. Thereafter, the Action Sheets provide examples of key actions, followed by illustrative process indicators and brief examples of interventions drawn from the field. The formatting of the Guidelines is simpler than other IASC Guidelines (especially the revised GBV Guidelines) and thus appears more readily accessible and user-friendly, including for users with screen readers.The IASC Guidelines for Integrating Gender-Based Violence Interventions in Humanitarian Action provide a detailed matrix of actions to be taken, by themes/sectors, disaggregated as to responsible humanitarian actor and arranged in accordance with the program cycle, and across two stages of emergency: (1) pre-emergency/preparedness; and (2) emergency/stabilized stage. It draws on a wealth of prior practice (this being the second revised edition of the GBV Guidelines) and field examples. It is voluminous, at 300+ pages, and thus provides comprehensive guidance as to what GBV is, its risk factors for a wide range of at-risk groups, including persons with disabilities, as well as what needs to be undertaken to reduce risk and promote resilience and recovery and also provides guidance on how the recommended interventions can be achieved. It also targets a wide range of humanitarian actors in the provision of guidance, thus contributing to its level of detail.By contrast, the IASC Guidelines Addressing HIV in Humanitarian Settings, provide a brief narrative of the key actors and structure of humanitarian action in the context of HIV. Key pointsIn the formulation of the first set of Guidelines on the inclusion of persons with disabilities in humanitarian action, careful consideration should be given to the depth and breadth of the resulting content. The diversity of the population of persons with disabilities, the reality that this is a new and unfamiliar issue area within humanitarian action, and the complexity of humanitarian action especially when filtered through a rights-based, social model understanding of disability, ostensibly favors comprehensive guidelines that could easily approximate or even expand upon the IASC GBV Guidelines. That said, and acknowledging the need to amplify disability rights protection in furtherance of Article 11 of the CRPD and IHL, consultations and past practice suggests that a more modest approach be taken that is clear and accessible and lays the groundwork for progressive development over time in view of continued practice and research.The initial consultations with Task Team members during the course of this Desk Review suggests that this approach could prevent overwhelming the audience for the Guidelines and instead build a more sustainable foundation that will be taken up by humanitarian actors. Such an approach must be transparent in its purpose, namely, that the Guidelines are a living document, subject to continuous review and updating and reflective of lessons learned. This is consonant with the approach taken in other IASC Guidelines.UN Agency Guidance UN agencies are increasingly providing guidance on protection and assistance for persons with disabilities within the framework of their own policies and programming and in the development of disability-specific guidance for humanitarian actors. Some of the most relevant work has already been cited in other sections of this Desk Review. For instance, UNHCR’s Need to Know Guidance, published in 2011, focuses specifically on providing guidance on the needs of persons with disabilities and actions to address them in instances of forced displacement.In 2016, the World Bank approved new Environmental and Social Safeguards that will take effect in 2018 for Bank funded projects. The new framework establishes for the first time non-discrimination as a mandate and expressly includes persons with disabilities as a group whose needs must be accounted for in Bank-funded projects and for whom disadvantage and discrimination often occurs.In 2017, UNICEF launched the first in a series of guidance resources on the inclusion of children with disabilities in humanitarian action. The first volume provides general guidance, to be followed in subsequent volumes with thematically-focused guidance in the areas of education; health and HIV/AIDS; Nutrition; Protection; and WASH. UNHCR’s 2010 ExCom Conclusion on Refugees with Disabilities and other Persons with Disabilities Protected and Assisted by recognizes that refugee host States, very often developing countries, have limited resources and face various challenges in providing services and facilities for persons with disabilities; underscores UNHCR and the international community’s role to assist States in fulfilling responsibilities for protecting refugees with disabilities, recommends measures such training on the needs, rights and dignity of persons with disabilities, ensuring identification and registration of persons of concern with disabilities, ensuring programs, services and procedures are accessible, enhancing international cooperation for improving living conditions and ensuring equal opportunities for durable solutions and appropriate support.DPO & NGO GuidanceField work in the area of inclusive humanitarian action, with a focus on persons with disabilities, has resulted in recommendations and guidance, either in the framework of field reports or in standalone documents produced by DPOs, coalitions of DPOs, and by NGOs. Many of these are cited in this study and/or are referenced in the bibliography at Annex A. Of particular note are those referenced below:Minimum Standards for Child Protection in Humanitarian Action (Child Protection Standards). In 2010, the membership of the global Child Protection Working Group agreed on the need to develop child protection standards in humanitarian settings. The resulting guidance, Child Protection Standards were developed to support child protection work in humanitarian settings with the objective of establishing common principles for those working in child protection, and to strengthen coordination between them; improving the quality of child protection programming, and its impact for children; improving accountability within child protection work; providing a synthesis of good practice and learning to date and enabling better advocacy and communication on child protection risks, needs and responses. The Child Protection Standards integrate disability in a comprehensive way, Integrates disability throughout, pointing to the particular risk that children with disabilities face in emergencies, the need to include children with disabilities in assessment, the need for awareness raising, disaggregation as to disability where feasible or as soon as possible, among other issues without providing detailed guidance or procedurally detailed information. Other guidance specific to children protection and children with disabilities is the joint publication, Introduction to Child Protection in Emergencies Training Package, Module on Children with Disabilities.Minimum Standards for Age and Disability Inclusion in Humanitarian Action (ADCAP Minimum Standards). The pilot set of standards entitled is currently being finalized and was developed by a coalition of organizations, the Age and Disability Capacity Building Programme (ADCAP). They are comprised of inclusion criteria based on the Core Humanitarian Standards. Guidance is provided for the following sectors of humanitarian action: Protection; Water, Sanitation, & Hygiene; Food Security & Livelihoods, Shelter, Settlements and Non-Food Items; Nutrition, Health, and Emergency Education. The standards articulated for each sector focus on what is needed to ensure an inclusive response. Action tips are supplied that focused on how a response can be made inclusive. Further resources are listed for more detailed guidance in the various sectors. A limited number of good practice highlights are provided for each sector. The pilot Minimum Standards are available in several accessible formats and are undergoing participatory reviews and final revision.Identification of Gaps. In the development of the draft Minimum Standards, the following gaps were identified in the existing literature and resources. The IASC Task Team should therefore consider in the development of the IASC Guidelines whether and how they might be addressed:Lack of systematic consideration of the needs and participation of carers, both as regards their role in ensuring that the needs of the people they care for are and regarding their own specific needs and vulnerabilities as carers.Lack of standards and guidance in either specialist or mainstream literature on meeting the needs of people in residential institutions, including care homes, special schools, orphanages, psychiatric institutions, detention centres and prisons, where many people with disabilities may reside. More attention is required for addressing humanitarian response in controlled setting such as camps or extremely remote environments. Less attention is given to contexts such as urban environments where humanitarian actors often have far less control.More work is needed to assess the implications of a move to cash programming and the inclusion of persons with disabilities such schemes.More attention is needed to identify the human resource requirements associated with inclusive programming. Finally, the review of the pilot Minimum Standards also reveals a major omission, namely, the failure to include as part of the supporting principles the concept of reasonable accommodation, While the supporting principles reference non-discrimination, they do so without mention of reasonable accommodation which is recognized as a core element of the non-discrimination duty (which is also equally applicable to older persons).Key PointsDPOs and NGOs, especially those working in the humanitarian action context, have made significant contributions to the implementation of CRPD Article 11 and the disability rights framework within the context of humanitarian action. Such work should be utilized to inform the development of IASC Guidelines and should be seen as complimentary to the forthcoming Guidelines. In addition, such work should lend insights into emerging good practices that may be highlighted in IASC Guidelines. Gaps identified in existing resources as part of the development of the Minimum Standards are worthy of consideration by the Task Team.Further, insofar as the proposed Guidelines will highlight barriers and other risks associated with protecting persons with disabilities in emergencies, drawing on the growing evidence base among both reporting by DPOs and NGOs, together with academic research, should be utilized.The failure to reference reasonable accommodation as an element of non-discrimination in the supporting principles is problematic and must be addressed in future IASC Guidelines (and indeed in the next iteration of the ADCAP Minimum Standards)Other Supporting ResourcesThere is an emerging literature on the impact of humanitarian crises on persons with physical, mental and sensory disabilities. This work is referenced primarily in Part II of this report to trace the various barriers and risks encountered by person with disabilities in humanitarian crises. A more extensive bibliography of these resources is provided in Annex A. This work is contributing to the growing evidence base and should be used to inform the development of IASC Guidelines and, in future, the ongoing review and updating of those Guidelines. Of special relevance are those research results that focus, in whole or in part, on the actual lived experience of persons with disabilities in humanitarian crises and their voices.Conclusions, Recommendations & Suggested Approach The foregoing sections have provided an overview of the law, policy and programming implications of ensuring the rights of persons with disabilities in humanitarian action. These point to the following set of recommendations and possible approaches for the development of IASC Guidelines on Humanitarian Action Inclusive of Persons with Disabilities.The aim is to reinforce understanding among humanitarian actors of the particular needs of risks experienced by persons with disabilities in humanitarian crises in order to bring about improved and comprehensive response. Persons with disabilities represent a diverse and heterogeneous population and their roles in society are socially and culturally determined. Humanitarian responses and action must be adapted in order to achieve the protective goals of international law for populations at risk while, at the same time, avoiding the characterization of persons with disabilities as helpless victims.Title: The title of the proposed Guidelines, in order to be fully consistent with terminology employed by the UN, in academic literature and disability inclusive development, ought clearly to include the phrase “Disability Inclusive Humanitarian Action.” To do otherwise is not only awkward, but entirely out of alignment with prevailing usage.Conceptual Framing of Guidelines. The proposed IASC Guidelines must define their conceptual starting point, underscoring a rights-based, social model orientation, with implications for terminology, process of development of guidelines, such as robust consultations with persons with disabilities, both individual experts and representative organizations (i.e. DPOs).Conceptual Clarity. The landscape of humanitarian action resources is variously described as “Standards,” “Guidance,” “Guidelines,” “Principles,” “Policy.” Many of the resources reviewed during this research use a number of these terms. There is no apparent consistency in how the terms are used, and they are rarely if ever defined. This leads to the potential for confusion. The figure below is a suggested way of framing these different terms and their relationship to the content and objectives:Figure 3: Terminology Pyramid IASC Guidelines and Disability Policy Framing. The Desk Review revealed that there is no current policy on the inclusion of persons with disabilities in humanitarian action and thus no policy to form the basis of the conceptual framework for the Guidelines. The Guidelines will serve as a tool that helps to frame policy approaches and could inform a future policy should the IASC undertake future policy work in this area. The IASC, in its work on gender equality in humanitarian action, adopted first in 1999 and then again in 2008, an IASC Policy Statement Gender Equality in Humanitarian Action. The IASC Guidelines should thus be anchored by an articulate and well-conceptualized statement on the rationale for the Guidelines and the relationship of the Guidelines to the international legal framework within which they must be developed. Guiding Principles. The proposed IASC Guidelines should be practical, operationally oriented, yet undergirded by key principles. This is in keeping with prior IASC efforts. These should include non-discrimination and equality (inclusive of the concept of reasonable accommodation); participation and inclusion of persons with disabilities; accessibility; and, consonant with humanitarianism generally, the principle best expressed as “Do No Harm.” (See Annex D for a table of relevant principles). Consideration should be given to the applicability of two principles referenced in the MHPSS Guidelines, namely building on available resources and capacities and integrated support systems. Others may also be included, such as the key humanitarian principles. Complementarity. The practice of IASC efforts that have led to the adoption of guidelines is to draw on previous efforts, where appropriate and adapt from prior approaches, where appropriate. This approach serves to promote consistency across the various guidelines. It also promotes accessibility to users of the various guidelines. It is also consistent with the approach taken in past IASC processes to adopt an intersectoral approach. Cross-cutting & Transversally Applied Elements. Existing IASC Guidelines emphasize the importance of avoiding “siloing” of humanitarian interventions, a recognized risk given the organization of humanitarian action into sector/cluster specific areas. Care is taken to highlight cross-sectoral issues and, in the revised IASC GBV Guidelines, each thematic area contains a matrix that identifies cross-cutting themes for that particular sector across all sectors. For example, in the section on child protection, a matrix identifies concrete actions to facilitate coordination on child protection in the GBV context across all other cluster area. In the context of including persons with disabilities, while cross-sectoral issues will need to be addressed, a number of cross cutting issues are also important to consider integrating, among them, the diversity of disability, age, gender, and other elements that are cross-cutting in nature, such as data collection, humanitarian mine action/survivor assistance, and gender-based violence. Reflect the Emerging Common Consensus as to Key Elements of Disability Inclusive Humanitarian Action. The Desk Review discloses common ground across the landscape of standards and guidelines that address persons with disabilities in the context of humanitarian action. Chief among these are the principle of non-discrimination on the basis of disability, accessibility, including universal design, recognition of the diversity of disability, the necessity of full and effective participation of persons with disabilities in all aspects of humanitarian action, the importance of disability awareness-raising among all humanitarian actors, and the need to identify specific actions to facilitate disability inclusion across all sectors of humanitarian action. Identify and Decide Whether and How to Address Gaps in Existing Standards and Guidelines. Gaps that were identified in the review of literature and guidance underscores the evolving nature of this new issue area and warrant specific attention in the crafting of future IASC Guidelines. Most notable (and surprising) is the lack of attention to a core element of non-discrimination on the basis of disability, namely, the duty to provide reasonable accommodation. As this concept is one of the major contributions of the CRPD to human rights law generally, and core to the effective inclusion of persons with disabilities in all areas of life, it is essential that the new IASC Guidelines clearly identify reasonable accommodation as a core duty for humanitarian actors and provide specific guidance as to what reasonable accommodation might look like, illustratively, in various contexts. Attention should likewise be given to reflecting all aspects of accessibility as set forth in Article 9 of the CRPD, including accessibility in the ICT context which is an important component of humanitarian action in many instances. Issues areas which are sector-specific and are increasingly recognized as requiring more attention include: cash assistance; nutrition. These and other gaps are summarized in Table 4.Table 4: Gaps in Existing ResourcesConceptual GapsSector GapsOtherClarity as to the principles that should underpin the Guidelines (e.g. how to square CRPD, IHL and humanitarian action principles in a way that synthesizes the core principles that should animate the new Guidelines).Nutrition (limited evidence base, practice still emerging)Role of caregiversLack of an IASC Policy on Disability Inclusion in Humanitarian ActionCash assistance (limited evidence base, practice still emerging)Ex-combatants with disabilitiesReasonable accommodation as a core element of non-discriminationLegal access (specific attention to law and process and the multiple barriers that persons with disabilities experience in formal and informal justice mechanisms)Necessity of budgeting for accessibility and related measures.Accessibility and all of its elements, including ICT accessibilityMatrix Approach. Prior IASC Guidelines all adopt a matrix approach, identifying key interventions that should be taken. A challenge with this approach is the formatting of the matrices which poses accessibility challenges. Should highlighting key interventions be considered an essential element of the proposed Guidelines, serious consideration will need to be taken on selecting an accessible and user-friendly design for presenting such content. Also of note is the approach taken with regard to developing the WHO’s CBR Guidelines which commenced with the development of a matrix composed of five overall components, each with five elements and further sub-divisions. Once consensus was achieved on the overall matrix, tasks were allocated among a large core group for development of chapters within each of the five overall components.Table 5. Outline of Options for IASC Guidelines on the Inclusion of Persons with Disabilities in Humanitarian ActionTitle PageForewordAcknowledgementsTable of ContentsList of AbbreviationsPart 1: IntroductionBackgroundOpportunities and Risks: Persons with Disabilities in Humanitarian CrisesGuiding PrinciplesCross-cutting themes and how they are addressed in the GuidelinesPurpose and Use of the GuidelinesPrimary & Secondary Target AudiencesStructure and Format of the GuidelinesPart 2 (Option 1)Part 2 (Option 2)Part 2 (Option 3)Organized According to Response PhasesThematically Organized Guidance-Inclusive of, for instance, the following:Combined Approach-General Guidelines in three phases of preparedness, response and early recovery, and recovery and reconstruction followed by thematic/sectoral sectionsIdentifying key interventions on participation, inclusion and access-ibility, in order to ensure that persons with disabilities are included in humanitarian action.Camp Coordination and ManagementPreparednessProtectionPart 2.1 - PreparednessResponse and early recoveryShelterPart 2.2 Response and early recoveryRecovery and reconstructionWASHPart 2.3 Recovery and reconstructionFood, Water, NutritionPart 3 Thematic/Sector3.1 Camp Management and CoordinationHealth and Rehabilitation3.2 ProtectionEducation3.3 ShelterLivelihoods3.4 WASHInformation and Legal Access 3.5 Food, Water, Nutrition3.6 Health and Rehabilitation3.7 Education3.8 Livelihoods3.9 Legal AccessChapter 3 (or 4 under Option 3). Matrix of Interventions – Guidelines on key actions for protecting and promoting the protection of persons with disabilities in humanitarian action. Divided as to sector and type of response (emergency, minimum response and comprehensive response). Inputs by Task Team members also supports the inclusion of a section on empowerment/awareness which is a pre-condition to the successful inclusion of persons with disabilities in humanitarian action. Note: A major challenge is to provide this content in a user-friendly and accessible presentation and format(s).AnnexesAnnex 1. Glossary of Key TermsAnnex 2. Legal Obligations to Respect and Protect Persons with Disabilities in Humanitarian Action (Table)Annex 3. Plain language summaryCould also include plain language summary at beginning of Guidelines or in the form of key points at the end of every section. May also consider separate products.Annex 4. Bibliography Encompassing all resources cited OR only key resources?Formatted in alphabetical order or by sector/thematic issue area?Recognition of the Guidelines as a “Living Document.” IASC guidelines and other IASC documents routinely emphasize their evolving nature and underscore that they are likely to be periodically updated. This takes on particular importance for a new set of guidelines in an issue area for which the evidence base and good practice is still emerging. Moreover, insofar as the CRPD acknowledges that disability is “an evolving concept,” this lends further credence to viewing these first IASC disability-focused as subject to review and revision over time. Accessible, user-friendly format and design. IASC guidelines specify that IASC products should be “user-friendly” and should avoid, among other things, jargon, dense text and small fonts. Versions for non-specialists, in particular, should be as simple and short as possible. It further states that “[p]roducts can be made more effective and user-friendly by including diagrams and pictures, section summaries for easy reference, setting out minimum requirements, information boxes, checklists,?practical ?do’s ?and ?don’ts, ?and ?best ?practice examples.” It also emphasizes that where the product is to be disseminated electronically, the size of the product file should be consistent with download using low bandwidth.The Task Team should give consideration to the following:What is required in order to make the “main product” (i.e. the Guidelines) as accessible as possible?What additional specifications (beyond the existing IASC product guidelines) are needed for the development stage – e.g., text box formatting that is most conducive to screen readers; color choice in any printed materials; utilization of accessible checkers for PPTs being developed? Should accessible versions be considered for development contemporaneously? For example, should a plain language version be included as part of the Guidelines, perhaps as an executive summary or as an annex?Is an accessibly developed infographic a product worth considering given recent attention to infographics? Any infographics developed separately or for the final product should be developed by someone well-versed in accessibility of infographics.Supporting and ancillary material. After completing?the ‘main?product,’?a variety of supporting materials may be required to reach different target audiences and support application of and learning of the ?‘main ?product’. It is likely that such enhancements will take time to develop after the initial product is released. Taken together these materials are?referred to as the ‘product family’. Note that the first product being developed – the ‘main product’ – does not need to be a printed document. It might be a poster or a power point presentation, which will later be supported by other materials. The Task Team should accordingly consider the following:Will supporting materials be required to reach different target audiences? What other materials might improve the accessibility of the product to a broader audience and to individuals with disabilities who may not find the main product accessible?Peer Review. Past practice supports a robust peer review of Draft Guidelines. In the instant case, peer review should reflect the diversity of sectoral expertise across the Task Team; the diversity of disability; and different geographic perspectives. The IASC Task team on MHPSS engaged a range of experts from the academic field with representatives from around the world in the peer review process which was deemed successful. This was in addition to peer review among Task Team members and also peer reviews organized by individual organizations overseeing various parts of the guidelines (such as the action sheets). Consideration could be given to the establishment of a Blue Ribbon Panel of experts, particularly those involved in the drafting of the CRPD and leading commentaries on it, as this would yield helpful feedback and would confer additional legitimacy on the resulting guidelines (especially if the group is broadly representative of persons with disabilities). This is the process followed in a great many of the leading materials on the CRPD, including practitioner-oriented works produced by UN agencies and others.Annexes BibliographyGlossaryTable of CRPD Article 11 CRPD Committee Concluding Observations & RecommendationsPrinciples that Inform Inclusive Humanitarian ActionTable of Standards and Guidelines that Inform Inclusive Humanitarian ActionMatrix of Key Legal Obligations Mapped Against Humanitarian Action Sectors ................
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