“A devastating toll”: COVID-19 and intersecting forms of discrimination

This blog is an excerpt from a webinar presentation made by Gertrude Oforiwa Fefoame in June 2020. The webinar, hosted by the International Disability Alliance and International Disability and Development Consortium, focused on how to have a response to COVID-19 that is compliant with the UN Convention on the Rights of Persons with Disabilities.

COVID-19 has had a significant impact on equality for people with disabilities. Despite the pre-existing inequalities faced by all people with disabilities, COVID-19 poses an even greater risk to marginalised groups comprising women, girls and older people with disabilities. Many other underrepresented groups such as indigenous populations, refugees, migrants, prisoners, homeless and other minorities with disabilities are equally at risk.

Disability in itself does not make a person vulnerable, but attitudinal, environmental and institutional barriers posed by society can put someone in a vulnerable position. These barriers include marginalisation, inaccessible physical environments and information, communication barriers and stigmatisation.

The committee that monitors implementation of the United Nations Convention on the Rights of Persons with Disabilities (CRPD) has a General Comment (a document expanding on the Convention’s articles) on equality and non-discrimination. This defines intersectional discrimination as “when a person with a disability or associated to disability suffers discrimination of any form on the basis of disability, combined with, colour, sex, language, religion, ethnic, gender or other status.”  For instance, older women with disabilities may face intersecting forms of discrimination based on their gender, age and disability. The COVID-19 situation has therefore greatly exposed the huge health care and social protection gap for all people of the world but particularly for marginalised people with disabilities. This then places them at greater risk of exclusion.

For many people with disabilities, support care services are essential for a safe, healthy and independent life. Measures to curtail COVID-19 have seen significant disruption to services, support systems and informal networks such as personal assistance, sign language, exercise regimes and socialisation. Limited access to information by marginalised people with disabilities also hinders their right to access preventive and treatment services during the pandemic. This has implications for poorer health outcomes and makes people with disabilities susceptible to co-morbidities such as lung problems, diabetes, heart disease and obesity and eventually death from COVID-19.

Women and girls with disabilities are more at risk of domestic violence, abuse and neglect as social isolation measures are increasing gender-based violence. Most women and girls with disabilities are now ‘locked down’ at home with their abusers. Article 6 of the CRPD highlights the issue of multiple discrimination faced by women with disabilities and requires states parties (UN member states that have ratified the CRPD) to put in place measures to safeguard their health and wellbeing.

As most women with disabilities work in informal sectors, restrictive measures meant to contain the spread of COVID-19 are having a devastating toll on their economic and social wellbeing. The role of women as caregivers at home and in care institutions, as well as female-headed households, places them in precarious situations that threaten their livelihoods and deepen poverty levels. This reduces their access to financial resources to stock for essential food, medicine and services to sustain themselves and their families. The short and long-term implications for their livelihoods are deepened as unemployment figures are increasing exponentially across the world.

Women and girls with disabilities risk being excluded in policy conversations and decisions due to their low participation and inclusion in political and governance discourse. And due to fear of infections, many women and girls with disabilities are distancing themselves from health facilities, depriving themselves of needed critical care in situations of pregnancy and other sexual and reproductive health situations.

Older people with disabilities may face intersecting forms of discrimination based on their age, the possibility of an underlying health condition and disability. They are at a higher risk of severe disease and mortality following infection with COVID-19. Globally, an estimated 46% of people aged 60 years and over are people with disabilities. Almost 66% of people aged 70 and over have at least one underlying condition placing them at increased risk. Age discrimination in decisions on medical care and life-saving therapies may highly affect the health outcomes of older persons with disabilities.

As the pandemic is having a devastating toll on care homes across the world, older people are facing distressing situations of violence, abuse, neglect and mistreatment. The COVID-19 situation is also threatening the social and economic wellbeing of older people as their social networks and interactions, as well as economic ventures, have been highly affected by social distancing protocols and stay-at-home orders. This inadvertently affects their health, physical and psychosocial wellbeing.

Article 11 of the CRPD obliges states parties to ensure the protection and safety of people with disabilities in situations of risk. The following are suggested ways by which states parties can contribute significantly to non-discrimination against marginalised people with disabilities:

• Ensure that all marginalised people with disabilities, including older people and those with underlying health conditions, are given priority for testing and care.
• Consciously implement interventions that ensure equality and non-discrimination in access to health and other related services.
• Ensure that marginalised persons with disabilities receive the quality health care they need, when they need it, without incurring financial hardship. This requires the removal of barriers experienced by most people with disabilities in accessing affordable, quality health care, water, sanitation and public health information during and beyond the pandemic.
• Make disability inclusion an essential aspect of pandemic responses by working with people with disabilities and their representative organisations to ensure that responses account for the needs of all persons with disabilities, particularly women, girls, older people and other underrepresented groups.
• Coordinate short and long term recovery initiatives using the SDGs and CRPD as the key frameworks to promote the agenda of leaving no one behind.
• Build sustainable, disability-inclusive social protection systems that provide solutions to marginalised persons during and after the pandemic (for example, ensure now that there are no disruptions to social protection payments).
• Ensure distance learning is accessible and inclusive of students with disabilities and that return-to-school programmes are inclusive of children and young people with disabilities in recognition of the increase in the learning gap for these students.
• Make sure disability indicators (which measure progress towards specific targets, for example the number of people with disabilities accessing health services) are included when data is collected and when COVID-19 responses are being planned and provided.
• Invest in community-based solutions to initiate, accelerate and complete deinstitutionalisation strategies and transition to community based-solutions.

Global advocacy actions around disability have consistently called for inclusion and a rights-based model to dealing with the barriers and discrimination facing people with disabilities. Article 5 of the CRPD emphasises non-discrimination and equality as the building blocks to ensure that no one is left behind during COVID-19. Equality in all fields should be enshrined in laws and policies. COVID-19 interventions and responses must reflect and address the multiple and intersecting forms of discrimination faced by persons with disabilities, to ensure that the most marginalised groups are not left behind.