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Turkey: People with disabilities neglected in humanitarian response to devastating earthquakes - new report

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70 percent of injured earthquake survivors are expected to have a disability

People with disabilities living in dire and unsanitary camp conditions

Urgent need to scale up mental health and psychosocial support services

There are clearly fundamental failings in supporting people with disabilities in the aftermath of the earthquakes’ - Nils Muižnieks

People with disabilities living in displacement camps after the devastating earthquakes in Turkey are being overlooked in the humanitarian response to the disaster, Amnesty International said in a new report published today (27 April).

The 29-page report - ‘We all need dignity’: The exclusion of persons with disabilities in Turkey’s earthquakes response - documents how people with disabilities are now living in inadequate shelters, with their dignity and right to health undermined by the authorities’ and humanitarian organisations response to the disaster.

More than 48,000 people were killed and over 100,000 were injured – many of whom lost limbs and sustained other life-changing injuries –- during the powerful earthquakes that struck Turkey in February.

An estimated 3.3 million people have been displaced, with approximately 2.3 million people currently sheltering in tent camps and container settlements. As many as 70 percent of injured earthquake survivors are expected to have a disability, according to a UN assessment

Amnesty recognises the scale and gravity of the humanitarian crisis caused by the earthquakes, but no matter the size of the emergency, the rights of people with disabilities should be fully respected.

The report is based on visits to the following provinces in southern Turkey: Adiyaman, Gaziantep, Hatay and Kahramanmaras. A total of 131 interviews were carried out by Amnesty researchers in March and April with survivors of the earthquakes, documenting the experiences of 34 people with disabilities (10 women, 15 men, and nine children). Interviewees included 19 people with different types of disabilities, 26 relatives of people with disabilities, and 13 aid workers involved in the response.

Inadequate conditions in displacement

In all 21 locations visited by Amnesty, communal sanitation facilities were inaccessible to people with limited or no mobility, a wider pattern confirmed by aid workers. Unable to access toilets, many have become dependent on caregivers and on aid items such as adult nappies.

One woman, a 48-year-old Syrian refugee who has had her left leg and part of her right foot amputated because of diabetes, said:

“I can’t manage to use the shared toilets. My relatives have to help me to move from my wheelchair to the commode (toilet chair) and then they have to empty and clean the commode every time I use it… We all need a bit of privacy and dignity, but it is very difficult in these circumstances.”

Nurcan, a 32-year-old woman with a physical disability who relies on family to carry her to facilities in the camp, said:

I can’t use the toilet. I can’t take a shower… I can’t eat well. I’m afraid if I eat here the way I ate before, that I would need to [be carried] to the toilet.”

A 13-year-old girl who lost her right leg in the earthquake which also killed her mother spoke to Amnesty about her experience. She has been forced to use nappies, and relies on her 18-year-old sister to change and clean her. Her sister said:

“She can’t use the commode because it is too unstable and if she falls this would be very dangerous for her amputation wound… Sometimes I feel it’s a nightmare, but then I realise that it is reality.”

This emergency response falls short of human rights obligations as well as humanitarian principles of inclusivity and non-discrimination. Almost every person with a disability who Amnesty interviewed – including older people with limited mobility – had to rely on relatives, as they could not collect food and other aid such as hygiene kits from distribution points.

Urgent need for specialist health services

Amnesty also documented a shortage of suitable assistive devices – such as wheelchairs – and the interruption of specialist care, such as rehabilitation services.

Bahir Ghazi, 58, who lives in a camp for displaced persons in a central part of Antakya, said that his two daughters with physical disabilities, aged 22 and 32, visited a physical rehabilitation centre twice a week, but the building collapsed during the earthquake. No alternative has yet been provided.

The earthquakes caused massive interruptions to health services, including those for people with disabilities, due to the complete collapse of or severe damage to facilities and the death, injury and displacement of personnel.

Amnesty also found that there is an urgent need to scale up mental health and psychosocial support services to address existing and developing needs.

Fadime Cetin, 51, is a cancer patient who supports her husband with Alzheimer’s disease and two children with disabilities told Amnesty how her family was pulled from under the rubble five days after their three-storey building in Kahramanmaras city collapsed, killing several family members.

Fadime said the safety of her 17-year-old son, who has a mental health condition, is a constant concern. She said

“sometimes he grabs women’s headscarves… When he does these things, [people] beat him and insult him”,

and that he sometimes wanders off in the street near their informal displacement site and sits amid traffic. As a result, she feels she has to tie one of the boy’s feet to a wood pallet outside their tent during the day to restrict his movement. She added:

“Inside [our] house, we didn’t used to tie him. He was free at home.”

Melek, 35, currently lives with her three children and in-laws in a tent encampment in Narli outside Kahramanmaras city. She described how her five-year-old daughter has been exhibiting signs of distress since the earthquake, including speaking in her sleep. Melek said:

“Sometimes when I wake her up to go to the toilet, the first thing she asks me, ‘Is there an earthquake?’”

Inclusive humanitarian response needed

Turkey is a state party to the Convention on the Right of Persons with Disabilities, and as such the Turkish government is required to take measures to promote, protect and ensure the full and equal enjoyment of all human rights and fundamental freedoms by all people with disabilities.

The Turkish government and humanitarian organisations must ensure that people with disabilities and their carers are properly supported, including by making sanitation facilities accessible and improving aid delivery. This should also include systematically collecting and analysing data with disaggregation by age, gender and disability, that should be made available to humanitarian organisations and agencies involved in the emergency response to ensure adequate and efficient needs-based service.

Matthew Wells, Amnesty International’s Deputy Director for Crisis Response Research, said:

"The immense hardship faced by so many in the aftermath of the earthquakes has been compounded for people with disabilities, who have been neglected in the humanitarian response.

“A ‘one size fits all’ approach to emergency shelter arrangements excludes specific requirements for people with disabilities to live with dignity, and renders many of them unable to access relief on an equal basis.

“The Turkish government and humanitarian organisations, including international donors, must take immediate action to ensure that the humanitarian response is inclusive for all survivors, including people with disabilities. Their needs must be addressed by providing much-needed specialist support.”

Nils Muižnieks, Amnesty International's Europe Director, said:

“There are clearly fundamental failings in supporting people with disabilities in the aftermath of the earthquakes. The effects of this humanitarian disaster will be felt for generations. It is crucial that people with disabilities have equal access to facilities and services.”                         

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