Friday, 7 September 2012

Project:1 A study on causes of disability in Syria during the Revolution, with focus on military operations against the civilians


Terms of Reference

Estimates indicate that anywhere between 5  and 10 percent of the Syrian population are persons with disabilities (2008). Conflict situations increase the vulnerability of persons possessing already a disability and raise the number of newly disabled persons. That happens indirectly by breakdown of social structures and services like family links and health and other infrastructures the persons with disabilities rely on, and directly by casualties caused by weapons, mines, bombs and other explosives.

The Syrian military operations against the Syrian people represents a grave breach of the Geneva conventions of 1949, according to international humanitarian and human rights agencies; these include the use of banned arms against civilian targets and in densely populated areas; extensive destruction of the civil property including hospitals, schools, places of worship and the people’s homes while they are still in them without prior warning.


According to conservative estimates, the Syrian upraising has resulted in over 29,338 people killed. These include 2,230 children, 2,517 woman and over 1500 elderly people, the number of wounded has exceeded 63,400.[1]    Many of the wounded will most certainly be left with permanent and life-long disabilities. Additionally, there is no information about the persons with disabilities in Syria, the difficulties they faced during the constant bombardment in an area where there are few shelters for those without disabilities let alone safe havens accessible to persons who are disabled.

The Syrian military operations against the Syrian people during upraising generated thousands of casualties (63,400)[2]  August 2012, although there are no clear statistics for the number of persons left disabled because of the military operations in Syria, but casualties caused by gunshot, bombs and other explosives increased the number of persons with disability . The Syrian authorities’ war against the people of Syria has caused long-term and, permanent disabilities in large segments of the Syrian population.  Furthermore, civilians wounded in protests or other incidents related to the uprising as documented by Amnesty International and Doctors Without Borders include, denial of medical care; obstruction of ambulances on their way to pick up wounded people; lack of basic medical supplies; in addition to torture in detention places. [3]& [4]

The unjustified blockade and the present military operation against the people of Syria have had a devastating impact in particular on persons with disabilities and their related services. Emergency services in Syria are limited now and for the most part inaccessible which have resulted and will continue to result in serious threats to persons with disabilities.

Many of those who were injured during the military operations sustained permanent disabilities owing to the severity of their injuries and/or the lack of adequate and timely medical attention and rehabilitation.  Syrian hospitals reportedly had to discharge patients too early so as to handle incoming emergencies.  Many injuries cases resulted in amputations or disfigurement. Many injured persons are expected to have long-term disabilities. (e.g. brain injuries, amputations, spinal injuries, hearing deficiencies, mental health problems) as a result of the military operations. It reported speculations that there might be some hundred cases of amputees; while the exact number of people who will suffer permanent disabilities is still unknown. We understands that many persons who sustained traumatic injuries during the conflict still face the risk of permanent disability owing to complications and inadequate follow-up and physical rehabilitation.

Many persons with disabilities were wounded fighting for freedom and dignity, and we have to provide them with the dignity they were fighting for.  We need urgent action to start immediately assessing the implication of military operations on disability during the Syrian upraising with the aim of gaining knowledge and information on the living conditions of persons with disability and their need for rehabilitation.

The UN Convention on the Rights of Persons with Disabilities, 2006, (which was ratified by Syrian Government in 2008) determines that all necessary measures to ensure protection and safety for persons with disabilities in situations of risk, including situations of armed conflict …“have to be taken. The rights of persons with disability need to be protected in accordance with the Universal Declaration of Human Rights, , the International Covenant on Economic, Social and Cultural Rights.   Up to this date, there are no studies, research or any kind of information on injured persons and persons with disabilities as a result to the military operation in Syria.  Urgent efforts needed to address the needs of  persons with disabilities and their families with the aims of mainstreaming rehabilitation programmes in all planned emergency and humanitarian programmes that will be implemented  by the UN and other international NGOs. 

Primary objective:

1-      To collect appropriate information, including research data on persons with disabilities during the uprising in Syria to enable UN agencies and international and national organizations to provide emergency rehabilitation programme for persons with disabilities in Syria.

Secondary Objectives

1-               To investigate the causes of disability in Syria during the uprising, using the two studies and testimonies prepared on the Health situation in Syria prepared by Amnesty International and Doctors Without Borders  as a baseline information, more specifically:

·       preventing ambulances to rescue injured people by armed and security forces;
·       denial of medical care and treatment and violence at the hospitals;
·       Torture and denial of medical care at detention facilities.
·       Lack of  rehabilitation services and emergency assistance for people with disability

2-               Assessing economic, social and psychological impact of depriving persons with disabilities from rehabilitation, emergency and humanitarian services during the upraising;
3-               Needs assessment for the rehabilitation and emergency for persons with disabilities in Syria;
4-               Help in mobilizing resources for the Coordination Committees, NGOs ,and Field Hospitals, to provide rehabilitation services to persons with disabilities (surgeries, rehabilitation equipment, Prosthetic devices, and other operation expenses);
5-               Public awareness on disability issues with the aim highlighting their needs and  mainstreaming services of persons with disabilities in all programmes and activities.


Methodology

•        A questionnaire (Annex 1) will be posted on all websites related to the Syrian Revolution in order to collect the needed information on the causes of disability and the rehabilitation services needed.

•        The questionnaire will be sent to all coordination committees, medical committees, field hospitals, NGOs, and  health committee at the refugee camps

•        Focus groups with medical and rehabilitation team, health and social workers and volunteers working to support injured and persons with disabilities on the causes of disability and the rehabilitation programmes needed.

•        Analysis of the causes of disability during the military attack on Syrian people, and the need for rehabilitation programme will be conducted by a group of experts with the aim of preparing an analytical report, including findings and recommendations.

•        A workshop will be organized to discuss the findings of the report.with the team members

•        The report will be distributed to all UN agencies and organizations concerned with disability rights, humanitarian and relief agencies in order to mainstream services for persons with disability in their humanitarian programmes for Syria, and start planning for rehabilitation programmes.

•        An awareness campaign on  the rights of persons with disabilities will be conducted throughout all the period to highlight the needs for rehabilitation and accessibility.

Timeframe

1 September – 30 October 2012:  Posting and distribution of questionnaire
November 2012: preparing the study and organizing the workshop
December 2012: finalizing and distributing the study.

The Study Team:

-        Team Leader:
-        Principle researcher: 
-        Team members: 
-        Field investigators:



Appendix Annex: 1
   
QUESTIONNAIRE 
PERSONS WITH DISABILITIES IN SYRIA


Section 1: Basic Information

Name of the Respondent:……………………………………………………………….

Region………………………………………  Urban………… Rural…………………….. 

Date of Interview: …………………..

I declare hereby the information collected is true and accurate and these are collected in line with the instruction.

Name of Interviewer:………………………………………  

Signature of Interviewer: 

Name of Supervisor :………………………………………  

Signature of Supervisor:


Type of disability: 

1.      Hearing impairment  …………………....
2.      Speech Impairment ……………………….
3.      Visual Impairment  ………………………..
4.      Physical impairment ………………………
5.      Intellectual Disability ……………………..
6.      Psychological problems
7.      Multiple Disability (if one have more than one Impairment)
8.      Others (specify) ………………………..
9.      Not applicable ………………………….

Section 2: CAUSES OF DISABILITY

•        gunshot
·                   bombs
·                   other explosives
·                   wounded in protests
·                   other incidents related to the uprising
·                   house demolition
·                   airplane attack
·                   accidents during escape
·                   others

•        Preventing ambulances to rescue injured people by armed and security forces

o       Availability of ambulance 

o       Ambulance allowed to reach hospital

o       Ambulance have  medical personnel

o       Others


•         Denial of medical care and treatment and violence at the hospitals

o       Medical care provided

o       Patient dismissed without treatment

o       Patient was treated with violence

o       Patient was punished

•        Patient treated at “Field Hospital”

o       Field hospital  have facilities (beds, medical supplies, etc)

o       Field hospital have medical personnel (doctors, nurses, volunteers)

o       Field hospital have capacity for surgeries

o       Difficulties to reach field hospital

•        Torture and denial of medical care at detention facilities

o       Security forces prevented medical treatment

o       Patient had a health problem

o       Patient was tortured

o       Medical treatment denied    


Section 3: REHABILITATION SERVICES NEEDED BY PERSONS WITH DISABILTIES

o       Did the PwD have the necessary rehabilitation equipment (wheelchair, crutches, hearing aids, eye glasses, etc.)

o       The equipment provided by  (Field hospital, registered NGO, volunteers,  Red Crescent, Medical committee, etc)

o       Did the PwD have any kind of  rehabilitation services:

o       Physical treatment

o       Psychological help

o       Social support

o       Humanitarian/ emergency assistance

o       Others

Individual needs for PwD

o       The need for surgery, please provide details.
o       The need for  special treatment, please provide details:
o       The need for prosthetic devices:
o       Leg  amputees
o       Arm amputees
o       Other needs

Section 4:  LIVING CONDITONS OF PERSONS WITH DISABILITIES

•        Accommodation

o       Lives with parents
o       Lives with  other members of family
o       Lives with friends
o       Lives with other, specify

        Transportation

o       Public transport (bus, taxi, etc)
o       Family support
o       Do not have the ability to move

•        Living expenses

o       Family support
o       Friends and neighbors
o       Charitable support form NGOs
o       Humanitarian assistance from Red Crescent
o       Humanitarian assistance form international organizations
o       Others

•        Cost of health care

o       Provided free by public hospital
o       Private health center
o       Field hospital
o       Others

•        Independence

•        PwD in need of assistant all the time
•        Partially independence
•        Independent

•        Social life

o       Married
o       Single
o       Friends
o       Others

•        Other issues needs to be considered related to the PwD.







[1] Network for Solidarity with Syrian People, 31 August 2012. https://www.facebook.com/Solidarity.Network.For.Syrian.Revolution
[2] Network for Solidarity with Syrian People, 31 August 2012. https://www.facebook.com/Solidarity.Network.For.Syrian.Revolution
[3] Amnesty International, Health crisis: Syrian government targets the wounded and health workers, 2011.  This report is based on research conducted in August and September 2011. Interviews were conducted with individuals wounded during the ongoing disturbances; relatives of those wounded and subsequently detained; relatives of people with firearm and other injuries related to the ongoing unrest; and health professionals and medics, including surgeons, doctors, nurses and other hospital employees. Government surveillance and restrictions on means of communication, and the poor quality of the internet connection in Syria were among the obstacles to research.
[4] Doctors Without Borders, SYRIA: Medicine as a Weapon of Persecution: These testimonies from injured people and doctors from across Syria were collected by Médecins Sans Frontières/Doctors Without Borders (MSF) staff between January 30 and February 6, 2012.

No comments:

Post a Comment