According to a United Nations spokesman, "Every hour people are being
killed, or being maimed and becoming permanently disabled in Syria." So
many horrors are occurring that it is impossible to provide an exact
number.
When we asked the Medical Health Commissions for the Syrian
Revolution and the field hospitals medical teams about the estimated
number of either temporary or permanently disabled people resulting from
military operations, we received these answers: "We can't tell," or "We
don't know." One of the Doctors said “I have seen many persons lose
eyes, hands, feet or arms as a result of war and other random acts of
violence, and the families lack the fundamental infrastructure to care
for the people--the men, women and children who become disabled."
According to conservative estimates, the Syrian military operations
have resulted in over 70,000 people killed. These include 10,000
children, 8,000 women and over 4,000 elderly people, the estimated
number of injured/ wounded has exceeded 300,000 persons. Many of the
wounded will most certainly be left with permanent and life-long
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 filed 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 and seeing deficiencies, mental
health and psychological problems) as a result of the military
operations. It reported speculations that there might be some thousand
cases of amputees; while the exact number of people who will suffer
permanent disabilities is still unknown. We understand 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.
The world's efforts to deal with the challenges facing people with
disabilities in Syria are abysmal. The fundamental rights of disabled
persons are consistently violated, and few organization are doing a
professional work to provide rehabilitation services for persons with
disabilities, but the need are much greater than their capacities.
Disability Rights, Syria (DRS) was established in August 2012,
from group of Syrian experts in disability, medial officers,
rehabilitation workers and persons with disabilities, hoping to be able
to contribute to the protecting the Rights of Disabled Persons in Syria,
especially during the Syrian Revolution
All members of this group are working towards promoting the rights of
persons with disabilities. Our guiding principles are: No
discrimination, equality of opportunity, effective participation in
society, accessibility and full integration into the society.
The Disability Rights, Syria was established as a response to the
urgent needs of persons with disabilities who were deprived from all
kinds of medical and emergency support and rehabilitation services.
The DRS works inside Syria, with the medical hospitals and local
coordination committee and NGO’s, and with neighboring countries hosting
Syrian refugees.
DRS is working with several projects and is preparing a continuous
needs assessment of the war injured in Syria and Refugees persons with
disabilities in neighboring countries (Jordan, Lebanon, turkey, and
Iraq).
The Rapid Assessment of Disability (RAD) project aims to improve the
lives of people with disabilities and their communities by enabling
humanitarian organizations to seek reliable and comparable information
about people with disabilities, which enables the design and evaluation
of effective programs for all.
It aims also to design rehabilitation projects which include or
target people with disabilities, as the implementers of development
activities need information about people with disabilities and the
barriers they face.
The 1st phase of the rapid assessment of disability was
conducted combining survey instruments and focus group discussions with a
view to collect both quantitative and qualitative data. It targeted war
injured persons with disability in Syria. The Preliminary results
obtained showed in particular unmet needs, assistance and protection
gaps, and critical psychosocial conditions of persons with disabilities.
The conditions in which the majority is living are often completely
unhygienic, and most of their rehabilitation needs are not met.
Therefore, the assessment has confirmed that this group of persons
needs to receive comprehensive rehabilitation services and attention
that can reduce the negative impact is having on their physical, health
and social condition.
According to the result of the 1st phase of the Rapid Assessment of Disability (RAD) the following needs are identified:
Mobility and Prosthetic Equipment
Most of the persons with disabilities need mobility devices. They
need tricycles, wheelchairs, artificial limbs, corsets, and so on, to
facilitate their physical mobility. However mobility devices are not
available in Syria which makes it difficult for most of those who need
them, especially in the rural areas to access them. There is need to
support locally made mobility devices and to increase their outlets in
the rural areas. This will make the mobility devices more affordable and
easy to maintain. There are urgent needs for prosthetic devices as
most of the persons with disabilities, spend most of their time in bed,
they lack the needed equipment to make them able to move and depend on
themselves. Also there are needs of colostomy bags, special anti-bedsore
mattresses, pain relief medication, and anti-coagulants.
Post-Traumatic Stress Disorder (PTSD) Support
Many war victims with disabilities were traumatized and they need to
be supported to overcome trauma. Many were reported to have lost
self-esteem and thought that they could not do anything on their own,
that they had to be dependents. There is need for counseling services,
social and economic support for the injury victims.
Such horrific experiences have resulted in victims suffering from
various types and degrees of Post-Traumatic Stress Disorder (PTSD) which
require extensive and on-going psychological support to assist victims
to cope with what has happened to them in the long term, and to improve
their quality of life.
Medical and Rehabilitation Care
There is a need to enhance the coverage, effectiveness and sustainability of medical care and rehabilitation services for war survivors in Syria. The
medical care and rehabilitation of war injured persons require a
comprehensive approach, for example the limb amputation patients
involves a comprehensive, multidisciplinary approach as the patient
progresses from initial triage, pre-operative assessment and
resuscitation to amputation, prosthetic fitting, rehabilitation and
eventual community reintegration. Psychosocial services should still be
integrated as early as possible in the pre-deployment planning.
There are needs to establish a Community-based Rehabilitation Programme (CBR)
in Syria in order to reach war injured with disability in all areas
and communities in Syria (CBR is a bottom-up, multi-sector strategy that
works towards "community-based inclusive development" by including
community stakeholders, including people with disabilities, in
development programmes). The CBR programme will be designed to support
the inclusion of people with disabilities in health, education,
livelihood, social, skills training and other services at community
level.
Information Management System
There are several organizations providing rehabilitation support to
persons with disabilities, but there is no coordination or collaboration
to unify efforts to provide reliable rehabilitation services to war
injured. Field hospitals, community groups have started some programmes
to provide rehabilitation services for disabilities, but it was evident
that there is a great need for networking between different groups as
the activities of the different players in the rehabilitation process as
are loosely linked. Disability Rights, Syria will work to coordinate
and strengthen linkages between the different players to ensure
effective service delivery.
There is a need to develop a networking system and an effective
referral system to rehabilitation services in places that is available
inside Syria or in the neighboring countries. There is a need for
regular compilation of data and reports regarding rehabilitation
activities (Rehabilitation Management Information System RIS) to ensure
effective follow up and support to the service providers and the target
population. This will require identification and registration of injured
war victims, by the community workers. Disability Right, Syria has
established an online registration system for Syrian war injured that
will be used for effective delivery of rehabilitation services.
Community workers are visiting the war injured persons and registering
the cases in a special questionnaire that is used to compile the
rehabilitation management information system.
Children with Disabilities
Among the injuries that are usual causes of permanent disabilities in
children during armed conflicts are injuries to the brain and spinal
cord, bone deformities in the arms and legs and loss of sight, hearing
or mental capacity. That is to say, diseases producing disabilities,
spread again during the crisis, such as meningitis, tuberculosis,
poliomyelitis, etc., have now been joined by diseases that are the
result of war and of lack of care, such as: compound fractures, bone and
tendon infections and deformities due to delay in medical care or lack
of proper treatment.
Provision of medical treatment, prosthetic and orthotic devices, and
other assistive devices and mobility aids, and physical therapy
treatment. The need for the same as adults but with specific
measurement for children.
Capacity building
Capacity building for the health care providers within the NGO’s
members, and CBR workers at community level. Training is needed on
treatment of war surgery, post-op rehabilitation, and home care for
war survivors. This aims at strengthening the practices and procedures
about war victims’ care for rehabilitation team members through
continuing education and training.
Also there are need to provide assistance and training, for national
rehabilitation team in Syria responsible for providing rehabilitation
support in field hospitals, and community workers operating at the
community level in delivery of services to the disabled. The technical
assistance and training, which would be carried out both within Syria
and in neighboring countries, would be focused on developing capacity to
assess disabilities requirements and provide emergency care, including
physical therapy.
Other training needed is on the specialized appropriate medical
support to be provided in the right time mainly patients received
amputations. Primary intervention for complex severe wounds and
fractures could potentially have been salvaged if the appropriate
medical support is provided in the right time. Such as training of
medical officers to optimize resuscitation and wound management in the
early stages of limb injury.
The needs are so great, most of the war victims we talked to
they do not know what to do or where to go for rehabilitation
services. The need is beyond our capacity, but through coordination
and cooperation with other national, regional and international agencies
working on the ground we need to start a programme that will expand and
develop to become a sustainable programme for supporting war victims
and persons with disabilities during the revolution, during the
transition period and until we have a new Syria that is capable of
providing protection and a sustainable rehabilitation programme for all
its citizens.
We need international support so that our people live a life of
normality, of dignity, of liberty and freedom. I hope that our cry for
freedom may be heard. These war injured persons with disabilities paid
the price for our freedom and it is their rights to provide them with
the dignity and rights they are entitled to.
Horror is something to which we are subjected every day, we see all
kinds of disability, we see the suffering of people who have lost part
of their bodies, we see the fear and the anger of families, and we see
so many horrors. Some suggest that we are becoming immune to the sight
of such horrors, others bemoan our children's exposure to such images
but, whatever opinion is voiced, it seems that the graphic depiction of
human misery is one of the 'benefits' of contemporary media news
services.
There is, however, a horror which has remained almost invisible: the
ongoing and, in many cases, the systematic, abuse of disabled people.
Contrary to what some would have us believe, human rights are not a
sword to smite good intentions; they are a shield to deflect oppression.
Human rights, for example, by the Universal Declaration of Human
Rights, should be a minimum below which no society falls. Instead, they
too often remain an ideal to which many can only aspire.
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