Executive Summary
The needs of crisis-affected populations with disabilities are notably absent from global sexual and reproductive health (SRH) and gender guidelines and standards for humanitarian practice, despite the fact that Article 25 of the Convention on Rights of Persons with Disabilities (CRPD) states that persons with disabilities should have the same range, quality and standard of free or affordable health care, including in the area of SRH, as provided to other persons.
The Women’s Refugee Commission (WRC), the Association of Medical Doctors of Asia–Nepal (AMDA), the Nepal Disabled Women Association (NDWA) and the National Federation of the Disabled Nepal (NFDN), in coordination with the United Nations High Commissioner for Refugees (UNHCR), undertook a qualitative assessment of the specific risks, needs and barriers for Bhutanese refugees with disabilities to accessing SRH services in Beldangi refugee camp, Damak, Nepal.
Their capacities and practical ways to overcome these challenges were also examined. The target population of refugees was those with long-term physical, intellectual, sensory and mental1 impairments who experience barriers in society that hinder their full and effective participation on an equal basis with others. This group included women with disabilities aged 20-49 years; men with disabilities aged 20-59 years; and adolescent girls and boys with disabilities aged 15-19 years.
Caregivers and family members of adolescent or adult refugees with disabilities were also consulted.
Participatory methods, based on a literature review and consultative processes, were applied. Participatory activities among refugees with disabilities included: mapping, sorting and timelines to explore knowledge of the reproductive system and fertility; community perceptions surrounding persons with disabilities and their SRH; barriers to accessing information and services; perceptions on how society treats persons with disabilities; and risk and protective factors. Activities among family/caregivers spurred discussion regarding new experiences and concerns that emerge as a result of a child maturing into a teenager or an adult, and experiences seeking health care for their child/family member with disabilities. Persons with disabilities were recruited as part of the study team from NDWA, NFDN and its local chapter—Damak Disability Helping Committee (DDHC)—to utilize their skills and capacities and facilitate empowerment processes.
This study among refugees with a variety of disabilities in the Bhutanese refugee camps is one of three studies exploring the intersections between SRH and disability in humanitarian settings. In the Damak study, a total of 89 refugees with disabilities participated, of whom 50 were women and girls, and 39 were men and boys. Fifteen caregivers and family members of refugees with disabilities were also engaged.