Daily Times

There has recently been a flurry of scholarly publications by international humanitarian organizations to perhaps compensate earlier oversight or academic guilt signifying increasing disability consciousness especially around World Disability Day. The United Nations Convention on the Rights of Persons with Disabilities (UNCRD) highlights the situation of disabled persons affected by humanitarian emergencies and calls for inclusive humanitarian intervention. The needs of persons with disabilities (PWD’s) requires to be responded on emergent basis yet at the same time it is imperative for contemporary systematic humanitarian intervention flowing from trends in research.

There is surprisingly no mention of health and social costs to the citizens of Pakistan in any government stance especially the inhabitants of the tribal areas arising from acts of terrorism. The Economic Survey of Pakistan for 2016-17 says that over the past 16 years the direct and indirect cost incurred by Pakistan due to incidents of terrorism amounts to USD 123.1 billion without any evidence being shared. Historically speaking PWD’s have been neglected within humanitarian programs targeted at internally displaced persons (IDP’s) resulting in unmet needs and diminished opportunities to improve the quality of life (QoL) of IDP’s with disabilities.

Recent research conducted on the IDP’s in Pakistan in the Federally Administered Tribal Areas has established that significant information gaps exist as to the intensity and extent of widespread disability in IDP’s, particularly children being vulnerable and exposure to trauma resulting in stress bringing about communication disorders. Disability in IDP’s in the tribal areas of Pakistan is shown in recent research to be associated with impact of shell shock. These IDP’s are citizens of Pakistan. Hearing, an invisible disability, is one of the four disabilities recognised by WHO. Females with disabilities are more disadvantaged in terms of gainful employment, enrolment ratio for schooling and marriage with corresponding compromise on QoL. There is an urgent requirement to quantify this information gap by investigating health associated wants of IDP’s with communication disabilities and how these needs can be overcome in the context of displacement camps housing IDP’s being Pakistanis.  These IDP’s remain unnoticed in terms of health planning by the federal and provincial governments and access to basic health services is denied to IDP’s let alone addressing their disability specific needs. In the IDP camps no intervention or rehabilitation services exist for children condemning them to a life of lowered QoL. Prominent disability related communication disorders include stammering, delayed speech in children and lack of timely detection of hearing loss in infants. Access to appropriate health and rehabilitation services for persons with disabilities is an essential human right incorporated in the UNCRPD also acknowledged as warranting close attention in UN’s Executive Committee’s Conclusions on displaced PWD’s yet the policy planners in Pakistan pay scant regard to the plight of IDP’s in Pakistan and are yet to enact a legal framework for the protection of IDP’s. Consequently no domestic IDP health status ascertainment institutional mechanisms exist at the federal or provincial level. Though WHO intervention and support is visible in epidemics of communicable diseases in the IDP camps specialized health needs extending beyond basic primary health care is conveniently ignored perhaps as no sensationalism is involved. The Convention on the Rights of Persons with Disabilities is the most assented of human rights treaties. Dislocation increases risk of injury and thus disability acquisition. Studies in the tribal areas on IDP’s disclose that instances of communication disorders are mounting amongst IDP’s in families compelled to flee their homes in order to avoid the brunt of terrorism related violence. Certain communication disorders are higher in female IDP’s routinely encountering psychological trauma whenever they are displaced on account of terrorist attacks or imminent threats.

Recent research conducted on the IDP’s in Pakistan in the Federally Administered Tribal Areas has established that significant information gaps exist as to the intensity and extent of widespread disability in IDP’s, particularly children being vulnerable and exposure to trauma resulting in stress bringing about communication disorders

Anxiety caused in children of IDP’s due to exposure to a stressful situation including forced evacuation from home under threat of terrorist attacks and even violation of human rights by law enforcement personnel leads to communication disorders despite having no family history. Displacement of IDP’s results in low self esteem and insecurity in children leading to various other disorders occurring on account of sounds of explosions above certain decibels in near proximity and even disease may cause hearing loss in children and infants remaining undetected. Children of IDP’s in Federally Administered Tribal Areas vis-à-vis similarly displaced populations and their children suffering from perinatal trauma requiring hospitalisation may suffer brain damage caused as a result of unhygienic conditions in IDP camps leading to multiple infections. Such infections cause chronic health hazards resulting in disabilities among the newborn and absence of qualified medical care is the outcome of policy failures. The nefarious designs of the enemies of Pakistan can be countered by treating the IDP’s suffering from health disorders, as distinct from refugees, by providing access to age appropriate disability specific intervention and health rehabilitation services to enable them to enter mainstream activity as productive citizens of Pakistan. The government can share evidence with the international community as to the extent of health and incidental social costs directly caused by terrorism induced displacement as established by recent research undertaken highlighting IDP’s plight.

The writer is PhD Rehabilitation Sciences, has done Fellowship in Clinical & Research Neuro Rehabilitation, Department of Rehabilitation Medicine from Seoul National University Hospital, South Korea

Published in Daily Times, December 14^th 2018.