As the number of migrants grows, there are certain groups with specific vulnerabilities that are proportionally increasing in number. Migrants are not a homogenous group, as each individual and family have their own backgrounds, unique struggles, and goals and dreams. In the last decade, proportions of migrants and refugees with disabilities have increased (IOM, 2016).
Migrants, refugees, and asylum seekers with disabilities face unique challenges in their countries of origins, space of transition/migration journeys, and the places in which they resettle. Many asylum seekers and refugees fleeing areas of conflict procure various impairments during the migration process (Arsenijević et al., 2018). Despite international frameworks aiming to protect the human rights of people on the move and people on the move with disabilities, a lack of attention to the intersection between the two has created gaps in research, policy, support programmes, and legal protections (Pisoni, 2021).
This online resource outlines the challenges that migrants, asylum seekers, and refugees with disabilities face, as well as suggested policy solutions to improve the efficacy of refugee-assistance services for those with disabilities.
An estimated 1.3 billion people globally are experiencing a significant disability, accounting for 16% of the world’s population (United Nations (UN), 2023a). The UN Convention on the Rights of Persons with Disability (CRPD), defines persons with disability as “those who have long-term physical, mental, intellectual or sensory impairments, which in interaction with various barriers may hinder their full and effective participation in society on an equal basis with others.” Prior to the development of the CRPD, there were no existing international human rights treaties that outlined and protected the rights of people with disability. Since its conception in 2006, 164 signatories and 188 parties and 187 countries have ratified the CRPD (UN, 2023b). The treaty marks a paradigm shift in societal views of disability, promoting agency, dignity, and inclusion rather than isolation (Series, 2019). However, the CRPD does not mention displaced people, asylum seekers, or migrants (Pisoni, 2021). It is a similar situation with policies built to protect migrants: the New Pact on Migration, developed by the European Disability Forum briefly attempts to address disability, but uses terms such as “vulnerable persons,” and “persons with mental disorders.” This language is outdated and fails to incorporate the political and social dimensions of disability that impact the lives of migrants (Ibid).
The language used in existing policy reflects differing views on the concept of disability itself and the vulnerabilities that accompany it. In one lens, referred to by scholars as the biomedical model, vulnerability due to disability is perceived as a natural consequence of impairment, rather than the outcome of exclusionary social structures and physical environments (Bell et al., 2019). In recent years, a social relational model has been encouraged by disability advocates. This model recognizes exclusionary structures as the root of struggle, rather than placing blame on the disability itself (Ibid). When social relational models and language are utilized, it becomes easier to create effective policy that takes a human-rights approach, rather than a paternalizing one. Policy should ideally empower disabled migrant populations rather than victimize and problematize them.
The intersection of disability and migration is a topic that has not yet been adequately researched. There are no official statistics available for the number of disabled migrants, despite the International Organization for Migration (IOM) estimating that 12.4 million of the people who were forcibly displaced in 2020 were people with disabilities, or about 15% (Migration Data Portal, 2022). This estimate is calculated using the global disability prevalence data, but country-specific studies suggest that some countries have much higher rates of disability among their forcibly displaced populations (Ibid.) While numerical data is sparse, there is growing scholarly interest in the intersection of migration and disability and its implications for citizenship, identity, and access to services (Burns, 2017).
Although there are national and international policies on disability, few are cognizant of the needs of migrants and refugees with disabilities and the intersectionality between the two, resulting in their exclusion in social welfare programming, health and rehabilitation services and human rights protection (Pisani & Grech, 2015; Govere et al., 2021; Mirza, 2011). In addition, migration policies internationally do not directly integrate disability (Govere et al., 2021). Migrants living with disability are often not accounted for in national disability service planning and delivery, leading to the subjugation of their rights and voices. Furthermore, they suffer a heightened predisposition to exploitation and abuse (Piasni & Grech, 2015; Govere et al., 2021). Due to limited attention to these issues, they are likely to experience adverse impact of disability.
People on the move with disabilities often experience a double disadvantage, or dual vulnerability since they face additional structural barriers due to both their status as migrants/refugees compounded by their disabilities. For example, a person’s disability may negatively impact their ability to attain citizenship or refugee status, while their status as refugees or undocumented migrants may affect the types of health care and social support services available to them (Tataranni, 2022). The difficulties faced by migrants with disabilities are complex and wide-ranging. There is great variation in cultural understandings of disability, type of care available versus type of care an individual may desire, and the severity of the impact disability may have on a person’s life (Ibid.)
On-the-Move: Dangerous journeys and unmet needs
In migrating from one place to the other, people on the move with disabilities are presented with adverse conditions and challenging circumstances. When facing forced displacement, people with disabilities and their families must make special considerations. Particularly for those with physical disabilities, fleeing areas of conflict is extremely difficult. In one case detailed by the European Disability Forum, a young Syrian girl lived in fear of needing to evacuate during a time of crisis, because she was in a wheelchair, living on the 5th floor of a building without an elevator (Leenknect, 2020). Further, in areas with high levels of conflict, people with disabilities may be singled out as targets for harassment, torture, violence, or exploitation by military recruits (Berghs, 2015). Studies by Doctors Without Borders estimate that up to a third of migrants have been victims of violent or traumatic events, with numbers among migrants with disabilities likely higher (Abbas et al., 2018). This kind of persecution and violence can be a motivating force for migration for individuals with disabilities.
Upon leaving their countries of origin, disabled migrants, asylum-seekers, and refugees continue to face obstacles during their journey to resettle. Disabled migrants, refugees and asylum seekers struggling with physical impairments often experience bouts of mental health crises as they try to navigate their complex journeys, with difficulties exacerbated by a lack of accessible services, and social stigma (Rfat et al., 2023). According to the UN Refugee Agency, approximately 22 percent of refugees, about 6.6 million people, live in refugee camps globally (UNCHR, 2021). People living in refugee camps may stay temporarily while moving from one place to the next, while others may reside there for months or years. Refugees with disabilities face particular challenges within these camp settings.
Mirza (2011) has conducted research on the challenges people with disabilities face while living in displacement camps. During her field work at various camps in Africa and the Middle East, Mirza observed that disabled residents in displacement camps rarely have official advocates or integrated services, thus must organize their own committees to advocate for their rights (Mirza, 2011). Healthcare resources, usually funded by organizations and foundations, are limited in refugee camps. There tend to be too few resources to meet the basic needs of large influxes of migrants, let alone populations with specific needs like migrants with disabilities (Crock et. al, 2012). Funding for health services provided by humanitarian organizations is often allocated for HIV/AIDS prevention and reproductive health whilst the needs of migrants with disabilities are often forgotten or unspecified (Mirza, 2011). Furthermore, the needs of displacement camp residents with disabilities often reach beyond the primary healthcare and mental health counselling provided by humanitarian organizations. Types of care that disabled residents may need could include technical aids and devices, corrective surgeries, and on-going treatment for chronic conditions (Reilly, 2010). While parents of children with disabilities or advocates can request special medication, camps tend to be acutely under-resourced for basic, common medications (Mirza, 2011).
In addition to a lack of adequate health services, people with physical disabilities that live in refugee camps encounter obstacles navigating the sprawling geography of the camps. For example, if there are no mobility aids likes wheelchairs and canes available bumpy roads and vast landscapes can make access to health and social services extremely difficult (Mirza, 2011). Some camps have toilets with stair access which are thus inaccessible without physical assistance (Leenknecht, 2020). Newly built refugee camps have increasingly included accessible infrastructure, but geographical inaccessibility remains a pertinent issue in many existing and highly populated camps (Smith-Kahn & Crock, 2018).
There is also an important distinction between the treatment and experience of refugees and migrants in refugee camps run by humanitarian organizations and government-run detention camps that house migrants “caught” crossing boarders illegally. Conditions in detention camps are often extremely harsh, inhumane, and insanitary with high rates of disease (Arsenijević, 2018). Additionally, it is less likely that special needs of people with disabilities will be recognized or catered to in a detention setting.
Further, during perilous journeys crossing borders, travelling by sea, or living in refugee camps, people with disabilities are at a particularly high risk of facing violence. Children with disabilities are almost four times as likely to be victims of violence compared to their peers (UNCHR, 2019). Young women with disabilities are more likely to experience sexual violence and intimate partner violence (Hourani et al., 2021) and despite heightened they are often overlooked in prevention and response programmes (UNCHR, 2019).
Barriers to successful resettlement: Misconceptions and lack of opportunities
Once migrants have reached their place of destination, they often continue to experience human rights violations and barriers. Refugees and migrants with disabilities face unique struggles in the destination country, which differ in severity and scope depending on the country of destination. Each country has different laws in place regarding access to education, healthcare, employment, and citizenship (Smith-Khan & Crock, 2018).
Employment and welfare
As migrants, asylum-seekers, and refugees resettle in host countries, the main goal quickly becomes economic stability. Migrants with disabilities face singular difficulties as they seek this stability. They often face additional financial strain beyond shelter and food costs due to the costliness of specific medicines and treatments (Rfat et al., 2023). As migrants resettle in host countries, seeking employment is often a priority. However, when a member of a migrant family has a disability, there are special considerations. For example, if a child has severe cognitive disability, their parent is often obliged to serve a caretaker role, often limiting their time and resources to seek or hold employment (Hamidi et al., 2022). Conversely, children, growing up in families where a parent or sibling has a disability, are often required to work to help support their families, limiting opportunities to finish schooling and thus impairing future employment opportunities (Ibid).
Compounding these challenges is the issue of transportation. Refugees and migrants often resettle in affordable areas that are quite a distance from employment and healthcare locations, coupled with limited access to public transport (Hamidi et al., 2022). Even where public transport may exist, the systems can be difficult to navigate for both physical accessibility and communication reasons (Ibid).
According to Burns (2017) many countries, particularly Western countries, have immigration policies that revolve around the economic suitability of potential immigrants. Applicants are often divided based on preferred / non-preferred categories with special attention to their potential economic contributions and social and educational status (Burns, 2017). As mentioned prior, migrants with disabilities are often regarded as unemployable. This has a direct impact on the likeliness of gaining citizenship. In many host countries, disability is viewed as a ‘burden’ to the state (Burns, 2017). Migrants with disabilities are thus assumed to be too costly to welfare systems, social services, and medical services (El-Lahib & Wehbi, 2011). In practice, the same principle applies for migrant families with disabled children (Ibid). Ideas of dependency become an obstacle as migrants with disabilities seek citizenship and can even hinder the asylum-seeking process. Additionally, psychosocial disabilities and language barriers may inhibit an asylum seeker’s ability to fully understand questions and deliver consistent testimony (Crock et al., 2012). Since there are no existing procedural protections to ensure asylum seekers have appropriate accommodations when appearing before adjudicators (Ibid). Ableist immigration policies and a lack of protections reinforce the marginalization of migrants with disabilities, prevent them from participating fully in the political systems of their host countries, and further limit access to necessary services.
Access to healthcare
Migrants and refugees with disabilities require special healthcare services and face systemic barriers to accessing the care they need as they resettle in the host country. Navigating complex, bureaucratic, and unfamiliar healthcare systems presents challenges. Language barriers make communication difficult and dissuade migrants from seeking the care they need. There are often long waits for medical interpreters, and even with interpreters, the complexity of certain conditions can get lost in translation (Mirza, 2018). Further, migrants who are undocumented and refugees who have not yet been granted asylum may fear detection and detainment by authorities. As a result, many may avoid seeking the healthcare services they desperately need, which can be especially detrimental for migrants with disabilities and chronic health conditions (Lewis et al., 2014).
Healthcare systems that are particularly bureaucratic, such as in the United States, are hard to navigate for people unfamiliar with the process. Mainstream healthcare services and specialized care services are often disconnected and fragmented, meaning migrants need support from case managers to seek help (Mirza, 2018). However, a shortage of competent case workers and cuts in funding to refugee assistance programmes means that families must navigate the systems unassisted Some migrants seeking assistance may miss opportunities for help if they miss a return call from a provider and do not follow-up (Hamidi et al., 2022). Additionally, migrants with disabilities coming from long transitionary journeys do not have access to medical records. This hinders the identification of the correct specialized care and treatment plans, especially since language barriers can limit communication about past treatments and the specifics of any given impairment (Rfat et al., 2023).
Barriers to Education
The UN’s International Covenant on Economic, Social and Cultural rights has regarded education as a universal human rights since 1966 (Smith-Kahn & Crock, 2018). However, migrant children with disabilities face a double disadvantage as they attempt to access this right: migrants already have difficulties accessing school in many cases: although protected by law, some administrators will insist on identification documents (Kaya & Yildiz, 2023). Additionally, people with disabilities face many unique barriers to education, depending largely on whether the disability is psychosocial, cognitive, or physical, and the degree of severity (Tataranni, 2022).
Globally, refugee children are five times less likely to attend school compared to non-refugee children (Smith-Khan & Crock, 2018). A study by the UNCHR found that 64 out of 81 refugee-hosting countries placed no legal restrictions on refugees attending national schools. However, schools in some host countries are over capacity and unable to cater to the rising numbers of refugee children seeking education (Ibid). For refugee children with disabilities, attendance rates are estimated to be even lower, and drop-out rates are high (Reilly, 2010).
Additionally, there is a great variance in educational opportunities for disabled migrants and refugees, depending on the country of resettlement. In under-resourced communities, schools do not have the resources to make education accessible for children with disabilities. For example, many mainstream schools do not have elevators or ramps or enough funding to install them, therefore rendering them inaccessible for those with physical disabilities (De Wet & Mabetha, 2023). Training teachers on how best to assist students with disabilities is not a priority in communities with few resources. In countries where schools fail to meet educational benchmarks for their own nationals, there are very few opportunities for refugee children, particularly those with disabilities (Smith-Khan & Crock, 2018). Limited access to education can entrench vulnerability and inhibit the ability to generate income or gain future employment.(Ibid).
Addressing challenges: Intersectional policy and empowerment
Migrants, refugees, and asylum seekers with disabilities deserve to live dignified lives with access to necessary resources, protection from harm, and opportunities for economic advancement. Ensuring the human rights and freedoms of disabled migrants are protected necessitates policy changes at the governmental level, guidelines for organizations and service providers, and greater public visibility.To fully realize best practices for protecting the rights of disabled migrants, more research is needed. Comprehensive data allows policymakers, service-providing organizations, and other stakeholders to identify the needs of migrants with disabilities and to develop effective solutions (Vidal & IOM, 2022). However, there is limited data regarding the number of migrants with disabilities, their locations, type of impairment, living situations, and other characteristics (IOM, 2016). Migrants and refugees with disabilities are often overlooked in official registration or data-collection attempts, due to isolation, less visible impairments, or repeated displacement (UNCHR, 2019). Further, migrants, refugees, and asylum seekers may be protective of their disability status that they may assume will reduce their change of successful asylum or resettlement (IOM, 2016). The United Nations Commission on Human Rights suggests that ongoing data collection efforts must emphasize informed consent procedures and confidentiality to ensure that individuals feel safe. Additionally, while the ProGres software currently used to gather data about refugees allows for some data collection regarding disability, it lacks appropriate terminology leading to inaccuracies in data collected (Ibid.) Standardizing data collection methods and emphasizing confidentiality and safety can allow for more accurate information.
As a result of limited information, disabled refugees, migrants, and asylum seekers are rarely on the radar of social workers, international agencies, employers, and resettlement service providers. It is essential for resources, particularly physical and mental health services to be made readily available for refugees to combat prolonged trauma and minimize continued harm (Rfat, 2023). There is need for collaboration between local disability service networks and refugee service networks to ensure that the needs of refugees with disability are being properly met (Mirza et al., 2013). Organizations of people with disabilities, also known as Disabled Persons Organizations (DPOs), at the local, national and international level can work with refugee assistance organizations to ensure service providers have accurate information and awareness of available resources (UNCHR, 2019). DPOs are comprised of and led by people with disability, therefore they can be a source of peer support, rights protection, and empowerment for migrants with disabilities at every point in their journeys (Ibid). When refugee assistance and advocacy organizations engage DPOs, their programmes will become far more effective.
At a governmental level, international frameworks like the United Nations Convention on the Rights of Persons with Disabilities (CRPD) and the Refugee Convention and Protocol promote a rights-based framework (Crock et al., 2012). However, there is an ongoing debate as to whether rights protections defined by the CRPD apply only to nationals. This area of international law is complex and thus, government policies do not adequately protect the rights of disabled migrants and refugees (IOM, 2016). Since policies surrounding migrant rights and disability differ greatly from country to country, non-governmental organizations (NGOs) play an important role in protecting the rights of this population.
By setting aside specific and continuous funding for initiatives seeking to serve disabled populations, international agencies and humanitarian organizations can make a real impact (Pisoni, 2021). Once-off funding can work in some cases, but it is not actually sustainable and does not address the root of the issue (Smith-Kahn & Crock, 2018). In some cases, progress has been made in physical accessibility measures in displacement camps, including paving of main roads and construction of accessible toilets, but further investments in infrastructure must be made to ensure people with disability can navigate and access services (Ibid.) Additionally, humanitarian organizations must ensure that services for persons with disabilities are in close proximity to where they reside or in cases where this is impossible, adequate transportation should be provided (UNCHR, 2019).
Furthermore, overhauling convoluted healthcare systems is not immediately attainable, therefore, increasing resources to help migrants navigate health services is a start. For example, there is a pressing need for medical interpreters fluent in languages of recently resettled communities. One suggested avenue to achieve this is by identifying and training individuals from refugee communities, effectively creating employment opportunities while also addressing a dire need (Mirza et al., 2013). As for education, protections to prevent the exclusion of disabled migrant children must be improved, but beyond that, the situation calls for innovative solutions. For example, providing specific vocational training can open doors to income generation and empower disabled migrant populations to be self-sufficient and to thrive economically (Smith-Khan & Crock, 2018).
Finally, the United Nations Human Rights Commission (UNCHR) emphasizes that one of the main ways to ensure the rights of migrants with disabilities is to change attitudes and narratives surrounding people with disabilities. Negative beliefs about people with disabilities held by service providers and broader communities are often some of the main barriers to accessing services and social integration (UNCHR, 2019). Public awareness campaigns focusing on the positive contributions of people with disabilities and seeking to eliminate myths and prejudices have the potential to reframe narratives surrounding disabled migrants (Pisoni, 2021). The creation of campaigns and informative materials should always involve people with disabilities and community leaders to ensure that messaging is a positive reflection of the community (UNCHR, 2019). It is essential to broadly amplify stories that reflect the diversity among disabled refugee and migrant populations, as they are not homogenous (Pisoni, 2021).
Disability and migration in South Africa
The situation for refugees, asylum seekers, and migrants with disabilities in South Africa reflects the global challenges this social group. According to the South African Community Survey (2016) about 7.7% of the population are living with disability. According to the City of Johannesburg (2021), there are approximately 3.5 million people with disability in South Africa. However, there are no statistics or data on how many of these are migrants and refugees (Migration and Health Project Southern Africa, 2021). In South Africa, the rights of persons with disability are safeguarded by international, continental, regional and national frameworks (Govere et al., 2021). At an international level, South Africa has ratified to the Convention on the Rights of Persons with Disabilities and its optional protocol in 2007 (Disabled World, 2022). To some extent, these international frameworks recognize the importance of addressing the needs of persons with disabilities, however, the migration component is still generally missing. Migrants and refugees with disabilities thus remain largely invisible in regional frameworks. Despite South Africa having signed a range of international and regional frameworks relating to migrants and refugees with disabilities, their implementation at the national level remains problematic, due to unclear guidelines (Govere et al., 2021).
There are various laws seeking to protect the rights of migrants and people with disability respectively, but not specifically disabled migrants. These laws include the Constitution of the Republic of South Africa, 1996 (South Africa, Government, 1996) which gives rights to all people in the country including migrants; the Disability Rights Charter of South Africa (Disabled People South Africa, 1997) and the White Paper on the Rights of Persons with Disabilities (South Africa, Government, 2016) which protects the rights of people with disabilities. Other instruments which protect the rights of migrants and refugees include the Refugees Amendment Act No. 11 of 2017 (South Africa, Government, 2017); Immigration Act No. 13 of 2002 (South Africa, Government, 2002), Draft Immigration Amendment Act 13 of 2011 (South Africa, Government of, 2011) and Commencement of the 2011 Immigration Amendment Act (South Africa, Government, 2014).
Despite these many policies aimed at protecting the rights of people with disability, migrants and refugees in South Africa, there is still a clear gap between the policies and their implementation. The disability policies barely mention the rights of migrants with disability and the migration policies seldom gives attention to disability among migrants and refugees. Both gives little or no acknowledgement of the intersection between the two (Migration and Health Project Southern Africa, 2021). Consequently, most migrants and refugees with disabilities living in South Africa have little choice but to survive through support from NGOs, informal networks, and religious organizations (Hölscher, 2016). Undocumented migrants’ fear of arrest, detention, or deportation makes them hesitant to engage with government services, thus putting them at a heightened risk. Additionally, refugee children with disabilities face substantial difficulty accessing their constitutional right to education. In fact, only 5 per cent of refugee children with disabilities are enrolled in school in South Africa (De Wet & Mabetha, 2023). The low enrolment rates reflect challenges within the government and education systems as well as a lack of training for teachers on how to engage with disabled students among other factors (Ibid.)
To ensure fulfilment of rights, protection, equality, access, and participation for people with disability including migrants and refugees, it is important to be cognizant of the apposite barriers. These include the barriers in policies and programming in considering the migrants/refugees living with disability or the intersection between the two. Irregular migrants and asylum seekers should be protected for them to engage with services available for their well-being.
For additional information regarding best practices for programmes empowering disabled migrant populations, visit the UNCHR’s “Need to Know” guide:
Resource prepared by Roxie Richner (SIHMA Intern) and Rachel Chinyakata (SIHMA Head of Research)
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