Increased scholarly attention on disability awareness in Pakistan has uncovered significant information and service gaps that exist for people who have been internally displaced and are living with disabilities from Northwest Pakistan and Federally Administered Tribal Areas (FATA). Studies reveal that instances of mental disorders are growing within internally displaced families that have been forced to flee their homes to avoid terrorist-related violence. According to the United Nations High Commissioner for Refugees (UNHCR), Pakistan is home to nearly one million refugees, and more than 449 000 internally displaced persons (IDPs). Statistics on disability within Pakistan are outdated, however, the World Health Organization (WHO) World Report on Disability released in 2011 estimates there were potentially as many as 29 million people living with a disability in Pakistan.
Dr. Nazia Mumtaz, a PhD in rehabilitation science who has previously completed a Fellowship in Clinical & Research Neuro Rehabilitation with the Department of Rehabilitation Medicine at Seoul National University Hospital, reported in Pakistan’s Daily Times that children are most vulnerable to the effects of conflict and consequent mental disorders. She stated, “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 resulting from exposure to stressful situations, stammering, delayed speech in children and a lack of timely detection of hearing loss in infants largely associated with the impacts of explosions above certain decibels, and shell shock are disorders most often reported to affect children.
In recognition of the crisis unfolding in Pakistan, the United Nations Convention on the Rights of Persons with Disabilities (UNCRD) has called for greater action on inclusive humanitarian intervention for those affected by humanitarian emergencies.
Despite ratification of the UN Convention on the Rights of Persons with Disabilities (UNCRPD) in 2011, policy planners in Pakistan have paid little attention to the plight of people with disability, and enacted limited legal framework for the protection of IDPs living with disability. Action has mainly been carried out by a select few NGOs and civil society actors. Handicap International is training providers in the northwest region of Pakistan on disability, rehabilitation and awareness-raising. In collaboration with the IKEA Foundation, Handicap International is also developing accessible and secure play areas for children in refugee camps that will enable children with disabilities to play and learn in an inclusive environment.
Greater effort is required from the Pakistani government, research institutes and bodies, and domestic health, service and education providers.
Dr. Mumtaz believes it necessary to bridge the current information gap and formulate strategies to manage the needs of people living with disabilities in the context of displacement camps. She states no domestic IDP health institutional mechanisms currently exist and at present, “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”.
Pakistan’s history of providing for citizens living with disability is one spotted with limited action, while the health and social costs of ongoing conflict and violence incurred upon civilians has not been openly communicated by the government.
Financially, The Economic Survey of Pakistan for 2016-17 estimated that over the past 16 years the direct and indirect cost incurred by Pakistan as a result of terrorism amounts to USD$123.1 billion.
The single piece of legislation providing protection for those living with a disability is the Disabled Persons (Employment and Rehabilitation Act) Ordinance of 1981, which prescribes that employers of more than 100 staff ensure that at least two per cent of their staff are people living with disabilities. Unfortunately, according to the British Council, the implementation of this law has been weak.
A study conducted by Islamic Relief in 2018 found that there are no special education schools in FATA, access by permit to FATA for local or international NGOs to provide services for the disabled remains difficult, and locals reported that health services and facilities do not exist for people living with disabilities.
Statistics from the study found that 82 per cent of people living with disabilities in FATA had received no education, and 29 per cent of people living with disabilities were unemployed.
As the Pakistani government has recently eliminated the threat of conflict from the FATA, IDPs have begun returning home. The United Nations Office of the Coordination of Humanitarian Affairs (UNOCHA) reported that, as of March 2018, 330 000 families have returned to FATA, however, some believe that the process of return has been mired with a lack of guaranteed security and safety and a continued lack of basic services. While the government states they have eliminated the threat of conflict in FATA, their biggest challenge now is to develop services that provide a better quality of life for those affected by past conflict.