Approximately 15 percent of the world’s population, or an estimated 1 billion people, live with disabilities. But neglect, discrimination, and abuse are still all too common among disabled youth, leaving them deprived of rights including those to education, health, and employment. Credit : Melody Kemp/IPS

By Tharanga Yakupitiyage
UNITED NATIONS, Mar 29 2019 (IPS)

People with disabilities are being left behind, and steps must be taken to ensure their inclusion in the world of education and work.

Approximately 15 percent of the world’s population, or an estimated one billion people, live with disabilities. But neglect, discrimination, and abuse are still all too common among disabled youth, leaving them deprived of rights including those to education, health, and employment.

“Children with disabilities must have a say in all matters that affect the course of their lives…They must be empowered to reach their full potential and enjoy their full human rights – and this requires us to change both attitudes and environmental factors,” United Nations High Commissioner for Human Rights Michelle Bachelet recently said.

UN Special Rapporteur on the rights of persons with disabilities Catalina Devandas Aguilar echoed similar sentiments upon the launch of her annual report, stating: “Deprivation of liberty on the basis of disability is a human rights violation on a massive global scale. It is not a ‘necessary evil’, but a consequence of the failure of States to ensure their obligations towards people with disabilities.”

Aguilar noted that a key factor preventing the inclusion of disabled youth is the ongoing discrimination against and segregation into special schools and institutions.

According to the UN Educational, Scientific, and Cultural Organisation (UNESCO), 90 percent of children with disabilities in developing countries do not attend school.

More than 10 percent of persons with disabilities have been refused entry into school because of their disability, and more than quarter reported schools were not accessible or were hindering to them.

Such exclusion also extends to the labor market as the employment-to-population ratio of persons with disabilities aged 15 and older is almost half that of persons without disabilities.

In fact, unemployment among persons with disabilities is as high as 80 percent in some countries, according to the International Labour Organisation (ILO). Women with disabilities are two times less likely to be employed.

Those who are employed tend to earn lower wages than their counterparts without disabilities.

“This is a legacy of a model which has caused exclusion and marginalisation…we can no longer have children being hidden away and isolated, children with disabilities must have the opportunity to dream of a full and happy life,” Aguilar said.

In Bangladesh, the Bridge Foundation hopes to bridge these gaps and help create opportunities.

Inspired by the movie ‘Forrest Gump’ and the autobiographies of Helen Keller and Stephen Hawking, Natasha Israt Kabir wanted to support and empower people with disabilities, or the “differently abled.”

“I believe there should not be norm in the way things are done, but there should always be opportunities to do things differently… achieving sustainable development won’t become a reality without the social inclusion and empowerment people living with disabilities,” Kabir said.

Kabir, along with co-founder Swarna Moye Sarker, implemented a programme teaching information technology (IT) and arts, providing people with disabilities with the skills to work. They also established an online platform helping students showcase their skills and talent in order to sell their products and even gain employment.

“I believe technology will give them a voice, help them connect with the world and become independent,” Kabir said.

“Children with disabilities need special care and special management for their education and to merge them with the mainstream education system, social and youth led organisations like Bridge Foundation are playing a pivotal role,” Executive Director of the Center for Research and Information (CRI) Sabbir Bin Shams told IPS.

“Increasing and improving youth led initiatives for vulnerable women and children with disabilities may turn the experiences of economic growth a more equitable and inclusive one,” he added.

In a UN newsletter, Kabir recounted some of the programme participants including Falguny, a physically-challenged student without wrists who was able to quickly develop fast computer operating skills.

Another student, Rajon, showcases determination and courage everyday, attending classes with crutches.

“These people are the source of my strength and inspiration now. I strongly believe—if you have the idea and vision to change the world, yes! You can,” Kabir said.

The Bridge Foundation received the Joy Bangla Youth Award in 2018 for its work in empowering people with disabilities.

The media and public perception play a role in how different conditions are treated and how the disabled view themselves. Credit: Bigstock

By Samuel Oakford
UNITED NATIONS, Oct 2 2013 (IPS)

When U.N. Secretary-General Ban Ki-moon opened a recent high-level meeting on disability and development that promised a place for the issue in the post-2015 agenda, he cited three examples of incapacity.

All three were stories of children or adolescents, even though the World Health Organisation estimates nearly 200 million adults have a functional difficulty.When aid is “solutionist", it only looks for problems where data lies, like the drunk who searches for his keys under a streetlamp and not where he dropped them.

Ban’s comments illustrate what many see as a key difficulty in representing disability, both in language and in the democratic decision-making process.

Activists say the lack of attention at the international level is not simply an oversight but a product of a confused conception of disability and the unique experiences of different groups of disabled people.

The reality, they argue, is that certain classes of disabled people coincide more easily with the orientation of international guidelines for healthcare intervention and with public understanding of health.

A dominant assumption in interventions is that “we save people because when we save them they are going to have a full life and produce a lot, so society benefits,” said Bruce Jennings, director of bioethics at the Centre for Humans and Nature and a lecturer at Yale University.

Saving lives means a country will have a more reliable workforce, a guarantee of vital importance in places like Sub-Saharan Africa where populations have been ravaged by HIV/AIDS.

But a focus on mortality puts those with severe and cognitive disabilities in a precarious limbo.

“What is the rationale for spending a great deal of resources for supporting the quality of life of people with severe cognitive problems when the usual answer our society gives for spending resources in healthcare is future productivity?” Jennings told IPS.

In developing countries, where 80 percent of the world’s disabled live, social integration and sustained healthcare for them can be financially unpalatable to governments when set alongside well-subsidised international measures that focus on vaccines for polio or cutting edge treatments for AIDS.

Programmes that focus on pharmaceutical solutions are seen as easier to account for in cost-benefit terms.

But for the disabled, there is often no pill to end their distress or help overcome social barriers. For severe cases, years of rehabilitation and attention from public sector healthcare are required.

“It’s a difficult subject to bring up,” said Antony Duttine, rehabilitation advisor at Handicap International.

“It’s perceived as quite costly to provide care and support but equally it’s a moral and legal issue that you have to look into.”

Whose voice?

As is true for many activists, those with first-hand experience of disability are often the clearest voices for progress.

“We need to include people with disabilities not just as the beneficiaries but the participants,” said MP Reen Kachere, minister of disability and elderly affairs in Malawi.

Participation is especially important in developing countries, said Kachere, where international projects have to navigate the historical question of paternalism.

“The disability advocacy community has very much been oriented towards inclusiveness and participation of individuals with impairments in the decision-making processes,” Jennings said.

A common refrain among advocates is “nothing decided for us without us.”

But participation raises the question of representation, he said.

“I’m not sure someone who has experience living in a wheelchair is a good representative for someone with cognitive impairments,” noted Jennings.

Because of how varied conditions are, differences arise in how integrated the disabled feel in society.

“It is relatively easier for a person who is blind or a person with physical disability to access services, but there is much more stigma attached to cognitive disabilities,” said Gopal Mitra, a programme specialist for children with disabilities at UNICEF.

“Disability is not a homogeneous group,” he told IPS.

The media and public perception play a role in how different conditions are treated and how the disabled view themselves.

In the United States, victims who lost limbs when bombs went off at the Apr. 15 Boston marathon have received millions in crowd-sourced medical care. At the same time, more than 50,000 U.S. diabetes patients undergo lower extremity amputations each year. Worldwide, someone loses a leg to diabetes every 30 seconds. All of them will require lifetime care.

Images of children or victims of a tragedy are easier to digest for the public than those whose descent into incapacity is slow or genetic. Physical disabilities are easier to understand than mental ones, and as a result societies are more likely to allocate money to that which they can comprehend, said Jennings.

“There is an image of the disabled as being physically limited and cognitively sound,” he said. “By having the public have a person in a wheelchair be the paradigm of disability in their mind and thinking that we deal with disability if we have wide doors and lifts on public buses is an unfortunate mistake.”

Even as organisations catch up with contemporary theory on the fluidity of gender and sexual orientation or the vastness of the disability spectrum, their efforts can still be constrained.

The problem, as disability activists see it, comes in large part from the total lack of language concerning the disabled in U.N. Millennium Development Goals (MDGs). See Part One

The result can be a self-perpetuating cycle.

“Countries are not tracking and reporting progress on children and adults with disabilities as far as MDG achievements are concerned,” said Mitra. “Countries are not connecting data. Unless you have numbers, it is difficult to plan or allocate resources.

“However, the point is 15 percent of the world’s population is people with disability. If you don’t include this 15 percent no development goals can be achieved.”

At its worst, say critics, when international aid is “solutionist”, it only looks for problems where data lies, like the drunk who searches for his keys under a streetlamp and not where he dropped them. And disability is notoriously hard to define and track.

Though an understanding of the different forms of disability may allow society to better help, the ultimate solution may be the idea of a common shared experience.

“I think the rational is solidarity, empathy, dignity, mutuality, equality and respect,” says Jennings. “It’s very hard to put a metric on those.”

Excerpt:

Disaster Risk Management Project (DRM). An elderly person with a disability goes down the stairs of the Cyclone shelter in Mohanagar, Sitakunda, Bangladesh. Credit: Brice Blondel/Handicap International

By Lucy Westcott
UNITED NATIONS, Aug 20 2013 (IPS)

Upon first glance, the emergency checklist distributed in Haiti after the 2010 earthquake looks like any other. Organised into key categories like water, sanitation and hygiene, and psychosocial support, the information is typical of the kind circulated for emergency response.

But after a closer read, with recommendations for latrines to be built with a 90cm diameter so a wheelchair can turn around, and 80-cm-wide doors for wheelchair or crutch-users to pass through comfortably, it is clear that the checklist, distributed by Handicap International, was intended for persons with disabilities living in the disaster-ravaged country.“When we don’t include people with disabilities, that’s when the most deaths and casualties happen.” -- Fred Doulton of UN Enable

Natural disasters are common in many developing countries across the globe, and organisations like Handicap International are helping communities plan better for their disabled populations. There are between 2.9 and 4.2 million persons with disabilities among the world’s 42 million forcibly displaced population, according to data from the United Nations Refugee Agency (UNHCR).

For many people living with disabilities in developing countries, social stigma and cultural barriers prevent community cohesion, which is essential for emergency planning and preparedness, Annie Lafrenière, social inclusion and technical adviser at Handicap International, told IPS.

“People won’t speak about social barriers… they’ll talk about ramps [instead],” Lafrenière said. “[People with disabilities] are not considered the same as everyone else.”

Developing countries are vulnerable and at a higher risk of disasters because they are less prepared and equipped to deal with them, and not necessarily because they are more exposed to hazards, Lafrenière says. Persons with disabilities are often invisible to relief activities and unable to reach food or water checkpoints due to destroyed roads or non-accessible transportation.

“Meeting basic needs… remains a priority and often a challenge for communities affected by disasters, whether they are persons with or without disabilities,” Lafrenière says. “What our experiences have shown us… is that the presence of disability amplifies the impact of the disaster on a person’s life… and reduce[s] the range of strategies to cope with them.”

Inclusive planning is one improvement that can be made by communities in developing countries, and one that Handicap International stresses. It’s vital that disabled people are part of planning meetings and committees, as they help to spread awareness while offering their expertise.

“When we don’t include people with disabilities, that’s when the most deaths and casualties happen,” Fred Doulton, social affairs officer at UN Enable, which focuses on the rights of disabled people and is part of the United Nations Economic and Social Council (ECOSOC), told IPS. “By asking [people with disabilities] directly about what they think, you get to the core issues.”

The United Nations Office for Disaster Risk Reduction (UNISDR) recently released a survey asking persons with disabilities around the world about their experience living with and preparing for disasters.

In the Indonesian province of East Nusa Tenggara (NTT province), Handicap International is working with schools and children with disabilities and their families to improve awareness and response to disasters. The region is prone to flooding, landslides and whirlwinds; in 2012 there were 258 whirlwinds, 28 times the number recorded in 2002, according to Indonesia’s National Disaster Mitigation Agency (BNPB).

“We are implementing activities within the community to increase resilience to natural disasters, but we are also implementing activities within schools to be sure that children with disabilities will be taken into consideration,” Catherine Gillet, programme director for Handicap International in Indonesia/Timor-Leste, told IPS from the ground.

The NTT province consists of rural communities living in hilly areas and on dry and rocky land. The terrain can be treacherous, with communities staying either in valleys near the rivers, where there is a high risk of floods during the rainy season, or on the slopes of hills near areas suitable for crop cultivation, but where landslides pose a huge risk.

The children, mainly in grades three to five, raise awareness among their peers about disaster risk and are involved in risk assessment and identification. Disabled and non-disabled schoolchildren also demonstrate good practices for evacuation in disasters and work together in mock drills.

“For children with disabilities [the main challenge] is the problem of access, the problem of moving around,” Mathieu Dewerse, regional operational coordinator for Handicap International in Indonesia/Timor-Leste, told IPS.

“This is compounded in the case of disasters. If we think about a landslide, the road may be cut, there could be rocks on the road. If this is a child that uses crutches, it’s very hard to move around,” Dewerse says.

During past disasters, children with mobility disabilities have been supported by tricycles or motorbikes, Dewerse says.

For children with sensory impairments in the region, access to information is one of the main concerns. Communities have set up flag systems to compensate for the sound of an evacuation signal, which can’t be heard by children with hearing impairments, and have recruited friends and family to make sure they get away safely.

“Take the example of a child who doesn’t see. It’s a very big problem, especially if they have to evacuate quickly,” Dewerse says.

The provision of more mobility devices adapted to the needs of children with disabilities is an important step in helping communities the next time there is a flood or landslide, Dewerse says.

In the neighbouring Philippines, Handicap International replaced the cumbersome wheelchair of Joshua Degas, a 10-year-old boy with cerebral palsy, after Tropical Storm Washi in 2011, with one his own size, improving his future mobility in the face of potential disasters.

(See Part One and Part Two)

Excerpt:

Shaheen Begum receives skills training at the PPC paraplegic centre in Hayatabad in northern Pakistan. Credit: Ashfaq Yusufzai/IPS

By Ashfaq Yusufzai
PESHAWAR, May 13 2013 (IPS)

Gul Shada thought it was the end of the road for her when she and her husband met with a road accident last year in the Nowshera district of Khyber Pakhtunkhwa, one of the four provinces of Pakistan. Not only did the mishap leave Shada widowed at the relatively young age of 37, she also sustained an injury to her back that immobilised her.

It was then that she came to the country’s sole paraplegic centre (PPC) at Hayatabad, to the southwest of Peshawar, the capital of Khyber Pakhtunkhwa. And it was here that she was taught that you don’t need to be on your feet to be able to stand on your own.

Along with helping her regain her physical strength, the centre also gave Shada training in sewing and embroidery. Today, she is able to earn a living of her own, enough to provide her three children with a decent education.

“I had thought I would be bedridden forever and my children would have to beg on the streets,” Shada told IPS. “But I am a shining example of how the PPC is helping its patients. I was referred for physiotherapy here after being operated on for spinal injury at the Hayatabad Medical Complex. My hopes were raised further when I was taught sewing and embroidery here and I became somewhat of an expert.”

Established by the International Committee of the Red Cross (ICRC) in 1983 for those wounded in the 1979-1989 Soviet war in Afghanistan, the centre was left in the hands of the Pakistan Red Crescent (PRC) after the ICRC withdrew in 1995.

The PRC managed the centre till the reins were handed over to the current management in 2005. The provincial government of Khyber Pakhtunkhwa – which borders Afghanistan to the northwest – then made it an autonomous body governed by a board, through a 2009 Act.

The PPC, which has a staff of 110, remains the only centre of its kind in Pakistan which provides free treatment and rehabilitation to patients who have received injuries to their spine. Some 1,200 women and 800 men have benefited since 2005 under its training centre, bringing hopes to lives that have foreseen only despair.

One among them is Shaheen Begum from Khyber Agency, one of the eight tribal areas that make up the Federally Administered Tribal Areas, to the west of Khyber Pakhtunkhwa. The 25-year-old fell from a wall in February last year, damaging her spine. After treatment at the local hospital, she was shifted to the PPC for physiotherapy.

“Not only did the physiotherapists give me tips on different exercises during my two-month stay here, they also helped me acquire computer skills. Now, I work as a composer from home,” Begum told IPS.

She may be confined to a wheelchair now, but that hasn’t dented Begum’s confidence.

On a follow-up visit to the PPC she told IPS that “I have only one son. I feel proud to be able to operate a computer and earn enough so that I can afford a proper education for him. Otherwise, I would have been roaming the streets of Peshawar with a begging bowl.”

She said she couldn’t thank god enough for giving her the opportunity to be able to work and earn her own living despite her misfortune.

The PPC’s chief executive officer, Syed Muhammad Ilyas, takes pride in the progress of his patients. He urges them to regain their physical strength and rather than be a burden on others, learn to help not just themselves but also their families.

“These are healthy young men and women who have become prisoners in their own bodies and have lost control over their bodily functions. One can well imagine the level of frustration and anxiety they go through,” he said.

The trap becomes worse if they are the sole breadwinners of the family, he added. This is, in fact, the case with 80 per cent of the patients who come to the PPC, while more than 90 per cent of them fall below the poverty line.

Many of the spinal cord injuries are sustained during road accidents, said Ilyas. But he added that falls from rooftops, trees or electricity poles, as well as firearm injuries, were also common. Patients at the centre are as young as 26 years old, he said, and they tend to arrive at the centre with little or no hope.

Few things are more expensive than treating and rehabilitating patients with spinal injuries. The cost of rehabilitating a patient in Europe or the United States can go up to millions of dollars. “We achieve the same with a fraction of that amount by getting patients to a stage where they can move about on a wheelchair and by imparting them different skills,” Ilyas said.

Sultana Gul, 51, says she came to the centre for physiotherapy 10 years ago, where she learned skills as a seamstress. Her house in Charsadda district now serves as a training centre for local women, helping many earn respectability and an income.

“In the past decade, I have taught these skills to at least 200 women in my neighbourhood,” Gul told IPS. “Around 10 women, who were earlier reduced to begging in the market square, are now earning their own living because we brought them here and taught them how to knit and sew. We train them for a month after which they teach the same skills to other women around them, everyone making a decent sum of money in the bargain.”

“It takes only a month to train a patient,” said Gul Pari, a trainer at Sultana Gul’s centre. They are initially hesitant to go through training, but agree once you convince them of how it can change their lives, she said. The centre trains about 80 women every year, she said, and there six trainers like her.

And that gives a whole new meaning to women’s empowerment.

Women disabled in Taliban attacks on a campaign in Peshawar to seek rights for themselves and action against the Taliban. Credit: Ashfaq Yusufzai/IPS.

By Ashfaq Yusufzai
PESHAWAR, Mar 18 2013 (IPS)

People disabled through bomb and suicide attacks by the Taliban in the Federally Administered Tribal Areas and the nearby Khyber Pakhtunkhwa province are seeking support for themselves, and demanding strict action against the Taliban.

“There’s an urgent need of a campaign against Taliban militants to stem the tide of militancy and safeguard people,” Muhammad Imran, a resident of Bajuar Agency within the Federally Administered Tribal Areas (FATA) told IPS. Imran, 34, was a successful farmer before he lost both legs in a bomb attack by the Taliban in January 2009.

“Any delay in action against the Taliban would add to the club of the disabled population,” he said.

FATA, located on the border with Afghanistan, was quiet before the arrival of the Taliban whose government was dismissed by U.S.-led forces in Kabul towards the end of the 2001. The region has been a hotbed of terrorism since the Taliban began targeting Pakistan forces, police and marketplaces in 2005.

“The number of disabled persons, widows and orphans has increased alarmingly in KP and FATA since 2005 due to militancy,” KP social welfare minister Sitara Ayaz told IPS. “The government has registered about 100,000 disabled persons and 50,000 widows.”

The number of orphans had also risen, she said. The population is still vulnerable to militancy which can hit people further and lead to more deaths and more people with disabilities, she said. “Only in Swat where the Taliban held sway between 2007 and 2009, about 7,000 people became disabled.”

Javidullah Shah, who now needs support sticks to walk, says he was sitting in his tailoring shop in his native Swat when he was injured in a Taliban suicide attack in September 2008. “After three months, doctors amputated my right leg,” he said. “Now, my only request to the government is that they come down hard on the Taliban because they deserve no mercy.”

Shah says he himself knows of about 150 people disabled in bombs and suicide attacks.

“The majority of people who suffered Taliban atrocities are opposed to any sort of negotiations with the Taliban, and argue that such a dialogue with militants is tantamount to betraying the people who stood by the government in fighting terrorism,” he said.

“The majority of these disabilities are very serious, and these people cannot work,” Dr Akbar Ali, an orthopaedic surgeon in Peshawar told IPS. The injured, he said, included women and children who suffered injuries outdoors, or even inside their homes in conflict zones.

Zari Jana, 50, a housewife, received serious injuries when a rocket landed in her house in August 2009 in Mohmand Agency. “I am now using a wheelchair in my home to move from one place to another, and I cannot work at all,” she said.

The Taliban militants are responsible, she said. “Due to my disability, my children have suffered a lot because I cannot serve them. God will punish the Taliban, they have destroyed thousands of people like me.”

The Habib Physiotherapy Complex in Peshawar is a major centre for treatment. “This year we dedicated Women’s Day to giving free treatment to women who suffered injuries,” Dr Mahboobur Rehman, head of the centre told IPS.

Most of the injured continue to need physiotherapy, he said. But beyond that they also need more support to include them in economic, political and social activities, he said.

“The government is planning a programme for the handicapped population in the conflict areas to reduce their pain, restore or improve function of their affected organs, give them physical exercises and improve the quality of their lives,” said Dr Rehman, who is the focal person for a government programme to rehabilitate the disabled population in KP and FATA.

But, he said, the government has limitations in providing physical health services for the war affected population. “Therefore, we are asking philanthropists to come forward and protect the future of the people who became disabled for no fault of theirs.”

Muhammad Wali from the Khyber Agency was injured by a shell that exploded near him in January this year. He is now awaiting an artificial limb. Hundreds of others are waiting like him, he said, and they need donor agencies to come forward.

Sartaj Ahmed of the social welfare department says the United States Agency for International Development (USAID) is conducting a survey to register widows, orphans and permanently disabled persons with a view to rehabilitating them.

“The majority of the disabled people are becoming beggars. We receive 15 people on average every day seeking financial assistance,” he said.

Underlining the persistent power of their party’s most right-wing elements, a majority of Republican senators Tuesday blocked ratification of the long-pending International Convention on the Rights of Persons With Disabilities (CRPD).

Sen. John McCain, who suffered life-crippling injuries as a result of his plane crash over North Vietnam and subsequent mistreatment as a prisoner-of-war, issued a strong appeal for a favourable vote. Credit: Chris “Mojo” Denbow/cc by 2.0

While sixty-one senators, including a number of senior Republicans, voted to ratify the treaty, it fell five votes short of the required two-thirds needed for ratification under the U.S. constitution. Thirty-eight senators – all Republicans – voted to oppose it.

Nonetheless, the Majority Leader, Sen. Harry Reed, vowed to bring up the treaty for another vote when a new Congress, which will include two additional Democratic senators, convenes next year.

Independent analysts agreed that ratification would indeed be possible because several Republicans who had previously indicated they favoured the treaty changed their position at the last moment.

“I plan to bring this treaty up for a vote again in the next Congress,” Reid said after the vote, which was roundly denounced by human rights and disability groups. “Our wounded veterans and millions more around the world deserve better.”

The White House, which some activists criticised for not lobbying more strongly for the treaty, also expressed disappointment with the result, noting that ratification “would improve the lives of Americans with disabilities – including our wounded service members – who wish to live, work, and travel abroad.”

The Convention was initially negotiated by the administration of former Republican President George H.W. Bush and was largely based on the landmark Americans for Disabilities Act (ADA) that Bush signed into law in 1990. It is one of half a dozen treaties Barack Obama had prioritised for ratification when he became president in 2009. He signed the treaty shortly after taking office.

Besides the disability treaty, the Law of the Sea Treaty (LOST) and the 1979 Convention on the Elimination of Discrimination Against Women were also given top priority.

But none has been ratified due to opposition by Republicans, a majority of whom have argued that international treaties unduly constrain Washington’s freedom of action in the world or threaten U.S. sovereignty.

“The treaty threatens U.S. sovereignty through the establishment of the unelected U.N. bureaucratic bodies called the Committee on the Rights of Persons with Disabilities and a Conference of States Parties that would implement the Treaty and pass so-called ‘recommendations’ that would be forced upon the U.S. as a signatory,” said Oklahoma Republican Jim Inhofe after the vote.

“The ability of (that committee) to investigate and recommend changes also chips away at the ability of a sovereign nation to govern itself.”

The Convention, which was opened for signature in 2007 and entered into force a year later, bans discrimination against people with disabilities and promotes their dignity, independence, and full participation in society. It has been signed by 154 nations and ratified by 126.

“U.S. leadership has been influential in putting disability rights issues on the international agenda, but the Senate vote is a big step backward,” said Antonio Ginatta, US advocacy director at Human Rights Watch.

“Ratifying the treaty would have built on the U.S. commitment to the values embodied in the (ADA) and provided the framework to advance and promote the rights of people with disabilities globally,” he noted.

The treaty’s provisions are considered fully consistent with the ADA, which was approved by the Senate, including a large majority of Republicans, by a 91-6 margin 22 years ago – testimony to how far the party has moved to the right in the two decades since.

Indeed, Republican opposition was particularly remarkable in light of the efforts by two former Republican presidential nominees – both wounded war veterans, no less – to lobby their party colleagues up to the very last minute to vote yes.

Sen. John McCain, the party’s 2008 candidate who suffered life-crippling injuries as a result of his plane crash over North Vietnam and subsequent mistreatment as a prisoner-of-war, issued a strong appeal for a favourable vote, while 89-year-old former Sen. Robert Dole, the 1996 presidential nominee whose arm was shattered during World War II, made an extraordinary and dramatic appearance on the Senate floor in support of the treaty.

“This is one of the saddest days I’ve seen in almost 28 years in the Senate, and it needs to be a wake-up call about a broken institution that’s letting down the American people,” said Senate Foreign Relations Committee Chairman Sen. John Kerry, who led the floor fight and is reportedly on Obama’s shortlist to succeed Hillary Clinton as secretary of state.

“This treaty was supported by every veterans group in America, and Bob Dole made an inspiring and courageous personal journey back to the Senate to fight for it,” he said. “It had bipartisan support, and it had the facts on its side, and yet for one ugly vote, none of that seemed to matter.”

But the opposition, including the Republican leadership, was determined. After the Nov. 6 elections, no less than 36 Republican senators – enough to block any ratification – signed on to a letter opposing consideration of any treaty during the current “lame-duck” session of Congress.

Preventing ratification of the disabilities treaty also became post-election crusade of far-right former Pennsylvania Sen. Rick Santorum, a disappointed rival of Mitt Romney’s for the 2012 presidential nomination whose well-funded political action committee, Patriot Voices, mobilised its Tea Party supporters around the country. The far-right Heritage Foundation also campaigned against the treaty.

Last week, Santorum, during a press conference featuring his own four-year-old severely disabled daughter Bella, who was born with Trisomy 18, argued that the treaty’s “best interests of the child” standard could result in the government’s determining that she was not entitled to special treatment that was designed to keep her alive.

“Now that the CRPD is defeated, we know that the United Nations won’t have oversight of how we care for our special needs kids,” Santorum said after Tuesday’s vote.

Santorum and other treaty foes also mobilised opposition from the growing home-school movement, whose roots lie in the 1960s “counter-culture” but which now consists mostly of Evangelical Christians and Tea Party activists.

“I and many of my constituents who home-school or send their children to religious schools have justifiable doubt that a foreign body based in Geneva, Switzerland, should be deciding what is best for a child at home in Utah,” Utah Sen. Mike Lee, who also objected to the reporting requirements included in the treaty, told The National Review this week.

But these reasons were mocked by the treaty’s backers who said the Republican position recalled the right-wing paranoia of the early 1990s when members of the so-called “militia movement” raised alarms about alleged “black helicopters” from the U.N. running surveillance flights over the U.S. heartland.

“The 38 senate curmudgeons who voted down this treaty remain stuck in a partisan twilight zone of U.N. black helicopters and conspiracy theories – even when the U.S. Chamber of Commerce, veterans groups, and disabilities rights organisations were clear about what was best for the nation and the world,” said Don Kraus of Citizens for Global Solutions, a national grassroots group.

*Jim Lobe’s blog on U.S. foreign policy can be read at http://www.lobelog.com.

In 1996, Maria Mamerita Mestanza Chavez, a 33-year-old Peruvian mother of seven, was threatened with imprisonment if she did not comply with the government policy of undergoing sterilisation. After suffering post-operative complications for which she was refused treatment, Chavez died nine days later.

After years of legal proceedings in the Inter-American Commission on Human Rights (IACHR), in 2003 the Peruvian government finally acknowledged international legal responsibility for its actions.

Chavez’s story is not the only case in which national law has forced women to undergo involuntary sterilisation. Although many women’s and disability rights organisations and other human rights bodies have condemned coercive sterilisation, thousands of women and girls worldwide are still denied the right to make decisions about their own reproduction.

Participants on the first day of the Fifth Session on the Conference of States Parties to the Convention of the Rights of Persons with Disabilities, hosted by the U.N. Sep. 12-14, 2012. Credit: UN Photo/Rick Bajornas

Involuntary sterilisation, an operation which, without an individual’s consent, permanently ends his or her ability to reproduce, has occurred in regions with many different cultural backgrounds, ranging from the United States and Switzerland to Japan, China, Puerto Rico, Brazil and others.

The operation “has historically targeted…marginalised groups of women such as women with disabilities, women from ethnic minorities, indigenous women, low-income women and women living with HIV”, said Luisa Cabal, vice president of the New York-based Centre for Reproductive Rights, at a side event organised by the World Health Organisation (WHO) at the U.N. headquarters Sep. 13.

WHO estimates that over a billion people in the world, or approximately 15 percent of the global population, have disabilities.  According to a WHO report, disabled women are particularly vulnerable to involuntary sterilisation.

Forced sterilisations on disabled women are often performed under the auspices of medical legal services or with the consent of court-appointed guardians, who have the authority to decide on behalf of the patient. Various justifications are offered for the procedure, including disabled women’s inability to parent, protection from sexual exploitation and abuse, population control, or so-called menstrual management.

An international approach

The United Nations Convention on the Rights of People with Disabilities (CRPD), adopted in 2006 and ratified so far by 119 countries, recognises that disabled individuals have the right to make decisions freely and responsibly regarding their reproductive lives.

These rights and others were discussed at the Fifth Session of the Conference of States Parties to the CRPD, which concluded at U.N. headquarters Sep. 14. This year’s conference focused on women and children.

Strongly advocating the rights of women with disabilities at the conference was Prince Zeid Ra’ad Zeid Al-Hussein, Jordan’s ambassador and permanent representative to the United Nations.

In his remarks at the opening session, Hussein outlined the role Jordan’s Higher Council for Affairs of Persons with Disabilities (HCD) has played in raising awareness of and advocating for the rights of Jordanian women with disabilities who are subject to sterilisation, which he called a “misconceived and shameful practise”.

“The committee targeted parents, doctors and gynecologists, legal experts and judges as well as religious leaders to address this issue,” Hussein explained.

Despite the existence of the CRPD, disability is not even explicitly mentioned in the U.N.’s Millennium Development Goals (MDGs), pointed out Ahmed Abul Kheir, Egypt’s ambassador and advisor to the Minister of Social Affairs. He urged the U.N. to tackle the issue at a high-level meeting of the General Assembly on disability and development in September 2013.

Government accountability

In 2011 five women with mental disabilities brought their case before the European Court of Human Rights. Each had involuntary undergone the process of tubal ligation without their informed consent. This case, Gauer and Others vs. France, remains open but is considered best example of how involuntary sterilisation can be effectively tackled by international institutions.

“A positive decision from the court in this important case would have a tremendous impact on reinforcing the autonomy of women with disabilities with respect to their reproductive health,” said Yannis Vardakastanis, president of the Brussels-based European Disability Forum, in a press release.

“States are under an obligation to take measures to prevent such violations and to investigate and prosecute them to the fullest extent when they do occur,” he added.

Nevertheless, preventive measures and support services are often limited and insufficient, according to Cabal, the Centre for Reproductive Rights vice president.

“Governments and health institutions have weak or inadequately implemented informed consent policies, guidelines, procedures to protect patient rights,” she said. “There is very little accountability for the ethical and human rights violations.”

“The human rights obligations of each state requires the adoption of all necessary measures – legislative, budgetary, judicial and administrative – to ensure women with disabilities access to reproductive health services,” Cabal told IPS. States must also establish accountability mechanisms to ensure laws and policies are fully implemented.

Moreover, victims of forced sterilisation must have access to the court system to vindicate their rights, Cabal said.

According to Erszébet Földesi, the vice president of the European Disability Forum, one of the main challenges preventing forced sterilisations is providing women with disabilities with appropriate information about their sexual and reproductive health care options. Another challenge is obtaining their free, full and informed consent to such procedures.

Health professionals ought to be “trained to deal with and assist women with disabilities in the area of sexuality and reproductive health and motherhood”, she added.

Asked what support must be delivered to the victims of forced sterilisation, Földesi told IPS that victims must have access to “recovery, rehabilitation and social integration”.

Highlighting the issue through social media networks or elsewhere online could help raise the awareness of the general public and policymakers about forced sterilisations, Földesi added.