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Nepal and climate change: the challenges faced by people with disabilities

Health Prevention
Nepal

In 2023, HI published a report highlighting the impact of climate change on people with disabilities in Nepal, one of the countries most exposed to the consequences of this phenomenon.

A person in a wheelchair stands where HI's activities take place.

During the floods in Nepal in 2017, HI launched an emergency response to help those affected. | © HI

It is becoming increasingly clear that the effects of climate change on people with disabilities are exacerbated by multiple pre-existing vulnerability factors, such as poverty and stigmatisation, but there is little data illustrating the links between disability and climate change. To help shed some light on these links, Handicap International has conducted a survey  among people with disabilities in Nepal.In Nepal, communities relying heavily on natural resources for their livelihoods are particularly vulnerable to  major climate risks such as floods, landslides and droughts.

Easy-to-understand warnings 

HI's survey shows that in the event of extreme weather events, people with disabilities face additional challenges, starting with a lack of access to warning information. This limits their ability to take protective measures before the event happens.

While most of the people surveyed seemed to be familiar with the principle of weather forecasting, awareness of an early warning system in their community for extreme weather events was very low: 85% stated they were unaware of the existence of such a system, and this figure was even higher among the over-60s (97%).
The survey further shows that these warning systems are not sufficiently adapted to the needs of people with disabilities: messages inaccessible for people with hearing loss, simulation exercises not sufficiently inclusive, etc.

"There’s still huge room for improvement, but we’ve identified some examples of good practice shared by organisations of persons with disabilities (OPDs). OPD representatives have reported improvements since the COVID-19 pandemic. Information is now easier to understand, with sign language interpreters used in information videos, more accessible formats for web documents and more audio documents. These initiatives are encouraging," explains Jennifer M'Vouama, HI's Disaster Risk Reduction expert.

Safe shelters, accessible to everyone

HI’s survey found that, in reaction to a warning, or when a disaster occurs, the majority of the people surveyed (87%) do not take any particular evacuation measures and stay at home. 

Yet shelters play an essential role in protecting people affected by disasters. Unfortunately, 80% of the respondents reported a lack of fully accessible shelters for people with disabilities, although recently built infrastructures are a little more compliant with standards, with ramps and accessible toilets, for example, which indicates greater inclusion of people with disabilities. However, needs exceed available resources. The decision to stay at home was found to be mainly due to concerns about safety in public shelters: accounts of harassment, violence and abuse were shared by those surveyed.

"Many women reported that the lack of separate spaces and privacy was a major problem, particularly when it came to menstrual hygiene. It was also massively reported that the shelters were unsafe for women and girls, particularly those with psychosocial disabilities", says Jennifer M'Vouama.

For these reasons, most of the people surveyed stated that they prefer to stay at home; they feel this is a safer solution than collective shelters.

Unconditional access to healthcare

After an extreme weather event, it is difficult for people with disabilities to access humanitarian aid on an equal footing with others and to receive aid that effectively meets their specific needs. 
Climate disasters often cause major disruption to already fragile health systems.When the health services are finally able to resume their activities, they are stretched to the limit and struggle to care for people with special needs, such as people with disabilities.*

People with disabilities living in rural and isolated areas already have problems accessing health services. For example, mobility and transport are a major challenge for people who use wheelchairs and live in hilly areas, as the roads are not accessible. People with disabilities are also vulnerable to neglect and inadequate healthcare. Discrimination and stigmatisation have been reported, particularly against people with psychosocial disabilities, further reducing the quality of care.
Disaster situations exacerbate these pre-existing vulnerabilities, with 56% of respondents stating that extreme weather events limit access to their usual healthcare facilities. 

"Before disasters, people with disabilities are probably less prepared, less able to perceive risks and access warning information - and to act accordingly. During disasters, they are therefore less able to escape danger and risk losing essential medication and assistive equipment such as prostheses, or being left behind in an evacuation. This leads to major disruptions in the continuity of their care, with serious consequences," concludes Jennifer M'Vouama, HI expert in Disaster Risk Reduction.

The impacts of climate change on mental health

In the eyes of people with disabilities, the general population is better equipped to access food and shelter. They, on the other hand, often feel more vulnerable, with a limited ability to cope mentally and emotionally with the stress that these situations create. This is particularly true for people with mental health issues. Distress caused by climate change concerns has been observed, particularly among people whose livelihoods depend heavily on natural resources.Moreover, in rural areas, family units are regularly broken up. Young people and men are increasingly moving to urban centres in search of work, thereby weakening the support network for people with disabilities. Under normal circumstances, mental health support is generally inadequate and unevenly distributed across the country.Nepal has just 200 psychiatrists and a handful of mental health professionals for its 30 million inhabitants. These professionals are mainly based in towns and cities, leaving smaller towns and rural areas with poor access to mental health services. Moreover, mental illness is linked to social taboos and superstitions; many people avoid seeking mental health care because of the stigma, discrimination and the high cost of psychiatric care and medication.

Anticipating risks and preparing communities for the impacts of climate change 

One of the ways to protect people with disabilities from climate change is to give communities the means to anticipate and prepare for the risks. Urgent action is required, which is why HI is deploying around twenty disaster risk reduction projects in countries prone to climate disasters, such as Madagascar, the Philippines, Mali, Nepal and Haiti.  HI’s teams work hand in hand with organisations representing at-risk groups, in particular OPDs, so that they can make a significant contribution to the public debate and decision-making processes on climate change, at all levels.

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