Submission from Keelin Barry, Irish Research Council Government of Ireland PhD scholar, Irish Centre for Human Rights (ICHR) and Centre for Disability Law and Policy (CDLP), School of Law, University of Galway, Ireland
November 17, 2023
This statement aims to respectfully request urgent attention to the current catastrophic situation faced by persons with disabilities in Gaza.
Israel ratified the Convention on the Rights of Persons with Disabilities (CRPD) on the 28 September 2012. Israel has a clearly defined responsibility to take all measures to ensure the safety and protection of all persons with disabilities, under Article 11 of the Convention on the Rights of Persons with Disabilities (CRPD) titled ‘Situations of Risk and Humanitarian Emergencies’.
‘State Parties shall take, in accordance with their obligations under international law, including international humanitarian law and international human rights law, all necessary measures to ensure the protection and safety of persons with disabilities in situations of risk, including situations of armed conflict, humanitarian emergencies, and the occurrence of natural disasters’ United Nations, (2006).[1]
This statement aims to highlight the extreme and particular risk to life, precarity, injury, and protracted suffering that persons with disabilities and older people face, living in Gaza during the widespread attacks on civilian areas, civic infrastructure, refugee camps, designated shelters and medical facilities in all parts of Gaza. We also wish to acknowledge, and bear witness to, the immense bravery and agency of persons with disabilities and older people in Gaza, who have been disproportionately affected by the previous wars on Gaza, and the 17 year blockade.
We call Israel to account on its obligation to comply with the object and purpose of the Convention on the Rights of Persons with Disabilities during the current armed conflict in Gaza, specifically in relation to Article 11 ‘Situations of Risk and Humanitarian Emergencies’ of the CRPD.[2] We call for an immediate ceasefire, and the full protection of persons with disabilities living in Gaza. We also remind Israel of its duty to uphold its obligations under international human rights law and humanitarian law, as well as its obligations under United Nations Security Council Resolution 2475, to protect persons with disabilities during armed conflict. We stand in solidarity with persons with disabilities and older people in Gaza, and assert that calling for a full and immediate ceasefire is an issue of disability human rights and justice.
According to UNOCHA as a result of the complete collapse of the health system the Gazan Ministry of Health (MoH) has been unable to update the fatality figures since 10th November 2023, when it last released fatality figures of 11,078 people killed, of whom 4,506 are children, 3,027 are women, and 678 are elderly people. A further 27,490 people in Gaza have been injured as of the last MoH update on 10 November 2023 (with a likely significant increase in fatalities and injuries in the past seven days without a MoH update of the figures). It is estimated that another 2,700 people are currently missing including 1,500 children. Over 1.6 million people have been displaced since 7 October 2023. Of those killed 68% of fatalities are estimated to be women and children. In addition, the widespread destruction of civic infrastructure, whole neighbourhoods, universities, medical facilities, roads, and community facilities have a direct correlation to the loss of disabled accessible support infrastructure in Gaza, which will have catastrophic impacts on access, agency, and the participation of persons with disabilities in public life in Gaza for years to come.
During armed conflict, persons with all types of disabilities, as well as older people can be largely invisible, and are therefore at heightened risk during conflict, and are disproportionately impacted by violence.[3]
Since October 13 2023, there have been ongoing short notice evacuation orders given by the Israeli authorities to the people of Gaza, instructing the entire population to ‘evacuate’ from the North of Gaza to the Southern region, including evacuation warnings for hospitals without any safe pathways or places to be able to evacuate to for safety. The reality is persons with disabilities and older people may not be included in emergency ad hoc evacuation attempts during the attacks on Gaza or may physically not be able to evacuate as a direct result of their disability(ies). This means some persons with disabilities will not be able to evacuate and will remain at home when others leave to try to seek safety.
Specific issues impacting disabled people in Gaza include a lack of electricity resulting in lifts not working in high rise apartment blocks acting as a barrier to disabled people trying to evacuate. Most bombardments happen without notice, or with very short notice. These warnings, where given, may allow only minutes to evacuate, which is not enough time for many persons with disabilities to evacuate to safety.
Other barriers to evacuation arise for persons with certain types of disabilities including those with physical disabilities (including people who use mobility aids), as well as older persons with disabilities, low vision or blind persons with disabilities, people with intellectual disabilities, deaf or hard of hearing people, people with psychosocial disabilities, and children and women with disabilities who may face additional barriers to being able to evacuate. In addition, some persons with disabilities may be unable to leave due to lack of accessible evacuation options and high support individual needs acting as a barrier to evacuation. Another barrier to persons with disabilities evacuating is that the bombing of Gaza has caused extensive damage to the local environment creating inaccessible pathways for disabled people.
The widespread loss of life and huge burden of injuries sustained has also resulted in many persons with disabilities themselves being killed or injured. In addition, the significant numbers of people including children who have been severely injured in the bombings of Gaza will undoubtly cause many people to have newly acquired long term disabilities because of these injuries, with potentially lifelong impacts. Persons with disabilities may also face a loss of personal carers and family care supports because of the injuries or death of their carers and family members. The loss of these social and kinship support mechanisms increases levels of risk, isolation, and reduces agency and coping strategies available to persons with disabilities and older people living in Gaza.
The ongoing 17-year blockade of Gaza has seen the people of Gaza already experiencing widespread food insecurity, malnutrition, and entrenched poverty as a result of this structurally violent protracted blockade. Since October 7, 2023, the situation has worsened.
The bombardment of the Southern part of Gaza has also occurred, which disproportionately impacts on persons with disabilities and older people who have been displaced as a result of Israeli warnings to move to the South of Gaza, but who may not have support services or accessible accommodation available, including those who are living in tents and overcrowded shelters.
Cutting of electricity and communication by phone and internet also disproportionately negatively impacts on disabled people. For example, the lack of electricity limits the operation of electric wheelchairs or scooters, CPAP & BPAP machines, dialysis equipment, prevents persons with disabilities charging their phones and being able to operate vital assistive technologies.
The restrictions on access to internet and limited communications also disproportionately impacts upon persons with disabilities who may use mobile phones as a means of alternative communication and assistive devices. This compounds the already existing problem that most emergency information in conflict is not made accessible to persons with disabilities, and without access to the internet this reduces persons with disabilities ability to directly access information.
The entire population in Gaza is water insecure with water production currently at 5% of normal capacity. According to the UNICEF WASH Cluster as of November 2nd 2023, 2.3 million people of Gaza have access to 6 litres of water per day (domestic and drinking) in comparison to the World Health Organisation (WHO) daily recommendation of 100 litres per person per day. In addition, there is a lack of electricity to pump and clean water so individuals in Gaza are not able to easily access clean water. People are drinking brackish water, which increases risks to health because of waterborne diseases, and dehydration, especially persons with disabilities who may face additional barriers to accessing clean water. According to OCHA people drinking water from agricultural wells are consuming saline water with over 3,000 mg per litre of salt content. This causes serious health risks raising hypertension levels, especially in babies under six months, pregnant women, people with kidney disease, and also increases risk of diarrhoea and cholera, with potentially negative health impacts on persons with disabilities. In addition, it is important to remember that there is often a requirement for persons with disabilities to have access to clean water for certain medical equipment to function.
The basics of life such as access to clean water, electricity, heat, cooking gas, and food have been severely cut since the war began, compounding an already food insecure precarious situation as a result of the long 17 year blockade of Gaza. During the current Israeli military strikes, ongoing bombings of civilian targets such as bakeries, community buildings, and neighbourhood shops have occurred across Gaza. The lack of food has seen pictures of hundreds of people queuing for food and bread for hours each day despite the risks. However, the reality is many persons with disabilities are not able to queue for hours for food and are therefore currently in a position of extreme food and water insecurity. Some persons with disabilities have special nutritional requirements, including medical nutritional formulas that may not be available as a result of the erosion of medical stocks and supplies, as well as difficulty accessing pharmaceutical supply centres, due to destruction of medical facilities, and difficulty travelling. People fleeing bombings may have left assistive devices behind or have had assistive devices destroyed in the bombings. Supplies of batteries for people who use hearing aids may not be available, or batteries for other assistive devices. Similarly, many persons with disabilities require medications or medical supplies for chronic health conditions including insulin for diabetes, heart medications, cancer drugs, pain management drugs, psychiatric drugs, and other specialist treatment drugs, that are not available due to a lack of supplies of medicines, with negative health consequences. According to OCHA, people currently at high medical risk in Gaza include 1,000 kidney failure patients, 9,000 cancer patients, and 130 neonatal babies in incubators.
Prior to the current war on Gaza, as a result of the protracted 17 year Israeli blockade, there was already a severe lack of access to medicine and medical equipment and supplies of all types. Since October 7, 2023, Israel has only allowed the bare minimum of medical supplies to enter Gaza. This has resulted in a complete collapse of the health system and depletion of medical supply stock available, which disproportionately impacts persons with disabilities, many of whom rely on medications and medical equipment to sustain life.
All women who are pregnant, including disabled women who are pregnant, face extreme risk being pregnant and giving birth in Gaza. Access to post-partum care for pregnant women including disabled women is also likely to be reduced.
According to OCHA, 1.6 million people are currently internally displaced in Gaza. Internally displaced persons (IDP’s) with disabilities are often forced to live in inaccessible overcrowded accommodation such as UNWRA schools, tents, or other shelters. The first winter rains and flooding have occurred in Gaza this week, heightening the grave difficulties persons with disabilities face living in these shelters in wet and cold conditions during the coming winter months.
Another significant issue for displaced disabled people living in crowded shelters are the widespread lack of disabled accessible toilet facilities which is very problematic, as a majority of toilets are squat toilets and are not accessible to use for many persons with disabilities.
Some persons with certain types of disabilities may have a strict bladder and bowel management plan that necessitates bladder self-catheterisation every three hours, for example for those with spinal cord injuries. Similarly, a lack of running water and ability to shower for certain persons with disabilities including those with skin integrity issues, or bowel or bladder incontinence can have negative impacts on their health. Lack of available supplies of hygiene and sanitary products, continence pads and continence aids, menstrual hygiene products, and other required medical supplies also have negative health ramifications for persons with disabilities. Concerns have also been raised about an extreme lack of sexual and reproductive health supplies including a lack of access to contraceptives, and lack of access to sexual and reproductive health care for internally displaced women and girls.
Displaced persons with disabilities face increased risks in new unfamiliar environments, that are not accessible. These locations can be extremely difficult for persons with disabilities to orientate to and navigate. This is especially the case for persons with disabilities who as a result of death or injury of carers over the past five weeks, may face additional difficulties navigating these new shelter environments having lost kinship support and carers. Orientation and access issues in internally displaced shelters can also be extremely challenging for individuals with certain types of disabilities such as blindness and visual impairment, physical disabilities, hearing impairments, intellectual disabilities, as well as those who have recently sustained injuries or acquired new or additional disabilities.
There is a lack of access to emergency psychosocial supports in Gaza, and prior to this war there was a dearth of long term psychosocial supports available. This is particularly relevant for people who have sustained newly acquired psychosocial disabilities, in the context of Gaza’s current severe lack of emergency psychosocial supports not being available. It is also important to recognise the impact of trauma on children, with a particular focus on the heightened vulnerabilities of children, including children with disabilities, who have lost parents and grandparents, and other family support members.
Just as medicine shortages impact on the health of persons with physical disabilities and chronic illnesses, many persons with psychosocial disabilities may want access to a consistent supply of psychiatric medications. The current severe lack of medications in Gaza includes interruption of access to psychiatric medications, which could result in negative health consequences for persons with psychosocial disabilities.
Over the past five weeks, the grave, unprecedented levels of violence and ongoing indiscriminate bombardment of Gaza is arguably a mass disabling event, including widespread psychological trauma, injury, and newly acquired forms of disability for both children and adults, that will have potentially lifelong impacts on people’s lives in Gaza.
We call for:
- An immediate ceasefire.
- Immediate and unconditional release of all hostages.
- Effective protection to all persons with disabilities in Gaza respecting and fulfilling Article 11 of the Convention on the Rights of Persons with Disabilities (CRPD) ‘Situations of Risk and Humanitarian Emergencies’.
- Compliance with United Nations Security Council Resolution 2475 adopted in 2019, to protect persons with disabilities during armed conflict.
- Humanitarian access, with immediate opening of all border crossings into Gaza including Kerem Shalom, Erez Crossing, and the Rafah Crossing, expediating all medical supplies, fuel, and food entry to the Gaza Strip.
[1] CRPD, (2006), Art 11:10.
[2] To see 14th March 2023 Joint Irish Centre for Human Rights (ICHR) and Centre for Disability Law and Policy (CDLP) submission to the CRPD Committee Draft General Comment on Article 11 of the CRPD please see: https://www.universityofgalway.ie/media/irishcentreforhumanrights/files/14.2.23-Keelin-Barry-Joint-Sublmission-ICHR-and-CDLP-to-the-Draft-General-Comment-on-Article-11-of-the-CRPD-docx.pdf.
[3] See: Report of the UN Special Rapporteur on the Rights of Persons with Disabilities, Mr Gerard Quinn, 19th July 2021, A/76/146, ‘Rights of Persons with Disabilities in the Context of Armed Conflict’ available here, and his subsequent thematic report 20th July 2022, A/77/203, ‘Protection of the Rights of Persons with Disabilities in the Context of Military Operations’ available here. Also of note is that on the 1 of November 2023, Human Rights Watch released its report ‘Gaza: Israeli Attacks, Blockade, Devastating for Persons with Disabilities’ which documents the difficulties persons with disabilities face in the current Israeli war on Gaza, and importantly details testimony directly from persons with disabilities living in Gaza that is available here.
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