Living in war zones: The experiences of individuals with disabilities

Dr. Carmit-Noa Shpigelman & Prof. Marc Gelkopf Department of Community Mental Health,

University of Haifa, Israel

Email :carmits@univ.haifa.ac.il

The study was supported by the National Insurance Institute of Israel

RI World Congress, October 26th 2016

Exposure to Chronic Political Violence

• Anxiety

• Posttraumatic stress disorder (PTSD)

• Depression

• Health problems and functioning difficulties

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The United Nations Convention on

the Rights of Persons with Disabilities

Article 11: Situations of risk and humanitarian emergencies

States 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.

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Qualitative Methodology

• 3 focus groups (physical/visual/hearing disabilities).

• 18 participants (12 women and 6 men). • The majority (94%) had a congenital disability. • All the participants lived in the community

(alone, with a spouse and/or children or with their nuclear family).

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1. External stressors

1.1 Inaccessible physical environments • "I always think to myself if I hear the rocket alarm at

night, will I get into the shelter in time or not? I can't just stand up [a wheelchair user] and race for a shelter.“

• "The protective chemical mask that we had to wear [during the First Gulf War] is not accessible for users of vision or hearing aids such as glasses or a hearing aid."

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1. External stressors

1.2 Lack of information

• "I was tense and worried about whether I would hear the rocket alarm or not because the beeper did not work well."

• “The subtitles in the news are incomplete; the titles only summarize what happened. They don't transcribe every word."

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1. External stressors

1.3 Caring for others

• "This situation is very stressful since you have to take care of two - yourself and your dog."

• “I felt tense since I had to take care of my kids.”

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2. Responses to stressors

2.1 Emotional responses

• “As soon as the rockets came close to my apartment building, I was anxious and felt helpless.“

• "The first rocket fell very close to our apartment building. I became agitated. I felt as though I didn't have the mental strength [to cope]."

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2. Responses to stressors 2.2 Behavioral responses • "I don't go out alone. I prefer to join my brother,

who can hear and warn me.“ • "During the war, I went to bed wearing my

hearing aid and the implant. I didn't remove it at night. Although it was uncomfortable, I could not let myself be completely deaf even for a moment."

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2. Responses to stressors

2.2 Behavioral responses • "My mom was very tense and it had an impact on me.

She called me many times while I was studying at the university and she kept asking when I was coming back.“

• "Every time I heard an ambulance siren, I was very tense; it sounded like a rocket alarm.“

• “I could not hear [the rocket alarm] so I sat in the living

room and continued to do a crossword puzzle. I remember that I wanted to deny the fact that there was a war."

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2. Responses to stressors 2.2 Behavioral responses • "During the war, I hung on to my routine. I didn't go

to the grocery, postponed shopping, and other chores.“

• "I didn't leave the house as there was no-one to ask for help."

• "When the rockets started to fall very close to my home, I asked the disability organization to help me find a safer place.“

• "First, I looked at what I could do for others, if there were any casualties."

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3. Future recommendations

3.1.1 Organizational level • "We need adapted chemical masks; a mask that will

not press the implant.” • "One authority should integrate all services for

people with disabilities." • "Service providers should learn about people with

disabilities, their needs, and how to adequately communication with them.”

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3. Future recommendations

3.1.2 Personal level

• "You should look for accessible shelters in advance.”

• "We have to practice what to do through

simulations.”

• "We don't know and don't assert our rights. We must get this information."

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Conclusion

Rehabilitation practices should learn how to accommodate services to meet the needs of individuals with disabilities in a way that should protect their safety and ensure their well-being and quality of life.

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Thank You for your Attention!

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Carmit-Noa Shpigelman & Marc Gelkopf (2016): The experiences and needs of individuals with disabilities exposed to chronic political violence, Disability and Rehabilitation, DOI: 10.3109/09638288.2016.1138557