According to the World Health Organization, about 15% of the World’s population has some form of disability; 2-4% has significant functioning barriers. In Nepal’s case, there is still not a comprehensive data available on disability; however, available statistics are varied by source to source. According to the Central Bureau of Statistics, the prevalence of disability is 1.94%. The disability sector always remains back, specifically in the middle- and low-income countries. The global crisis of COVID-19 puts people with disabilities at the highest risk in developing countries like Nepal. Due to accessibility challenges, social norms, culture, poverty, inadequate legal provision, lack of rehabilitation facilities for persons with disabilities- keep them the highest risk of COVID -19 It is because of the various comorbidities and pre-existing medical conditions they are suffering. People with disabilities dependent on support workers can not maintain appropriate physical distancing, increasing their vulnerability to infection from COVID-19. Simultaneously, persons with disabilities are less likely to use modern technology that inhibits them from getting relevant information relating to the virus.

Furthermore, people with disabilities encounter numerous challenges to getting daily needs such as medicine, incontinence supplies, antiseptics, etc. which are basic needs of them. At the same time, they are deprived of necessary services such as nursing care, physiotherapy, occupational therapy, counseling, and other essential supports. As a result, their condition can deteriorate continuously, and they will suffer more.

If we do not think this issue seriously this time, the situation will go out of control. After a crisis also, their condition becomes miserable. Personal Protective Equipment (PPE) is essential for preventing the spread of this virus to and from healthcare professionals and people with disabilities that rely on the availability and appropriate use of PPE-gloves, face masks, respirators, goggles, face shields, and gowns.
Additionally, pandemic brings mental health issues in people with disabilities due to social segregation and uncertainties of the future. As I know, there are no accessible mental health and counseling services available for persons with disabilities in the Nepalese context. There is no specialized hospital set up for people with disabilities in Nepal (both physically and professionally). In my mind, there is no emergency response plan for persons with disabilities in Nepal. There are many challenges around people with disabilities to utilize existing public health facilities that keep them in the vulnerability of COVID-19.

In the present-day scenario, people with disabilities have limited access to daily necessities such as medical care, medicine, food, and other accessories to manage their condition. Various people with disabilities have distinct needs as the types and severity of disabilities. In this circumstance, people with disabilities, including their families, are directly affected by this devastation. So, special attention should be needed to cope with this situation and safeguard people with disabilities utilizing the following measures:

1. Local-level government has the sole responsibility to manage disabilities in Nepal. They need to update the record and provide the necessary service to them. For example, giving relief packages for them, keep contact with them, ensure they are getting daily necessities, and getting support to cope with this threat. The person who has restricted access and living in the community should deliver extra relief packages on their residence.
2. Government or stakeholder can give special priority to persons with disabilities and should be announced a special package for them and ensure they get it through local government.
3. Remove barriers for the people with disabilities to get relief packages and ensure they are getting required services as their need. They should be in priority as they are the vulnerable populations of this catastrophe.
4. People with disabilities who are staying with their families should provide constant care to them as their need and need more emotional support at this particular time. Families should offer more choices to keep them happy, safe, and stress-free.
5. The service provider should be more flexible at crisis time and provide holistic care to persons with disabilities.
6. People with disabilities in institutional-based rehabilitation (IBR) facilities need the same type of care and services they received before this pandemic. Currently, they need more emotional support and mental health care, along with regular care.
7. Ensure people with disabilities receive necessary materials, including food, medicine, incontinence supplies, and personal protective equipment to safeguard themselves and their networks.
8. Watch, observe, and learn from overseas, manage this situation, and provide services to persons with disabilities in this crisis and apply them in our local circumstances.
9. Encourage and use community resources (local leaders, organizations, volunteers, community networks) to identify who is in need and struggling to survive in this catastrophe.
10. Connect people with disabilities through digital devices and assure them we all are with them. They are not alone in this situation. This provides them belongingness and inclusion and encourages them to cope with the situation.

To conclude, the disability sector is constantly behind. It remains in the shadow, and the voice of people with disabilities is not heard appropriately. In a crisis, they are highly vulnerable people, they need extra support to keep them safe and sound. Our responsibility is to make sure they are getting appropriate care and services as they need either they are living with their family, living independently, or in care/service facilities.

October 1, 2020