3. Targeting by society
3.7 People with disabilities
ISIL fighters Human Rights Watch notes in January 2017 that tribal leaders in Anbar are blocking their return home.1408
For more information on tribal dispute resolution see EASO COI Report, Iraq: Actors of Protection.
The same source mentions that ‘the disabled are often kept hidden away in their homes with little exposure to the rest of society. Most Iraqis with disabilities are socially and economically excluded because of the lack of infrastructure, medical care, prosthetic equipment, and social and rehabilitation services. While not all Iraqis with disabilities are marginalized, the majority of them are.’1418 Furthermore, the chances of employment are rare for people with disabilities.
If employed, they are often relegated to low-skilled, low- paid job.1419 According to USAID, ‘the vast majority (estimated at 90 %) of Iraqis with disabilities live in poverty.’ Most often his/her family is the only support that a person with disability will have. As such, all respondents contacted by USAID perceive the family as the core contributor – either benefiting or limiting- to their health, safety and enjoyment of life. USAID further notes that families function within a wider social context that discriminates against people with disabilities and frames their families’ treatment of them:
‘Tribal masculine culture alongside religious conservatism dominates Iraqi society.
Rigorous gender roles, separation of men and women (especially in public places), cultural norms that confine women to the private sphere and expectations of heightened masculinity all have a direct impact on Iraqis. These dovetail with discriminating social attitudes towards people with disabilities to exacerbate the difficulties they face living in Iraq.’1420
Discussing civil society support for people with disabilities, USAID reports such groups in Iraq
‘suffer from lack of or irregular funding’ but noted that civil society has a longer history in the KRI, so civil society support for people with disabilities is ‘more established’ in the region than in other areas of Iraq. The same source remarked that in the KRI ‘only 2 % of people with disabilities do not receive the social security salary. Although the legislation is equal for men and women, the implementation of the law takes discriminative forms.’1421
3.7.2 Health care for people with disabilities
A December 2017 report by the Carnegie Endowment for International Peace noted that Iraq’s already compromised public health system is struggling to provide adequate support to the growing number of people with disabilities and chronic diseases. At 3 % of GDP, the share of Iraq’s budget allocated to the health sector is low compared to other Middle East and North African countries. Government-run facilities that treat long-term disabilities struggle to provide cost-free treatments.1422
Discussing the possibility to live independently and to be included in the community, UNAMI remarks that the Iraqi health care system appears overstretched and suffers from lack of infrastructure, equipment and capacity.1423 The same source further states that ‘the psycho-social health sector in particular is perceived to lack specialized and trained staff and is under-resourced.’ Such is the result of increased poverty, due to the conflict, the international sanctions regime during the 1990s, as well as the targeting of medical and paramedical professionals during 2003-2008, which led to a ‘brain-drain’ of specialised health professionals.1424 Some of the NGOs interviewed by UNAMI also note the limited help families
1418 USAID, Iraq access to justice program, March 2014, url, p. 11.
1419 USAID, Iraq access to justice program, March 2014, url, p. 23.
1420 USAID, Iraq access to justice program, March 2014, url, p. 21.
1421 USAID, Iraq access to justice program, March 2014, url, p. 26.
1422 Boskovitch, A., A struggle to care for Iraq’s disabled, 20 December 2017, url.
1423 UNAMI/OHCHR, Report on the Rights of Persons with Disabilities in Iraq, December 2016, url, pp. 11-14.
1424 UNAMI/OHCHR, Report on the Rights of Persons with Disabilities in Iraq, December 2016, url, p. 11.
of persons with disabilities receive from the State to support them. Civil society organisations working on disability rights reported to UNAMI that they received limited or no state financial support. Respondents to the questionnaire UNAMI sent out acknowledged that some health care facilities were available for persons with disabilities. However, these services seemed to be decreasing, were mostly available in larger urban centres, and tended to focus on persons with physical disabilities.1425 USAID notes the limited number of doctors available in Iraq stating that ‘In the Muslim world, Iraq’s doctor-patient ratio was higher only than Afghanistan, Djibouti, Morocco, Somalia and Yemen.’1426
Persons with disabilities can get an allocation of USD 35 per month. If the impairment is acquired as a result of previous or current conflicts, the disability pension ranges from USD 250 to USD 750 per month. Persons who acquired their disability as a result of terrorist attacks are eligible to receive a lump-sum payment of USD 3 500, in addition to a USD 350 monthly payment. UNAMI, however, remarks that challenges in claiming these benefits are numerous.1427 In an August 2015 article Al-Monitor reports that disabled people face neglect and isolation in Iraq and dire poverty leads some of them to street begging.1428 Ahmed Hassin and Mays Al-Juboori noted that disabled women and girls are not entitled to social security payments if they are married or if their father is alive.1429
USAID notes that persons with disabilities encountered obstacles to obtaining cash transfer benefits. These obstacles include difficulties obtaining the required documentation (including a medical assessment report) and the accessibility and the bureaucratic processes of government offices and services. The social security pension can be inadequate as a sole income and as a consequence many people with disabilities do not see the point in applying.1430 USAID further notes that specialised institutions for children with disabilities exist in the KRI’s major cities (e.g. Dahuk, Erbil, Sulaymaniyah), but such facilities are missing from rural areas. Such is also the case in Iraq’s central and southern regions. Although, approximately 25 % of government schools have special needs classes, schools are generally unequipped for the needs of children with disabilities.1431
In a March 2014 article Al-Monitor discusses the limited capabilities of the Iraqi health care system when it comes to diagnosing autism or treating it properly.1432
In a March 2013 article the medical journal The Lancet notes the significance of mental health problems among the many adult survivors of trauma in both Iraqi Kurdistan and southern Iraq.
In both regions most participants described substantial symptoms of depression, anxiety, and post-traumatic stress. The Lancet reports that the Iraq mental health system is unable to meet these needs:
‘The system is hospital-based and relies on psychiatrists providing inpatient and outpatient services even though there is only one long-term care hospital in the country—the Al Rashid Hospital in Baghdad. Previous reports have estimated that
1425 UNAMI/OHCHR, Report on the Rights of Persons with Disabilities in Iraq, December 2016, url, pp. 11-14.
1426 USAID, Iraq access to justice program, March 2014, url, p. 10.
1427 UNAMI/OHCHR, Report on the Rights of Persons with Disabilities in Iraq, December 2016, url, pp. 17-18.
1428 Al-Monitor, Iraq’s disabled lack basic help, 11 August 2015, url.
1429 MRG/Ceasefire Centre for Civilian Rights, Humanitarian challenges in Iraq’s displacement crisis, 22 December 2016, url, p. 25.
1430 USAID, Iraq access to justice program, March 2014, url, pp. 15-19.
1431 USAID, Iraq access to justice program, March 2014, url, p. 22.
1432 Al-Monitor, Iraq government fails to address rise in autism, 4 March 2014, url.
there are fewer than 100 psychiatrists in all of Iraq and most of them have little formal training in child and adolescent mental health. Other mental health professionals, such as clinical psychologists or social workers, do not exist at levels of any significance in the mental health care system. Psychiatrists in both regions report that treatment is limited almost exclusively to drugs, partly because of drug-focused training and partly because other therapies are too time consuming.’1433
3.7.3 Violence against persons with disabilities
In a 2012 report the World Health Organization (WHO) noted that, although robust studies are absent for most regions of the world, adults with disabilities are at a higher risk of violence than are non-disabled adults, and those with mental illnesses could be particularly vulnerable.1434 A July 2012 WHO study found that overall children with disabilities are almost four times more likely to experience violence than non-disabled children. Children with mental or intellectual impairments appear to be among the most vulnerable.1435
All respondents contacted by USAID in 2014 perceived the family as the core contributor – either benefiting or limiting- to their health, safety and enjoyment of life.1436 One of UNAMI’s interviewees mentioned cases of persons with disabilities exposed to domestic violence.1437 In a March 2014 article an administrative assistant for the Iraqi Institute for Autism, a community centre that was established to treat autistic children, informed Al-Monitor that the majority of the centre’s clients have been victims of domestic violence.1438
In February 2015, an expert of the UN Committee on the Rights of the Child informed Reuters that ISIL used children who are mentally disabled to commit suicide bombings.1439