Structural violence, ableism and COVID-19

COVID-19 presents additional barriers for people with disability that are linked to structural violence and ableism.  Unequal global and local political-economies and social organisation inflict embodied harm on people, in this case disabled people. This is structural violence. Ableism is a form of prejudice that characterises people with disability as inferior to the non-disabled. Discrimination is often experienced based on disability and under the assumption of limited capabilities and skills.

This is the fourth blog in our series on disability and COVID-19. In this blog we summarise learning from a Twitter Chat that was held earlier in the month.

Yesterday, we explored how the response to COVID-19 has been hampered because of the failure to include people with disabilities (and their representative organisations) in planning and decision making. Without this expert insight many of the public health messages and policy prescriptions continue to reflect ableist assumptions.

This is not a small oversight; it leads directly to disproportionate harm to people with disabilities. As @dr_ateeb put it, “People with disabilities are vulnerable to neglect, this may be exaggerated in outbreak contexts.” Neglect is not always passive. Sometimes it is an active choice. It is an active choice to continue to organise our societies in ways that discriminate against people with disabilities. Pushing back against this inequity needs to be part of our ways of working as we respond to COVID-19.

Access to personal care

During the Twitter Chat we heard that much of the advice to remain at home with your household and not to mix with people from outside is not possible if you require carers to assist you. COVID-19 planning and messaging has not adequately considered how the pandemic is affecting what care is available as helpers stay home or become ill. Tweeters were fearful of harm being caused to those who need carers to support them with daily tasks such as bathing and washing – this is particularly the case for those with complex disabilities.

Tweeters suggested that policies are adapted to take the needs of people with disabilities into account.

Access to assistive equipment

Equipment like wheelchairs and hearing aids and other assistive technologies need to be maintained during the pandemic. As @ShikukuObosi pointed out, this could be particularly acute for older people who may have been institutionalised in homes and asylums for many years where they are isolated and ignored.

Community initiatives

Participants explored how people with disabilities may not be prioritised in community-level responses to the pandemic. Health care providers and first responders may not be familiar with the rights of disabled people and exacerbate this problem.

Decisions about rationing care

Finally, various country protocols created in response to COVID-19 openly discriminate against older people and people with certain disabilities. Some care rationing policies discriminate against people with disabilities who experience serious symptoms of COVID-19 in ways that challenge article 10 and 15 of the UNCRPD.

Pandemic responses and recommendations have to take into consideration the rights of people with disabilities. This is particularly important during periods of crisis or shock to the health system and it is imperative that the needs and values of people with disability are considered now more than ever. We must do all that we can to ensure that people with disabilities have equal opportunity to attain their highest possible right to health during this period and beyond.

<<Find out more about this series of blogs on disability and COVID-19