Introduction
In a civilized world people with disabilities should enjoy the opportunity to participate in the community with a number of barriers as low as possible. There is no justification to abandon this principle in major emergencies. However, people with disabilities may experience physical barriers or be subject to particular difficulties in communicating that prevent them from responding effectively to crisis situations and deny them the opportunity to obtain technical assistance provided to persons without disabilities.
The whole question of how to provide assistance to disabled persons in emergency situations has been largely ignored. The body of academic literature on the subject remains very small (eg. Parr 1987, Tierney et al 1988) and there are no particular signs of renewal of the commitment of scholars. In addition, the issue is rarely discussed during the meetings of civil protection. Despite this, there have been some useful initiatives, such as the Verona Charter on the Rights of People with Disabilities in Disaster (ULSS20 Verona, 2007 - see below). In the world there are some study centers (eg. The Centre for Disability Studies, University of Leeds, UK; Hemingway and Priestley 2006, Priestley and Hemingway 2006) and have been published copies of some manual procedures (eg. FEMA 2003). However, some reports on the state of the art in this field have provided a list of measures and inadequate descriptions of cases of failure care (CID 2004, Tady, 2006, White et al 2004).
This article will attempt to restore balance and encourage measures to promote good care of the disabled in disaster. Address some of the main issues related to the condition of disabled persons in crisis situations generally will try to detect problems and draw attention to some possible solutions.
In the context of civil protection, what is disability? The classic
view of disability is that of a person in a wheelchair to be taken away by force from the source of physical danger. In reality the issue is much more complex. First, there are many forms of disability, the list includes paraplegia, quadriplegia, deafness, blindness and visual defects, illness and mental retardation, brain damage, stroke, senility and dementia, Alzheimer's disease and, in fact, many forms of dependence on personnel, equipment and supplies to support vital functions. Although old age is not in itself a disability, many elderly people are weak, lack of agility of younger people and can also be sick or suffering from various medical conditions.
Compared to the classification, the disabled fall into the following categories: problems of mobility, inability to see (with the possible use of guide dogs), deafness, problems of communication and articulation of words (as in victims of stroke), cognitive disorders, various medical problems, need to use life support systems, intolerance to chemicals or environmental, psychiatric disorders and panic attacks, and weakness due to old age. So the list is long and impressive. In addition, people with disabilities may suffer from more than one form of disability. Clearly, the different categories should be associated with an extensive list of measures to be taken during emergencies, including transport of disabled persons, the use of specialized means of communication for people with cognitive difficulties or defects in articulation of words, use of portable tools replacement or other means to those in need of life support systems, and psychiatric support for people with mental health problems.
disasters may create discrimination against persons with disabilities. For example, in the event of an earthquake on a person confined to a wheelchair could not take refuge under a desk or table, or run into the street via the stairs of a building (Rahimi 1993, 1994). Le persone sorde, o affette da difetti visivi, potrebbero non riconoscere un pericolo o non sentire istruzioni verbali che intimino l'evacuazione (Kailes 2002). Per di più, le persone che dipendono da attrezzature elettriche (macchine per la dialisi, ventilatori, o semplicemente mezzi elettronici di comunicazione) potrebbero trovarsi in difficoltà nel caso in cui la corrente elettrica venisse a mancare durante un'emergenza. Infine, tutti i servizi offerti al pubblico generale nelle emergenze e nelle crisi (trasporto per l'evacuazione, alloggio provvisorio, assistenza morale e psicologica, ecc.) dovrebbero essere accessibili anche ai disabili.
Il problema, si nota, non è insignificante. In Toscana, il 16% of the population report some form of disability. Ben 54 million Americans and 90 million Indians are disabled (and in India the basic law on civil protection offers no provision for the disabled). At the time of Hurricane Katrina on the U.S. coast of the Gulf of Mexico, well 155,000 people in three cities of Biloxi (MS), Mobile (AL) and New Orleans (LA) were registered as disabled. Many found themselves in serious difficulties on arrival of the hurricane. Since 71% of the 1,330 confirmed victims of the hurricane were people older than 60 years, it is clear that the impact of the disaster was huge on the disabled (Tady 2006). Despite the fact
that 19.3% of the U.S. population suffers from some form of disability, as much as 80% of emergency coordinators consulted in a recent survey (NCD 2005) did not take into account people with disabilities in their emergency plans. In fact, 57% did not know how many disabled people were registered in their jurisdiction, and only 27% of them had taken a course offered by the U.S. Federal Emergency Management Agency (FEMA) on how to protect disabled people in disasters. Moreover, the problem can be particularly serious if the event is of vast proportions: for example, on 11 September 2001 a group of physically disabled people gathered in a room eightieth floor of the World Trade Center in New York waiting to be evacuated by firemen, but the building collapsed before they could be saved (CID 2004).
We can conclude that major emergencies bring people with disabilities more at risk than other members of the population, can trap them and put them in jeopardy by the imposition of new barriers. Despite this negative picture, not everyone sees the situation in a negative way. For example, in 1994 in the Mainstream magazine, Douglas Lathrop wrote that "in a way that disabled people can live with some level of independence are more prepared to deal with dangerous situations than people without disabilities. They benefit from a 'psychological advantage'..." (Lathtrop 2004). E 'possible, but when it occurs undisastro we can not and must not leave everything to the special survival skills of the disabled. The next section is then devoted to practical strategies for assistance.
Helping people with disabilities in disasters
In an emergency situation it's pretty easy not to recognize the nature of the disability that a person accused and so it is possible that the assistance provided is the wrong type. Organizations working in civil protection are used to provide assistance to large groups of people, but disabled people have individual needs that may differ from those of the groups. In fact, to assist the disabled in disaster means not only introduce specific procedures, but also establish special preparations and plans are hand made for their needs. Unfortunately, pay attention to individuals in emergencies requires precisely when labor supply is considerably short of demand. However, special assistance is one way of showing that, despite their disabilities, people with disabilities are full members of society, with all the benefits, rights and privileges associated with this.
In planning and emergency management would be the time to consider the problems, special needs and views of disabled people. For example, follow the evacuation plan calls for the più l'abilità di camminare, guidare, vedere e udire. Bisogna dunque adattare tali piani ai bisogni delle persone che non possono fare una o più di queste cose (Kailes 2002).
L'esperienza dei disabili nei disastri rileva certi bisogni, come ad esempio assicurare la continuità dei servizi per persone che dipendono dalla presenza dell'elettricità, del telefono, dell'acqua corrente, e di altri servizi di base. Le persone disabili hanno bisogno di sapere come cavarsela quando ci sono disordini e detriti a casa, e quali servizi di trasporto e mobilità saranno disponibili nelle situazioni di crisi. Devono inoltre essere informate su come possono rifornirsi di generi di prima necessità nelle situazioni di emergenza. Esiste the question of how soddisfarei needs of dogs (FEMA 2003).
A report on disabled people in disasters (White et al 2004) argues that very few empirical data have been collected on the question of how to evacuate disabled people effectively and safely during emergencies and disasters (see Kailes 2002). Moreover, in many situations lack the integration and cooperation between different organizations working with disabled people and representatives of civil protection that plan and manage emergency response. It 'important to start the dialogue, because the issue is complex. No single strategy applies to all disabilities. Also, how to assist people with disabilities to better a matter linked to other needs, such as assistance to minority ethnic groups, single mothers, and people who need special medications.
's relatively easy to list the basic principles that govern the disabled. First, the services and procedures should be available equally in times of calm and crisis. Emergency communications should be accessible, understandable and reliable. The associations regularly provide assistance to people with disabilities should be involved in civil protection activities and in the planning process. Where there is a real risk of disaster, should prepare a special program of preparation, education and training for both members of civil protection for the disabled beneficiaries of their services. Finally, we draw the media attention on their potential role as providers of emergency information to the disabled.
A guide to civil protection written specifically for people with disabilities (FEMA / ARC 2004) recommends three actions to be performed, if possible. The first is to estimate the type and extent of risks at work and at home. Second, they should create a support network composed of at least three people for each place you usually frequent. The third action is to assess their ability to respond with self-protective actions in case of crisis. In addition to the types of disability that are not obvious, it might be helpful to wear a necklace or a bracelet indicating the disability in question. These are examples of a practical approach that can be done to increase the safety of disabled people in crisis situations. However, this form of pragmatism depends on the ability and willingness to develop a positive attitude towards the problem in the community of representatives of civil protection.
Conclusions
As noted above, the academic literature on disabilities in disasters is really poor (Parr 1987, Rahimi 1993, Tierney et al 1988). It seems that this indicates that the problem is still neglected in both theoretical and practical terms. It is however, clearly a matter of great importance. In the words of Hemingway and Priestley (2006): -
"The disabled have been made more vulnerable to natural hazards through historical processes of exclusion and impoverishment. As a result, their experience of disaster may be more acute and more long life compared to non-disabled population. Throughout the world these effects are accentuated in poor communities, where people with disabilities remain among the poorest of the poor. Also, when a disaster strikes, people with disabilities are experiencing differences in access to housing temporary and rescue and are often excluded from full participation in the activities of response and recovery. "
The idea that the occurrence of an emergency or disaster means the suspension of normal rules should not result in discrimination against the disabled in terms of the assistance. It should instead mean the opposite, doubling efforts to assist the disabled in emergencies, and giving special consideration and priority to their needs. In addition, the occurrence of crisis conditions should not offer an excuse for violating the dignity of disabled people. It 'important to consider the category of people with disabilities in the formulation of emergency plans. This is a moral imperative and also a matter of simple justice and equality. E 'need to know where are the disabled when there are emergencies and ensure that the right services are available to them. It may also be recommended monitoring element to ensure that disabled people are not subject to discrimination. In the European Union
the publication of the Verona Charter on the Rescue of Persons with Disabilities in Case of Disaster (ULSS20 Verona 2007) is a milestone in the official recognition of a problem that must be addressed. The Verona Charter is the culmination of a project that has studied the category of disabled people in disasters in various countries of Europe and has therefore contributed to the formulation of a clear picture of the problem and possible solutions. Despite a record full of bad examples (see NCD, 2005), there is always the opportunity to improve the situation. Doing so would be a sign of civilization and an affirmation of the rights of people who, despite their disabilities, are full members of society and deserve to be protected when a disaster strikes.
Citations
CID 2004. Lessons Learned from the World Trade Center Disaster: Emergency Preparedness for People with Disabilities in New York . Center for Independence of the Disabled, New York (see http://www.cidny.org/ ).
FEMA 2003. for People with Disabilities Disaster Preparedness . U.S. Federal Emergency Management Agency, Washington DC (vedi www.fema.gov/library/disprepf.shtm).FEMA/ARC 2004. Preparing for Disaster for People with Disabilities and Other Special Needs. US Federal Emergency Management Agency and American Red Cross Society, Washington DC, 20 pp.
Hemingway, L. e M. Priestley 2006. Natural hazards, human vulnerability and disabling societies: a disaster for disabled people? Review of Disability Studies 2(3): 57-67.
Kailes, J. 2002. Evacuation Preparedness: Taking Responsibility For Your Safety: A Guide For People With Disabilities and Other Activity Limitations . Center for Disability Issues and the Health Profession, Western University of Health Sciences, Pomona, California (vedi www.westernu.edu/cdihp.html ).
Lathrop, D. 1994. Disaster! If you have a disability, the forces of nature can be meaner to you than anyone else. But you can fight back. Be prepared. Mainstream (Nov. 1994), (vedi www.accessiblesociety.org/topics/independentliving/disaster.htm ).
NCD 2005. Saving Lives: Including People with Disabilities in Emergency Planning . US National Council on Disability, Washington DC (vedi http://www.ncd.gov/ ).
Parr, A.R. 1987. Disasters and disabled persons: an examination of the safety needs of a neglected minority. Disasters 11(2): 148-159.
Priestley, M. e L. Hemingway 2006. Disabled people and disaster recovery: a tale of two cities? Journal of Social Work in Disability and Rehabilitation 5(3/4): 23-42.
Rahimi, M. 1993. An examination of behaviour and hazards faced by physically disabled people during the Loma Prieta earthquake. Natural Hazards 7(1): 59-82.
Rahimi, M. 1994. Behavior of mobility-disabled people in earthquakes: a simulation experiment. Earthquake Spectra 10(2): 381-401.
Tady, M. 2006. Disabled people left behind in emergencies. The New Standard .
Tierney, K., W. Petak and H. Hahn 1988. Disabled Persons and Earthquake Hazards . Monografia n. 46, Institute of Behavioral Science, Program on Environment and Behavior, University of Colorado, Boulder, Colorado.
ULSS20 Verona 2007. Verona Charter on the Rescue of Persons with Disabilities in Case of Disasters . ULSS no. 20, Verona, 17 pp.
White, G., M. Fox, J. Rowland, C. Rooney and S. Aldana 2004. Nobody Left Behind: Investigating Disaster Preparedness and Response for People with Disabilities . Lawrence, Kansas ( see www.rtcil.org / resources.htm ).
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