Refugees with disabilities

Servicenavigation

Refugees with disabilities (March 2018)

Need for action to ensure refugee reception in Germany meets people’s needs

Refugees with disabilities require special protection. They have the right to a reception process in Germany which meets their needs. However, on arriving their need for support is neither systematically recorded nor taken into consideration. Even in times where fewer people seeking refuge are arriving in Germany, these problems still persist. The Federal Government, regional governments and local authorities should ensure that the needs of refugees with disabilities are recognised and that they are given the corresponding support. (1)

Persons with disabilities who arrive in Germany as refugees or asylum seekers require special protection. They face linguistic and cultural barriers as well as barriers based on disability. This can result in them being especially disadvantaged if they do not receive the individual support they need. This includes blind and deaf people, men travelling on their own with physical disabilities from war injuries, chronically ill or traumatised people, and children with intellectual impairments. It is not known how many refugees with disabilities are living in Germany and what disabilities they have. Currently no data are being collected on this question, neither at a federal nor at Länder level. However, estimates indicate that at least 15 per cent of all refugees have a disability. (2) The percentage of traumatised people is considerably higher: Studies indicate that between 16 and 55 per cent of asylum seekers who arrived in Germany in recent years were traumatised.  (3)

The UN Convention on the Rights of Persons with Disabilities (CRPD) requires state parties to apply the rights of refugees with disabilities. Of key importance is the right to accommodation that is suitable to the disability and is fully accessible (Article 28 in conjunction with Article 9 CRPD), the right to the enjoyment of the highest attainable standard of health (Article 25 CRPD), and the right to rehabilitation measures (Article 26 CRPD). The EU Reception Conditions Directive also emphasises these requirements by stipulating that Member States take particular notice of those requiring a high level of protection, including persons with disabilities, in the reception of refugees. This includes identification, consideration for their situation when assigning accommodation, and necessary medical and other aid. (4)

However, the Federal Government, regional governments and local authorities are not adequately fulfilling the above-mentioned obligations regarding human rights. This is clear from field reports which the National CRPD Monitoring Mechanism at the German Institute for Human Rights evaluated in 2017 and which are based on advice provided to around 2,000 refugees with disabilities. They were proven to match to a very great extent and provide the basis for the shortcomings listed below. (5)

Disabilities are not recorded, needs not identified
Accommodation is neither barrier-free nor in readily accessible locations
Insufficient healthcare
Recommendations


Disabilities are not recorded, needs not identified

So far refugees with disabilities have not been recorded as such in Germany. This means the authorities do not record whether a person has a disability or the type of disability. Nor do they determine whether the people need individual support because of their disability. However, identification and determination of needs is a precondition for reception of these people in accordance with their needs. In order not to be placed at a disadvantage in the refugee reception process, they need different types of support according to the type of disability. This ranges from special forms of communication (sign language, simple language, braille), accessible facilities, through to the appropriate health care. Hereupon the UN Committee on the Rights of Persons with Disabilities pointed out the following: in 2017 it called on the international community of states to introduce administrative procedures to record refugees with disabilities and their needs.(6) The corresponding obligation to identify refugees who require special protection also derives from the EU Reception Conditions Directive; however, this has not yet been implemented in Germany.

In practice disabilities and the special needs of refugees with disabilities are only recognised by chance and at most sporadically, insofar as the Monitoring Mechanism is aware. No Federal state appears to have developed a systematic procedure with which the authorities can ensure that the rights of persons with disabilities can be guaranteed sufficiently. Disabilities are only recognised in the refugee reception process either during the mandatory first medical examination by the health authorities, but which is only intended to diagnose transmissible diseases in order to protect public health (Article 62 of the Asylum Law), or by social workers during ongoing operation of the facilities. Neither method is aimed at systematically recording disabilities and determining individual needs; they reach only a fraction of those affected and generally only visible disabilities are recognised, if at all. This cannot replace the necessary systematic identification procedures by the authorities. In actual fact, according to practical reports, many persons with disabilities live in refugee accommodation for months or years without being recognised as such and receiving support.

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Accommodation is neither barrier-free nor in readily accessible locations

Refugees with disabilities are seldom accommodated according to their needs in Germany. There are only a few isolated accessible communal accommodation centres of regional and local authorities. The exact number is not known and is not recorded systematically. (7) In addition, no care is taken to ensure that persons with disabilities are taken to the facilities available in some locations which have accessible places or accommodation for people requiring special protection. Practical experience tends to show that when allocating accommodation the fact that a person has a disability is often ignored. For example, a 13-year-old with spastic paralysis had to be carried up and down stairs by his single mother every day to go to the bathroom or to the kitchen since the room they were allocated was on another floor and there was no lift in the communal accommodation building. Furthermore, accessibility is generally understood simply as being wheelchair accessible. The needs of persons with other disabilities are seldom met. These include, for example, blind guidance systems, flashing light doorbells for the deaf or hearing impaired, or signs using pictograms for persons with intellectual impairments.

Another difficulty: communal accommodation facilities for refugees are mostly located in industrial areas, on the edge of towns, or in the country. They are not well connected to the local transport system or to public life. This makes it more difficult for persons with disabilities to access support for disabled persons: Facilities provided by social services for the disabled, advisory services, health services, but also schools and daycare facilities for children, can only be reached with difficulty. This lack of orientation of facilities to social interaction limits the social participation of refugees with disabilities and is not consistent with their right to live independently and being included in the community (see Article 19 CRPD).

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Insufficient healthcare

According to reports from the field, refugees with disabilities are often not provided with sufficient care during the first 15 months of their stay in Germany. In accordance with the Asylum Seekers Benefits Act, asylum seekers are only entitled to medical treatment for acute illnesses and pain during the first 15 months of their stay (Article 4 of the Asylum Seekers Benefits Act (AsylbLG)). Other benefits beyond this lie within the discretionary powers of social welfare authorities and can be granted “if they are essential in the individual case to ensure the means of subsistence or to maintain health” (Article 6(1) AsylbLG). (8) For refugees with disabilities this means that they have to apply for the necessary help in complex procedures and it is never certain what the authorities’ decision will be. They do not have a subjective claim to disability-related benefits. This applies, for example, to psychotherapy, rehabilitation measures (ergotherapy, speech therapy, physiotherapy), hearing and vision aids, orthopaedic aids (such as artificial limbs, wheelchairs, walking aids), blood pressure gauges and blood glucose meters, as well as care aids (incontinence pads, nappies). However, many refugees are dependent on these aids, also in order to prevent disorders from causing chronic conditions.

The current state of affairs shows that the social welfare authorities across Germany take a very restrictive approach to granting disability-related support. Applications for benefits are granted late after a complex procedure, even in urgent cases, or are rejected. Staff in local authorities often do not have the necessary specialist knowledge of medical and rehabilitation issues in order to assess needs. When assessing applications, the authorities reject necessary aids due to the negative issue of refugees staying in Germany. This results in disorders deteriorating and in some cases irreversible sequelae, such as the case of a two-year-old boy who needed orthopaedic aids (foot braces) and a standing aid in order to learn to walk. However, his applications for aids were repeatedly rejected. He received the necessary aids only eighteen months after arriving in Germany; in the meantime he had developed deformities in his hips and joints.

The situation is particularly difficult for people who have to be cared for as in-patients or who need care around the clock, have serious or multiple disabilities, or the terminally ill, who need palliative care. They too have to apply for aid via the AsylbLG and do not have a right to in-patient care outside refugee accommodation facilities. However, these accommodation facilities cannot provide the necessary support and care.

According to the Federal Government itself, it has no information on the specific care situation of asylum seekers with disabilities nor on the actual application of the Asylum Seekers Benefits Act. However, it assumes that the supply of drugs and aids is not inadequate in Germany. (9) In view of the shortcomings in provision, this statement does not ring true.

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Recommendations

Refugees with disabilities can invoke the rights granted under the CRPD. In view of the structural shortcomings seen in current refugee reception practice, special efforts are needed to include the issue of disability systematically in refugee policy ("disability mainstreaming"). This also applies to times when fewer people are seeking protection in Germany. The National CRPD Monitoring Mechanism therefore recommends:

  1. The Federal and regional governments should issue binding instructions on how the number of persons with disabilities among the new arrivals and the type of their disability is to be recorded systematically and disability-related needs determined (identification and determination of needs).
  2. Regional and local authorities should firstly ensure a sufficient number of accessible places in communal accommodation is available. They should comply with current standards; accessibility should not be limited to accessibility for wheelchair users. Secondly, regional and local authorities should ensure that refugee accommodation is connected to the disability-related support system.
  3. The Federal legislator should create the legal prerequisites for satisfactory healthcare for refugees with disabilities. It would be advisable to stipulate an individual right to needs-related benefits in Paragraph 6 of the Asylum Seekers Benefits Act (AsylbLG). The corresponding range of benefits should be determined in the implementing regulations. Hardship cases, such as persons with severe or multiple disabilities, those in need of care, or palliative patients who cannot be properly cared for in refugee accommodation, should be cared for within the normal care system. Local authorities should train social welfare staff responsible for application of the Asylum Seekers Benefits Act in disability-related needs and an application of the law that is consistent with human rights.
  4. Federal, regional and local authorities should ensure that refugees with disabilities are informed of their rights and are able to assert them.

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1 This Position is based on: German Institute for Human Rights (2017): Development of the human rights situation in Germany. July 2016–June 2017. Report to the German Federal Parliament in accordance with Article 2(5) of the Act on the Status and Tasks of the German Institute for Human Rights (DIMRG), P. 63–78. (accessed on 02.03.2018).
2
This corresponds to the percentage of disabled persons in the global population. A survey of Syrian refugees in 2013 revealed that 22 per cent of those surveyed had a physical, sensory or mental disability and 15.6 per cent had a chronic illness. See HelpAge International / Handicap International (2014): Hidden victims of the Syrian crisis: disabled, injured and older refugees. London/Lyon. (accessed on 02.03.2018).
3
See Bozorgmehr, Kayvan et al. (2016): Systematic review and evidence mapping of empirical studies on health status and medical care among refugees and asylum seekers in Germany (1990–2014). (Article in German) In: Bundesgesundheitsblatt 59, p. 599–620, here o. 609–610.
4
Directive 2013/33/EU of the European Parliament and of the Council of 26 June 2013 laying down standards for the reception of applicants for international protection of 29.06.2013.
5
In 2017 the National CRPD Monitoring Mechanism investigated the practical difficulties faced by refugees with disabilities and the effect of national legislation on them. See: German Institute for Human Rights (2017), l.c. During this investigation the Monitoring Mechanism consulted civil society organisations which support refugees with disabilities. Information on the consultation can be found here (accessed on 28.02.2018).
6
UN, Committee on the Protection of the Rights of All Migrant Workers and Members of their Families (CMW) / Committee on the Rights of Persons with Disabilities (CRPD) (2017): Addressing disabilities in large-scale movements of refugees and migrants. Joint Statement. Geneva, P. 3
7
Bundestag (2017): Response of the Federal Government to the minor interpellation of MPs Corinna Rüffer, Luise Amtsberg, Maria Klein-Schmeink, of other MPSs and the party BÜNDNIS 90/DIE GRÜNEN – Publication 18/11271 – Zur Lage von geflüchteten Menschen mit Behinderungen (On the situation of refugees with disabilities). Bundestag publication 18/11603, Berlin, 22.03.2017, No. 22; Antwort der Staatskanzleien der Länder auf einen Fragebogen des Deutschen Instituts für Menschenrechte (Response of the state chancelleries of the Länder to a questionnaire of the German Institute for Human Rights (May 2016).
8
With the Federal Participation Act (Bundesteilhabegesetz (BTHG)) adopted in December 2016, the exclusion of beneficiaries of the AsylbLG from benefits to facilitate integration was enshrined in the Rehabilitation and Participation Act for the first time (Article 100(1) Social Security Code IX (SGB IX) amended).
9
Bundestag (2017), l.c.

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