Humanitarian aid from Ukrainian Charity “Turbota pro Litnif v Ukraini” to lonely people 70+ in Donbass: challenges, lessons learned and recommendations

The situation in Donbass is quite challenging due to the conflict and its consequences in the resident population. The TLU team used the new WJR grant of 10 000 GBP received in winter 2020-21 to make the necessary procurements and arrange the delivery of humanitarian aid to 384 residents aged 70+ in 14 villages located in the contact line.

By Galina Poliakova, Ukrainian Chartity “Turbota pro Litnih v Ukraini”

 The situation in Donbass is quite challenging due to the conflict and its consequences in the resident population. Younger people have left the region and have settled in more prosperous and safer places. Older people prefer to stay in their own homes. When asked about this choice they replied “I would like to die in my own home” or “I want to be buried near my parents”. Which is not very optimistic, but still their choice. Furthermore, the area is not only in the “buffer zone” of the conflict but also in the “orange” COVID-19 quarantine zone. Public transport was very scarce before the epidemic, and nowadays it has become even worse. The area is partially demolished by shelling and unfortunately, the combat activity continues. As a result, old people who live alone, especially those with restricted mobility, have very limited access to shops and other services.

In addition, most humanitarian missions and charities have lost interest in Ukraine and the war conflict in Donbass. The Ukrainian Charity “Turbota pro Litnif v Ukraini” (TLU) and their partners are providing support to these marginalized older persons living in Donbass with the financial support of the British Jewish community’s international humanitarian agency “World Jewish Relief” (WJR), that has been offered from the beginning of the war in 2014. This support had saved many lives of old lonely people in the non-government-controlled area and in the buffer zone close to the contact line.

The TLU team used the new WJR grant of 10 000 GBP received in winter 2020-21 to make the necessary procurements and arrange the delivery of humanitarian aid to 384 residents aged 70+ in 14 villages located in the contact line, namely: Ceramik, Novoselivka, Novoselivka-1, Novoselivka-2, Novoselivka-3, Novokalinove, Novobakhmutivka, Ocheretine, Pervomaiske, Oleksandropil, Semenivka Verkhniotoretske, Vodiane, and Zhelanne. The humanitarian aid contained food products and sanitation/hygiene items (including reusable masks).

The delivery of the humanitarian aid is not, however, without challenges. The first challenge the staff of both TLU and our partner organisation “Slavic Heart” encountered was the difficulty of handling heavy-weight products and materials. This challenge was overcome with the assistance of two young volunteers from Kiev. They unloaded the lorries arriving from the suppliers of the goods, helped to pack the individual packages and then loaded the lorries to deliver the humanitarian aid to the beneficiaries.

The second challenge was caused by the focus on a very specific group of beneficiaries: these were lonely people aged 70+ with health problems. As they could not come to the meeting points and bring home their two packages (one with food and the other with sanitary items), the humanitarian aid had to be delivered to every house in every village. This effort increased the cost of delivery which was covered by a small grant provided by the German Federal Fund “Erinnerung, Verantwortung und Zukunft” (EVZ).

The third challenge was related to the weather conditions: short daylight hours and icy roads made the delivery process more difficult. However, the experienced team could cope with these problems and deliver the aid packages to the beneficiaries. Taking into account the mentioned inconveniences the team had to be more careful and to drive in day time. Of course, this entailed the need to do more trips and thus the project implementation took about two weeks longer. However, despite dreadful roads and adverse weather conditions, the packages were delivered to the beneficiaries.

Every single beneficiary was attended personally and the parcels were delivered to every home. Yet, this is not a common practice. Several humanitarian missions prefer to provide vouchers to the people living in the “buffer” zone. Although this approach gives them a chance to select the products on their own, unfortunately old and frail people cannot make use of this privilege. The supermarkets are located in bigger localities which are inaccessible for old people with partial immobility, to say nothing of those who are confined to beds. We believe that for these categories of people in need, measures and services provided should take into consideration what the needs are and how to provide for them in an accessible way, otherwise they might not achieve the intended results. Simple actions such as door-to-door delivery can make a significant difference and should be incorporated in any initiative.

Foster care in Albania

Referring to the latest annual report of State Social Services, during 2020 15 children from the public residential institutions of children in Albania have been reunited with their biological families, while 27 children have been adopted. The national program for the establishment of the new foster care service is institutionalized since 2008 in the Strategy of social protection and the action plan for its implementation.

By Merita Xhumari and Megi Xhumari, University of Tirana

There are approximately 700,000 children in Albania, representing a dependency ratio of 25.0 children per 100 working age population. Close to 0.12 per cent (1.2 per 1,000) of the child population lives in residential institutional care, as reported by the State Inspectorate for Social Services in June 2016. Referring to the latest annual report of State Social Services, during 2020 15 children from the public residential institutions of children in Albania have been reunited with their biological families, while 27 children have been adopted. The national program for the establishment of the new foster care service is institutionalized since 2008 in the Strategy of social protection and the action plan for its implementation. Law 18/2017, “On the children’s rights and protection” defines the institutional mechanisms for the protection of children’s rights at central and local level. These developments reflect the commitments of the Albanian government towards the United Nations Sustainable Development Goals 2030, Objective 1.4 Article 20: “Children deprived of their family environment are entitled to special protection and assistance from the State which provides… an alternative care” in the National Agenda for Children Rights 2017-2020. Albania’s EU integration process also requires the development of policies and services according to Principle 11 “Care and support for children” of the European Pillar of Social Rights.

In order to support alternative care for children, SOS Children’s Villages Albania in partnership with Tirana Legal Aid Society (TLAS) have been implementing the project “The Development of CSOs for foster care in Albania”, financed by European Union. The objective of the project was to: “Support good practices and models of protection of children from abuse and violence, alternative care, family strengthening, inclusive education and early childhood development with a special focus on vulnerable & minority groups”. The project started in April 2018 and ended in March 2021, implemented in 3 main regions of Albania, Tirana, Durrësi and Korça.

Despite the fact that in the last years, de-institutionalization and the development of family-based services and foster care have become a priority for governmental agendas, the accessibility to a range of care options, including foster care, has not really been prioritized and residential cares prevails and continues to account for the highest number of children in alternative care. The main challenges faced that were identified in the course of the project implementation on foster care have been the lack of information and public awareness about this new family-based service. In Albania, the placement of children in kinship families has traditionally been applied without any court process. On the one hand, it has been the mentality of biological parents to leave their children in residential care rather than in foster care families, as they fear they might lose their child forever. On the other hand, there is the mentality of Albanian families, who want to have a child permanently as part of the family, to better decide for adoption rather than have a foster family that provides a temporary care for children without parental care. Furthermore, there are also macro level challenges related to the capacities of local government, courts and other local actors that need to be developed to be able to manage the new foster care service.

The key recommendations drawn from the project implementation include the actions to increase public awareness on foster care, the creation of a juvenile court, free legal service for foster families; the establishment of better synergies across institutions; and for foster family to be recognized as a profession and to have an adequate payment.

In support of these recommendations, one of the main outputs of the project was the development of a Practical Training Manual for Foster Care in Albania by Bethany Social Services, the first local NGO piloting foster care service in Albania, to guide local professionals and key stakeholders in foster care service implementation. The Manual published in the Albanian language can assist professionals from Kosovo, North Macedonia, as well as Montenegro where a considerable Albanian population is living.

The central axis for addressing the main topics of the Manual is the United Nations Convention on the Rights of the Child ratified by the Albanian government, which stipulates that “… the child, for the full and harmonious development of his / her personality, must grow up in a family environment, in a happy atmosphere, with love and understanding”, as well as the UN Guidelines for Alternative Care for Children.

Content-wise, the Training Manual aims to provide knowledge, develop skills and competencies related to:

  • The value and importance of the family for children;
  • Laws, regulations and policies governing the foster care service;
  • The process of implementing the foster care service;
  • Categories of competencies for the foster care service;
  • Commitment to the role as a member of a professional Cross-cutting Technical Group.

Impact of the COVID-19 pandemic on the deinstitutionalization of child care reform in Ukraine

“The first wave” of the childcare deinstitutionalization reform in Ukraine started in 2008. As a result, since 2017, more than 90% of orphans and children deprived of parental care are raised in families or in family-type forms of care (under guardianship/custody, by relatives, in foster families, family-type child homes) according to the data of the Ministry of Social Policy of Ukraine.

By Iryna Demchenko & Nataliia Bulyha, NGO Analytical Center “Socioconsulting”

“The first wave” of the childcare deinstitutionalization reform in Ukraine started in 2008. As a result, since 2017, more than 90% of orphans and children deprived of parental care are raised in families or in family-type forms of care (under guardianship/custody, in particular by relatives, in foster families, family-type child homes) according to the data of the Ministry of Social Policy of Ukraine.

But despite this, institutional care facilities still operate and host children. For example, according to the results of a comprehensive study of the child protection system in Ukraine “Illusion of protection” conducted by “Hope and Homes for Children”, there were 751 institutional care facilities in Ukraine by September 2016. And more than 100 thousand children received services in such institutions, but only 8% of them were orphans or of parents deprived of the parental rights; the remaining 92 % had parents.

This dual system has several negative consequences: firstly, the irrational use of funds, as the system still supports the institutional care which proved inefficient. And, on the other hand, the families of institutionalised children might still receive state benefits, allowances, and other support, since these are not to subjected to the physical presence of the child in the family.

Secondly, the current system also allows parents to place a child in an institution for a long period only by submitting an application. This possibility does not motivate the parents to overcome life challenges and to improve family well-being. Accordingly, a child who has spent many years in an institution returns to an unfavourable family environment, which significantly reduces his/her chances of successful integration and achieving professional and life goals. Besides, such a child is not entitled to receive benefits provided to orphans and children, whose parents are officially deprived of parental rights (i.e., priority placement in a dormitory and free use of the accommodation).

All of these reasons prompted the acceleration of the deinstitutionalization reform. In 2017, the “second wave” took place. There were some positive developments in 2019 compared to 2017, according to the input on the ‘Monitoring of Institutional care facilities’ provided by the Presidential Commissioner for Children’s Rights on January 1, 2020, namely an 8% decrease in the number of institutions, an 8% decrease in the number of children who received services in institutions, and a 13% decrease in the number of children, who stayed in institutions 24/7.

According to the data of the Ministry of Social Policy of Ukraine, as a result of the COVID-19 pandemic, more than 40 thousand children from institutions were returned to their families in March 2020. However, about 6 thousand children (no more than 10%) remained at the institutions because they had nowhere else to go. Experts unanimously characterized this situation as a sign of the futility of the existing system and the de facto beginning of the overdue deinstitutionalization reform.

In June 2020, the Ministry of Social Policy of Ukraine approved the “Procedure for enrolment of children for 24-hour stay in child institutional care and upbringing facilities” (which could be considered the “third wave” of the deinstitutionalization reform). This document included two key innovations:

  • enrolment of a child in the institution is possible only when all other care options have been exhausted (in other words, parents must provide papers to prove that the placement of a child in an institution is necessary);
  • the suspension of payment of state aid to the family if the child is placed in educational institutions 24/7.

However, the implementation of this document has encountered fierce resistance, which is caused by several factors, namely:

1) The inclination of the local authorities to preserve the status. For the united territorial communities (UTCs) placing a child in a regional level institution allows not to take responsibility for this child, besides, a large facility on the territory of the community means jobs and revenues to the local budget. In this way the regional administrations receive significant funds from the state budget to maintain huge land lots (up to 125 ha) and premises (up to 95 thousand square meters).

2) A significant number of community level administration is not properly aware of the depth of the issue, do not see the need to make significant efforts, and invest in the development of basic community social services. The sector experts state that only a third of the need for social workers at UTC is met. This leads to a low level of coverage of vulnerable families with preventive social services which will reduce the number of neglected.

3) The parents still support the institutionalisation due to the fact that it is economically advantageous for parents to place their children in boarding schools. In particular, the legislation provides ample possibility for the parent to be exempted of all costs related to childcare and education in the boarding schools.

4) The institutionalisation is further aggravated by the inadequate development of health, educational, rehabilitation, and social services for families with children in the community, which objectively complicates/makes it impossible to raise a child in a family.

On the education side, there is a lack of general education services in the rural areas including issues with transporting children from one community to another, and lack of basic community services such as after-school activities and supervision, food provision. The insufficient development of inclusive education pushes parents to place their children in specific institutions to provide them education per the peculiarities of their development.

As a result of the resistance to childcare deinstitutionalization reform, a decree of the Cabinet of Minister’s “On Amendments to the National Strategy for Reforming the System of Institutional Care and Upbringing of Children for 2017-2026” was recently drafted and is now at the stage of approval. The document in fact closes out the reform of deinstitutionalization in Ukraine, namely excludes an essential part of institutions from the reform and delays to 2026 the termination of children under 3 years placement in institutions. Currently, international and Ukrainian NGOs working in the field of children rights protection are fighting to prevent this decree from being approved.

The situation of children with disabilities in Belarus

Stigma and discrimination, both structural and social, against children with disabilities are widespread. Communities at large fail to understand that most families with children with disabilities could enjoy fulfilling lives if given adequate support by social protection, education and healthcare sectors.

By Alexander Karankevich, independent consultant

Children with disabilities in Belarus continue to face multiple institutional, attitudinal and structural barriers to realizing their human rights despite the efforts of the country to protect and promote their rights. Stigma and discrimination, both structural and social, against children with disabilities are widespread. Communities at large fail to understand that most families with children with disabilities could enjoy fulfilling lives if given adequate support by social protection, education and healthcare sectors. The State policy is grounded on a medical model of disability that cannot address complex societal and other barriers that children with disabilities face.

Inclusive education is in its very beginning in Belarus. Health problems and disabilities prevent children from studying on an equal basis in regular general education school and such children are at greatest risk of being placed in residential institutions. A large share of the children living in residential care are children with disabilities (48.2%), and about 75% of these children have parents who have either abandoned them voluntarily (35%) or been deprived of parental rights (40%) according to data from the Belarus Statistical Committee. Once in institution, a child with disabilities usually spends most of his/her life in residential care and is transferred from one institution to another. There are several types of institutional care, mostly specialized on age and specific needs of the child: infant homes (healthcare system), orphanages and boarding schools (education system), boarding homes (social protection system).

Those parents who choose to keep their children often limit their contact with the community because of fear of stigma and discrimination. Considerably a small number of substitute parents (guardians, foster, adoptive parents) dare to take the responsibility for the care of a child with special needs.

The services for children with disabilities in Belarus are provided by a range of actors, including education, social protection and healthcare systems. The lack of coordination hinders the effective provision of these services. Even if coordination mechanisms are technically in place, they often fail to address children with disabilities’ particular risks of social exclusion and isolation. Professionals generally lack the competence and knowledge to adequately address the needs of children with disabilities, underestimate the role of the family and the adverse impact of institutionalization on a child’s well-being.

The de-institutionalization process in the country led to the closure or reorganization of the residential care network. The process of the reorganization of the residential institutions under the health sector started in 2015 and only in 2018 in the social protection sector.

The boarding homes for children and young people with disabilities are the largest residential care institutions in Belarus. They function under the social protection system and provide accommodation, education and care to children and youth with severe disabilities. The boarding homes are closed type institutions, mostly located far from settlements and completely cut off from the society. These are settings where children are deprived of any family like environment. It happens that children live in the crowded wards, this is especially common for children with severe and multiple health disorders.

The light at the end of the tunnel is the commitment of the Belarus Ministries of Education, Health, Labour and Social Protection to reform the residential care institutions’ network and strengthen the community-based support services for families caring for children with disabilities as stated in their ‘Сross-sectoral Plan of inter-agency measures for integrated deinstitutionalisation of children and youth for the period 2020-2023’. Early intervention healthcare services system for young children and inclusive education national policy agenda have a great potential to keep the child with special needs close to their families.

Childcare in the Western Balkans and Eastern Europe

The European Centre for Social Welfare Policy and Research conducted research on the situation of children at risk of losing the parental care and children that have lost the parental care in Albania, North Macedonia, Armenia, Belarus and Ukraine.

Veronica Sandu, European Centre for Social Welfare Policy and Research

From May to December 2020 the European Centre for Social Welfare Policy and Research conducted research on the situation of children at risk of losing the parental care and children that have lost the parental care in five countries from Western Balkans and Eastern Europe region: Albania and North Macedonia, Armenia, Belarus and Ukraine. The research was part of a broader report done in cooperation with SOS Children’s Villages Worldwide Hermann-Gmeiner Fonds Deutschland and SOS Children’s Villages National Associations in the respective countries.

The analysis was done based on the review of legislation, policy reports and strategic documents, childcare national and regional reports, and other relevant documents. The UN Convention on the Rights of the Child (UNCRC) and the Convention on the Rights of Persons with Disabilities (UNCRDP) country concluding observations have been consulted as part of the desk review. National statistics on vulnerable children were collected by referring to the national and international data sets and reports. In addition, key childcare stakeholders in depth interviews have been done in all countries.

There are many causes of risk for children to lose parental care and to be institutionalised. These risks can be related to: individual attributes (e.g., disability, skills, gender, sexual orientation, etc.); family circumstances (e.g., migration, poverty, stigma, language, ethnicity, geographic area, etc.); circumstances related to a specific risk (e.g., abduction, trafficking, homelessness, domestic violence, juvenile crimes, etc.); and humanitarian situations (displacement, armed conflicts, social breakdown, etc.).

About 11 million children live in the 5 selected countries, about 3 million of them live below the national poverty line, and about 210 thousand children are children with disabilities. The institutional care remains the main form of care in almost all countries. In total, in the region, about 100,000 children receive care in large residential facilities and 78,000 children receive care in some sort of family-based type of care service. The share of children receiving care in large institutions is almost twice the share of children in family-based care. One exception is Belarus, where many children receive care in their extended families under the guardianship/tutorship type of care.

The five countries make significant efforts to develop the family-based care as part of a broader de-institutionalization (De-I) reform or in parallel to improving the quality of residential care. The most common type of family-based care is the guardianship/tutorship care followed by foster care. Both of these services though are developed unevenly in terms of child vulnerability (very few foster care services are available for children with disabilities, for babies, for children with behavioural problems). All countries lack specialised foster care for emergency situations, and for appropriate care of children with special needs. Adoption is limited in all countries, with the exception of Belarus, where the number of adopted children is close to that of children placed in foster care.

The childcare systems in all these countries are undergoing major reforms such as the De-I reform, alternative care service development, community-based service development, development of child abandon and prevention programs, and preventions programs for families at risk of being separated from their children. At the same time, various policy gaps are limiting the childcare policy impact. These gaps refer to poor financing of childcare in the region, human resources in the sector not equipped in terms of skills, knowledge and resources to support these reforms, and childcare roles and responsibilities between administrations levels not fully clarified. The public private partnership in care provision is unregulated, and quality monitoring not fully in place.

The research conducted by the European Centre for Social Welfare Policy and Research will support the Children’s Villages Worldwide Hermann-Gmeiner Fonds Deutschland and SOS Children’s Villages National Associations in policy dialogue, advocacy efforts, internal planning processes to further support the childcare reforms in the 5 selected countries.

Criminal Law Protection of People with Disabilities against Discrimination in the Republic of Serbia

Persons with disabilities in the Republic of Serbia are a very sensitive category that is discriminated against in multiple ways and excluded from the main social aspects. The mechanisms of protecting persons with disabilities, securing equal representation and their complete integration are achieved through adequate legislation and criminal laws, and also special protection in big crisis such as pandemic COVID-19.

Filip Mirić & Aleksandra Nikolajević, University of Niš, Republic of Serbia

For an open and democratic society, it is of crucial importance that all its citizens, regardless of their personal characteristics and features, have a right to education, cultural activities, recreation, access to the labor market, and equality in all segments of social life. Persons with disabilities in the Republic of Serbia are a very sensitive category that is discriminated against in multiple ways and excluded from the main social aspects. The mechanisms of protecting persons with disabilities, securing equal representation and their complete integration are achieved through adequate legislation and criminal laws, and also special protection in big crisis such as pandemic COVID-19.

In the legal system of Republic of Serbia discrimination is a crime. Firstly, we should mention the criminal offense of violation of equality under Article 128 of the Criminal Code of the Republic of Serbia (hereinafter referred to as CC). Another important offence envisaged in Article 387 of the Serbian Criminal Code is the criminal offense of racial and other discrimination. The basic form of this criminal offense is committed by anyone who, on the grounds of differences in race, color, religion, nationality, ethnic origin or some other personal characteristic, violates the fundamental human rights and freedoms guaranteed by universally accepted rules of international law and international treaties ratified by Serbia; the perpetrator of such a crime may be punished by a term of imprisonment ranging from six months to five years. Apart from this, there are other forms of the same criminal offense. The same punishment (imprisonment ranging from six months to five years) will be imposed on those who persecute organizations or individuals for their efforts to promote equality.

A number of offences are punished by imprisonment ranging from three months to three years, such as in the case of anyone who spreads ideas about the superiority of one race over another, or propagates racial hatred or incites racial discrimination; anyone who disseminates or otherwise makes public texts, pictures or any other representation of ideas or theories that advocate or encourage hatred, discrimination or violence against any person or group of persons based on race, skin color, religious affiliation, nationality, ethnicity origin or other personal property; and anyone who publicly threatens to commit a criminal offense punishable by imprisonment exceeding four years against a person or a group of persons belonging to a particular race, color, religion, nationality, ethnic origin or other personal property. The criminalization of equality violations from Article 128 CC can be considered as a positive development. Namely, the amendments to the Criminal Code (adopted in 2016) also mention disability as one of the grounds for the violation of equality, which is in compliance with Article 21 of the Constitution of the Republic of Serbia concerning the prohibition of discrimination.

Awareness of persons with disabilities is a very important factor in preventing discrimination in all areas. The results of a study conducted by Filip Mirić in 2019 on the awareness of persons with disabilities about the legal protection mechanisms available to them, show that as many as 70.59% of respondents do not have enough information on criminal protection against discrimination. In addition, the existence of a large percentage of under-informed respondents indicate the need to create active policies to raise awareness about the mechanisms of legal protection of persons with disabilities against discrimination. While the legal framework seems to be complete, it is clear that more needs to be done in terms of awareness raising on the existence and applicability of these laws to protect persons with disabilities and their right to full integration in the Serbian society. The responsibility rests, certainly, on the institutions themselves and the created social policy measures that aim at the social integration and equality of all citizens in Serbia and that can be monitored by the evaluation of established measures and factual indicators of their representation.

The impact of COVID-19 on persons with disabilities across Europe

Persons with disabilities are among the most affected groups during the COVID-19 pandemic. The EU Agency for Fundamental Rights (FRA) recently reported that the pandemic continues to affect the provision of essential services such as education, healthcare, community-based support and transport for persons with disabilities.

Magdi Birtha, European Centre for Social Welfare Policy and Research 

The Coronavirus outbreak still presents a major challenge at national and local levels across the EU and beyond. Persons with disabilities are among the most affected groups during the COVID-19 pandemic. The EU Agency for Fundamental Rights (FRA) recently reported that the pandemic continues to affect the provision of essential services such as education, healthcare, community-based support and transport for persons with disabilities. Children with disabilities are facing particular barriers when it comes to accessing education and support, including challenges to take part in distance learning, without their assistants. In some countries, FRA noted that physical, occupational, speech and language therapy services for children with disabilities were suspended (e.g. in Malta) (FRA, 2020).

Service provision for persons with disabilities

Similarly, to the devastating impact of the pandemic on older people in residential homes, persons with disabilities who are living in institutional settings also face increased mortality rate due to COVID-19. For example, in Romania, 10% of the total COVID-related death were of persons with disabilities living in institutional care (FRA, 2020). While the majority of residential care facilities for persons with disabilities remained open during the outbreak, the service delivery had to be re-organised significantly, for instance by longer working hours for staff, operate with reduced staff (family duties, sick leave, burnout, resignations, etc.) and face additional administration (EASPD, 2020). Measures to ban visitations have been in place, in order to protect residents and limit the risk of contagion, often leading to isolation and difficulties to maintain contact with family members. The strict confinement measures and diversion from the routine may have negative impact on the well-being and mental health of persons with disabilities, thus the use of digital communication technologies or safe visitation forms are of key importance (EASPD, 2020).

Social and health care services, provided in the community or in-home have been suspended during the pandemic, leaving many persons with disabilities without access to essential services. As FRA reports, this includes cut-backs on personal assistance (e.g. in Slovakia), cancelling rehabilitation services (e.g. in Estonia) and the lack of access to psychosocial services (e.g. in Austria) (FRA, 2020). The European Association of Service Providers for Persons with Disabilities (EASPD) reported that in 18 European countries, home care services were provided mostly online, during the pandemic, leaving thousands of people without adequate support (EASPD, 2020). The suspension of home-care services also put additional pressure on family members who needed to fill this gap and provide more informal care.

In general, there was little coordination or exchange of experiences or good practices within the care sector, or at national and European level.

Involvement of persons with disabilities in COVID-19 responses

Evidence shows that the voice of persons with disabilities was mostly absent from discussions on how to best respond to the crisis (FRA, 2020). The European Disability Forum, an umbrella organisation of persons with disabilities that defends the interests of over 100 million persons with disabilities in Europe, published several resources in relation to the impact of COVID-19 on persons with disabilities.

They provide recommendations to authorities, for instance on exit measures for transport services, in light of COVID-19 or on how to make public health communication accessible for persons with disabilities. EDF called authorities across Europe to put non-discriminatory measures in place, i.e. when health care professionals cannot provide the same level of care to everyone due to the lack of equipment or underfunding.

How to recover from the impact of COVID-19?

The economic and social impact of the COVID-19 pandemic is still not fully assessed and will largely depend on the developments in the coming months, concerning a potential second wave. EASPD closely monitors the impact of COVID-19 on persons with disabilities and on the care sector. The EU has launched several recovery programmes for EU Member States, but there are also some instruments available for countries in the Western Balkans and in the Eastern Partnership. EASPD organised a webinar on 17 June 2020, dedicated to these COVID-19 EU funding opportunities for non-EU Member States, including:

Resources:

EASPD (2020), The impact of Covid-19 on disability services in Europe, EASPD Snapshot report, available here

EU Fundamental Rights Agency (2020), Bulletin #3: Coronavirus pandemic in the EU – Fundamental rights implications: with a focus on older people, available here

Crisis in Serbia: Economic Measures regarding the Coronavirus Situation

In periods of crisis caused by major social upheavals such as the current coronavirus pandemic (SARS-CoV-2), society is derailed with great consequences to social institutions and people’s lives. The states’ response to this challenge is varied, although most countries are implementing measures to regulate the market and its basic principles in order to meet the subsistence minimum and ensure the socio-economic security of their citizens.

Aleksandra Nikolajević, Teaching Assistant, University of Niš

In periods of crisis caused by major social upheavals such as the current coronavirus pandemic (SARS-CoV-2), society is derailed with great consequences to social institutions and people’s lives. The states’ response to this challenge is varied, although most countries are implementing measures to regulate the market and its basic principles in order to meet the subsistence minimum and ensure the socio-economic security of their citizens. Globally, we are witnessing various market shifts such as increasing government interventions, extensive capital expenditures, the emergence of alternative supply chains, and the like. Although the range of state intervention measures is very broad and varied depending on the country, we will also look at the packages of measures that the Government of the Republic of Serbia recently adopted as a “tool” for combating the socio-economic consequences caused by the coronavirus.

The measures adopted by the Serbian Government have mostly already been implemented, while it will take a longer period of time to see their effects.  The adopted socio-economic measures are aimed at preserving the well-being and living standard of the people, with a special emphasis on maintaining the achieved level of employment and strengthening entrepreneurs significantly affected by the crisis. In times of major turbulence, it is a special challenge to find an effective formula for the sustainability of public revenues and expenses, adjusting tax policy, and reorganizing budget funds. A great impoverishment of the population, mass layoffs, and a decline in living standards are just some of the burning problems that the Republic of Serbia is facing during the pandemic. Overcoming the crisis and remediating the mentioned consequences are possible only through state intervention and the implementation of a set of socio-economic measures that, in the case of Serbia, come in the form of tax-policy, stabilization, and comprehensive socio-economic measures.

First of all, tax-policy measures aim to relieve entrepreneurs (employers) of the great pressure created by the suspension of trade and production, the ban on public gatherings, and the introduction of a curfew, which has stopped many economic activities. The initial idea is to empower employers in the period when they are conducting business with large losses and to maintain the liquidity of business entities and taxpayers in order for them to successfully cope with the crisis (and keep their employees). Specifically, this set of tax-relief measures for the economy means that 1) all private companies are allowed to defer the payment of payroll and contribution taxes during the state of emergency (at least over a three-month period); 2) the payment (advance) of profit taxes is deferred for the second quarter of 2020, and 3) taxpayers that donated equipment/funds for remediating the consequences of the pandemic are exempt from paying VAT.

In order to prevent the “economic virus of illiquidity“, other direct assistance measures for the private sector were introduced in the form of providing assistance to all entrepreneurs over a period of three months in the amount of three net minimum wages for large, medium, and micro-businesses. Special measures were aimed at large enterprises, which were granted assistance in the amount of 50% of the net minimum wage (for employees who have been sent home). Additional planned financial incentives for preserving the liquidity of business entities include favorable loans from the Development Fund and loans from commercial banks. Companies that fulfill the conditions for exercising the rights to financial incentives include those that have not reduced the number of their employees by more than 10%, and that have not stopped their operation during the state of emergency.

The next set of measures are of a stabilizing character and are aimed at maintaining the stability of the currency, which the Western Balkan countries mostly achieve by borrowing on the domestic and international capital markets. Serbia has recently borrowed more than 29.3 billion RSD (around 249 million EUR) in order to partially remedy the budget deficit and implement economic measures to mitigate the consequences caused by the pandemic. A goodly portion of those funds will be spent on providing financial incentives as well as direct financial aid to all adult citizens, which was criticized by the Fiscal Council itself. While the Serbian Government sees the latter measure as stimulative to consumption and conducive to economic growth, a significant part of the expert community strongly criticizes this move by the government. The argumentation presented by the expert community indicates the lack of an adequate explanation of the manner and form in which the direct assistance to citizens will be paid. A well-founded question arises as to why the aid was paid in cash to the citizens’ bank accounts and not through vouchers for the purchase of provisions, which unequivocally ensures the growth of consumption and stimulates domestic production. The next point of criticism deals with the (un)selective character of the financial aid and the non-existence of a material census as a qualification criterion for this incentive. It is estimated that this budget expenditure for financing the one-time assistance to all adults would not only be enough to cover the funds for social assistance beneficiaries over a five-year period, but also significantly affect the generosity of measures aimed at the poorest strata of the population. The adverse attitudes of the general public are influenced by the visible irregularities in the method of applying for the financial assistance and the existence of citizen groups who are excluded from material aid (e.g. children in a well-to-do family of four whose members are all adults receives 400 EUR, while a single mother with three minor children receives only 100 EUR; or people from rural areas without digital skills and information on how to apply), causing the general public to interpret this monetary incentive as “purchasing political votes” (the presidential elections are expected to be held in June / July, despite the pandemic).

It should not be overlooked that the state passed bylaws that especially protect the elderly population – they banned the reduction of pensions, awarded pensioners one-time assistance payments in the amount of approximately 35 EUR, postponed the payment of utilities, and introduced a moratorium on loan payments (the latter is a universal assistance measure for citizens).

Finally, the last set of measures is mainly geared towards workers in the public (state) sector and aims to maintain the workers’ safety (which cannot be regulated in the private sector). Namely, layoffs in the public sector were banned, employment contracts that were to expire during the state of emergency were automatically extended, and salary reductions were abolished. As expected, the private sector suffered the most. The data on the number of dismissed workers since the introduction of the state of emergency vary. While state monitoring institutions provided data on the number of dismissed workers amounting to only 15,000, the SECONS Development Initiative Group together with FES presented the data of its research which cites the number of laid-off workers on an incomparably higher level (about 200,000 people lost their jobs). Private company employees at the highest risk of losing their jobs are workers in the hospitality, trade, and construction industries, including self-employed and informally employed workers, as well as those who worked with fixed-term contracts.

It is still difficult to assess the extent and character of the devastating effects the state of emergency and the suspension of socio-economic life had on human lives. Undoubtedly, most of the adopted measures were a necessary basis for stimulating the economy and maintaining the liquidity of business entities in Serbia, but it is still impossible to give objective data on the long-term effects of adopted and implemented socio-economic measures and incentives. If we want to see the real effects of state interventionism and what consequences this crisis has left behind, it is necessary to evaluate the mechanisms for implementing these measures, insist on transparency of all processes, and point out irregular practices and the (political) abuse of public funds and institutions. It is still unclear how much the proposed measures and the manner of their implementation will succeed in preventing economic contractions caused by the current crisis, and what consequences they will leave on the labor market and the economic sector (the economy of the Serbian society). Non-governmental researchers and trade union representatives warn that the real consequences of the suspension of economic activity caused by COVID-19 (SARS-CoV-2) can be expected only after the state incentives have ceased (as early as in September). Unlike the countries of the region, where state measures and interventions are prescribed for a period of 6 months, Serbia plans on ending its incentives after just three months. After the three-month state programs come to an end, union representatives expect mass layoffs in the private sector, an expansion of grey economy, a deterioration of the position of workers in the labor market, as well as an increase in poverty and a decline in living standards.

UNNECESSARY VICTIMS: Older persons in the covid-19 pandemic

At first glance, there is a solid ground for singling out older people during the current pandemic as a special group: the mortality related to COVID-19 is increasing with the age and for those 80 and above years old it is five times the global average based on WHO data.

Alexandre Sidorenko & Alexey Golubev

This entire pandemic was invented to mow down the elderly.

Irina Denisova, writer, Russia

“Boomer Remover” [is] a mean nickname for the novel coronavirus COVID-19… The term … references the higher mortality rate among older people infected with COVID-19—particularly among people over 60, including the Boomer Baby age cohort approximately between the ages of 56 and 74.

Andrew Whalen, Newsweek

The above quotes are just two typical manifestations of the situation and feelings of older persons during the ongoing COVID-19 pandemic. These quotes are also reflective of the thriving ageism which has just found a new content in marginalising older people and excluding them from society.

At first glance, there is a solid ground for singling out older people during the current pandemic as a special group: the mortality related to COVID-19 is increasing with the age and for those 80 and above years old it is five times the global average based on WHO data.  About 95 per cent of those who have died from COVID-19 in Europe were over 60 years, and more than half of them were over 80 years. This tragic statistics has prompted governments to focus their anti-epidemic measures on older persons by often demanding their self-isolation for the period beyond the terms set for younger population.

We have analysed data on COVID-19-related mortality in Spain, Italy, and Sweden and found the following*: in the range of ages from 30 to 90 years, the dependency of the logarithm of mortality upon age is linear in all three countries. Moreover, the regression lines are strictly parallel to those related to the total mortality in these countries, which is in accordance with the Gompertz law. In all analysed cases, and irrespective of the stage of epidemic, the doubling time of mortality in this age range is close to 7.5 years. Our calculations based on limited data reported from Japan and Iran have also revealed that the rates for SARS-Cov2 infection diagnosed on the basis of the symptomatic manifestations of the disease and on serological tests are dependent on age significantly less. Meanwhile, the self-isolation measures reportedly aimed at limiting the spread of the infection, which are quite justified in principle, in their most severe forms are imposed precisely upon the population of 65+ years old.

The above analysis combined with the review of literature sources leads to the following conclusions:

– Older persons are the main victims of the COVID-19 pandemic, but they are not the main agents of spreading the SARS-Cov2 virus.

– Nevertheless, older persons are often treated as the principal target of measures aimed at controlling the spread of SARS-Cov2 infection, which is not justifiable, especially as forced isolation of older persons is more dangerous for their health and even life compared with younger people, moreover, it compromises health-maintaining practices available for older people, and thus is discriminatory and unacceptable.

One more conclusion is based on the international policy frameworks on ageing, such as the Madrid International Plan of Action on Ageing: older persons should be seen as contributors “to the reestablishment and reconstruction of communities and the rebuilding of the social fabric following emergencies”. We believe this conclusion is of particular relevance as the humanity is gradually moving to the recovery.

* This blog entry is based on recent research published by the authors:

G. Golubev, A. V. Sidorenko (2020) Theory and practice of aging upon COVID-19 pandemic. Uspekhi Gerontologii [Advances in Gerontology]. 2020. Vol. 33(2): 397–408. (In Russ. with Engl. summary)

Dismantling health and social care systems kills

Research carried out by the European Centre had already shown pervasive inequalities in access to care as well as in the coverage of health insurance and potential remedies. The Covid-19 crisis brings the evidence to the headlines of the news that social inequalities and the dismantling of health and social welfare systems are killing people. The current crisis also shows that health and social care are not a ‘product’ which can be produced low-cost and provided to those with sufficiently large incomes only.

Kai Leichsenring, Executive Director of  the European Centre

Research carried out by the European Centre had already shown pervasive inequalities in access to care as well as in the coverage of health insurance and potential remedies. The Covid-19 crisis brings the evidence to the headlines of the news that social inequalities and the dismantling of health and social welfare systems are killing people. The current crisis also shows that health and social care are not a ‘product’ which can be produced low-cost and provided to those with sufficiently large incomes only.

Yet, inequalities persist. While many of us continue to work in secure home offices, a great number of people have to keep working to provide our basic necessities including water, energy supply, waste collection, pharmaceuticals, groceries, and health care. Older people and persons with disabilities, in particular those living in isolation or in care homes, have complex care and support needs and were already disadvantaged before the pandemic, now they are additionally confronted with triage mechanisms and even total neglect as social services are suspended. Professionals in health and social care have struggled with working conditions already before the crisis. Now they are facing Covid-19 and a high risk exposure to the disease while many still try to maintain operating levels of standard care services. Moreover, inequalities and inequities in health care systems, in social determinants of health and in access to health care mean that those who are already disadvantaged are less equipped to deal with the virus itself – and some countries are better prepared to protect their citizens than others. It does not help to blame decisions made in the past, but we should learn from the damage done. If we really strive “to leave no one behind” we need to address Covid-19 and its consequences as a global challenge with global policies. This can be illustrated by a brief example that is much discussed in the context of Covid-19.

A key argument for implementing drastic measures to flatten the curve of new infections has been to avoid the breakdown of the hospital system in any affected region. All of us have seen the ‘red line’ in simulations marking the health care system capacity, i.e. the number of very sick people that can be treated in hospitals. Of course, no health system in the world is designed to have enough beds to counter the unprecedented Covid-19 emergency. However, the ‘red line’, i.e. the number of beds in hospitals, has been lowered over the past decades in all countries due to budget cuts, alleged efficiency gains and market-oriented governance. To a certain degree it is certainly recommended to reduce the role of hospitals, if countries invest in alternative care pathways such as primary care centres or long-term care in the community. However, many regions were not able to do this second step after reducing hospital beds. In this context, quantity of beds in itself is certainly not the most robust indicator – without infrastructure, sufficient staff and technical devices at disposal, a ‘hospital bed’ is nothing more than a piece of furniture. And yet, reality has shown in many regions that the ‘red line’ of hospital capacities has been exceeded rather quickly. The figure below shows the extent of reductions in hospital beds as of 2017 (latest available data) highlighting Italy and some of its regions. While hospital capacity had already been reduced before 2005, further reductions could be observed over the past years (e.g. Italy). This has made it so difficult to respond to the Covid-19 outbreak in the relatively wealthy northern regions of Italy (Lombardia, Veneto, marked in orange) with particularly hard and deadly consequences. Not only Italian authorities are worried about a potential spreading in the southern regions (e.g. Calabria), where cuts in health care infrastructure, starting from a weaker baseline, have been even stronger. The consequences of comparable imbalances between regions and countries regarding the allocation of resources to health care can also be observed in Spain and the UK, and other countries and regions are likely to experience similar impact.

These regional differences point to the necessity of European or even global strategies of cooperation also in health and social care. Rather than leaving individual regions alone to tackle the Covid-19 crisis and to compete for ventilators, masks and protective gear, we need exchange and coordination of knowledge, professionals and material across Europe and beyond. This is even more important with a view to potential learnings after the crisis to which we shall contribute with further research:

  • How can we address inequalities and inequities by social policies and research during and beyond the current crisis? We have seen a wide range of measures that are putting human rights and even democratic principles ‘on hold’. We therefore need to make sure that these restrictions will be removed as soon as possible and to establish new approaches to ensure democracy and human rights for all in post-growth societies. The Sustainable Development Goals can serve as a rough guideline, but there will be more about social justice, values and new mechanisms to shape and support individual life-courses through a more equal distribution of life-chances, income and work.
  • How can we avoid further cuts in public expenditures on health and social care during times of enormous and rising public debt? The leverage of billions of Euros (Dollars, Pounds …) has been a necessary intervention by national governments and international organisations during the crisis. The challenge for the very same institutions will be to ensure the promotion of social inclusion, equal opportunities and international partnerships in the context of the economic downturn, nationalist approaches and the widening gap between rich and poor.
  • How can we work together to ensure universal health coverage and decent funding mechanisms for health care that are not discriminating by race, gender and age? Further cooperation to build bridges between research and policy-making beyond existing silos will be necessary to underpin a post-crisis scenario with a policy focus on human rights, social inclusion and public health systems that ensure social equity and care for all.

This blog was first posted at the European Centre’s Covid19 blog site.