page 1
One Billion Forgotten

One Billion
Forgotten

pROTECTING THE huMAN rights
of Persons with Disabilities

page 2One Billion Forgotten

One Billion Forgotten

page 3
One Billion Forgotten

Introduction
Across the world, more than one billion people – or 15% of the world’s
population – live with disabilities. They face significant barriers torealizing their human rights, including discrimination in education,
employment, housing and transport; denial of the right to vote; and being
stripped of the right to make decisions about their own lives, including
their reproductive choices. Individuals with physical, sensory, intellectualand mental disabilities often face increased violence, yet they remain
invisible in their communities. Governments fail to protect their rights,
and make access to redress difficult.
Over the past few years, Human Rights Watch has become a pioneer inmainstreaming disability rights within the broader human rights agenda,
and is seen by disability rights experts and disability rights organizations
as an important partner in global advocacy efforts. In more than 25
countries, our work has addressed a broad range of issues such as
violence against women and children with disabilities, access to educationand health care, institutionalization, legal capacity, political participationand the impact of armed conflict.

TABLE OF CONTENTS
04
06
10
14
18

Recent Impact
Disability Rights in Institutions and Places of Detention
Political Participation and Access to JusticeChildren with Disabilities
Women with Disabilities

An empty wheelchair outside of the day care center for 35 children with intellectual andmultiple disabilities run by the Resource Center for Rehabilitation and Development, in
Bhaktapur, Nepal. © 2011 Human Rights Watch

Through our global advocacy, we have pressed for broader ratificationand implementation of the groundbreaking Convention on the Rights
of Persons with Disabilities and stronger protections for people withdisabilities worldwide. Specifically, we have monitored legal reform
processes in a number of countries and incorporated disability rights
concerns in our advocacy on such issues as violence against children andabusive treatment in health care.
This brochure highlights Human Rights Watch’s growing body of work andadvocacy to uphold the rights of people with disabilities around the world.

page 5
One Billion Forgotten

RECENT IMPACT
Increased pressure for ban onsolitary confinement in the
AMERICAS: Following our reportand joint advocacy, the InterAmerican Commission on Human
Rights formally recommended
that members of the Organizationof American States adopt aban on solitary confinement of
persons with mental disabilities.

Countries with recent
research and advocacy
peru

Limits to Arbitrary Detention of
People with Mental Disabilities
in Peru: As a result of HRW joint
advocacy with local disability
advocates, the government of
Peru abolished a law permitting
involuntary detention for treatment ofpeople with psychosocial or mental
disabilities in circumstances that did
not comply with international humanrights law.

Croatia Adopts
Deinstitutionalization Plan:
Following our 2010 report “Once
You Enter, You Never Leave,” theCroatian government adopted aplan for deinstitutionalization of
the more than 9,000 people withintellectual or mental disabilities
living in institutions.

People with Mental Disabilities
No Longer CategoricallyExcluded from Voting in
Libya: Human Rights Watch
raised concerns about voting
restrictions on people withmental disabilities
in the 2012 draft electoral
law, and this provision was
subsequently removed before
the law was passed.

Stronger Protections for People
with Mental Disabilities in
Ghana: After the publication of
our 2012 report “Like a Death
Sentence,” which describes how
people with mental disabilities
suffer sever abuses in psychiatricinstitutions and “prayer camps”,
the Ghanaian government madea commitment to monitor the
spiritual healing centers throughregular visits, and to prepare
the necessary legal regulations
to implement the country’s newmental health law.

Russia Takes Steps Towards
Accessibility: Following our 2013
report “Barriers Everywhere”, theMoscow Metropolitan Authority
committed to making 38 metro
stations more accessible forpeople who are blind or low
vision. The Ministry of Labor
also adopted an order requiring
employers to adapt workplaces
to the individual needs of people
with disabilities.

croatia

nepal
libya

ghana

Greater Awareness of HIV and Disability
Through Multimedia: Our video about aSouth African disability rights advocate
living with HIV led to a CNN feature
program: “Deaf, gay and HIV positive
activist battles against stigma”, raising
significant public awareness of thiscross-cutting issue. The Joint UN Programon HIV/AIDS (UNAIDS) screened ourvideo at its executive board meetingand in briefings for its staff in Geneva,
increasing understanding among program
staff about the need for disabilityinclusive HIV programs and policies.

UgandaGender-Based Violence ProgramsMore Inclusive of Women and Girlswith Disabilities in Northern
Uganda: Drawing upon our 2010
report “As If We Weren’t Human,”international organizations
providing services for survivors of
sexual and gender-based violencein Uganda developed targeted
outreach and training programs for
women and girls with disabilities, inpartnership with disabled persons’organizations. These organizations
are also providing training for healthworkers, police and lawyers on how
to intervene in cases of violenceagainst women with disabilities.

Concrete Steps Toward Inclusionof Children with Disabilities in
Schools in Nepal: Responding toour 2011 report “Futures Stolen,” theWorld Bank and other development
partners in Nepal began developinga strategy to integrate children
with disabilities in their programs.
The Department of Education alsobegan developing a curriculum forchildren with intellectual disabilities
with participation of local disabled
persons’ organizations.

russiapage 6
One Billion Forgotten

page 7
One Billion ForgottendISABILITY riGHTS IN
institutions andplaces of Detention
Under the presumption of mental disability, countless
individuals around the world languish in psychiatric institutions
for years, some without adequate access to mental healthservices, personal hygiene, or even water. Conditions in suchinstitutions are rife with mistreatment, including verbal abuse
and beatings, forced treatment, lack of medication, and useof restraints and confinement as punishment. Our long-termgoal is a systematic shift in the treatment of people with mental
disabilities from institutionalization to community integration.
A man chained to a tree at Jesus Divine Temple (Nyakumasi) Prayer
Camp, Cape Coast, Central Region, Ghana sleeps on a bed made out ofbamboo. This is where he has lived for over eight months.
© 2012 Nick Loomis/Human Rights Watch

page 8One Billion Forgotten

page 9One Billion Forgotten

Despite these guarantees, Human Rights Watch, based on field research in the Greater Accra, Central, and Eastern Regions of
Ghana between November 2011 and January 2012, found that the rights of thousands of persons with mental disabilities are still
being routinely violated. Many are placed, often against their will, in overcrowded and dirty psychiatric hospitals; others face
confinement, often in appalling conditions, in some of the thousands of the nation’s prayer camps, the privately owned
Christian religious institutions with roots in the evangelical and pentecostal churches.

This report describes how thousands of people with mental disabilities are forced to livein psychiatric institutions and spiritual healing centers, often against their will and withlittle possibility of challenging their confinement. In psychiatric hospitals, people withmental disabilities face overcrowding and unsanitary conditions. In some of the spiritual
healing centers, popularly known as prayer camps, they are often chained to trees,
frequently in the baking sun, and forced to fast for weeks as part of a “healing process,”while being denied access to medications.
hrw.org

October 2012

Abuses against Persons with Mental Disabilities in Ghana

In 2012 Ghana ratified the Convention on the Rights of Persons with Disabilities (CRPD), pledging to ensure that persons withmental disabilities can live in the community, make decisions for themselves, enjoy the highest attainable standard of health,and be free from physical and mental abuse. The Constitution of Ghana also guarantees the protection and enjoyment of rights
by every person on an equal basis with others, including persons with disabilities.

HUMAN RIGHTS WATCH | october 2012

“Like a Death Sentence”: Abuses against Persons
with“Like a Death Sentence”
Mental Disabilities in Ghana“Like a Death Sentence:” Abuses against Persons with Mental Disabilities in Ghana examines the experiences of people withmental disabilities in the broader community, public psychiatric hospitals, and residential prayer camps. Persons with mental
disabilities in psychiatric hospitals are sometimes forced to take medications against their will, sleep on bare floors or nearbroken and overflowing toilets. In some of the prayer camps, patients are chained to the floor or trees for long periods, forced
to fast for several days, and denied access to physical or mental health services. Under the CRPD and other international
standards, these are forms of cruel, inhuman, and degrading treatment.

Ghana’s new Mental Health Act, passed in July 2012, conflicts with the CRPD by allowing for the continued involuntary admission
and treatment of persons with mental disabilities without establishing proper safeguards to ensure their informed consent. The
new law also limits the ability of persons with mental disabilities to make decisions, for example, about where they live andwhat treatment they receive.
Human Rights Watch calls on the government of Ghana to bring the Mental Health Act in line with the CRPD, and to urgently
address the human rights abuses outlined in this report, particularly by ensuring adequate food, shelter, and health care for
persons with mental disabilities and by outlawing abusive practices such as chaining, forced fasting, prolonged seclusion, andother forms of cruel and degrading treatment in hospitals and prayer camps.

Victoria is a 10-year-old girl who was put in Jesus
Divine Temple (Nyakumasi) Prayer Camp, where she
was chained to a tree all day and slept on a mat inan open compound.

H U M A N
R I G H T S© 2012 Shantha Rau Barriga/Human Rights Watch

While ensuring accountability for crimes is a critical aspect of establishing the rule of law, arbitrary detention is rife in South
Sudan, with individuals who should not have been detained at all spending months or even years in one of the country’s approximately 79 prisons. There are people in prison detained simply to compel the appearance of a relative or friend; because they
were said to show evidence of mental disability; or because they are unable to pay a debt, court fine, or compensation award.
Many are serving prison terms for adultery or for customary law crimes such as “elopement” or “pregnancy,” which place undue
restrictions on the rights to privacy and to marry a spouse of one’s choice. Legal aid is almost totally absent, leaving individuals
charged with crimes—the vast majority of whom are illiterate—unable to follow the status of their case or to call and prepare
witnesses in their defense.

JUNE 2012

Arbitrary Detention in South Sudan

This report documents violations of due process rights, patterns of wrongful deprivationof liberty, and the harsh, unacceptable prison conditions in which detainees live.
Conditions for prisoners with mental disabilities are particularly harsh. Human Rights
Watch found 90 individuals imprisoned for being said to show evidence of mental
disability; very few were accused of a criminal offense. Some of these prisoners arechained day and night while naked and soiled in excrement, unable to access proper
health care. They cannot appeal their incarceration and most have no release date.

Abuses against Persons with Mental Disabilities in Ghana

HUMAN RIGHTS WATCH | june 2012

“Prison Is Not For Me”“Like a Death Sentence”

Ghana | “Like a Death Sentence”“Prison is Not For Me”: Arbitrary Detention in South Sudan

W A T C H

In “Prison Is Not For Me” Arbitrary Detention in South Sudan, Human Rights Watch documents how, because of weaknesses
across the criminal justice system, many of the approximately 6,000 individuals in South Sudan’s prisons are deprived of theirliberty arbitrarily and should not be living behind bars. It also describes the grim conditions in which they live—overcrowded
and unsanitary, and without adequate health care or food.

In the face of severe underdevelopment and myriad long-term challenges, South Sudan’s leaders have voiced their commitment
to uphold human rights. The government should urgently work to reduce arbitrary detentions by enacting legal and policy
reforms that limit remand detention and end imprisonment for adultery and for non-payment of debts. It should also find a way
to guarantee the right to legal aid, to ensure rule of law actors are sufficiently trained, and to provide proper care for people withmental disabilities outside of prison.

© 2010 Pete Muller

South Sudan | “Prison Is Not For Me”

Inmates in Bentiu Prison, Unity State, lining up
for the evening prisoner count before entering
the cells for the night. There are approximately
250 prisoners in Bentiu Prison.

H U M A N
R I G H T S
W A T C H

“Prison Is Not For Me”
Arbitrary Detention in South Sudan

hrw.org

Doris Appiah © 2012 Human Rights Watch

www.hrw.org

Front cover: Prisoners in their cell at Lira Prison in
Lira, Uganda. In March 2010, Lira Prison was packed
to 420 percent of capacity.
© 2006 Lynsey Addario

Below: Muinaina Farm Prison in Mubende, Uganda.
© 2011 Katherine Todrys/Human Rights Watch

H U M A N
R I G H T S
W A T C H

“Even Dead Bodies Must Work”: Health, Hard Labor, and Abuse in Ugandan Prisons documents brutal forced labor in Ugandan prisons,and the toll that work, physical abuse, miserable conditions, and infectious disease take on the health of inmates.
The research, based on on-site research and interviews with prisoners and prison officers in Uganda, found that despite some reforms,
the conditions at many of Uganda’s prisons constitute cruel, inhuman, and degrading treatment or torture. Overcrowding is as high as
3,200 percent of capacity and malnutrition leads to disease and blindness; prisoners drink filthy water and sleep on lice-infested
blankets. They are forced to work for the government, prison staff, and private landowners. Prisoners with HIV and tuberculosis may
be sent away from the one prison which offers prison-based treatment, to rural areas where no treatment is available, to easecongestion or to boost the farm workforce.

Uganda | “Even Dead Bodies Must Work”

This 80-page report documents routine physical abuse and the failure of the criminal
justice system to protect the rights of prisoners. Prisoners at rural prisons, including theelderly, individuals with disabilities, and pregnant women, are frequently caned, or areeven stoned, handcuffed to a tree, or burned, when they refuse to perform hard labor.
HIV and TB patients may be denied care and sent to farm prisons far from treatment
programs.

JULY 2011

H UMA N R I G H TS WATCH
350 Fifth Avenue, 34 th Floor
New York, NY 10118-3299

HUMAN RIGHTS WATCH | July 2011

“Even Dead Bodies Must Work”: Health, Hard Labor, and Abusein Ugandan Prisons

Uganda“Even Dead Bodies Must Work”
Health, Hard Labor, and Abuse in Ugandan Prisons

H U M A N
R I G H T S
W A T C H

Medical care is often non-existent, or prison officers delay or deny prisoners access to it. The flawed criminal justice system whichkeeps prisoners incarcerated needlessly and unjustly for years—over half are remanded, unconvicted of any crime—compounds thepoor conditions.

The Ugandan government should immediately eliminate abusive prisoner labor practices, and the physical abuse of prisoners. It
should scale up prison medical services, insist that prison staff take responsibility for prisoner health, and improve conditions ofdetention. The government should also enact criminal justice reforms to increase the use of bail and non-custodial sentences, and theavailability of legal representation. International agencies and donors need to prioritize prison health, and to support the government
to address corruption, and improve conditions, medical care, and justice for prisoners.

H U M A N

www.hrw.org

W A T C H

R I G H T S“Once You Enter, You Never Leave”
Deinstitutionalization of Persons with Intellectual or Mental Disabilities in Croatia

This report documents the plight of the more than 9,000 persons with intellectual ormental disabilities living in institutions in Croatia and the lack of community-based
programs for housing and support. Human Rights Watch research found that while morethan 4,000 persons with mental disabilities are living in institutional settings in Croatia,
the country has places for only seven people in supportive community living programs.
The situation is not much better for people with intellectual disabilities: Croatia has
facilities for only about 250 people in community living programs, while approximately
5,000 remain in institutions.
More than 9,000 persons with intellectual or mental disabilities in Croatia live in institutions. Some live in poor
conditions. But even when conditions are satisfactory and staff members treat residents well, their rights areneither fully realized nor realizable. Denied privacy and autonomy to make even the most simple life choices, theycannot lead anything like normal lives.

september 2010

H UMA N R I G H TS WATCH
350 Fifth Avenue, 34 th Floor
New York, NY 10118-3299

HUMAN RIGHTS WATCH | September 2010

“Once You Enter, You Never Leave”: Deinstitutionalization of
Persons with Intellectual or Mental Disabilities in Croatia
Few persons with intellectual or mental disabilities living in Croatian institutions have ever left to live in thecommunity. Life for the few that have has greatly improved. With assistance, many do their own shopping,cooking, and cleaning. Some even work. Yet the government has offered little commitment to expanding thesecommunity-based programs, despite their proven success.
Croatia was one of the first countries in the world to ratify the UN Convention on the Rights of Persons with
Disabilities, a document that explicitly applies basic human rights standards to persons with disabilities,
including the right to live in the community. In 2006, Croatia also pledged with the European Union to move
persons with disabilities from institutions into the community.

Croatia | “Once You Enter, You Never Leave”

This report details the stark contrast between Croatia’s commitments and its actions in fulfilling the rights of someof its most vulnerable people. It recommends that Croatia draws on the experiences of other countries and its own
community-based support programs to create and implement a plan to deinstitutionalize and move persons withdisabilities into the community. It also recommends that persons with disabilities should be involved in every partof the process, and that the European Union take a more active role in promoting community living and deinstitutionalization in Croatia.

Croatia“Once You Enter, You Never Leave”
Deinstitutionalization of Persons with Intellectualor Mental Disabilities in Croatia

H U M A N
R I G H T S
W A T C H

DORIS’S STORY“I used to feel lonely … ashamed … [being in the hospital]. ...What I needed was a clinical psychologist to
talk to and community-based rehabilitation, but these services are not easy to come by.”— Doris Appiah, a woman with mental disability, Ghana
Doris lives with bipolar disorder and at 22, she was taken to a “prayer camp,” a type of spiritual
healing center, where she lived for five years, tied to the wall with ropes, forced to fast and slept,bathed and defecated in the open. As is typical for prayer camps, the camp was run by a selfdescribed prophet who claimed to receive instructions from God about how to treat individuals
like Doris, whom he said were “possessed by demons.” Doris, now 58, overcame the experienceof the prayer camp, as well as time spent in deplorable conditions in psychiatric hospitals
where she witnessed severe abuse against people with mental disabilities. She completed herstudies as a nurse, started a family and is now a human rights advocate, working with community
groups to help families and persons with mental disabilities rediscover their lives after
institutionalization. Doris helped Human Rights Watch with research and advocacy surrounding
the publication of Like a Death Sentence: Abuses Against Persons with Mental Disabilities in Ghana.

POLITICAL PARTICIPATION AND access tojustice
Lack of access to civil, political and economic rights for people
with disabilities – including the right to a fair hearing, to vote,marry, seek employment, and access health services – iscommonplace worldwide. As Human Rights Watch’s countryspecific research has shown over recent years, deprivation oflegal capacity – or the right to make decisions about one’s own
life – profoundly impacts people with disabilities. Indeed inmany countries, national laws treat persons with disabilities as
unequal citizens, sometimes allowing them fewer rights thanchildren. This body of work underscores that no citizen should bedenied their civil and political rights on the basis of a disability.
Using sign language, Monica, a deafblind woman,
expresses her opinion on her right to political participation.
She is a member of SENSE International Peru, an NGO
working with deafblind people and their families.
© 2011 Human Rights Watch

page 12One Billion Forgotten

page 13
One Billion Forgotten

In Russia, official estimates suggest that 9 percent of the population, or 13 million people, have disabilities. The
Russian government has taken significant steps in recent years to better protect their rights, including by
ratifying the United Nations Convention on the Rights of Persons with Disabilities in September 2012 and by
hosting the Winter Paralympic Games in March 2014 in Sochi.
Yet for many people living with disabilities in Russia, many basic daily activities – such as going to work or
school, meeting friends, going to the doctor, or buying groceries – remain difficult, if not impossible.

(above) Denis Shipovich, a blind man, uses
his cane to find the edge of the train platform
in a Moscow metro station, February 15, 2013.
(front cover) Alexander Simyonov navigates
his wheelchair around a parked car in the
Adler district of Sochi, February 8, 2013.
© 2013 Kamil Satkanbaev

September 2013

Lack of Accessibility for People with Disabilities in Russia

Russia | Barriers Everywhere

This report documents everyday hurdles people with disabilities in Russia meet whengoing to government offices, shops, healthcare centers, places of employment, andBARRIERS EVERYWHERE
accessing public transportation. Those with physical disabilities who
use wheelchairs or
crutches may be confined to their homes because elevators are broken or nonexistent.
Many with disabilities receive substandard healthcare because of a lack of specialists intheir communities and health workers’ unwillingness to speak directly with them. People
who are blind or have low vision struggle with the lack of tactile on public
transportation.
hrw.org

HUMAN RIGHTS WATCH | september 2013

BARRIERS EVERYWHERE: Lack of Accessibility for People with
Disabilities in Russia

Barriers Everywhere is based on interviews with over 120 people with physical, sensory, developmental, andintellectual disabilities in six cities in Russia, as well as with local nongovernmental organizations andrepresentatives of disabled persons organizations. The report examines access to the physical environment,
transportation, employment, private businesses, and health and rehabilitation services. It finds that different
types of physical barriers, as well as discriminatory practices on the part of employers, transport operators, andothers, prevent many people with disabilities from leaving their homes, getting necessary medical care andeducation, enjoying meaningful employment, and participating more broadly in society.

H U M A N
R I G H T S
W A T C HBARRIERS EVERYWHERE

Lack of Accessibility for People with Disabilities in Russia

The report calls on the Russian government to build on important commitments already undertaken, rigorously
enforce federal accessibility laws, and raise awareness among people with disabilities of their rights.

The solitary confinement of adults can cause severe pain and suffering and can violate international human rights and US
constitutional law. But the potential damage to young people, who do not have the maturity of an adult and are at a particularly
vulnerable stage of life, is much greater. Yet, solitary confinement of young people is not necessary; there are alternative ways
to address the problems that officials cite as justifications for using solitary confinement.

The report is based on research in both US jails and prisons in five states ¬– Colorado,
Florida, Michigan, New York, and Pennsylvania – and correspondence with young
people in 14 others. This joint American Civil Liberties Union-Human Rights Watch report
document that isolation of solitary confinement causes anguish, provokes serious
mental and physical health problems, and works against the rehabilitation of teenagers.

oCTOBER 2012

Youth in Solitary Confinement in Jails and Prisons Across the United States

Every day in jails and prisons across the United States, large numbers of young people under age 18 are held in solitaryconfinement. They spend 22 or more hours each day physically and socially isolated in a small cell, often for weeks or evenmonths on end. Adolescents in solitary confinement are routinely denied access to needed treatment, services, andprogramming. The practice is serious and widespread.

HUMAN RIGHTS WATCH · ACLU | october 2012

Growing Up Locked Down: Youth in Solitary Confinement in
Jails and Prisons Across the United States Growing Up Locked Down
Human Rights Watch and the American Civil Liberties Union call on US federal and state governments to prohibit the solitaryconfinement of young people under age 18; prohibit the housing of adolescents with adults or in adult jails and prisons; strictly
limit and regulate all forms of segregation and isolation; and monitor and report on the segregation and isolation of young
people, whenever they are deprived of their liberty.

United States | Growing Up Locked Down

A cell at the Pinellas County jail, an adult facility
where young people are held in solitaryconfinement. One girl interviewed for the report
said she spent four months in isolation there.

© 2008 AP Photo/Pinellas County Sheriff's Office

Growing Up Locked Down

Youth in Solitary Confinement in Jails and Prisons Across the United States

H U M A N
R I G H T S
W A T C H

aclu.org | hrw.org

In “I Want to be a Citizen Just like Any Other,” Human Rights Watch examines the legal
and practical barriers that people with diverse disabilities in Peru face in exercising
their right to political participation. It also examines how restrictions on legal
capacity impact the ability of people with intellectual and psychosocial disabilities inparticular to enjoy a range of rights, including the right to own or inherit property, beemployed or legally represent their children.

(above) Participants at a workshop on disability
rights organized by FEDDIP, a regional umbrellaorganization that works with marginalized persons
with disabilities in the Puno region, particularly
members of indigenous, rural communities in the
Peruvian highlands.
(front cover) Using sign language, Monica, adeafblind woman, expresses her opinion on her rightto political participation. She is a member of SENSEInternational Peru, an NGO working with deafblind
people and their families.
© 2012 Human Rights Watch

H U M A N
R I G H T S
W A T C H

Barriers to Political Participation for People with Disabilities in Peru

www.hrw.org

H U M A N
R I G H T S
W A T C H

Deportation by Default
Mental Disability, Unfair Hearings, and Indefinite Detention in the US Immigration System

This report investigates how immigrants with mental disabilities are often unjustifiably
detained for years on end, sometimes with no legal limits. The report documents caseafter case in which people with mental disabilities were prevented from making claims
against deportation – including claims of US citizenship – because they were unable torepresent themselves. Some of the people interviewed for the report did not know theirown names, were delusional, could not tell time, or did not know that deportation meant
removal from the United States.

Registry for Identification and Civil Status (RENIEC). Maria Alejandra was told that she could not
vote because she has an intellectual disability and that, instead, she should be “interdicted,” aEvery year, several hundred thousand people in the United States are arrested for possible deportation by
Immigration and Customs Enforcement (ICE). The vast majority are held in immigration detention, both during
and even after their deportation hearings in immigration court. At least 15 percent of these immigration
detainees—an estimated 57,000 people in 2008—are thought to have a mental disability, some so severe thatthey do not know their own names or do not understand that deportation means removal from the country.

© 2008 Michael Schennum

United States | Deportation by Default

Personal belongings of undocumented
immigrants being loaded into an ICE plane
as part of the deportation process.

legal process by which a judge declares a person incompetent to take care of their self and denies
the person their right to vote. Maria Alejandra shared her experience about being barred from thevoter registry at the UN Conference of States Parties to the Convention on the Rights of Persons with
Disabilities in September 2011, and was subsequently featured in a number of media articles in

Despite these large numbers, the immigration system lacks meaningful safeguards for people with mental
disabilities—including US citizens— throughout the arrest, detention, deportation hearing, and removal process.
Deportation by Default highlights these deficiencies, including no right to appointed counsel; inflexible detention
policies that can result in lengthy and arbitrary detention, sometimes for years; lack of substantive or operative
guidance for attorneys and judges when people with mental disabilities are unable to present claims to remain in
the US without support.

The current immigration system violates US and international human rights standards of fairness and protections
against arbitrary and indefinite detention, and puts people with mental disabilities—including US citizens— atrisk of erroneous deportation.

would declare me to be.

her first national identity card, required for voting, and voted in subsequent elections. Things

jULY 2010www.aclu.org

have the right to inherit. I have the right to study, to health, and to work. I am not incompetent, but [interdiction]changed, however, in 2010 when Maria Alejandra went to renew her identity card at the National

HUMAN RIGHTS WATCH | July 2010

Deportation by Default: Mental Disability, Unfair Hearings,
and Indefinite Detention in the US Immigration System
HUMAN RIGHTS WATCH
350 Fifth Avenue, 34th Floor
New York, NY 10118-3299

When people are “interdicted,” they cannot vote. I have the right to vote. I have the right to elect my candidate. I

Maria Alejandra, 29, is a leader of the Peruvian Down Syndrome Association. At age 18, she received“I Want to be a Citizen
Just like Any Other”

Human Rights Watch calls on the government of Peru to reform discriminatory laws
and practices, and to actively involve people with disabilities in planning anddecision-making processes, thereby honoring its obligations to protect the right of all
people with disabilities to participate in public affairs.

AMERICAN CIVIL LIBERTIES UNION
125 Broad Street, 18th Floor
New York, NY 10004-2400

Maria Alejandra’s Story— Maria Alejandra Villanueva, a young woman with Down Syndrome, Peru
Peru | “I Want to be a Citizen Just like Any Other”

This report documents the legacy of a policy, changed only in October 2011, that
arbitrarily denied people with sensory, intellectual, and psychosocial disabilities
their right to vote, considering them legally incompetent to exercise such a decision.
Human Rights Watch also examined the barriers that people with disabilities face when
exercising their political rights, including the difficulty of getting identity documents
essential for voting, and the absence of support mechanisms to help people withdisabilities make voting decisions.
hrw.org
Peru was one of the first states to become a party to the Convention on the Rights of
Persons with Disabilities and has enshrined protection for many disability rights in its
laws. This should help to ensure equal rights for all persons with disabilities,
including the right to vote, stand for office, and participate in decisions about publicaffairs. However, gaps in Peruvian laws and policies mean that many people withdisabilities can still not fully exercise some of the their fundamental rights as
citizens.

May 2012

HUMAN RIGHTS WATCH | may 2012

“I Want to be a Citizen Just Like Any Other:” Barriers to
Political Participation for People with Disabilities in Peru

A national identity card, shown here, is required in Peru for voting as well as forfinancial matters, such as opening a bank account. © 2012 Human Rights Watch

Peru. One month later, following pressure from self-advocates, disabled persons’ organizations, civil
United States

Deportation by Default
Mental Disability, Unfair Hearings, and Indefinite
Detention in the US Immigration System

H U M A N
R I G H T S
W A T C H

society groups, and the public ombudsman’s office, the government reversed a longstanding policy
denying the right to political participation and other civil rights to people with mental and intellectual
disabilities.

page 14
One Billion Forgotten
Five children with intellectual disabilities playing on
the classroom floor of a resource class for children withintellectual disabilities at Mahendranagar Secondary Schoolin the far western region of Nepal.
© 2011 Shantha Rau Barriga/Human Rights Watch

Children withdisabilities

page 15
One Billion Forgotten

There are 120 to 150 million children withdisabilities under the age of 18 worldwide.
Human Rights Watch has found that children withdisabilities are denied access to school, subjected
to corporal punishment and other forms ofphysical violence, and face segregation in schools,
institutions and places of detention. In bringing
attention to these abuses, our goal is to ensure thatchildren with disabilities are no longer excluded andabused, and instead enjoy the same rights as allother children.

page 16
One Billion Forgotten

page 17
One Billion ForgottenChildren in Alternative Care in Japan

Some 34,075 children live in child care institutions in Japan and these children willon average spend 5 years living in institutional settings. Children with disabilities areover-represented in this statistic. The report examines the alternative care system’sorganization and processes, problems found in the institutionalization of children andinfants, and abuses that take place. The report also considers the difficulties many
children experience when they leave alternative care, and outlines problems with fostercare.

May 2014

WITHOUT DREAMS

More than 39,000 children in Japan live in alternative care settings because authorities determined that their parents were
either unable or unwilling to care for them properly. However, the alternative care system is heavily dependent on placements
in group institutions, with only a fraction of the children entering foster care, and even a smaller number being adopted. Japanis setting up some of its most vulnerable children to fail: many of these children are not taught necessary life-skills and are notgiven the continuing support they need to live independent, productive lives in Japanese society.

HUMAN RIGHTS WATCH | may 2014

WITHOUT DREAMS: Children in Alternative Care in Japan
Without Dreams examines Japan’s alternative care system for children. It analyzes the system’s organization and processes,
highlights problems found in the institutionalization of most children (including infants), and documents abuses that takeplace. It also considers the difficulties many children experience when they leave alternative care, and outlines continuing
problems with foster care. Finally, it examines the experience of orphans of the 2011 earthquake and tsunami.
The report draws on more than 200 interviews, including with children and adults who previously lived in alternative caresettings, foster parents, administrators of group institutions, child care workers, government officials, and experts specializing
in child care issues.

Human Rights Watch recommends that Japan undertake urgent reforms to transition its alternative care system away fromreliance on institutions toward greater use of foster care and adoption where children can live in family-like settings. Japan
should also reform its Child Welfare Act to support more child rights-friendly processes and ensure adequate resources andpolitical commitment to support children in alternative care.

Japan | Without Dreams

Beds in sleeping quarters for elementary
school girls at a child care institution in
Iwate prefecture. Eight girls share a room,and the space on their own bed is the only
place children are allowed some privacy.
Even such privacy is guaranteed only by asimple curtain surrounding each bed,
August 2012.

H U M A N
R I G H T S
W A T C HWITHOUT DREAMSChildren in Alternative Care in Japan© 2012 Sayo Saruta/Human Rights Watch

hrw.org

July 2013“As Long as They Let Us Stay in Class”: Barriers to Education
for Persons with Disabilities in China
This report documents the struggles of children and young people with disabilities in
China to be educated in mainstream schools in their communities. Currently, children
with disabilities are excluded from mainstream schools unless they can demonstrate the“ability to adapt” to the schools’ physical and learning environment. The report details
the ways schools deny these students admission, pressure them to leave, or fail toprovide appropriate classroom accommodations to help them overcome barriers related
to their disabilities.

www.hrw.org

W A T C H

R I G H T S

Futures Stolen

Barriers to Education for Children with Disabilities in Nepal“As Long as TheyLet Us Stay in Class”

Barriers to Education for Persons with Disabilities in China

August 2011

H U M A N

W A T C H

HUMAN RIGHTS WATCH | August 2011

Futures Stolen: Barriers to Education for Children with
Disabilities in Nepal
H UMA N R I G H TS WATCH
350 Fifth Avenue, 34 th Floor
New York, NY 10118-3299

H U M A N
R I G H T S

Children with disabilities are entitled to attend school like all other children. Yet, tens of thousands of children
with disabilities in Nepal are either deprived of this right or relegated to inferior, segregated education. The
government of Nepal promotes an inclusive education system, whereby children with and without disabilities
attend school together in their communities. However, in practice, Nepal has a system of separate schools for
deaf, blind, and children with physical and intellectual disabilities and segregated classes for children withdisabilities in mainstream schools. While international donors have contributed significantly towards the
improvement of education in Nepal over the past decade, Nepal and its international partners should do more toensure that children with disabilities are attending school and that the education system is accessible,
appropriate, and of good quality for children with disabilities, particularly those with intellectual and developmental disabilities.

This report documents the hurdles that children with disabilities face in obtaining
a quality education in Nepal. Some children with disabilities experience abuse andneglect at home and in their communities, making it harder for them to gain access toschooling. These barriers result in low attendance and high dropout rates for children
with disabilities compared with their non-disabled peers.

Nepal | Futures Stolen

In Futures Stolen: Barriers to Education for Children with Disabilities in Nepal Human Rights Watch examines thebarriers that children with disabilities in Nepal face in attending school and obtaining quality education. These
children were often denied admission or had to leave school prematurely because of inaccessible schools,
inadequately trained teachers, or lack of awareness among parents. Some parents of children with disabilities
who were unable to find schools or support to educate their children claimed that they had no choice but to locktheir children in a room or tie them to a post while they went to work or completed daily chores.
Nepal has ratified the United Nations Convention on the Rights of Persons with Disabilities and the Convention
on the Rights of the Child and is obligated to ensure that children with disabilities can attend school with theirpeers. Domestic laws and policies further promote the right to an inclusive education for all children in Nepal.

Human Rights Watch calls on the government of Nepal, with the support of donors, to make schools inclusive andaccessible and to honor its obligations to protect the right of all children with disabilities to receive a quality
education without discrimination.

A resource class for children with intellectual disabilities
at Mahendranagar Secondary School in the far westernregion of Nepal. The number of students in this classvaries from 2 to 15. Human Rights Watch research foundthat children with disabilities have lower attendanceand higher drop out rates than other children due toinadequately trained teachers, lack of appropriate
teaching materials, lack of awareness of the right toeducation among parents and negative parental
attitudes about the learning capabilities of theirchildren, among other factors.

- Lakshmi, mother to Amman, a boy with difficulties in motor skills and speech, Nepal
Amman, a 16-year-old boy with a physical disability limiting his movement and speech, started attending

H U M A N

Futures Stolen

R I G H T S

Barriers to Education for Children with Disabilities in Nepal

W A T C H

7 and 10 years old. His 11-year-old brother attended the same school but studied in Class 4. Amman uses a
tricycle, which was pushed by his mother or other children in the community, to get to school. Because theschool entrance had two steep steps and no ramps, Amman had to crawl to his classroom.

www.aclu.org

www.hrw.org

H U M A N
R I G H T S
W A T C H

Impairing Education
Corporal Punishment of Students with Disabilities in US Public Schools

In this report, the American Civil Liberties Union and Human Rights Watch found thatstudents with disabilities made up 18.8 percent of students who suffered corporalpunishment at school during the 2006-2007 school year, although they constituted just
13.7 percent of the total nationwide student population. At least 41,972 students withdisabilities were subjected to corporal punishment in US schools during that year. These
numbers likely undercount the actual rate of physical discipline, since not all instances
are reported or recorded.
Every year in the United States, at least 220,000 children in public schools are subjected to corporal punishment,
including almost 42,000 students with mental or physical disabilities. Nationwide, students with disabilities
receive corporal punishment at disproportionately high rates. In Tennessee, for example, students withdisabilities are punished at more than twice the rate of the general student population. Students with disabilities
face considerable barriers to success; corporal punishment makes those barriers even higher.

His mother, Lakshmi, told Human Rights Watch, “Amman sits [alone] on a smaller chair in the corner. He
August 2009

HUMAN RIGHTS WATCH
350 Fifth Avenue, 34th Floor
New York, NY 10118-3299

HUMAN RIGHTS WATCH/ ACLU | August 2009

Impairing Education: Corporal Punishment of Students with
Disabilities in US Public Schools
AMERICAN CIVIL LIBERTIES UNION
125 Broad Street, 18th Floor
New York, NY 10004-2400

Corporal punishment typically takes the form of “paddling,” a practice which is legal in 20 states and consists ofan educator hitting a child repeatedly on the buttocks with a long wooden board. As detailed in this report,
students with disabilities are routinely subjected to paddling, as well as other violent punishments, including
hitting children with other objects, slapping, pinching, or striking children, grabbing children with enough force
to bruise, and throwing children into walls or floors.

Corporal punishment causes pain, humiliation, and in some cases deep bruising or other serious injury; it also
can have long-lasting psychological consequences. Students with disabilities may see their underlying conditions
worsened as a result. Furthermore, it creates a violent, degrading school environment in which all students – andparticularly students with disabilities – may struggle to succeed.

The American Civil Liberties Union and Human Rights Watch call on the federal government and US states toreplace corporal punishment with effective, positive forms of discipline, so that children’s human rights areprotected, and so that every student throughout the United States can maximize his or her academic potential.

United States | Impairing Education

Students with disabilities can be physically punished for conduct related to their conditions. Students with
autism, for example, can be punished for behaviors common to autism, including spinning in a circle or rocking
from side-to-side. When students with disabilities are beaten for their conditions, their rights to education andnon-discrimination are violated.

© 2006 Tom Fox/Dallas Morning News/MCT“I stand him at the gate of the school and he enters by crawling.”

school two years before in his village in far western Nepal. He was in Class 2. His classmates were between
Nepal© 2011 Shantha Rau Barriga/Human Rights Watch

Almost a quarter of a million US public school
children were subjected to corporalpunishment in the 2006-2007 school year, anda disproportionate number of them werestudents with mental or physical disabilities.

Amman’s Story

Amman and his mother sitting in front of their home, next to a wooden tricycle.
© 2011 Shantha Rau Barriga/Human Rights Watch

sometimes drools, so the other children don’t feel easy about sitting near him.”
Amman has to refrain from using the toilet while in school from 10 a.m. to 4 p.m. When he needs to use thetoilet during the day, another child has to run home to fetch his mother to assist him. The teachers say that
if he has stomach problems, his mother should not bother bringing him to school.

United States

Impairing Education
Corporal Punishment of Students with Disabilities
in US Public Schools

H U M A N
R I G H T S
W A T C H

page 18
One Billion Forgotten

page 19
One Billion Forgotten

Women anddisabilities

Few women and girls with physical disabilities have functioning
mobility devices that can help them to access basic services
such as health centers, police stations or schools. This 35year old woman has seven children. She uses a hand-crank
bicycle to move around her village. But she says she still feels
vulnerable to sexual violence and HIV.
© 2010 Martina Bacigalupo for Human Rights Watch

Women with disabilities experience multiple
discrimination – as a result of their disability
and gender – and face a heightened risk ofphysical and sexual violence. Many factors
contribute to this risk, including limitations
in physical mobility, communication barriers,
isolation, and common myths that persons
with disabilities are weak or asexual. In many
countries, an alarming number of womenwith disabilities continue to be denied
reproductive and sexual rights through thepractice of forced sterilization. Our goal is tobring an end to violence and discrimination
against women with disabilities worldwide.

page 20
One Billion Forgotten

page 21
One Billion Forgotten

R I G H T S
W A T C H

H UMA N R I G H TS WATCH
350 Fifth Avenue, 34 th Floor
New York, NY 10118-3299

www.hrw.org

This report describes frequent abuse and discrimination by strangers, neighbors, andeven family members against women and girls with disabilities in the north. Womeninterviewed for the report said they were not able to get basic provisions such as food,clothing, and shelter in camps for displaced persons or in their own communities. The
research was conducted in six districts of northern Uganda – a region recently emerging
from over two decades of brutal conflict between the rebel Lord’s Resistance Army andthe government.

August 2010

H U M A N

HUMAN RIGHTS WATCH | August 2010

“As if We Weren’t Human”: Discrimination and Violenceagainst Women with Disabilities in Northern Uganda

All photographs© 2010 Martina Bacigalupo(right) A makeshift mobility devicein Omee IDP camp.

After two decades of conflict, many internally displaced persons in northern Uganda are leaving camps and returning to their villages, or
relocating to new areas. Others have decided to settle permanently inside the camps. For most displaced persons, the challenges torebuilding their lives are daunting. For women with disabilities – who experience discrimination because of both their gender and theirdisabilities – full participation in society is particularly challenging. Women with disabilities face multiple and distinctive hurdles that the
government has as yet failed to address.
In “As If We Aren’t Human,” Human Rights Watch examines the experiences of women who had disabilities before the war as well as
women who acquired their disabilities as a result of the conflict, from landmines, gunshot wounds, mutilation, and fire. Women withdisabilities experience stigma and isolation, sexual and gender-based violence, and obstacles to accessing justice. They also lack equal
access to care in rehabilitation, maternal health, family planning, and reproductive health, including HIV testing, treatment andprevention.

Uganda | “As If We Weren’t Human”(front cover) A woman with multiple
disabilities was raped by herneighbor while her husband wasaway. Over one-third of the womenwith disabilities interviewed told
Human Rights Watch that theyexperienced some form of sexual or
physical violence. Women withdisabilities are vulnerable to suchcrimes because of their isolation,lack of support structures, limitations
in physical mobility, communication
barriers and also because of myths
that women with disabilities are
weak, stupid or asexual.

Uganda“As If We Weren’t Human”

H U M A N
R I G H T S

Discrimination and Violence against Women
with Disabilities in Northern Uganda

W A T C H

Argentina

H U M A N

Illusions of CareR I G H T S

Lack of Accountability for Reproductive Rights in Argentina

W A T C H

The Convention on the Rights of Persons with Disabilities (CRPD) recognizes and seeks to eliminate the discrimination experienced by all
people with disabilities, including and particularly women. As a state party to the CRPD and the Convention on the Elimination ofDiscrimination Against Women (CEDAW), Uganda must ensure that women with disabilities enjoy the human rights protections afforded
by international human rights law. Uganda’s own constitution and domestic laws also guarantee basic rights to persons with disabilities.
Human Rights Watch calls on the Ugandan government to live up to its international and domestic obligations and to guarantee thatwomen with disabilities have equal access to government services and programs, are fully able to participate in society, and areempowered to live with dignity.

H U M A N

www.hrw.org

W A T C H

R I G H T S

Illusions of Care
Lack of Accountability for Reproductive Rights in Argentina

This report documents the many obstacles women and girls face in getting the
reproductive health care services to which they are entitled, such as contraception,
voluntary sterilization procedures, and abortion after rape. The report demonstrates how
obstacles to care can be even harder to overcome for women and girls with disabilities,
who must also at times deal with prejudicial treatment from health care providers.
The most common barriers to care include lack of physical accessibility, long delays
in providing services, unnecessary referrals to other clinics, demands for spousal
permission contrary to law, financial barriers, and in some cases outright denial of care.

august 2010

H UMA N R I G H TS WATCH
350 Fifth Avenue, 34 th Floor
New York, NY 10118-3299

HUMAN RIGHTS WATCH | August 2010

Illusions of Care: Lack of Accountability for Reproductive
Rights in Argentina
Pregnancy is not a debilitating illness. Yet every year, thousands of women and girls in Argentina experienceentirely preventable suffering because of their reproductive capacity.

Many become pregnant due to negligent care that deprives them of the right to make independent decisions
about their health and lives. Others are forced to carry life-threatening pregnancies to term because medical
providers refuse to provide abortions services that, in these circumstances, are legal. Some choose to seek
alternative and at times highly unsafe abortions from unlicensed providers. Others forego care entirely, and someeven die. In 2008, according to Argentina’s national health ministry, over 20 percent of deaths recorded due toobstetric emergencies were caused by unsafe abortions.

Over the past 10 years, Argentina has accumulated an impressive artillery of reproductive and sexual healthrelated policies. Though they ignore key constituencies such as women with disabilities, these policies would, if
implemented, go a long way to overcoming the suffering documented in this report and elsewhere.

For the state, the resulting and pressing public healthconcerns such as preventable maternal mortality,
unsafe abortion, and unwanted pregnancies, are also
costly. The ultimate human consequence of this lack of
accountability is suffering, and sometimes even death.

Argentina | Illusions of Care

But the laws and policies intended to benefit women and girls—such as the legal exceptions to the generalcriminalization of abortion—often go unimplemented. Moreover, the absence of oversight and accountability forthis failure indicates that few in authority seem to care.

Graffiti on the wall of the maternity ward
in a public hospital, Hospital Alvarez,
Buenos Aires, Argentina.
© 2010 Ethan Salwen

H U M A N

www.hrw.org

W A T C H

R I G H T S“I Am Not Dead, But I Am Not Living”
Barriers to Fistula Prevention and Treatment in Kenya

This report describes the devastating circumstances women with obstetric fistula in
Kenya face, and the wide gap between government’s policies to address reproductive
health and the reality of women’s daily lives. Obstetric fistula is a preventable childbirth
injury that can lead to long-term disability, and often triggers stigma and the breakdownof family, work, and community life. This report documents health system failures in fiveareas: education and information on reproductive and maternal health; school-based
sex education; access to emergency obstetric care, including referral and transportsystems; affordable maternity care and fistula repair; and health system accountability.
It also documents stigma and violence many women with fistula face.

JUly 2010

H UMA N R I G H TS WATCH
350 Fifth Avenue, 34 th Floor
New York, NY 10118-3299

HUMAN RIGHTS WATCH | July 2010

“I Am Not Dead, But I Am Not Living”: Barriers to Fistula
Prevention and Treatment in Kenya“This is a terrible illness. I thought I should kill myself. You can’t walk with people or travel. You can’t sleep
comfortably or eat well. You can’t work because you are constantly in pain. You are always sad because you stain
everything and you smell,” a 33-year-old woman who had lived with obstetric fistula for 17 years told Human
Rights Watch.

Obstetric fistula is a preventable and treatable debilitating childbirth injury that leaves its victims constantly
leaking urine and feces. Thousands of women and girls unnecessarily get fistula each year in Kenya, while many
more are living with untreated fistula. This happens because of government failure to provide sufficient and wellresourced health facilities with the capacity to handle obstetric complications, to inform women that theircondition can be treated, and the high cost of fistula repair.

“I Am Not Dead, But I Am Not Living” finds that strengthening health system accountability− giving people
accessible and effective ways of providing feedback, lodging complaints, providing redress, and ensuring that the
feedback leads to improvements −can greatly enhance the health system by allowing the people it serves to tell
the government what is working and what needs fixing. It also calls on the Kenyan government to develop andimplement a national strategy on obstetric fistula.

Patients in a ward in Machakos General
Hospital during a fistula repair camp.

Kenya | “I Am Not Dead, But I Am Not Living”

The Kenya government has taken some positive steps to make pregnancy and childbirth safer for women.
However, as this report shows through the voices of fistula survivors, the policy responses are not adequately
reaching the women and girls they are supposed to help, and there is urgent need to reevaluate and scale-up
many of the responses.

Kenya“I Am Not Dead,
But I Am Not Living”
Barriers to Fistula Prevention and Treatment in Kenya

H U M A N
R I G H T S
W A T C H

© 2006 Sven Torfinn/Panos Pictures

IRENE’S STORY“One night, when I was sleeping alone, a man who was drunk entered my home and started raping me. My husband
was not around. He had gone to look for food. No one came to rescue me, and the man raped me and beat me. I know
the man. He lives in the neighborhood. The man was arrested and was held for only one day.”-Irene, a woman with communicative and physical disabilities, northern Uganda
Irene is a woman with communicative and physical disabilities who communicates with her husband, who

Many Ugandans rely on makeshiftmobility devices to get around; this one
is at a camp for internally displaced
persons in Omee. Some women withphysical disabilities who left the camps
said that they now have to crawl long
distances to health clinics or pharmacies.
© 2010 Martina Bacigalupo for Human
Rights Watch

has a physical disability, through a combination of a few words, facial expressions and hand gestures.
Her husband explained to Human Rights Watch, “I can’t stay away from home. I heard there was food
distribution at another camp. … I went there, but that place was far, and I stayed there for a night. [My]neighbor came back [before me] and raped my wife.” In a follow-up interview with Irene alone, she told
Human Rights Watch that her husband had also beaten her in the past. As a result of severely limited ability
to move and communicate, Irene has little recourse and almost no ability to report the assaults to others.

page 22
One Billion Forgotten

page 23
One Billion Forgotten

Select Multimedia & Advocacy

At the Core
Human Rights Watch’s approach to our disability rights work has centeredon working in partnership with disabled persons’ organizations and persons
with disabilities. This approach recognizes the expertise within the disability
community and honors the principle of participation, enshrined in theConvention on the Rights of Persons with Disabilities.
Our disability rights work references a number of key principles and standards set
out in the Convention on the Rights of Persons with Disabilities, including:

HIV and Disability:

As part of Human Rights Watch’s advocacy on greater inclusivity of individuals with disabilities in HIV policy andprevention efforts worldwide, we published an advocacy brochure—including an easy-to-read version—and distributed
the brochures at the International AIDS Conference in Washington, DC. We also presented on HIV and disability at twopanels, distributed multimedia materials on this issue to hundreds of HIV advocacy organizations, and screened avideo we produced about a South African disability rights advocate living with HIV. This work led to the CNN feature
program: “Deaf, Gay and HIV Positive Activist Battles Against Stigma.”
We also produced an audio podcast featuring HIV activist Winstone Zulu and disability advocate Myroslava Tataryn,
which led to an opinion piece on HIV and disability in the New York Times. We are continuing our advocacy on thisissue, including pressing for the next international AIDS conference in 2014 to have a greater focus on disability andHIV.

Disability Rights in Russia:

Human Rights Watch created a multimedia piece,
Breaking Barriers: Disability Rights Movementin Russia, featuring photos from Platon, tobring attention to the efforts of disability rights
advocates in Russia. We also drafted an op-ed
that appeared in a major Russian newspaper anda dozen online media outlets.

Top photo: John Meletse is a deaf, gay, and HIV-Positive
South African man. © 2012 Human Rights Watch
Left photo: © 2012 Human Rights Watch•

Principle of “reasonable accommodation”•

Non-discrimination•

Accessibility•

Situations of risk and humanitarian emergency•

Equal recognition before the law•

Access to justice•

Freedom from violence and exploitation•

Protecting the physical and mental integrity of the person•

Respect for home and the family•

Education•

Health•Habilitation and rehabilitation•

Adequate standard of living and social protection•

Political participation

page 24
One Billion Forgotten

Human Rights Watch has broken
new ground with our research andadvocacy on disability rights under
the focus of a human rights lens.
We hope to continue to advance ourdisability rights work, strengthen
our collaboration with disabled
persons’ organizations in raisingpublic awareness of abuses, andconduct strategic advocacy at thehighest levels to effect change inthe lives of persons with disabilities
on the ground. We look forward topartnering with you and other allies
in this effort.

For more information,
visit: www.hrw.org/disability

People with physical disabilities living in remote places, like Filda, a woman
in Uganda have difficulty reaching HIV services, as well as entering them when
they arrive.
© 2009 Martina Bacigalupo for Human Rights Watch