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IV. Addressing the needs of vulnerable populations

Children, women and the disabled are particularly vulnerable in disaster situations. Apart from having to cope with psychological trauma, these groups often fail to gain equal access to humanitarian aid. Children can be separated from their relatives. They can also fall prey to epidemics or malnourishment because emergency food rations fail to accommodate their particular needs. The disabled can lose their assistive devices and be separated from their customary caregivers. Disruptions in family and community support structures, inadequate housing, and a lack of support services also put women and children at increased risk of violence or trafficking. 

The Guiding Principles on Internal Displacement34 recognize that certain internally displaced persons, such as children, especially unaccompanied minors, expectant mothers and those with young children, female heads of household, persons with disabilities, and elderly persons, are “entitled to protection and assistance required by their condition and to treatment which takes into account their special needs.”35 The UN Guiding Principles apply not only to persons displaced by armed conflict, but also by natural disasters.36

As discussed in detail below, protection of vulnerable groups should become part of the government’s disaster management policy.37 While the government has agencies dedicated to addressing the particular needs of such groups and has many directly relevant policies, the policies too often are not implemented on the ground.


Over a million children were affected by the tsunami.38According to UNICEF, nearly a third of the estimated 280,000 dead were children, who could not save themselves when the waves struck.39 Thousands of children were killed in India, and tens of thousands lost relatives.40

Children are especially vulnerable in disasters because they can easily become victims of illness, malnutrition, trafficking or sexual violence. Activists complained that during immediate relief and rescue operations, there was a lack of sensitivity to the needs of children, particularly the need for special food, nutrition, or psychological care.41 These were later addressed by some humanitarian agencies and voluntary organizations.42

Soon after the tsunami, the World Health Organization (WHO) issued warnings against water-borne diseases. Nearly 350,000 children were feared to be at risk. However, because of prompt efforts by the government and voluntary agencies, including WHO and UNICEF, epidemics of diarrhoea, cholera, and measles were prevented.43

Aid workers assisting children told Human Rights Watch that many children suffered physical injuries, particularly loss of eyesight, as well as post-trauma disorders.44 It is now widely accepted that early psychosocial interventions to mitigate the effect of trauma and alleviate psychological distress should be an integral part of humanitarian assistance. In the case of children and adolescents, psychosocial interventions must aim to maintain or re-establish their normal development process.45

At least 529 children orphaned by the tsunami are in state-run homes.46 The Guiding Principles call for appropriate action to be taken to hasten the reunion of families separated by displacement. The responsible authorities are to “facilitate inquiries made by family members and encourage and cooperate with the work of humanitarian organizations engaged in the task of family reunification.”47

Initially, there was a rush to adopt tsunami orphans.48 In view of the fact that so many children in India are still awaiting adoption, the enthusiasm to adopt children affected by the tsunami was thought by some activists to have been driven by media images and a short-term response to the crisis.49

Some activists have called for a one-year ban on the adoption of children affected by the tsunami.50 The Indian government too, has been cautious about allowing the adoption of tsunami orphans, and is still reviewing applications.51 This is because experts believe that uprooting children after such a trauma can cause more damage, and recommend that efforts initially focus on helping separated or orphaned children find a home with sympathetic relatives or customary care givers.52 However, there is a risk there, too, as in some cases so-called relatives have also come forward, hoping to get their hands on the compensation to which orphaned children are entitled.53 (The Indian government has distributed a hundred thousand rupees, about U.S. $2,300,54 to the next-of-kin of each person who was killed by the tsunami. Various states and union territories have also created fixed bank deposits for each orphan, to be claimed when they turn eighteen.)55

According to major humanitarian organizations, long-term care arrangements, including adoption, should not be made during the emergency phase.56 In the long term, if family reunification is not possible, then adoption may emerge as an option. But any adoption has to be determined as being in the child’s best interest and in keeping with national and international law.57

In the best interests of the child, the government should ensure that families are not inadvertently separated because of loss of livelihood as a result of the crisis. Utmost efforts should be made to locate relatives who are willing and capable of caring for affected children. Assistance should be provided to these relatives when necessary. Many children lost a parent in the tsunami. The surviving parent has to work and may find it difficult to take care of the children.58 Organized community care should be arranged and encouraged to help these families. Residential care should only be used as a measure of last resort, particularly as orphanages and other non-penal institutions in India are generally substandard facilities.59

Displaced children living in temporary shelters need special protection. Girls, in particular, are at risk of rape or sexual harassment. The tsunami has made children particularly vulnerable to trafficking because of loss of family and livelihood. It is important for the authorities to recognize that children not in the care of their parents or customary caregivers are at heightened risk of abuse and exploitation and could even end up in the worst forms of child labor. There should be constant monitoring and support for children affected by the tsunami.

Many children, particularly girls, are also not able to get to school on time because long queues in the morning prevent them from using toilet and bathing facilities in time to leave for school. Most schools have reopened, but many children lost their books and notebooks in the tsunami. While replacements are being distributed by NGOs and government agencies, distribution has been uneven. Authorities should ensure that every child affected by the tsunami receives a fair and equitable share of these and other resources. Some displaced children are in temporary camps far away from their schools. With livelihood destroyed, activists fear that parents may not be able to afford bus fares or schooling costs. As Ossie Fernandes of the Chennai-based Human Rights Advocacy and Research Foundation, warned: “We are going to get a high number of dropouts if nothing is done quickly.”60

Women and girls

Women and girls often confront discrimination and gender-based violence in the aftermath of large-scale natural disasters.61 Women confront discrimination in gaining access to humanitarian aid, often distributed through male household heads. Disruptions in family and community support structures, inadequate housing, and a lack of support services also put women and girls at increased risk of violence with limited access to help. Pregnant and lactating women may not have access to necessary health care and food supplements. 

The Guiding Principles call for special attention to the health care needs of women, including reproductive health,62 and for the right of women to be treated equally during distribution of aid.63

Many women and girls complained to Human Rights Watch that they did not have proper, safe and private toilet and bathing facilities in relief camps and temporary shelters for the displaced. One woman pointed to some shrubs behind the shelter and said that is what she and her daughters used as a toilet.

Human Rights Watch received reports that in some temporary shelters, women and girls have resorted to walking in pairs to and from community toilet and bathing facilities to ward off harassment from men frustrated by lack of work and fueled by alcohol abuse.64 As one woman told Human Rights Watch, “there are many fights all the time and long lines. At night, it is better to go somewhere close to the house because the men have been drinking and can make trouble.”65

To ensure the safety of women in temporary shelters, the government should refer to the guidelines of the United Nations High Commissioner for Refugees on the prevention and responses to gender-based violence.66 For instance, proper location of toilets, lighting in temporary camps, and proximity to fuel and water sources (for which women and girls typically are responsible) are important in reducing the risk of violence. Gender-sensitive complaint mechanisms in temporary settlement camps are critical so that victims of violence actually report incidents and receive referrals to health care, legal aid, and other support services.

A recent report in The Week, among the most widely circulated English-language magazines published in south India, said that sexual harassment was rampant in the camps. According to the report, widows have become particularly vulnerable to sexual abuse, especially from male relatives. Many women are illiterate, and although those widowed in the disaster have received compensation from the government, such payments are deposited directly into bank accounts and some women do not yet know how to access the funds.67

Instead of being able to claim an independent and equal share of humanitarian aid, women’s access is brokered through their husbands, fathers, or other male relatives. This is because the primary means of establishing identity and residence in India is the government issued ‘ration card,’ used to distribute subsidized food grain, which are all issued under the name of the male household head. After the tsunami, many women complained that distribution of relief and compensation was conducted through male heads of households. Press reports referred to several instances where women had complained that cash relief handed out to male survivors did not reach their families and was spent instead on liquor.68 Unmarried, widowed, and divorced women are often subsumed into the household units of their brothers or fathers or husband’s relatives, instead of being counted as independent, female-headed households.69

The Indian government did not treat tsunami-affected women from fishing communities as independent workers who contribute to the family livelihood. Most women from fishing communities were actively engaged in the trade prior to the disaster.70 Typically, after men brought in the catch from the sea, women cleaned the fish and sold it to vendors. With fishing at a standstill, women require alternate employment opportunities. Many women agricultural laborers have also lost their livelihood. Most women have resisted a transition into basket weaving or sewing offered by NGOs.71 These vocational offerings often provide low and irregular income. They also reinforce stereotypes about women’s work.

Lessons learned from other humanitarian disasters highlight key measures for ensuring women’s rights during relief and reconstruction.72 The government and aid agencies should register men, women, and children individually to ensure individual and equal access to aid. Women should be involved at all levels in the planning and actual distribution of food, shelter and economic assistance.73 Special efforts should be made to identify and help women at risk, such as widows, single mothers or pregnant women. Reporting and referral systems should be established for individuals who have suffered gender-based violence so that they can receive appropriate services. The displacement that followed the tsunami has made women and girls particularly vulnerable to trafficking because of loss of family and livelihood. To ensure that women do not become greater victims in this tragedy, the rebuilding efforts must make explicit efforts through education and proper implementation of laws to root out problems such as women’s inferior status in society and their limited access to resources.74

Finally, some women complained that they feel embarrassed to go to doctors visiting the temporary camps because there is no privacy and the doctors are usually male. Efforts should be made to improve privacy and, whenever possible, to ensure that female doctors are available to women and girls.


Disasters disproportionately affect persons with existing disabilities, and cause fresh disabilities among those injured in the disaster.

Persons with existing disabilities

People with disabilities are at heightened risk during disasters.75 They can also lose their assistive devices, including crutches, artificial limbs, hearing or visual aids. Their usual caregivers may also have been killed, injured, or diverted to other survival tasks. In January 2005, the National Center for Promotion of Employment for Disabled People, a Delhi based non- governmental organization, called for improved monitoring of disabled people affected by the tsunami and urged authorities to address disability concerns in their ongoing efforts at revival of livelihoods.76 In meetings with activists, government officials in Tamil Nadu admitted that there was no special policy to protect disabled people affected by the tsunami, but said that they would consider all recommendations made in this regard.77

Priority protection of the disabled should become part of the government’s disaster management policy. In a crisis, in the rush of immediate rescue and relief, they can otherwise be neglected.

During the rehabilitation phase, persons with disabilities must receive equal access to services. The government should also be sensitive to the fact that disabled people can be made destitute not only when they lose their own livelihoods but when relatives who in the past provided care or assistance are killed or can no longer afford to help them.78

Persons disabled due to tsunami-inflicted injuries

Nearly 7,000 people were injured in the tsunami, although the government has not yet provided any data on the number of people who were physically disabled. Considering the heavy death toll, this number can be assumed to be high. The World Health Organization says that falling structures and waters full of swirling debris inflicted crush injuries, fractures, and a variety of open and closed wounds.79 There are reports that several children lost their eyesight.80

The government should ensure that all those injured in the tsunami receive immediate attention from specialists in existing facilities. Those survivors with newly sustained permanent disabilities may have to cope with the loss of their traditional livelihood. Immediate assistance and alternative employment opportunities should be provided to those permanently disabled. In the rehabilitation phase, it is also crucial to construct shelters, health centers, housing, schools, or other public structures, that are accessible to the disabled.81

In March 2005, the national government announced that it had set aside over U.S. $800 million for the rehabilitation of those affected by the tsunami, including orphans, widows and the disabled.82 The Ministry of Social Justice and Empowerment also announced that 1,981 assistive devices had been distributed to persons with disabilities in South India, and another 200 had been distributed in the Andaman & Nicobar Islands.83 Under the scheme, the permanently disabled will be eligible for a compensation of U.S. $2,300 and those with partial disabilities will receive U.S. $1150. It is important that all those disabled because of the tsunami are properly identified so that they can claim compensation and receive assistance.

[34] Although not legally binding, the U.N. Guiding Principles on Internal Displacement (UN Guiding Principles), U.N. Doc. E/CN.4/1998/53/Add.2 (1998), noted in Commission on Human Rights res. 1998/50, provide an authoritative normative framework for the protection of IDPs. They are a firm restatement of existing international human rights, humanitarian and refugee law as it relates to the internally displaced, drawing heavily on existing standards and providing additional explanation and guidance where there are gaps. The Guiding Principles are intended to provide practical guidance to governments, the U.N. and other intergovernmental agencies and nongovernmental organizations in their work with IDPs. Human Rights Watch encourages the establishment of complaints mechanisms and other tools to address violations of the Guiding Principles when they occur.

[35] United Nations Office for the Coordination of Humanitarian Affairs, Guiding Principles on Internal Displacement, Principle 4.2.

[36] The Introduction to the UN Guiding Principles state: “For the purposes of these Principles, internally displaced persons are persons or groups of persons who have been forced or obliged to flee or to leave their homes or places of habitual residence, in particular as a result of or in order to avoid the effects of armed conflict, situations of generalized violence, violations of human rights or natural or human-made disasters, and who have not crossed an internationally recognized State border” [emphasis added].

[37] An integrated approach to humanitarian assistance from a human rights perspective can be found in The Sphere Handbook (2004 edition), The Sphere Project [online], (“Sphere is based on two core beliefs: first, that all possible steps should be taken to alleviate human suffering arising out of calamity and conflict, and second, that those affected by disaster have a right to life with dignity and therefore a right to assistance”).

[38] Children, as defined under the Convention on the Rights of the Child, are individuals below 18 years of age. Convention on the Rights of the Child, G.A. res. 44/25, annex, 44 U.N. GAOR Supp. (No. 49) at 167, U.N. Doc. A/44/49 (1989), entered into force Sept. 2, 1990.

[39] UNICEF [online], (retrieved April 2, 2005).

[40] “Debating the Future of Tsunami Hit Children,” Times Foundation, January 11, 2005 [online], (retrieved February 5, 2005).

[41] Draft note prepared by Terre des Hommes and the Tata Institute of Social Sciences, January 2005. Copy available with Human Rights Watch.

[42] On February 3, 2005 at a meeting held by the NGO Coordination Center for Child Care and Protection, participants called upon the government to adopt a series of measures on behalf of children including constant surveillance to prevent trafficking. For details see

[43] “Quick Tsunami Response Prevented Water Borne Disease,” UNICEF, March 17, 2005 [online], (retrieved April 12, 2005).

[44] Activists said that many children had suffered from shock and numbness. Others were in the grip of a fear psychosis and some even experienced seizures at the thought of seeing the sea again. Also see Anupam Srivastav, Traumatized Children at Risk of Infection [online], (retrieved May 6, 2005).

[45] ‘Psychosocial Care and Protection of Tsunami Affected Children – Inter-Agency Guiding Principles’, January 2005, produced by UNHCR, UNICEF, ICRC, the International Rescue Committee, Save the Children UK, and World Vision Internationa, January 18, 2005 [online], (retrieved February 9, 2005).

[46] Arun Kumar Das, “Tsunami Orphans Yet to be Adopted,” The Times of India, April 3, 2005, p. 7. Home Minister Shivraj Patil, in a statement in parliament regarding relief and rehabilitation of tsunami affected people on March 10, 2005 said that 530 children had been orphaned.

[47] Guiding Principles, principle 17(3).

[48] Orphan, in this case, means children that lost both parents.

[49] Sunil Raman, “Tough Decisions on Tsunami Orphans,” BBC News Online, March 3, 2005 [online], (retrieved April 11, 2005); George Iypem “Clamor to Adopt Orphans Of Tsunami,” Rediff Special, January 5, 2005 [online], (retrieved April 11, 2005).

[50] “One Year Adoption Ban Essential to Prevent Human Traffickers,” AFP, January 6, 2005 [online], (retrieved April 11, 2005 ).

[51] Arun Kumar Das, “Tsunami Orphans Yet to be Adopted,” The Times of India, April 3, 2005, p. 7.

[52] Unaccompanied and Separated Children in Tsunami-affected Countries, Guiding Principles by the International Committee of the Red Cross (ICRC), the International Rescue Committee (IRC), Save the Children UK (SCUK), the United Nations Children’s Fund (UNICEF), the United Nations High Commissioner for Refugees (UNHCR) and World Vision International (WVI), January 2005; “India, Tsunami Orphans Shun Adoption,” Reuters, January 17, 2005 [online], (retrieved April 11, 2005).

[53] “Debating the Future of tsunami children,” India Abroad News Service, January 11, 2005. Government officials in Tamil Nadu said that there was fear that the children might fall into the care of greedy caregivers.

[54] Exchange rate US$ 1= Rs. 43.35 on May 9, 2005.

[55] For instance, the Tamil Nadu government placed Rs. 500,000 for each orphaned child in a fixed deposit that will be given to the child when they turn eighteen. See Anupama Vishwanathan, “Tsunami: Government Yet to Give A Nod For Adoption,” January 25, 2005 [online], (retrieved April 11, 2005). The government of Andaman and Nicobar Islands has announced a Rs. 200,000 compensation for orphans and Rs. 100,000 for unmarried girls above the age of eighteen that have lost both parents. See Rajiv Gandhi Rehabilitation Package for Tsunami Affected [online], (May 6, 2005).

[56] Unaccompanied and Separated Children in Tsunami-affected Countries, Guiding Principles by the International Committee of the Red Cross (ICRC), the International Rescue Committee (IRC), Save the Children UK (SCUK), the United Nations Children’s Fund (UNICEF), the United Nations High Commissioner for Refugees (UNHCR) and World Vision International (WVI), January 2005.

[57] Adoption of children in India is monitored by the Central Adoption Resource Agency of the Ministry of Social Justice and Empowerment and its policies are determined by the National Policy on Welfare of Children and the Guidelines to Regulate Matters Relating to Adoption of Indian Children, 1994. These guidelines are based on a 1984 Supreme Case verdict in Laxmi Kant Pandey Vs. Union of India. Adoption policies in India are determined by the Supreme Court verdict, the guidelines on adoption as well guidelines provided under international laws like the United Nations Declaration on the Rights of the Child, 1989 and the Hague Convention on Inter-Country adoption of 1993.The Convention on the Rights of the Child in article 21 states in part that states:

shall ensure that the best interests of the child shall be the paramount consideration and they shall: … Ensure that the adoption of a child is authorized only by competent authorities who determine, in accordance with applicable law and procedures and on the basis of all pertinent and reliable information, that the adoption is permissible in view of the child's status concerning parents, relatives and legal guardians and that, if required, the persons concerned have given their informed consent to the adoption on the basis of such counseling as may be necessary.

[58] Pallava Bagla, “Caring for Children Hit Hard by the Tsunami,” March 30, 2005 [online], (retrieved April 11, 2005). In Tamil Nadu’s worst affected Nagapattinam district, 222 children lost both parents and 879 lost one parent.

[59] The Convention on the Rights of the Child, article 21, provides that alternative care for children permanently deprived of their family environment includes “foster placement, kafalah of Islamic law, adoption or if necessary placement in suitable institutions for the care of children. When considering solutions, due regard shall be paid to the desirability of continuity in a child's upbringing and to the child's ethnic, religious, cultural and linguistic background.”

[60] Human Rights Watch interview, Ossie Fernandes, Chennai, February 7, 2005.

[61] “The tsunami’s impact on women,” Oxfam briefing note, Oxfam International, March 2005 [online], (retrieved May 10, 2005).

[62] Guiding Principles, principle 19(2) states: Special attention should be paid to the health needs of women, including access to female health care providers and services, such as reproductive health care, as well as appropriate counseling for victims of sexual and other abuses.

[63] Guiding Principles, principle 21.

[64] In their March 13, 2005 report, a Mumbai based voluntary group called Youth for Voluntary Action (YUVA) which was involved in providing relief and rehabilitation in the tsunami affected areas, reported that ‘alcoholism is a serious problem among the men.’ Report available with Human Rights Watch.

[65] Human Rights Watch interview with Jhans Rani, Nagapattinam, January 29, 2005.

[66] Sexual and Gender-Based Violence Against Refugees, Returnees, and Internally Displaced Persons: Guidelines for Prevention and Response (Geneva: UNHCR, 2003).

[67] Litta Jacob, “Woe-Men of Tsunami,” The Week, Vol 23, No. 18, April 3, 2005, p.44.

[68] V. Jayanth, “Tamil Nadu still awaits Center’s relief package,” The Hindu, January 28, 2005, p. 4.

[69] David Devdas, “Tsunami Crisis: Abandoned Widows,” CARE, January 27, 2005 [online], (retrieved April 12, 2005).

[70] Traditionally, women from the fishing communities in Tamil Nadu are engaged in cleaning the catch, marketing fresh fish and processing the surplus catch. “Rehabilitation of Women Victims of Tsunami,” A. Gandhimathi and Jesu Rethinam, Sneha, Febryary 9, 2005, [online] (retrieved April 12, 2005); Recommendations For Tsunami Victims, National Commission for Women and Tamil Nadu State Commission for Women, January 20, 2005, [online] (April 12, 2005).

[71] Litta Jacob, “Woe-Men of Tsunami,” The Week, Vol. 23, No. 18, April 3, 2005, p.44.

[72] See UNHCR Sexual and Gender-Based Violence Against Refugees, Returnees, and Internally Displaced Persons: Guidelines for Prevention and Response (Geneva: UNHCR, 2003). Available at

[73] Guiding Principles, principle 18 provides that “[s]pecial efforts should be made to ensure the full participation of women in the planning and distribution of these basic supplies [essential food and potable water; basic shelter, appropriate clothing, and essential medical services and sanitation].”

[74] See Policy guidance on the gender perspectives of natural disasters, Division for the Advancement of Women, Department of Economic and Social Affairs, United Nations.

[75] Guiding Principles, principle 19(1) states in part:

All wounded and sick internally displaced persons as well as those with disabilities shall receive to the fullest extent practicable and with the least possible delay, the medical care and attention they require, without distinction on any grounds other than medical ones [emphasis added].

[76] Report by Rama Chari, Senior Program Officer, NCPEDP, New Delhi and Rajul Padmanabhan, Deputy Director, Vidya Sagar, Chennai, members of a core group to campaign for the rights of disabled tsunami victims. January 2005. Report on file with Human Rights Watch.

[77] State Level Consultation on Civil Society Partnership in Post-Tsunami Rehabilitation, Chennai, January 26, 2005.

[78] For instance, a center run by religious guru Mata Amritanandamayi has adopted three mentally challenged children whose parents can no longer take care of them after the tsunami [online] (retrieved April 11, 2005).

[79] Injuries and Disability: priorities for management of populations affected by the earthquake and tsunami in Asia, World Health Organization  [online], (retrieved April 12, 2005 ).

[80] Anupama Vishwanathan, “Tsunami Children: Government Yet to Give a Nod for Adoption,” Asian College of Journalism, January 25, 2005 [online], (retrieved April 11, 2005).

[81] See Disasters, Disability and Rehabilitation, guidelines from the World Health Organization, Department of Injuries and Violence Prevention [online], (retrieved April 12, 2005).

[82] Home Minister’s Statement in parliament regarding relief and rehabilitation of tsunami affected people. March 10, 2005.

[83] Relief Measures for Socially Backward People in Tsunami Hit Areas, Ministry of Social Justice and Empowerment, March 21, 2005 [online], (retrieved April 18, 2005).

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