State Welfare Organization Failures
Our research uncovered serious problems in the work of the State Welfare Organization (SWO), the main agency tasked with providing services to people with disabilities. Interviewees described how state social workers insulted and humiliated them. Many people we interviewed stated that social workers did not provide them with sufficient information in a timely manner about services and equipment to which they are entitled to and the procedures for obtaining them.
For the most part, those we interviewed who required assistance in fulfilling basic needs—including eating, getting dressed, or daily hygiene—relied solely on the help of family members or close friends. While family members often play important roles in the lives of people with disabilities, people with disabilities have the right to live independently and be included in the community on an equal basis with others. To ensure this, they should have access to a range of in-home and other support, including personal assistance. None of the people with disabilities interviewed for this report benefited from professional personal assistance (PA). A personal assistant is an individual supporting a person with a disability in different aspects of daily life – such as personal care, household tasks, assistance at school, university, or the workplace, driving, interpretation, and other tasks customized to the individual.
People who did hire individuals to help with personal care reported instances of caregivers not providing professional care, such as improperly inserting a catheter and causing injury, or stealing from them. Government officials have acknowledged the need for greater oversight of companies that offer home care services.
The SWO is responsible for providing assistive devices such as wheelchairs, crutches, and hearing aids. However, many people interviewed said that they encountered excessive waiting times, often up to a few years, and complex procedures to obtain free or subsidized equipment. People who did receive assistive devices found that they were of low quality and did not facilitate their independence. For example, the SWO typically only provides manual wheelchairs. People whom we interviewed who cannot use manual wheelchairs independently said that their only choice was to purchase electronic wheelchairs at their own expense, which many could not afford to do.
The SWO implements some community-based rehabilitation programs aiming to make services available within communities, particularly in rural areas. However, interviews with people with disabilities in Iran revealed that many of them face various barriers in accessing essential services such as physiotherapy, speech therapy, occupational therapy, and psychotherapy. Often, these services are not available in the communities where they live. Where they do exist, the quality may be poor, or services may be cost prohibitive: neither private nor public insurance schemes in Iran cover these services.
Human Rights Watch and the Center for Human Rights in Iran found that the current disability pension program is discriminatory and has serious shortcomings both in coverage and the amount paid. According to the government, 25 percent of persons with disabilities registered with the SWO, or 321,000 people, received “disability pensions” in 2016. However, many people with disabilities who need financial support do not receive the benefit. Unemployment among people with disabilities is 60 percent. Yet, only those with disabilities diagnosed to be “severe or very severe” are eligible. The lack of sufficient funding also limits the number of people who receive the pension. Some people we interviewed mentioned that SWO staff said that they will remain on waiting lists to receive the pension until another recipient becomes ineligible (finds a job, for example) or passes away. The amount of the pension in the most recent Persian year 1396 (March 2017 to March 2018), 1.48 million IrI (US$39.36), is not sufficient to meet basic needs; by contrast, in the same year, the official minimum wage was six times greater, or 9.3 million Iri ($247.34), which has also been criticized as being too low.
