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Disability Overview

What is disability?

A disability is any condition of the body or mind (impairment) that makes it more difficult for the person with the condition to do certain activities (activity limitation) and interact with the world around them (participation restrictions).

There are many types of disabilities, such as those that affect a person’s:

  • Vision
  • Movement
  • Thinking
  • Remembering
  • Learning
  • Communicating
  • Hearing
  • Mental health
  • Social relationships

People with the same type of disability can be affected in very different ways. Some disabilities may be hidden or not easy to see.

According to the World Health Organization, disability has three dimensions:

  1. Impairment in a person’s body structure or function, or mental functioning; examples of impairments include loss of a limb, loss of vision or memory loss
  2. Activity limitation, such as difficulty seeing, hearing, walking, or problem solving.
  3. Participation restrictions in normal daily activities, such as working, engaging in social and recreational activities, and obtaining health care and preventive services.

Disability can be:

  • Related to conditions that are present at birth and may affect functions later in life, including cognition (memory, learning, and understanding), mobility (moving around in the environment), vision, hearing, behaviour, and other areas.
  • These conditions may be
    • Disorders in single genes (for example, Duchenne muscular dystrophy);
    • Disorders of chromosomes (for example, Down syndrome); and
    • The result of the mother’s exposure during pregnancy to infections (for example, rubella) or substances, such as alcohol or cigarettes.
  • Associated with developmental conditions that become apparent during childhood (for example, autism spectrum disorder and attention-deficit/hyperactivity disorder or ADHD)
  • Related to an injury (for example, traumatic brain injury or spinal cord injury).
  • Associated with a longstanding condition (for example, diabetes), which can cause a disability such as vision loss, nerve damage, or limb loss.
  • Progressive (for example, Alzheimer’s disease), static (for example, limb loss), or intermittent (for example, some forms of multiple sclerosis). Retrieved in April 2017 from: (www.cdc.gov/ncbddd/disabilityandhealth/disability.html)

What do we mean by impairments?

  • Problems in body function or structure
  • Examples are: lacking part of or all of a limb; or a limb, organ or body mechanism that doesn’t fully function
  • May be long-term or short-term, physical, sensory, neurological, intellectual, mental or physiological
  • Multi-impairments are where a person has more than one impairment
  • Conditions caused by disease or injury that affect a person’s functioning or appearance.

What causes them?

  • Some impairments are congenital due to genetic factors
  • Other impairments can be caused by an injury or illness before birth
  • Others can be caused by injury or illness after birth
  • A person can have multi-impairments from one or more causes.

How do they affect people?

  • Physical impairment affects a person’s body movement and/or appearance (e.g. cerebral palsy, limb loss)
  • Sensory impairment affects sight, hearing, speech, smell, taste, sensation/feeling, physical balance (e.g. blindness, hearing loss)
  • Neurological affects nervous system, speech, motor skills, vision, memory, muscles, learning abilities (e.g. epilepsy, multiple schlerosis).
  • Intellectual affects cognitive functioning and behaviour (e.g. Down’s syndrome, learning difficulties)
  • Mental illness affects thinking, moods, ability to relate and capacity for coping with life (e.g. schizophrenia, bipolar disorder).

How should we treat people with disabilities?

  • Note that regardless of their impairment, a person can be ‘disabled’ by society because of stigma and prejudice.
  • Challenge stigma and discrimination
  • Realise that limitations may depend on other factors such as personality, background, support networks, cultural context

Barriers that People with disabilities face

There are three big roadblocks that prevent people with disabilities from participating in society on equal terms with non-disabled people. Here they are…

Attitudinal barriers

  • Prejudice, discrimination and stigma cause the biggest problems for people with disablities - who are assumed to be one or more of the following:
    • Incapable/inadequate
    • Of low intelligence
    • In need of a ‘cure’
    • Needing ‘special’ services or support
    • Dependent
    • Inspirational/marvellous/exceptional
  • People who make these judgements treat the person with disability as superfluous or superhuman. They either fail to respond to the individual – with all their inherent personality, strengths and weaknesses – or they assume they have ‘superhuman’ abilities to cope with their impairment.
  • Non-disabled people can respond with fear, pity, repulsion, or a sense of superiority. These assumptions and emotions are reinforced by the media. Negative language reflects and can reinforce prejudices. 

Environmental barriers

  • People with disabilities or a disability encounter these barriers in areas such as:
    • Public transport
    • Hospitals and clinics
    • Schools and housing
    • Shops and marketplaces
    • Offices and factories
    • Places of worship
    • Media and communications
    • Public information systems
  • Most people think of the physical barriers in this category – for example; a health clinic is inaccessible for wheelchair users if it has steps and narrow doorways. It’s relatively easy to identify these barriers in consultation with individuals with disabilities.
  • But communications can also be disabling for those with sensory impairments – e.g. for Deaf people if there’s no sign language; for those with visual impairments if medication isn’t appropriately labelled.
  • Students with hearing, visual or intellectual impairments are unlikely to access vital information unless their access needs have been met. And since 98 per cent of children with disabilities in developing countries do not attend school, they will miss out on important education and information. 

Communication barriers

Working or living with someone with a learning disability or communication impairment may challenge your idea of what communication is, and how you make yourself understood.

  • Try to imagine
    • not being able to read
    • not being able to tell someone how you feel
    • not being able to find the words you want to say
    • opening your mouth and no sound coming out
    • words coming out jumbled up
    • not getting the sounds right
    • words getting stuck,
    • someone jumping in, saying words for you
    • people assuming what you want, without checking with you
    • not hearing the questions
    • not being able to see, or not being able to understand the signs and symbols around you or    not understanding the words, phrases or expressions
    • not being able to write down your ideas
    • being unable to join a conversation
    • people ignoring what you are trying to say, feeling embarrassed and moving away
    • people not waiting long enough for you to respond in some way, assuming you have nothing to say and moving away.

Institutional barriers

These barriers exclude or segregate people with disabilities from many areas such as:

  • Legal system
  • Employment laws
  • Electoral system
  • Education policies
  • Health service provisions
  • Social services
  • Belief systems and religion
  • Humanitarian/development agency policies.

Many of the systems we take for granted have become ‘no-go’ areas for people with disabilities. Their marginalisation is similar to the negative treatment of women and ethnic minorities.

Exclusion from institutions has a knock-on effect – poorly regulated special education often makes fewer academic demands on pupils, and smaller schools expose them to a limited range of cultural experiences. The virtual exclusion of people with disabilities from teacher training colleges also limits the number of qualified disabled teachers as role models for disabled and non-disabled pupils in mainstream schools.

Families make the assumptions that a child with a disability will never work independently. So they don’t press the government to provide suitable formal education, or encourage the child to pursue a career. With such low expectations, people with a disability can easily become fatalistic about their own prospects.

Micro-finance institutions often have policies which are highly discriminatory. They may exclude deaf people on the assumption they won’t be able to talk directly with staff; or refuse to lend to a visually impaired businessperson on the grounds they’re not likely to make a profit as a disabled entrepreneur.

Here are real examples:

  • Read World Health Organisation  WORLD REPORT ON DISABILITY Summary here.

  • Kenya Policy on the Rights of Persons with Disabilities - KENYA Policy analysis report,  Bridging the GAP Project, by Winnie Khaemba, Joan Kariuki & Ann Kingiri (ACTS), July 2016. - A policy analysis in the domains of education, health, labour and social protection was conducted to assess barriers for Persons With Disabilities in Kenya. This exercise found that there is significant effort by the Kenyan Government towards inclusion of people with disabilities (PWDs) and mainstreaming disability across sectors. Kenya is party to international conventions such as the United Nations Convention on the Rights of the Child (1990) and the UN Convention on the Rights of Persons with Disabilities (2008). This report documents these findings arising from analysis of key policy instruments. It focuses specifically on identification of specific barriers to inclusion facing disabled children and adults in accessing health, education, social protection and labour. GAP policy analysis full report can be found here: https://www.ucl.ac.uk/leonard-cheshire-research/research/publications/documents/2017/Final_Kenya_Policy_Analysis_Report.pdf  

 

Myths, Taboos and Superstition about people with disabilities

 

Myth/Taboo/Superstition 

 

TRUE/FALSE

You can catch a disability by touching someone.

This is False

    Disability is caused by bad spirits

This is False

   Touching a disabled person brings bad luck

This is False

   A child with albinism is a demon or a curse caused by family wrong       doing

This is False

   Concoctions made from the body parts of people with albinism make     you rich.

This is False

   Owning the body parts of someone with albinism makes you rich

This is False

   People with learning disabilities are still not recognised as fully                human"

This is False

   People with learning difficulties are ten times more likely to have       serious sight problems

This is False

 

Witchcraft and disability

Many groups in sub-Saharan Africa have historically linked persons with disabilities with witchcraft as a component of a wider link between accusations of witchcraft and socially marginalized populations. It is commonly assumed that traditional prejudices towards persons with disabilities are receding in light of urbanization, education, mass media and efforts to confront such prejudice and stigma by governments, disability advocates and civil society. Ratification of the UN Convention on the Rights of Persons with Disabilities (CRPD) by many African countries is considered an additional impetus for change.

While beliefs differ throughout the region, there is an unsettling trend in many urban areas where traditional beliefs linking disability with witchcraft are being reinterpreted. Fuelled by quest for rapid social and economic advancement, urban ‘witch doctors’ promote beliefs that individuals and families can prosper if they perform rituals or sacrifice involving abuse, mutilation or killing of children and adults with disabilities. These beliefs are reinforced in popular media and some Pentecostal churches where disability is linked to evil spirits or the devil, while ‘cure’ of disability is linked to virtue and prosperity. Based on literature review and fieldwork in Tanzania and Uganda the article argues that with rapid urbanization, links between witchcraft and disability in contemporary African popular urban culture is an issue of concern that must be acknowledged and addressed. Download full article below.

Witchcraft, Wealth and Disability: Reinterpretation of a folk belief in contemporary urban Africa. 2013 Nora Groce and Julia McGeown. Working Paper Series: No. 30
1.  https://www.ucl.ac.uk/leonard-cheshire-research/research/publications/documents/working-papers/wp-30.pdf

References

  1. World Health Organization, International Classification of Functioning, Disability and Health (ICF).  Geneva: 2001, WHO.
  2. US Department of Health and Human Services. The Surgeon General's Call to Action to Improve the Health and Wellness of Persons with Disabilities. Washington, DC: US Department of Health and Human Services, Office of the Surgeon General; 2005.
  3. Leonard Cheshire Disability and Inclusive Development Centre, University College London, United Kingdom. Witchcraft, Wealth and Disability: Reinterpretation of a folk belief in contemporary urban Africa. 2013 Nora Groce*¹ and Julia McGeown² Working Paper Series: No. 30 1. Full Working Paper Series
  4. "Communicating with people with a learning disability - Retrieved from "Communicating with people with a learning disability - Mencap" (https://www.mencap.org.)