Helping disabled people out of the shadows

Helping disabled people out of the shadows

Amartya Sen and James Wolfensohn , Jakarta

Disabled people are not only the most deprived human beings in
the developing world, they are also the most neglected. As the
world marks the International Day of Disabled Persons this week,
it is important to acknowledge that more than 600 million people
in the world live with some form of disability. More than 400
million of them live in developing countries, often amidst
poverty, isolation and despair. Not only are they, typically, the
poorest of the poor, but they also need more money and help than
able-bodied people to overcome their handicaps, and attempt to
live normal lives.

As if the many hardships are not painful enough, disabled
people can face exclusion and discrimination at the hands of
their fellow citizens, even their own families who fear they will
be tarnished by association. For example, many disabled children,
whether deaf or in wheelchairs, are denied an education. Disabled
people are at increased risk of contracting HIV/AIDS due to
physical and sexual abuse, and a lack of preventive outreach
tailored specifically for disabled people. And yet, experience
shows that in countries where people with disabilities have
greater access to their broader communities, they can flourish.

It is estimated that at least ten percent of the developing
world's population is disabled in one way or another. In fact,
some estimates put the figure closer to twenty percent. Not only
do these deprived people deserve It is estimated that at least
ten percent of the developing world's population is disabled in
one way or another. In fact, some estimates put the figure closer
to twenty percent.

Not only do these people deserve the right to global attention
because of the extreme nature of their deprivation, but it is
also important to recognize the impossibility of achieving large
reductions in poverty and illiteracy in the world (as demanded by
the Millennium Development Goals, endorsed by more than 180 world
leaders in September, 2000), unless special efforts are made to
bring disabled people into the mainstream.

Take the case of education. An estimated 40 million of the
more than 100 million children out of school have disabilities.
And yet most of our schools are built without access for children
who have physical disabilities, and most teachers are not trained
to deal with children who have handicaps of one kind or another,
including learning disability.

However, with some basic social help, the terrible
consequences of disability can be substantially overcome. It is
also important to see that most disabilities are preventable.
Only a small proportion of the 600 million people living with
disabilities were born that way. For example, malnutrition and
lack of access to clean water can lead to blindness.

Other disabilities can result from HIV/AIDS, measles. polio,
road crashes, injuries at work or from discarded mines and
unexploded ordinance. While a rapidly aging population creates a
growing source of disabling conditions, the incidence of
disability can be significantly reduced through well-designed
social and medical attention.

As we consider how best to respond to the needs of disabled
people in poor countries, it is important to understand that
simple and inexpensive solutions do exist in many cases. For
example, during renovation or restoration efforts in the wake of
natural disasters or conflicts, it is possible to make sure that
the newly built or repaired buildings are made accessible to
people with disabilities, and this can add very little to the
costs involved. Take another example, the movements of disabled
and old people can often be restricted by high curbs that flank
their streets, but, as a good many countries have already shown,
these curb designs can be changed at little cost.

Also, many people are in a gray area with mild to moderate
mental health disorders or intellectual disabilities or physical
handicaps. Policies that can help them join the mainstream of
society can certainly be devised. A number of developing country
governments are working with national disability groups to
overcome restrictive barriers.

In Brazil, which is one of the first developing countries to
improve its collection of disability data, surveys showed that
large numbers of children with significant visual disabilities
simply needed spectacles. The World Bank has been closely
involved in these efforts, both in terms of providing glasses,
hearing aids, and other interventions, but also in gathering
better statistics on people's disabilities and their
consequences.

In this latter respect, social scientists also have a
responsibility to investigate the incidence of different
handicaps and their remedies. But change can happen on a larger
scale too. A World Bank funded project in Vietnam is supporting
a National Task Force to develop a set of guidelines for
inclusive education, and will help teachers improve their
classroom practice so that children with disabilities can learn
beside other children.

As we approach this year's International Day of Disabled
Persons, we have to be determined to bring disabled people out of
the shadowy world in which they are typically confined. This task
demands more global cooperation, involving national and
international institutions as well as organizations of disabled
people themselves. The United Nations is working on a Convention
on the Rights of Disabled People to help move disabled people
from exclusion to inclusion.

Disabled people want what we all want: the chance to get
educated, find rewarding work, lead worthwhile lives, and be
valued members of their community and in the world at large.
These desires need not be just idle dreams, since much can be
achieved if we are ready to give this extensive problem the
attention and commitment it demands. We need to mobilize the
determination to do just exactly that.

Amartya Sen, a Nobel Prize winner for economics, is Thomas W.
Lamont University Professor of Economics at Harvard University;
James D. Wolfensohn is President of the World Bank Group and a
former Board chairman of the International Federation of Multiple
Sclerosis Societies.