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Disabilities in Africa
by Adedoyin Onasanya
The United Nations
Population Information Network estimates that there are almost
800 million people living in Africa, 50 million of whom are disabled.
These 1 in 16 Africans form the highest proportion of Africa's
disadvantaged population: only 2% have access to any form of rehabilitation;
90% of children with mental disability die before age 5; and 70%
of disabled adults are unemployed and live in poverty. There indeed
is an urgent need to address the plight of Africa's disabled population.
Causes and Trends
The causes of disability
in Africa like anywhere else in the world are not farfetched:
they are chiefly malnutrition- occasioned by poverty, and war.
Though there is little information about the prevalence and incidence
of disabling diseases in Africa, it is clear that much of the
disability stems from poor nutritional status, communicable diseases
and low inoculation and immunization rates. While a handful of
green vegetables everyday is what is needed to save the eyesight
of all children who go blind annually because their diets lack
Vitamin A, most Africans who subsist on less than $2 a day cannot
afford this "luxury".
Accidents and conflict are also an important cause of African
disability. During conflicts, civilians (and soldiers) are at
risk from hostilities as well as from unexploded landmines and
violent excesses. The UN estimates that there are some 110 million
landmines scattered in 70 countries around the world and of those,
about 45 million are buried in 11 African countries. By far the
worst affected are Egypt, Angola and Mozambique, which have mines
numbering 23 million, 15 million and 3 million respectively. The
mines in Angola and Mozambique are among the "legacies"
of the bitter civil war fought in both countries, while those
in Egypt were laid during the Second World War and the Arab-Israeli
wars of between 1948 and 1973. One in 470 Angolans have had at
least a limb amputated while in Mozambique, mines have claimed
over 10,000 lives.
Perceptions, Disparities and Stereotypes
Disability is a stigma.
When a person becomes disabled or a disabled child is born, the
individual and family enter into a new world about which they
know next to nothing and about which they have a lot of stereotyped
notions. They are influenced by religions which see disability
as a curse or the manifestation of sin and disgrace in the family,
and alms given to the disabled beggar are a means of obtaining
spiritual grace and forgiveness for the non-disabled person.
Media portrayals of persons with disabilities have also helped
to enforce these stereotypes. The media all too often presents
images of dependency, unfitness, incapacity and villainy. It seems
that the only things that are newsworthy about disabled people
are their impairments and the length of time they have "endured"
their lives. All the books, stories and films that have impacted
on our collective consciousness have underlined this view of disabled
people. Most folklore is based on making the villain a disabled
person, just as the ever-popular James Bond movies have disabled
persons as the potential destroyers of mankind.
Disabled persons have not fared better in terms of access to education
and employment. They have lower education and income levels- if
any- than the rest of the population and are less likely to have
savings and other assets than the non-disabled population. The
reality in much of Africa is that disabled people are often excluded
from education and employment, immobilized by inadequate transportation
systems and architectural barriers, maintained in substandard
living conditions, and denied the benefits of long term healthcare.
Effects and Consequences
The consequences of
all the discrimination and stigmatization that disabled people
face are numerous and interwoven. A direct correlation exists
between disability and poverty- not only does disability add to
the risk of poverty, conditions of poverty also add to the risk
of disability. Poor households without adequate food, basic sanitation
and access to preventive and responsive healthcare, living in
lower quality housing and working in occupations that are more
dangerous, are more susceptible to malnutrition and other disabling
diseases, and otherwise preventable impairments quickly become
permanent disabilities. Their exclusion and marginalisation also
reduce the opportunities for the disabled to contribute productively
to the household and community. In Angola for example, the food
production in cities affected by landmines have been reduced by
more than 25%.
In addition to income-related factors, additional costs resulting
from the disability and the exclusion from services and/or social
and community activities also make disabled persons and their
families worse off. Without income maintenance and programs to
improve their quality of life, the disabled become the responsibility
of their families, and where family support is absent, a disabled
person's condition becomes very precarious- they line the streets
of major African cities begging for alms.
A Call to Action
Much of the disability
in Africa can be prevented if there are concerted efforts by all
stakeholders to tackle the problem. Prevention is accepted to
be better than cure. Increased public effort is therefore urgently
needed to strengthen prevention measures to promote and improve
maternal, child and primary healthcare. Efforts should be made
towards improving the nutritional standards of meals the African
child eats, as well as make immunization against disabling diseases
available to all children. Mass parental, especially maternal,
education and awareness campaigns should be embarked upon to inform
them of the importance of good dietary and food preparation habits.
Though prevention programs can achieve much, they will not totally
eradicate the disability problem, so much effort should also be
directed towards providing for those that still become or are
already disabled. In this regard, rehabilitation and healthcare
services should become readily available. Income-maintenance and
reserved-employment schemes also need to be introduced and equitably
implemented.
Little research has been carried out on the disability problem
in Africa, so there is need for intensive research, the result
of which will be used to design effective intervention programs.
Pertinent research agenda should be disability patterns, the link
between poverty and disability, and the various forms of malnutrition
and their effects on health and intellectual development.
A lot also need to be done to prevent and arrest conflict situations
in Africa. We must not wait till innocent lives and property are
destroyed before we take action to stem these conflicts.
All Africans, including those challenged by physical and mental
disabilities have a right to lives characterized by independence,
dignity and productivity. Governments, non-governmental organisations,
organized private sector and civil society, must all work together
to ensure that policies and programs are inclusive of persons
with disabilities. Disability is not about pity or charity, it
is a rights issue.
References
1. "Draft Policy Plan of Action," National Summit on
Africa, August 1998.
2. Elwan, A., Poverty and Disability: A Survey of the Literature.
Background paper for WDR 2000/20001 (World Bank, 1998)
3. Hurst, R., Communication and Disability, World Association
for Christian Communication, 1998. http://www.oneworld.org/wacc/media/hurst.htm
4. Ukabiala, J., "Impetus Towards a Mine-free World"
Africa Recovery, Vol. 12 No 4: 13.
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