Exclusion in the Dutch Educational System

Lieke Scheewe
November 08, 2009

The UNESCO Culture of Peace Program emphasizes that empowerment of marginalized voices is an essential part of peace building (Toh, 2007). The empowerment of the ‘disabled’ is only at the beginning of a long process toward inclusion. World-wide young people with disabilities, girls in particular, are still combating blatant educational exclusion (UNESCO, 2009a, p. 5). Of the 75 million children of primary school age who are out of school, one third are children with disabilities, thereby constituting the world’s largest and most disadvantaged minority (UNESCO, 2009b). While persons with disabilities make up ten percent of the world’s population, disability is associated with twenty percent of global poverty (UN, 2009). The strong association of disability with poverty especially in conflict zones prevents the achievement of the Millennium Development Goals unless the mainstreaming of disability in public education is developed in order to truly achieve golabl peace (UN, 2009).

An international milestone was reached in May 2008, when the UN Convention on the Rights of Persons with Disabilities entered into force, recognizing human dignity and promoting the rights of disabled (UN, 2006). In the Netherlands a law for ‘equal treatment on the basis of handicap or chronic illness’ (WGBH/CZ) was adopted in 2003, which applied to work places and vocational education. Three months ago the application of this law was expanded to include primary and secondary education (CGB, 2009). While the process of legal inclusion is slowly moving ahead, there are still many cultural challenges that have to be overcome in order for full inclusion to be realized. Two major challenges – the deep-rooted cultural meanings attached to the notion of disability as a social construct, and the way in which this construction of disability has been reinforced by the Dutch educational system – will be touched upon in this essay. It is hoped that this analysis will contribute to provide insight in the necessary steps that need to be taken to create a peaceful culture of diversity, in which there is equal room for everyone to fulfill their potential.

Disability as a Social Construct

Just as gender and ethnicity have in the past few decades been deconstructed and revealed as social constructions rather than objective facts of nature, so must the notion of disability be deconstructed (Burr, 1995; Murphy, 1990). In the same way that a distinction has been made between ‘sex’ and ‘gender’, a distinction should be made between ‘impairment’ and ‘disability’. Impairment is considered here to be a relatively objective notion, namely those symptoms or characteristics of the body that are classified by the medical world as physical or mental deviations from normality that inhibit ‘normal’ functioning. Disability then is the cultural meaning attached to certain impairments and is created through “the interaction with various attitudinal and environmental barriers, [that] hinder the full and effective participation in society on an equal basis with others” (UN, 2006). The language we use is central to the way we interpret experiences (Foucault, 2003). In this light it is important to note that the term ‘disability’ seems to imply a general characteristic attributed to those carrying this label as having fewer capabilities than those who are considered to be healthy. The label of disability comes with many societal myths, fears, expectations of (in-)capabilities, and assumptions of needs, and is applied to an enormously wide variety of individuals who would not necessarily consider themselves disabled. Within the Netherlands this concerns 2.5 million people (Radar, 2009).

Perspectives on disability change throughout time and across cultures (Ingstad & Whyte, 1995). Research in Western countries shows that we stereotype disabled as ‘high warmth’, ‘low competence’ (which inspires pity), needy, ‘less than human’, and that we often experience discomfort, anxiety, or disgust in the presence of disabled, resulting in either avoidance behavior or helping behavior (Park et al., 2003; Stanton, 2007). Throughout time this attitude has included varying types of disabilities – with the development of technology most people with visual impairments are no longer considered disabled, and with the shift in cultural values homosexuality has recently medically been accepted as part of the ‘normal variation’ rather than classified as a mental disorder. The Western notion of disability is understood by various anthropologists as being based on the medical model – that conceptualizes disability as a physiological or mental deficit that needs to be fixed (Silvers et al., 1998) – and on cultural norms of individuality, independence, and functionality. Talle’s ethnographic study among the Maasai in Kenya points out that the concept of ‘disabled person’, as defined within the Western context, does not exist there (Ingstad & Whyte, 1995). Rather, they define personhood in terms of participation in community reciprocity.

The deeply culturally embedded notion of disability as a natural phenomena unrightfully implies that ‘disabled’ are fundamentally different from ‘non-disabled’ and creates a normal/abnormal dichotomy- according to which society becomes divided. It thereby provides the legitimization for a wide variety of discriminatory policies and non-policies (i.e. policies that should be in place in order to create equal opportunities). Generally these policies are not discriminatory in the sense of purposefully attempting to oppress, marginalize, or eliminate disabled from society, but discriminatory and marginalizing nevertheless, and thereby constituting a form of cultural violence (Galtung, 1990). There are many societal structures and institutions through which this notion of disability is reinforced, including the media (that only rarely or stereotypically represent disabled), the welfare system (which classifies people as being disabled or ‘not disabled enough’ in order to receive benefits), and the medical system (which classifies impairments and conveys the idea that they are merely negative experiences that we should always try to ‘fix’). Another institution which is crucial for the reproduction of cultural norms and values (Freire, 2000), is the educational system and policies that reinforce these classifications; these characteristics will be described in the next section.

Inequality in Education

In my perspective I was lucky. At the age of 10, two years after I was diagnosed with a muscular disease, my teachers at primary school managed to convince my parents that I was better off in the regular school system than at a ‘special school’ (for children with disabilities). The reason was that they considered me to be more intelligent than the average student, and a ‘special school’ would not offer me enough intellectual challenge. I was lucky, because there was another boy in my school who did get advised to attend a special school, a boy who was ‘more severely disabled’ and was considered to have an average intelligence level. I was lucky, because I could stay with my friends in my own neighbourhood. I was lucky, because those who have stimulated me and believed in my capacities throughout my childhood were my teachers and friends in school. I was lucky, because if it would not have been for my teachers’ persistence 13 years ago, the chances that I would now be studying at the University for Peace in Costa Rica would have been very slim. I was lucky, because I got an equal opportunity to become who I want to be, while the other boy did not.

The account above is meant to illustrate what unequal opportunity in the Dutch educational system means on a personal level. Since August 1, 2009, a law exists that enforces equal treatment for disabled children in primary and secondary school (CGB, 2009). Prior to this law, regular schools were not obliged to accept these children and to offer the necessary facilities to accommodate their needs. So-called ‘special education’ exists, which refers to those schools that are set-up especially for children with mental and physical disabilities who cannot (or are considered not to be able to) participate in the education programs at regular schools; for example, students whom can only study a limited amount of hours per day or because they need school materials in Braille (NCRV, 2004). A Dutch documentary shows the struggle of the parents of a girl with a light form of the Down Syndrome, who went to 15 schools and through several court cases before they found a regular school that would accept their daughter. Once enrolled in the school, with an individual educational program that allows her to learn according to her own needs in an environment that also allows her to participate in mainstream society, both the parents, the girl, and the school were happy with the results. A poll showed that 60 percent of Dutch parents with a disabled child encountered a similar struggle (NCRV, 2004).

Segregation in the educational system (as well as the lower level of education in special schools) perpetuates discrimination in the labour market, which prevents the disabled from participating in society according to their abilities. Radar (2009), a Dutch organization that reports on discrimination, stated that two-thirds of 1300 researched employers were less likely to hire a disabled applicant, due to prejudice. Needing to accommodate for their needs is often perceived as a burden, misunderstandings exist around how many adaptations in the workplace need to be made (in many cases minimal adaptations will suffice), and low expectations occur around the contributions that disabled employees will be able to make. While the law is expanding to include more and more areas in which discrimination against disabled is prohibited, prejudiced attitudes towards them will not change overnight. Few figures or statistics exist around the extent of discrimination within the educational system, including primary schools up to universities, in the labour market, or the society at large. The few statistics that do exist, however, are enough reason for concern.

Towards a Culture of Diversity

Several transformations will need to take place in order to create a school system that respects diversity and stimulates the fulfillment of each and everyone’s potential to the fullest and most equal extent. No literature could be found on the fundamental reasons for the existence of a separate school system for disabled children in the Netherlands. From my understanding of Dutch society and culture, having grown up and lived in the Netherlands for 22 years, I do not consider it as a deliberate strategy to segregate disabled from society, but rather as a development resulting from a strive for efficiency; a concern for the quality of education for the non-disabled, if teachers would have to divide their attention between the disabled student and the rest of the class; from taking a non-disabled’ perspective on what the needs of disabled are, rather than incorporating perspectives of the disabled; and from a lack of creativity and flexibility.

The late implementation of a law for equal treatment in the Dutch school system is remarkable, considering that many other countries with a lot less available resources, such as Italy, have already started including disabled children in mainstream schools (NCRV, 2004). Also, in Costa Rica I have heard of a deaf boy in who is in class with a girl in my host family, whereby the whole class was taught sign language in order to be able to communicate with him. Yet, problems have also been identified with the inclusion of the disabled in a system and school culture that is not ready for them (NCRV, 2004). In a culture where prejudice against disabled exist and is not actively addressed in schools, children with disabilities are more likely than others to encounter bullying, to be avoided by peers, or to be treated differently by teachers who may hold lower expectations of their capabilities.

A crucial change in mentality needs to drive this transformation process in a positive direction. The Dutch government could, for example, stimulate campaigns for the recognition of equal treatment of the disabled as a human right. It could stimulate programs that inform schools about the different options for school materials and methods to accommodate for different needs, such as exchanges with schools in countries that have already implemented these changes. Programs could be set-up in hospitals and rehabilitation centers for parents of children with disabilities that inform them of the wide range of possibilities and that stimulate them to think of their children’s future in open and positive terms; as a way to not only empower the parents, but through them also empower the children to think of their capabilities, rather than focusing so strongly on their limitations. Flexibility and creativity will need to be key factors in this process.

While recognizing that accommodating for any kind of need related to impairment in any kind of school environment is a great challenge, requiring expertise and resources now concentrated in one separate ‘special school’ system. This transformation will be a beneficial process for everyone when based on principles of ‘humanization’ and ‘emancipation’ (Freire, 2000), rather than ‘normalization’ (i.e. applying traditional cultural values and standards of learning objectives). Opening up a school system to such a wide diversity of students in this way will transmit to children values of tolerance for difference and equality as well as enhance the development of creativity essential for a sustainable culture of peace.

References

• Burr, V. (1995) An Introduction to Social Constructionism. London: Routledge.
• CGB (2009) Expansion WGBH/CZ to Primary and Secondary Education [in Dutch]. Retrieved September 10, 2009, from CGB.nl: <http://www.cgb.nl/artikel/wgbhcz-ook-voor-primair-en-voortgezet-onderwijs>.
• Foucault, M. (2003) Society Must Be Defended. Lectures at the College De France 1975-1976. New York: Picador.
• Freire, P. (2000) Pedagogy of the Oppressed. New York: Continuum.
• Galtung, J. (1990) Cultural Violence. Journal of Peace Research, 27 (3), 291-305.
• Ingstad, B. & Whyte, S. R. (Eds., 1995) Disability and Culture. Berkeley: University of California Press.
• Liachowitz, C. H. (1988) Disability as a Social Construct: Legislative Roots. Philadelphia: University of Pennsylvania Press.
• Murphy, R. F. (1990) The Body Silent. New York: Grove Press.
• NCRV (2004) Special Education [in Dutch]. Documentary in Dutch television program ‘Netwerk’, 6 October 2004. Retrieved September 10, 2009, from Netwerk.tv: <http://www.netwerk.tv/node/3453>
• Park, J. H., Faulkner, J., & Schaller, M. (2003) Evolved Disease-Avoidance Processes and Contemporary Anti-Social Behavior: Prejudicial Attitudes and Avoidance of People with Physical Disabilities. Journal of Nonverbal Behavior, 27 (2), 65-87.
• Radar (2009) Discrimination on the Basis of Handicap and Chronic Disease [in Dutch]. <http://www.radar.nl/read/discriminatie_wegens_handicap_en_chronis>
• Silvers, A., Wasserman, D., & Mahowald, M. B. (1998) Disability, Difference, Discrimination: Perspectives on Justice in Bioethics and Public Policy. New York: Rowman & Littlefield.
• Stanton, D. (2007) Less Than Human. Psychology Today, January/February, 18.
• Toh, S. H. (2007) Pathways to the Building of a Culture of Peace. Presented at the Peace Education Workshop in Uganda, 10-13 July 2007, organized by the Ugandan National Commission for UNESCO and the Korean National Commission for UNESCO.
• UN General Assembly, 61st session. Convention on the Rights of Persons with Disabilities. 13 December, 2006 (A/RES/61/106). Retrieved September 11, 2009, from UN.org: <www.un.org/disabilities>.
• UN (2009) The Millennium Development Goals and Disability. Retrieved October 24, 2009, from UN.org: <http://www.un.org/disabilities/default.asp?id=1470>.
• UNESCO (2009a) Policy Guidelines on Inclusion in Education. Retrieved October 19, 2009, from UNESCO.org: <unesdoc.unesco.org/images/0017/001778/177849e.pdf>.
• UNESCO (2009b) Inclusive Education Website. Retrieved October 19, 2009, from UNESCO.org: <www.unesco.org/en/inclusive-education/>.

Peace and Conflict Monitor

Big East Is a Big Loser in Web Accessibility for Disabled People, Study Says

By Marc Parry

Denver – Big East colleges may shine on the basketball court, but they’re getting stuffed by the competition when it comes to the Web-accessibility battle.  The Big East posted the most consistent problems in a new survey of how good a job universities are doing in making their Web sites accessible to people with disabilities. The survey of 80 universities, presented at the Educause conference here this week, pitted five athletics conferences against one another in an attempt to draw attention to the issue.   The worst of the worst are Villanova University, Baylor University, and Providence College, says the study by Jon Gunderson, coordinator of assistive communication and information technology at the University of Illinois at Urbana-Champaign. The study skewered those institutions and 13 others on a list called “Schools Who Need New Coaches.”

The universities doing the best job of making their sites accessible are Illinois, Virginia Tech, and Michigan State, says the study, which crowned them as frontrunners in the “Sweet 16.” The Pac-10 posted the best performance over all.  Mr. Gunderson’s study, which is not available online, evaluated about 100 Web pages for each university using a free tool that assesses them based on categories like the use of headings, keyboard support, and layout issues. The bottom line for the worst-scoring colleges is that their disabled students will likely find themselves asking for help finding stuff on Web pages, whereas students at the high-scoring ones can probably find it on their own.

Very few colleges have administrators responsible for auditing and managing Web accessibility, says Mr. Gunderson. They have policies, he says, ”but there’s no follow up with responsibility or accountability.” He draws an analogy to the need to invest in security.  “Nobody wants to invest resources in security, but they have to insure privacy and integrity of data and applications,” he says. “The same is true for accessibility. Everybody wants it to happen, but without resources allocated to ensure accessibility, it won’t happen magically.”

The Chronicle

There’s a revolution in Britain that hasn’t made it to America.

Disaboom

When Danish IT specialist Thorkil Sonne found out his young son had autism, he decided to find out everything he could about the condition in a effort to make sure his child led as happy a life as possible.Turns out, the information led him on a crusade to change the way the world views people with autism.  Sonne, a 49-year-old father of three, started an IT company staffed almost exclusively by people with autism, and its success has power players such as Microsoft and Cisco Systems lined up to use its services. Specialisterne (Specialists in English) employs more than 40 people with an autism spectrum disorder at its headquarters in Denmark, and is set to branch out to Glascow next year in the first step of a worldwide expansion.

Astounded when his son once reproduced a map of Europe from memory, Sonne’s research had uncovered that certain people with autism have superior memory recall, focus and precision compared to people without the condition. By taking advantage of these skills in the IT sector, which requires spotting anomolies in large quantities of data, Sonne’s company boasts an error rate of only O.5 percent, versus the industry average of five percent. Specialisterne maintains a friendly environment for its employees. A support worker makes sure that sudden or loud noises are minimized and clear task instructions are provided, while the work week is kept to about 25 hours. Rather than face-to-face interviews, which are taxing or impossible for many with autism, Sonne assesses potential workers with a complex form of Lego.

Of his staff, Sonne says he has seen people transformed. He cites the consultant who handn’t worked in 24 years and is now testing for Cisco Systems. “He finally feels he is part of society and respected,” Sonne says. “He can talk up at family gatherings. He recently got a girlfriend. He wants to work for us as a trainer. I see no reason why eventually those who are at the lower points in the autistic spectrum should not work as well.”

Disaboom

From DNIS: “The reason we want a new law…”

Disabled rights activists from across the country were in New Delhi for the National Consultation on ‘The Rights of Persons with Disabilities (Respect for Dignity, Effective Participation and Inclusive Opportunities) Act, 2010’, organised by N.C.P.E.D.P. The demand for a new law was unanimous.Dorodi Sharma of D.N.I.S. caught up with a few of them with the poser, “The reason I want a new law…” From vehement demands for a rights based Act to strong voices for accountability, the views were mixed but not different.

Shampa Sengupta, Sruti Disability Rights Centre, Kolkata: “The reason I want a new law is because amendments to the old will not be able to cater to the ‘diverse’ needs of persons with ‘ALL’ kinds of disabilities.”

Sameera Shamim, Talking About Reproductive and Sexual Health Issues (T.A.R.S.H.I.), New Delhi: “The present law has many loopholes and does not look into the day to day lives and problems of people with disabilities. The definition of disability is very narrow, as is the understanding of other issues vis-a-vis disability. As someone who believes completely in affirmative rights towards sexual and reproductive health of all people, the present law completely neglects this area. Also post U.N.C.R.P.D., the existing law can be thrown away.”

C. Mahesh, Community Based Rehabilitation (C.B.R.) Forum, Bengaluru: “India needs to have a new and comprehensive Act that clearly defines all the rights in the context of people with disabilities. The current law is inadequate on how inclusion, participation, and exercising legal capacity by persons with disabilities in the areas of living in the community, accessing services, education and employment can be made possible. There is also no accountability and enforcement mechanism in the old Act.”

Amitabh Mehrotra, S.P.A.R.C. India, Lucknow: “We need a new law in line with U.N.C.R.P.D. that will look into the ground realities of our vast country. The concerns of the unheard voices need to be addressed immediately. Justice needs to be done to people who are intentionally or unintentionally segregated from the mainstream.”

Arun Rao, The Deafway, New Delhi: “The new law with U.N.C.R.P.D. as a base document would put deaf issues and concerns in a position where positive progress is possible. There will be a lot to consider naturally but the retrogressive thinking in the Disability Act of 1995 will be negated. This will open up fresh approaches to the future. On another track, the old Act has made us insecure, there is also a tendency to be very narrow minded and grabby about things. I guess any oppressed community is reactive and defensive without consciously wanting to appear so. As the broad scope of the new Act sinks in, people will put down their individual agendas and apprehensions and truly embrace inclusion in the spirit in which it deserves to be talked about and engaged.”

M. Srinivasulu, Network of People with Disabilities Organisation, Hyderabad: “The present situation demands that any disability legislation needs to be on the basis of U.N.C.R.P.D. To achieve this, the old Act has to be repealed. As a grassroot activist, my opinion is that if justice is to be done to all sections of the disabled population, we need a new law and not amendments.”

Suhas Karnik, National Association for the Blind (N.A.B.), Mumbai: “It is almost 14 years since we got the old Act. Amendments were due for a long time. But with India ratifying U.N.C.R.P.D., we have a different frame of reference now and mere amendments would not work. Although the Government has started the process of amendments, the concerns of the disability sector have not been taken into consideration. The most glaring drawback of the amendments is that it does not take into account 18 Articles of U.N.C.R.P.D. There is no mention of legal capacity, accountability and punitive measures. Having more than 100 amendments makes no sense. It is time to go for a new law which is in consonance with the U.N. Convention.”

Gautam Chaudhary, Sanchar, Kolkata: “There has been a major paradigm shift towards rights based approach since 1995. U.N.C.R.P.D., which has been ratified by India, gives us an appropriate frame work from the rights perspective to the issue of disability. When the whole framework of reference has undergone a vast change, it is rather futile to try to amend the old Act. Many of the significant chapters are not taken into consideration in the present process of amendments. One simply cannot include all the aspects of U.N.C.R.P.D. in the present law in its present format and if one is talking of changing the format, one is obviously talking of a new law. I strongly feel that we have no other alternative but to have a new law.”

Rajiv Rajan, Vidyasagar, Chennai: “The old law was enacted when the sector was still following the welfare model of disability. Now we should go for a rights based law that will reflect the letter and spirit of U.N.C.R.P.D. However much we try to incorporate the provisions of the U.N.C.R.P.D. into the old law, it will just be patchwork.”

Kanchan Pamnani, a visually impaired Advocate from Mumbai summed up the general feeling about the Disability Act of 1995: “I am fed up of the charity mindset that the old law projects. I think we all are.”

From DNIS: “No to Amendments,” is the writing on the wall!

While the Ministry of Social Justice and Empowerment continues to take an ostrich like attitude and push for Amendments to the Disability Act 1995, disabled rights activists from across the country were in Delhi on October 29 and 30 at the National Consultation on ‘The Rights of Persons with Disabilities (Respect for Dignity, Effective Participation and Inclusive Opportunities) Act, 2010’ organised by N.C.P.E.D.P., to take their demand for a fresh new law forward. Dorodi Sharma of D.N.I.S. takes a look at it.

Amendments to the Disability Act of 1995 have become like an urban legend in the disability sector. And why not? After all, from Maneka Gandhi to Meira Kumar to now Mukul Wasnik, amendments to the Act seem to be their favourite task. Although, the Ministry of Social Justice and Empowerment (M.S.J.E.) is all gung-ho about the amendments, for the disability sector it has come a tad too late – so late that it is time for a fresh new Act.

The Disability Act of 1995 came at a time when the rights based movement in India was at a nascent stage. Thus, it was like manna from heaven for a sector which till then had been neglected and segregated. However, 14 years since then, the paradigm has shifted considerably, more so with India ratifying the United Nations Convention on the Rights of Persons with Disabilities (U.N.C.R.P.D.). Popular sentiment in the disability sector is that any amendments to the old Act will merely be cosmetic and mostly a patchwork.

Disabled Rights Group (D.R.G.) had formed a Core Group which took up the task of drafting a new law. A delegation met with Mukul Wasnik giving him a detailed representation on how the proposed amendments left out several provisions of U.N.C.R.P.D. There is an infectious excitement throughout the sector regarding a new law. So much so, that the D.R.G. Core Group even thought of a new name!

With a view to broadbase this discussion, National Centre for Promotion of Employment for Disabled People (N.C.P.E.D.P.) organised a National Consultation on ‘The Rights of Persons with Disabilities (Respect for Dignity, Effective Participation and Inclusive Opportunities) Act, 2010’ in New Delhi on October 29 and 30. The top notch and most respected disabled rights activists from across the country were there. The Consultation was divided into different sessions over 2 days. The topics for discussion included ‘New Law and not Amendments’, ‘Definition of Disability’, ‘Legal Capacity’, ‘Accountability’ and ‘One Law and not Four Laws’. All the leaders and activists present unanimously agreed that the Disability Act of 1995 was archaic and had served its time.

What was interesting to see was that the issue attracted instant support from most mainstream, national level political parties. Prakash Karat, General Secretary of C.P.I. (M) and L.K. Advani of B.J.P. personally wrote to N.C.P.E.D.P. and nominated senior members from their parties to attend the Consultation. “Let me assure you that C.P.I. (M) is committed to the rights of people with disabilities. It would not be content with mere expression of solidarity or support. We will very much be part of your movement,” said Muralidharan, member of C.P.I. (M) at the Consultation.

“The 1995 Act was inadequate even when it was enacted. Today, in a changed circumstance, amendments by themselves even if aimed at overhauling the Act would not suffice. Only a fresh law replacing the 1995 Act would satisfy,” he stated categorically.

Najma Heptullah, Member of the Rajya Sabha from B.J.P. promised support on behalf of her party. She is the Chairperson of the Subordinate Legislation Committee and promised that she would also look into the lack of implementation of the Disability Act of 1995. She gave an assurance at the Consultation that she would personally take this issue up with Mukul Wasnik. Incidentally, Heptullah was the Deputy Chairperson of the Rajya Sabha when the Disability Act of 1995 was passed.

M.S.J.E. also seemed to be feeling the heat. Javed Abidi. Honorary Director, N.C.P.E.D.P. personally met Mukul Wasnik on October 22, who assured him that Ministry officials would be present at the Consultation. And sure enough Dr. Arbind Prasad, Joint Secretary and Nidhi Khare, Director, M.S.J.E. attended the Consultation on the first day. Dr. Prasad said that the Ministry was open to “suggestions”.

Although officials from M.S.J.E. seemed cagey about the whole issue, officials from the Prime Minister’s Office (P.M.O.) seemed to be more than willing to listen. Sanjay Mitra, Joint Secretary and Rajeev Topno, Deputy Secretary at P.M.O. answered queries from disabled activists ranging from the non – implementation of the XIth Five Year Plan to the question of a new law. Mitra said that disability was an issue close to the Prime Minister’s heart. He advised the sector to be resilient in their demand.

The discussions on both the days saw some exciting views come up. While the definition of disability was most debated, it was finally settled that the current definition envisaged in the draft Disability Act 2010 would be circulated and debated upon at a larger level to reach a consensus. Legal capacity and accountability were also discussed at length. Implementation of the law in general and accountability on part of both, government and the private sector in particular were a major concern at the Consultation.

“It is unfortunate that in this country a person can be penalized for cutting down a tree or for jumping a traffic light but there are no punitive measures to ensure that the rights of disabled people are judiciously implemented and that they are not exploited and abused,” said Abidi.

Praveen Kumar and Victor Cordeiro spoke at length about the need to take the grassroots level disabled population into consideration and ensure that the law is implemented properly. Another topic which saw a much heated argument was the issue of having one consolidated law rather than four different laws on disability. The leadership seemed to be clearly divided on the issue. Even though the merits of having an umbrella law were articulately placed by the speakers, the jury on this one is still out.

It became very clear by the end of the Consultation that there can be no two ways on the sector’s stand on amendments. However much the Ministry tries to play with semantics, the writing on the wall is loud and clear: “No to Amendments and Yes to New Law.” The leadership who attended the Consultation vouched to carry this cry to the length and breadth of India. N.C.P.E.D.P. is planning to follow this National Consultation with four Zonal Consultations, sometime around January next year. In the meantime, the drafting process of the Disability Act 2010 by the D.R.G. Core Group in New Delhi is expected to be over by December. This draft would be widely circulated and discussed in the sector and the final draft would then be submitted to the government.

The Indian disability sector has always been accused of being reactive. But this time around, they have decided to take control of things and play a strongly proactive role. If the Ministry officials have a quarter of pragmatism and intelligence they credit themselves with, they would surely see a golden opportunity to set an example by joining hands with the disability movement, rather than fight with them or mock at them. An example of Government – N.G.O. ‘partnership’. An example that probably will take the meaning of democracy to a new and higher level.

From DNIS

Disability and displacement

Refugees and internally displaced persons (IDPs) with disabilities are some of the most neglected and socially excluded groups within any population. With a major feature section on disability and displacement, Forced Migration Refugees (FMR) issue 35 aims to challenge and help empower the international community to respond to the needs and rights of disabled refugees and IDPs.  (We recognise that there are differences of opinion and practice relating to whether to refer to ‘people with disabilities’ or ‘disabled people’. We have used both forms in this call for articles.)

The very process of forced migration – often at short notice, in extremely difficult circumstances and possibly involving the loss of care-providers – can increase the vulnerability of disabled refugees and IDPs, especially as much displacement occurs in fragile or failing states where the capacity of the state to protect vulnerable civilians is greatly reduced. Among these already vulnerable populations of displaced people with disabilities, there are people with multiple needs and vulnerabilities – such as women, children, and the elderly – who may require particular protection and assistance.  It is estimated that between 3 and 4 million of the world’s approximately 40 million displaced people live with physical, sensory or mental disabilities. Many face discrimination, stigmatisation, harassment, neglect and exclusion, in their own communities and in host communities. They are often not counted or identified during registration, and data on the number of displaced persons with disabilities, and type of disability, are not available from governments, UNHCR or local partners. Where data do exist, they are often inconsistent or inaccurate. Those who have mobility disabilities face major problems with the physical layout and infrastructure of refugee camps and settlements – and most urban communities are even less welcoming or accessible. Furthermore, there is often inadequate consideration of the particular needs of displaced people with disabilities in terms of access to food, health services, education and administrative structures.

This issue of FMR will provide a forum for practitioners, care-providers, advocates, policymakers and researchers to present case studies from around the world which reflect the needs and concerns of displaced people with disabilities, debate approaches and initiatives, present examples of good practice and successes, and offer recommendations for action. In particular, the FMR Editors are looking for practice- and policy-oriented submissions, reflecting a diverse range of opinions, which address questions such as the following:

• What obstacles do displaced people with disabilities face in accessing services and opportunities, including education, employment, justice, water and sanitation, health, training and livelihoods? How can access be improved?
• How do different types of disability affect the level and quality of provision of assistance?
• How are the experience of disability and the provision of assistance affected by age and gender?
• What additional or particular protection challenges confront displaced people with disabilities, especially women and girls? How can these challenges be met?
• How can agencies meet the challenge of lack of data on disabled people when planning emergency interventions and recovery programmes?
• What steps have been taken to develop and implement improved methods for identifying disabled refugees and IDPs, collecting data and assessing needs? What are the gaps and how can they be filled?
• Are there any differences in the challenges and risks faced by disabled people in the rural compared to the urban environment? How are difficulties in identification and assistance exacerbated or created in an urban setting? How can we make sure protection and assistance programmes address both situations?
• How can disabled people be more widely included in camp management and in community organisation and assistance programmes?
• How do we protect disabled people who are left behind when their care-providers and families are displaced? What happens to disabled people during the course of displacement?
• What policies exist in relation to durable solutions for disabled refugees? Can having a disability improve one’s chances of resettlement?
• Do UN agencies and NGOs take account of any physical barriers to access that displaced people with disabilities might experience when visiting their offices? How good are the local employment practices of UN agencies and NGOs?
• What international policies and tools exist for improving awareness of and response to the needs of displaced people with disabilities? What impact has the Convention on the Rights of Persons with Disabilities had since it came into force in May 2008? How is it being applied to refugee contexts?
• What mechanisms exist to encourage governments to ensure that appropriate legislation and policies exist and are implemented, and that rights are respected, protected and fulfilled?
• What needs to happen to improve disability awareness and to mainstream disability within the humanitarian cluster system?
• How can we support displaced persons as agents of care, concern and accompaniment for those among them who have disabilities?
• How does the use of language impede progress towards wider inclusion and integration of displaced people with disabilities?
• How do attitudes stemming from cultural or religious beliefs reinforce myths, stereotypes, prejudice and discrimination against disabled people?
• How have educational and economic programmes successfully targeted and included disabled refugees and IDPs? Which programmes provide examples and models for successful inclusion and participation? How have the skills, experiences and talents of displaced people with disabilities been successfully tapped and utilised?

Deadline for submission of articles: 31st January 2010
Maximum length: 2,500 words.

We are particularly keen to reflect the experiences and knowledge of communities and individuals directly affected by disability.

Please email the Editors at fmr@qeh.ox.ac.uk if you are interested in contributing or have suggestions of colleagues or others who may wish to contribute. If you are planning to write, we would be grateful if you would take note of our Guidelines for Contributors at: www.fmreview.org/writing.htm.

From DNIS: M.S.J.E. continues to drag its feet on web access

News Network: More than half a year has passed by since the Ministry of Information Technology revised the web access guidelines mandating all websites in public domain to be W.C.A.G. 2.0 compliant. But Ministry of Social Justice and Empowerment (M.S.J.E.), the nodal ministry for disability and the national institutes and bodies under it are seemingly competing against each other to be the last to wake up to web accessibility!  D.N.I.S. has been following this story for months now. Despite, several letters and phone calls, only the National Trust and the Ministry of Social Justice and Empowerment had found it necessary to reply!  Dr. Vinod Aggarwal, Joint Secretary, M.S.J.E. told D.N.I.S. that the new, W.C.A.G. 2.0 compliant website of the Ministry is ready and would be unveiled anytime soon. According to sources, the last minute security tests are being conducted now. It was earlier scheduled to be launched in mid September. Poonam Natarajan, Chairperson, National Trust said that their W.C.A.G. 2.0 compliant website was to be released in mid September as well. However, when contacted a month later, National Trust said that they have been in touch with N.I.C. and hopefully the website would be fully accessible by October end.

The Rehabilitation Council of India, on the other hand, washed its hands off the issue by asking Media Lab Asia to respond to D.N.I.S. That was in the first week of September. A month and a half later, neither S.N. Goswami, Managing Director and CEO, Media Lab Asia nor Dr. J.P. Singh, Member Secretary, R.C.I. found the time to either come on the phone or reply to E-mails and letters.  But the winner obviously is the National Institute for the Visually Handicapped and a sure shot entry into Ripley’s Believe it or Not! The institute meant for people with visual impairment, who obviously will benefit the most from accessible websites, is not W.C.A.G. 2.0 compliant!

“We have been trying to get our website W.C.A.G. 2.0 compliant for the last 2 years now. But there are no experts on web accessibility in the country and that is why we have not been able to do so,” said Anuradha Mohit, Director, N.I.V.H. A statement that is extremely hard to believe! After all, a good number of government websites are on the verge of becoming W.C.A.G. 2.0 compliant. How come they did not have any difficulty in finding ‘experts’?  Dr. Arbind Prasad, Joint Secretary, M.S.J.E. had earlier directed all national institutes under M.S.J.E. to get their websites W.C.A.G. 2.0 compliant. According to sources, the Ministry is now tightening its reins. However, while most national institutes are scurrying to get their act together, N.I.V.H. apparently is the only one which has not responded. “We do not have to respond, we only have to act,” said Mohit when asked. “And we have been working on it for quite some time,” she added. And how many more months or perhaps years is it going to take to ‘act’? Well, your guess is as good as ours!

DNIS

“Mental illness is not a disability, it is a disease”: J.P. Gadkari

As the cry to include mental illness in the National Trust Act gets louder, organizations working with mental retardation, autism and cerebral palsy, etc. are vehemently opposing it. In an interview with Dorodi Sharma of D.N.I.S., J.P. Gadkari, President, Parivaar, the parents’ body for intellectually disabled people, gets candid on why they do not want mental illness in the National Trust Act.

D.N.I.S.: There is a huge debate in the disability sector on whether there should be four different laws on disabilities or one comprehensive law. What are your views on this?

J.P. Gadkari: A few back when a bureaucrat of the Ministry of Social Justice and Empowerment had posed a question to me as to why can’t we have a single comprehensive law dealing with all disabilities, I was somewhat taken aback by this poser. My apprehension was that under one such disability law, the persons with different categories of disabilities will be deprived of various benefits and facilities which they had won after a prolonged struggle. This apprehension was not without basis if you look at the bureaucratic attitudes displayed by those in power and administration from time to time.However, there is a paradigm change in the situation now. U.N.C.R.P.D. has also removed distinction among persons with disabilities by asserting that all persons with disabilities have legal capacity and equal rights like all other citizens. In this changed situation, there should not be any objection to a single comprehensive law with different chapters for all disabilities based on their specific needs and requirements. Also all existing facilities, concessions, etc., should be safeguarded and further improved upon in the light of the provisions of U.N.C.R.P.D.

D.N.I.S.: What do you have to say about the major debate to include mental illness in the National Trust Act?

J.P. Gadkari: We (Parivaar and myself personally) are firmly against the inclusion of mental illness in the National Trust Act. Because we believe that mental illness is NOT a disability, it is an illness or a disease. It can be treated and cured in most of the cases. It was a mistake to include it in the list of disabilities in the Disability Act of 1995. I want to emphasize here that National Trust Act is meant for persons with autism, cerebral palsy, mental retardation and multiple disabilities. These conditions are acquired from birth in most of the cases and are irreversible. It was enacted as a separate legislation for these four disabilities to fulfill their specific needs and requirements and provide permanent residential care, respite care, rehabilitation services and family support programmes. For the mentally ill there is a separate legislation – the Mental Health Act, 1987 which should not be considered as a disability legislation. It should be under the charge of the Health Ministry and the mental illness lobby can ask the Government to provide all facilities, which they require under this Act.

D.N.I.S.: There is a growing demand that people with mental illness and many other severe disabilities should also be covered under the various schemes of National Trust like Gharaunda and Niramaya. What is your take on this?

J.P. Gadkari: The severely disabled are already covered by the National Trust Act under the category of multiple disability. Other disabilities have adequate provisions under the Disability Act. As far as mental illness is concerned, I have already expressed my views.

D.N.I.S.: It is being alleged that organizations working for mental retardation, autism, cerebral palsy, etc. are putting pressure on the National Trust to not include other disabilities in general and mental illness in particular under the National Trust Act. What do you have to say on this?

J.P. Gadkari: It is patently and totally a false allegation that organizations working for mental retardation, autism, cerebral palsy etc., are putting pressure on the National Trust not to include other disabilities, mental illness, etc. under the National Trust Act. Infact, the National Trust through its website is conducting an opinion poll on these questions and everyone has a freedom of opinion to express his or her view.

Moreover, even if someone pressurizes the National Trust, they have no authority to change the law, include or exclude any of the disabilities from under their purview. That can only be done through an amendment to the present legislation by the Parliament.

D.N.I.S.: Recently, after much dithering, the Chandigarh administration has finally agreed to take care of an orphan mentally retarded girl who became pregnant after being raped at a government run shelter home. What are your views on the case?

J.P. Gadkari: It is a great victory for the entire disability sector which stood firmly by the girl. Since the crime was committed at a Government run sheltered home where the girl was staying, it was primarily the responsibility of the Chandigarh administration to take care of the victim and give her shelter, protection and all other facilities to take care of her advancing pregnancy and the forthcoming birth of the child. However, the administration wanted to wash its hands off this responsibility. It was only because of the active intervention on the part of the Disabled Rights Group (D.R.G.) and the National Federation of Parents Associations – Parivaar that the Chandigarh administration was ultimately forced to assume its responsibility.

DNIS

“Everyone who needs support should be included in the National Trust Act”: Poonam Natarajan

The National Trust for the Welfare of Persons with Autism, Cerebral Palsy,  Mental Retardation and Multiple Disabilities has been in the eye of quite a  few storms recently. From ensuring that an adamant Chandigarh administration takes onus of the mentally retarded rape victim to the debate on including mental illness in the National Trust Act. Poonam Natarajan, Chairperson, National Trust clears the air in an interview with Dorodi Sharma of D.N.I.S.

D.N.I.S.: There is a huge debate in the disability sector on whether there should be four different laws on disabilities or one comprehensive law. What are your views on this?

Poonam Natarajan: I think there should be one comprehensive law. However, from the earlier four laws, the Rehabilitation Council of India Act should be amended separately. It cannot be part of the comprehensive law, because manpower development is a separate subject. The new comprehensive law should also take a good look at all that we have achieved in the in the last 15 years and also some of the structures that are in place. For example, the Local Level Committees under the National Trust have a huge potential and they must stay. Some of the welfare schemes like pensions given by each state, insurance, etc.must be ensured to people with disabilities.

D.N.I.S.: Given the fact that there is a growing demand for one comprehensive law, doesn’t the Amendments to the National Trust Act become a futile exercise?

Poonam Natarajan: No, Amendments to the National Trust Act is not a futile exercise. Legal capacity has not yet been considered (in India). The amendments to the National Trust Act put in place legal capacity and supported decision making. The role of the Local Level Committees is also being enlarged to develop support systems for people who may need support in making choices and decisions. At present this is only for four disabilities. Perhaps, this can be expanded for all people who need such supports.

D.N.I.S.: An opinion poll has been put up on the National Trust website on whether mental illness should be included in the National Trust Act. It is being alleged that like the issue has been made into a frivolous exercise. What is your take on this?

Poonam Natarajan: Firstly, this is not a frivolous exercise. I think, it will generate discussion, debate and will get us the views of our stakeholders. Personally, I do not see anything wrong in such an opinion poll. However, we have got feedback that some people feel that it is not in good taste and we will reconsider having it on our website. In any case, an opinion poll is only an indicator, to see what the stakeholders are thinking and which way they would like us to go. It is not a final decision.

D.N.I.S.: There is a feeling in the sector that pressure from certain groups is keeping the National Trust from including mental illness in the Act. How much truth is there in this? If not, then why isn’t the National Trust including mental illness in the Act?

Poonam Natarajan: The National Trust Act cannot just include other disabilities, this will have to be done by Parliament. It is not a decision that the National Trust Board or the Chairperson can take. Yes, there are groups for and against the inclusion of mental illness. We also have requests from other groups like people living with Muscular Dystrophy and Multiple Sclerosis who would like to be included. My personal view is that everyone who needs support in decision making or a legal guardian should be included, no matter what the disability. The National Trust Act should become the Act for Legal Capacity or a similar chapter in the new law.

D.N.I.S.: The recent case of the pregnant mentally retarded girl in Chandigarh has highlighted the lack of State ownership and support systems needed for the care of intellectually disabled people. Is the National Trust working towards any policy that will ensure that such situations do not arise in the future?

Poonam Natarajan: This is a land mark case in our country. State ownership and support systems do exist, but they are lost in the earlier paradigms of protection, care and charity. This certainly needs to be changed, across the country.

The National Trust can be a facilitator and a catalyst to work towards more forward looking State Policies. This will need to be done in partnership with disability advocates. They will need to use U.N.C.R.P.D. as a tool to take this objective forward. We hope to work on these issues in the future.

DNIS

Special school ‘disappointed’ at claim it is not enrolling pupils

MARY MINIHAN

ST MICHAEL’S House Special School in Dublin says it is “surprised and disappointed” at the Department of Education’s claim that it is refusing to enrol any more children with disabilities. A statement from the school on Grosvenor Road said it was in the process of assessing a number of new applicants. “In all cases, St Michael’s House is in full consultation with the Department of Education and Science and the National Council for Special Education. St Michael’s House is therefore surprised and disappointed with the Department of Education and Science’s statement.”

The school statement said each referral was assessed individually, considering a child’s needs, supports required and limitations of the school building. “The first priority of St Michael’s House is to children with a disability and their families.” The statement responded to the department’s claim that staffing levels were significantly greater than normal pupil-teacher ratios applying to special schools. “St Michael’s House firmly believes that the current number of teachers and staff in Grosvenor Road is commensurate with the educational and care needs of the pupils currently enrolled.”

The school said it had lobbied the department since the early 1990s for a purpose-built school in a “more appropriate location” for the Grosvenor Road pupils. “It has secured a green field site in Ballinteer and on instruction from the Department of Education, submitted plans in 2006 to the department. However, regrettably, it appears that this project is on hold indefinitely.” A man who has a daughter with special needs and who gained access to the Green Party convention at the RDS recently, protested at the gates of Leinster House last week. James McDonagh from Dún Laoghaire said he tried to enrol 11-year-old Angel in St Michael’s. He said she had not attended school for a year, and that no school would accept her “because of Government cutbacks and because of lack of resources”.

St Michael’s said it could not comment on individual cases.

Irish Times

Blind student wins fight to take exam

Yogita Rao

Mumbai: A visually-impaired law student has finally won his battle against the Mumbai University after almost two years of perseverance. Amar Jain, a second year law student, refused to use a writer for his exams after a couple of bad experiences in the past. Well-versed in computers, Jain insisted on attempting his papers online in stead. However, the University rulebook did not permit any such liberty for a handicap student. After pursuing for almost two years, the controller of examination finally granted him the permission on Friday.  Jain, a student of the Government Law College, Churchgate, got a writer from a Hindi medium school to write his English paper in his class XII exams. He was disappointed to get only 55 marks because Jain had been a distinction student all his life. He decided to learn computers and was happy that he could attempt his own exams with the help of a screen-reading software. However, the University had not adopted the University Grants Commission (UGC)’s circular allowing blind students to use computers, which was passed in 2006.

With a little help from his principal, Parimala Rao, Jain approached the university. His application was forwarded to the Dean of Law, Mumbai University, which was then handed over to the controller of examination. However, nothing happened after that and repeated inquiries with the additional registrar’s office at the examination house in Kalina were futile.  This year, Jain directly wrote to the vice-chancellor’s office, on his new principal’s suggestion. He approached the VC’s office, early this month, and was pleasantly surprised by their quick response. “My letter was forwarded to the controller of examination this month. And they have finally granted me permission to write the exams using the screen-reader software this Friday. I am thankful to the controller of examination and the VC for finally making this provision available to me,” said Jain.  The controller of examination, Vilas Shinde, however, said, “The letter came to me and within three days I passed the order. The state government had already issued a circular in the past allowing blind students to use computers or typewriters, but the university needs to release its own circular on the same. So the permission was not granted. The student should have directly approached higher authorities earlier.”

DNA Bombay, Sunday, October 25, 2009 2:34 IST

Sidewalks become battlegrounds

Disability-rights advocate Scott Crawford of Jackson, rides down Terry Road in Jackson,
Miss. on Friday in his motorized wheelchair.

By Chris Joyner, USA TODAY

JACKSON, Miss. — The nation’s crumbling sidewalks have disabled residents taking their wheelchairs to the streets, a potentially dangerous practice that has cash-strapped cities and disability-rights advocates at odds over how to fix the problem.ities across the nation are dealing with eroding sidewalks that do not meet standards set by the Americans with Disabilities Act. Under the ADA, state and local governments cannot discriminate against the disabled in providing “services, programs or activities,” including access to sidewalks.Although there are no specific statistics on the number of accidents involving wheelchairs in streets, according to the U.S. Department of Transportation’s Fatality Analysis Reporting System, disability was a factor in 617 pedestrian traffic fatalities last year.

Disabled residents here take their lives in their hands getting from point A to point B, says Scott Crawford, a disability-rights advocate. In March, James Smith, 68, was killed when an SUV, struck by another vehicle, plowed into his motorized wheelchair on Medgar Evers Boulevard, one of Jackson’s main thoroughfares. Where they exist, the sidewalks often are in such disrepair as to be impassible to people in wheelchairs, says Crawford, leaving the roadway as the only other option. “I’ve been beeped at and honked at and cussed at,” by motorists, he says.

Lois Thibault, coordinator of research for the U.S. Access Board, a federal agency that provides guidance to local governments on ADA issues, said Jackson is in the same boat with a lot of cities that for years stalled spending federal dollars on sidewalks to spend money on roads. “It’s deferred maintenance,” she said. “We’ve been so focused on new construction that we’ve let the maintenance go.” Crawford is a plaintiff in a federal lawsuit aimed at getting the city to comply with ADA standards by making sidewalks, bus stops and other public areas accessible to the disabled. The Justice Department has joined in the lawsuit. In the past 10 years, the Justice Department has inked settlement agreements of ADA complaints with dozens of cities as part of a push called Project Civic Access, an effort to ensure cities eliminate physical and communication barriers for people with disabilities.

Elsewhere:

• In California, state officials are fighting a federal class-action lawsuit filed by disability-rights advocates who want thousands of wheelchair ramps installed along 2,500 miles of sidewalks on state roads across the state. Mary-Lee Kimber, staff attorney at Disability Rights Advocates, a non-profit law firm representing the plaintiffs, said the two sides are working toward a settlement after a judge last month halted the trial to allow more negotiations. If the state loses, it faces potentially billions of dollars in sidewalk-repair costs.
• In Arlington, Texas, the 5th Circuit Court of Appeals ruled in June that two disabled residents could proceed with a lawsuit against the city over the condition of its sidewalks. John Nevins, attorney for residents Richard Frame and Wendell Decker, said his clients, who are disabled, sued because they could not access the sidewalks in their wheelchairs, keeping them from getting to medical and city services.
• In Columbia, Mo., the City Council last week passed an ordinance making it a misdemeanor for motorists to harass disabled people in the public rights of way. Mayor Darwin Hindman said the language for wheelchairs and walkers was added to an existing law for bicyclists to protect “more vulnerable classes” of pedestrians.

“As with most cities, we have a certain number of deteriorated sidewalks that are not suitable for wheelchairs,” Hindman said.

Jackson Councilman Kenneth Stokes said the ultimate solution is for the city to fix the sidewalks. In the meantime, Stokes sponsored a measure that passed this month requiring wheelchairs to have reflectors or a blinking light if disabled residents intend to use them in the street after dark.

Joyner reports for TheClarion-Ledger in Jackson, Miss.

USA Today

Deciding who lives and who dies

QALY (Quality Adjusted Life Score) is the methodology used by the United Kingdom (UK) to determine whether or not an individual is eligible to receive treatment for an illness.  The formula reduces the decision making to a dollars and cents evaluation.  In short, if it costs too much, the patient is denied care.

Fortunately, we have not yet reached the point where our own health care is decided purely on the basis of cost.  Or have we?

As legislators and the public have debated health care reform, claims and counterclaims by each side that the other is trying to scare the public into supporting their position have only served to confuse the issue.  However, comments made by Robert Reich, former Labor Secretary in the Clinton administration, now an Obama economics advisor, are worth noting. While campaigning for the Democratic presidential nomination at the UC Berkeley campus in 2007, he said:

I’m so glad to see you, and I would like to be president. Let me tell you a few things on healthcare. Look, we are we have the only healthcare system in the world that is designed to avoid sick people. That’s true. And what I’m going to do is I am going to try to reorganize it to be more amenable to treating sick people, but that means you, particularly you young people, particularly you young healthy people, you are going to have to pay more.

And by the way, we are going to have to, if you are very old, we’re not going to give you all that technology and all those drugs for the last couple of years of your life to keep you maybe going for another couple of months. It’s too expensive. So we’re going to let you die.

Also I’m going to use the bargaining leverage of the federal government in terms of Medicare, Medicaid—we already have a lot of bargaining leverage—to force drug companies and insurance companies and medical suppliers to reduce their costs. What that means, less innovation and that means less new products and less new drugs on the market which means you are probably not going to live much longer than your parents. Thank you.

Secretary Reich’s honesty is refreshing.  However, since honesty and transparency are hardly hallmarks of the Obama administration and Congress, we are forced to read between the lines in an effort to determine their true intent for reforming America’s health care system. Is it now the prevailing attitude that the government intends to let old people die because caring for them is too costly? The Brits’ QALY system is used to make life and death decisions about which patients will receive care or medicines.  The decision-making process is reduced to a formula for rationing health care based on age and the estimated costs of providing medical treatment and/or services, including prescription drugs.  (see http://www.york.ac.uk/inst/che/pdf/mathprog.pdf).

David Lee, a GE health economist, explained QALY as “…Quality adjusted life year, a year of life adjusted for its quality or its value.  A year in perfect health is considered equal to 1.0 QALY.  The value of a year in ill health would be discounted.  For example, a year bedridden might have a value equal to 0.5 QALY…We try and evaluate benefits and costs.  The way we measure that is a QALY, quality adjusted life year…We try to figure out what the QALY for certain technologies are. Is the gain in QALYs to the gain in costs worth it? The UK has something like £30,000 per QALY.  If the technology can deliver at less than that they’ll pay for it, it it’s more than that they won’t…What it’s telling technology developers is that if you’ve got a high cost with low medical benefit product your chances of getting into market are lower.  If you’re a cancer patient that stands to benefit from an additional three months of life that will cost the NHS (National Health Service) $70k is it worth it or not?”

This places a monetary value on human life. Decisions are made based on life expectancy.  If a particular treatment isn’t determined to be worth the cost, care is denied.  The rationale is that, while these may be difficult decisions to make, they are necessary. The thinking is that there has to be some way to measure costs in order to keep them from getting completely out of control. On the surface, that may make sense, unless, of course, you’re the one who needs the treatment.

Once again, the admonition, “be careful what you wish for,” applies.

In a society that bases life and death decisions on cost, such as the QALY system in Great Britain, it’s easy to see how it’s possible to deny health care to people who have the potential for great accomplishments.

For example, Helen Keller, who was born blind and deaf, through the patience and perseverance of her nurse and companion, ultimately became a world renown figure for her accomplishments in helping the handicapped.  However, my guess is that if she were born at a time when the health care industry was making cost-based decisions about who should live or die, she would not have been spared.  She has been quoted as saying, “I dreamt of heaven the other night, and the pearly gates swung wide. An angel with halo bright, ushered me inside. And there to my astonishment, stood folks I’d judged and labeled as quite ‘unfit,’ of ‘little worth,’  and ‘spiritually disabled.’ Indignant words rose to my lips, but NEVER were set free, for EVERY face showed stunned surprise, not ONE expected Me!”

Another person who probably would not be with us today when the health care system restricts access on the basis of cost is one of world’s greatest physicists, Stephen Hawking (1942-).  Hawking has suffered for approximately 40 years with ALS (amyotrophic lateral sclerosis), more commonly known as Lou Gehrig’s Disease.  The list of his accomplishments is too long to detail here, but he has authored a number of important contributions to the fields of cosmology and quantum gravity, including “black holes.”  Hawking developed ALS in his youth, while attending Cambridge, and has become increasingly paralyzed over the years, to the point that today he is almost completely immobile and can no longer speak. He has been quoted as saying, “It is a waste of time to be angry about my disability. One has to get on with life and I haven’t done badly. People won’t have time for you if you are always angry or complaining.”

If the British QALY system for evaluating the worth of individuals had existed at the time Stephen Hawking first became paralyzed, would he have received the care and support that has kept him alive for the past 40 or 50 years, or would the cost of his care resulted in the conclusion that it was simply too expensive?

There is a long list of people who have made significant contributions to society and who might well have been denied health care on the basis of cost under the British QALY system or a similar policy that could potentially become the method for health care decision-making in America under the type of health care reform that the Obama administration has been pushing.  Following are just some examples:

• Christopher Reeve (1952-2004), actor: Was crippled as a result of a horse-riding injury and dedicated the remaining years of his life attempting to harness the power of medical research to enable people with spinal cord injuries to recover and walk again.
• Ray Charles (1930-2004), musician: Became blind at age seven, learned to play the piano and went on to be one of America’s greatest entertainers.
• Jose Feliciano (1950-), Stevie Wonder (1950-) and Ronnie Milsap (1945-), composers and musicians: Were all born blind and overcame their handicaps to become leading song writers and entertainers.
• Franklin Delano Roosevelt (1882-1945), U.S. President 1933-1945: suffered with Polio, which he contracted in 1921.
• Louis Braille (1809-1852), inventor of the Braille System of reading and writing.  Became blind at age 3 as a result of an accident.
• Anne McDonald (1961-), Australian author and activist for the rights of people with communication disability. She developed cerebral palsy as a result of a birth injury. Diagnosed as having severe intellectual disability at the age of three she was placed in an Australian government institution for people with severe disabilities and lived there without education or therapy for eleven years. Anne wrote her story in Annie’s Coming Out, a book she co-authored with Rosemary Crossley in 1980 (the film Annie’s Coming Out based on the book won several Australian Film Institute awards and was released in the U.S. under the title Test of Love).
• Hubert H. Humphrey (1911-1978), two-term Vice President of the U.S. and U.S. Senator, is credited with saying: “The moral test of government is how it treats those who are in the dawn of life . . . the children; those who are in the twilight of life . . . the elderly; and those who are in the shadow of life . . . the sick . . . the needy . . . and the disabled.”

Important words everyone should keep in mind during the current debate about reforming America’s health care system.  If the changes lead to health care rationing and decision making about who lives and who dies based on monetary considerations, we will not have moved forward but backward in our quest for fairness and equity.

Comments and observations about disabilities that provide us with revealing insights:

• Death is no more than passing from one room into another. But there’s a difference for me, you know. Because in that other room I shall be able to see…No pessimist ever discovered the secret of the stars, or sailed to an uncharted land, or opened a new doorway for the human spirit…”I also dislike people who try to talk down to my understanding. They are like people who when walking with you try to shorten their steps to suit yours; the hypocrisy in both cases is equally exasperating.” – Helen Keller (1880-1968), born blind and deaf.
• “The problems of deafness are deeper and more complex, if not more important, than those of blindness. Deafness is a much worse misfortune. For it means the loss of the most vital stimulus–the sound of the voice that brings language, sets thoughts astir and keeps us in the intellectual company of man.” – Helen Keller
• “Science may have found a cure for most evils; but it has found no remedy for the worst of them all — the apathy of human beings.” – Helen Keller
• “Each handicap is like a hurdle in a steeplechase, and when you ride up to it, if you throw your heart over, the horse will go along, too.” – Lawrence Bixby, author of over 40 books.
• “We all have a disability of some kind; all are lacking in one way or another. Saul has an injury to his leg. What if his personality was deformed? How much worse if his soul was lame? Preachers or teachers look for the good in all of us. (Bless them for doing so.) I don’t see a cripple. I haven’t met anyone yet who isn’t handicapped in some way. So what’s the big deal? Don’t hide your deformity. Wear it like a Purple Heart.” – Georgiann Baldino, author, co-founder of cancer support group.
• “I discovered early that the hardest thing to overcome is not a physical disability but the mental condition which it induces. The world, I found, has a way of taking a man pretty much at his own rating. If he permits his loss to make him embarrassed and apologetic, he will draw embarrassment from others. But if he gains his own respect, the respect of those around him comes easily.” – Alexander de Seversky (1894-1974), aviation pioneer.
• “But pain… seems to me an insufficient reason not to embrace life. Being dead is quite painless. Pain, like time, is going to come on regardless. Question is, what glorious moments can you win from life in addition to the pain?” – Lois McMaster Bujold (1949-), science fiction writer.
  “The healthy and strong individual is the one who asks for help when he needs it. Whether he’s got an abscess on his knee or in his soul.” – Rona Barrett (1936-), Hollywood columnist, author, TV
• “Disability is not a brave struggle or ‘courage in the face of adversity.’ Disability is an art. It’s an ingenious way to live.” – Neil Marcus (1954-), poet, playwright, disabled from age eight.
• “Not only do physically disabled people have experiences which are not available to the able-bodied, they are in a better position to transcend cultural mythologies about the body, because they cannot do things the able-bodied feel they must do in order to be happy, ‘normal,’ and sane….If disabled people were truly heard, an explosion of knowledge of the human body and psyche would take place.” – Susan Wendell, Ph.D., feminist author, suffers with chronic fatigue syndrome.
• “For me, the wheelchair symbolizes disability in a way a cane does not.” – Annette Funicello (1942-), actress, suffers with multiple sclerosis.
• “A true friend knows your weaknesses but shows you your strengths; feels your fears but fortifies your faith; sees your anxieties but frees your spirit; recognizes your disabilities but emphasizes your possibilities.” – William Arthur Ward (1921-1994), author, poet, columnist.
• “It (hepatitis C) will kill four times as many Americans as AIDS will over the next decade. I feel that whatever kind of disability God has given me, as an entertainer and as a public figure, it is so I can be a representative for others.” – Naomi Judd (1946-), singer, entertainer, mother of actress Ashley Judd and singer Wynonna, suffered with hepatitis C.
• “Americans believe that people should work hard and get ahead on their own, but when disaster strikes and they need help with retirement or disability, Americans as a whole should come to their aid.” – Jacob Hacker, Ph.D. (1971-), professor of Political Science, UC Berkeley.
• “Disability is a matter of perception. If you can do just one thing well, you’re needed by someone.” – Martina Navratilova (1956-), world champion tennis player.
• “Congress acknowledged that society’s accumulated myths and fears about disability and disease are as handicapping as are the physical limitations that flow from actual impairment.” – William J. Brennan, Jr. (1906-1997), Associate Justice of U.S. Supreme Court.
• “The only disability in life is a bad attitude.” – Scott Hamilton (1958-), American figure skater, four time Olympic champion.
• “I was slightly brain damaged at birth, and I want people like me to see that they shouldn’t let a disability get in the way. I want to raise awareness – I want to turn my disability into ability.” – Susan Boyle (1961-), Scottish singer.
• “It is a lonely existence to be a child with a disability which no-one can see or understand, you exasperate your teachers, you disappoint your parents, and worst of all you know that you are not just stupid.” – Susan Hampshire (1937-), English actress, TV star. “It was ability that mattered, not disability, which is a word I’m not crazy about using.” – Marlee Matlin (1965-), American actress, deaf (from 18 months of age)

© 2009 Harris R. Sherline, All Rights Reserved

Read more of Harris Sherline’s commentaries on his blog at “www.opinionfest.com”

The Examiner

A historical perspective of learning disabilities

At one time scientists thought that all learning disabilities were caused by a single neurological problem but research has demonstrated that the causes are more diverse. Historically, speculation had attributed learning disabilities to heredity, or other unknown mysterious factors. An early explanation concluded that learning problems that were primarily the result of poor vision or hearing, motor disabilities, mental retardation, autism, emotional disturbance, or environmental, cultural or economic disadvantage while considered to be eligible for special education, were not considered to be a learning disability. The real concern, at that time, was why children with average or above average intelligence were having difficulty learning, and sometimes performed below their average peers in academic achievement.

The very recent advances in modern technology have provided an answer to this question by allowing scientists to look into the living brains of children. The amazing finding has been that the way in which the brain and nervous system develops is influenced by the experiences the child has during the early childhood years while the nervous system is developing. It seems that the development of the brain and nervous system differs from child to child and that the specific differences in brain and nervous system development accounts for the specific differences in learning abilities.  These findings resulted into a more indepth look at how early childhood experiences contributed to the development of learning problems in children. While intensive research identified many early learning experiences that contribute to the development of learning disabilities, the environmental factor identified as having the most impact upon the child’s development was found to be his relationship with his parents and their attitude toward his success. This relationship is referred to as parenting, and all other factors in the environment were found to be secondary to it because parents create the environment that the developing child experiences.

Other important factors in the child’s environment found to have an impact upon the development of learning abilities included nutrition, allergies to food, toxic chemicals, and heavy metals. A lack of sleep and physical exercise are additional factors. And, most importantly, when parents control these factors, the brain continues to develop, or returns to normal functioning.  The exciting result is that parents need not despair about their child’s learning problems, for research findings suggest that specific learning disabilities can be prevented, remedied, or corrected by identifying, and removing the specific factors in the environment that are preventing normal development of the child’s learning abilities.  Simply stated, to prevent, mediate or correct the cause of a child’s specific learning disability, a summary of this research appears to be suggesting that if you become proactive in greening up the child’s environment by removing toxic chemicals that may be causing allergies, see that he eats nutritious food, gets plenty of sleep and physical exercise it will go a long way toward helping your child become a better student. Researchers report that, in some instances, suggested methods have shown results in only a few days.

Examiner.com

Research and Markets: Wheelchair Market Shares Strategies, and Forecasts, Worldwide 2009 to 2015 – Market to Reach $7.9 Billion by 2015

DUBLIN–(Business Wire)–

Research and Markets (http://www.researchandmarkets.com/research/3cfe60/wheelchair_market) has announced the addition of WinterGreen Research, Inc.’s new report “Wheelchair Market Shares Strategies, and Forecasts, Worldwide, 2009 to 2015″ to their offering.  Wheelchair markets are poised to achieve significant growth the use of wheelchairs is based on providing a chair for everyone who does not have the ability to walk one quarter mile. The ability to walk longer distances is impossible for some people and then they need a wheel chair. Custom units, light weight units, stable chairs, comfortable chairs are all an issue in general market seating and are moving to be adopted in the wheel chair market. Hospital and homecare wheelchair technology is evolving to give people with disabilities more mobility. Markets are poised to create the ability for people with disabilities to get more exercise and have more mobility. Impact on the healthcare delivery industry is positive because it is encouraging mobility of people who were previously bed ridden.

This 2009 study has 484 pages, 235 tables and figures. Worldwide markets are poised to achieve significant growth as the wheelchairs are used globally. Growth comes as the population ages in every region.   According to Susan Eustis, the lead author of the study, “the use of wheelchairs is based on providing a chair for everyone who does not have the ability to walk one quarter mile. The ability to walk longer distances is impossible for some people and then they need a wheel chair. Custom units, light weight units, stable chairs, comfortable chairs are all an issue in general market seating and are moving to be adopted in the wheel chair market.”   Hospital and homecare wheelchair technology is evolving to give people with disabilities more mobility. Markets are poised to create the ability for people with disabilities to get more exercise and have more mobility. Impact on the healthcare delivery industry is positive because it is encouraging mobility of people who were previously bed ridden.

Wheelchairs impact care delivery, permitting the patient to control mobility for the rehabilitation efforts. Lightweight wheel chairs give patients the ability to control movement. Transport wheelchairs are used for moving patients from the bed to another place. Patients and family gain more control over the care delivery with the availability of transport wheelchairs. Care can be delivered in familiar home settings Wheelchair market driving forces include the fact that baby boomers are starting to hit age 65 resulting in growth in the population over age 65. As overall life expectancy increases, more wheelchairs are needed.   The home medical equipment market includes home health care products, physical rehabilitation products and other non-disposable products used for the recovery and long-term care of patients. The demand for domestic home medical equipment products continues to grow. Growth during the next decade and beyond is a result of several factors:

• Wheelchair markets are expected to grow as the baby boomers age. The aging of  the population is expected to change markets. Older people need more support for continued mobility through disability. Rehabilitation becomes more prevalent.
• The ability to get reimbursement has been a significant market factor. As baby boomers age and need wheelchairs, they will be willing to pay directly for mobility and comfort as they do for homes and cars now. This trend will assure market growth worldwide.
• Wheelchair and scooter markets at $3.9 billion in 2009 are expected to grow to $7.9 billion by 2015. Wheelchairs and scooters provide improved lifestyle for disabled people by enabling mobility and move the healthcare delivery system toward the lower cost homecare.

Key Topics Covered:

Wheelchair Market Shares And Forecasts

1. Wheelchair Market Dynamics And Market Description
2. Wheelchair Market Shares And Forecasts
3. Wheelchair Product Description
4. Wheelchair Technology
5. Wheelchair Company Profiles

Companies Mentioned:

Market Leaders:

• Invacare
• Drive Medical
• Handicare
• Medline
• Merits
• Meyra
• Sunrise Medical
• Pride Mobility

Wheelchair Company Profiles:

• 21st Century Scientific Inc
• Amigo Mobility
• Chiaphua Motors
• Convaid
• ConvaQuip
• Eagle Sportschairs
• Gendron Inc
• Glide Rehabilitation
• GF Health Products / Graham Field
• Graham-Field Quality Brands
• Gunnell
• Hoveround
• LEVO AG
• Magic Mobility
• MED Group
• Melrose Kiwi Concept Chairs
• Product Design Group
• Otto Bock HealthCare GmbH
• Permobil
• Piaggio
• Pihsiang Machinery Manufacturing Company Limited
• RGK
• Shoprider Mobility Products
• Soleus Mobility
• Teftec Mobility
• The Scooter Store
• Vestil Manufacturing Corporation / Innovation in Motion
• Yamaha Motor Corporation, U.S.A.

For more information visit http://www.researchandmarkets.com/research/3cfe60/wheelchair_market

Research and Markets Laura Wood,
Senior Manager press@researchandmarkets.com
U.S. Fax: 646-607-1907
Fax (outside U.S.): +353-1-481-1716

Copyright Business Wire 2009

The ‘lesser’ among the less privileged

Mental illness in India has a huge taboo, ignorance and terrifying superstitions attached to it. The memory of Erwadi, where 27 women with mental illness were charred to death as they were chained to their beds while the building they were in caught fire is long forgotten. While the fate of mentally ill people continues to be dismal, Dorodi Sharma of D.N.I.S. takes a hard look at the debate raging in the Indian disability sector whether or not mental illness should be included in the National Trust Act.

The Indian disability sector has many things to be proud of. Like the paradigm shift from charity and welfare mindset to a rights based attitude towards disability. Or the shift from the medical model of disability towards the social model. Even the whole mantra of inclusion, for that matter. But despite these evident paradigm shifts, there still are many things that we cannot be proud of. The condition of people with mental illness for example. Or the segregation that they still face. And segregation not only from the rest of the society but also from the so called champions of ‘inclusion’ within the disability sector!

If one goes by statistics, at any given point of time, around 5 percent of the country’s population is afflicted with mental illnesses. The change to a rights based outlook also brought about rights based legislations. While people with physical disabilities got the Disability Act of 1995 and those with autism, mental retardation, cerebral palsy and multiple disabilities got the National Trust Act of 1999, people with mental illness continue to remain ‘invisible’.

There is a huge stigma attached to mental illness in the society. The fact that a person has mental illness not only makes him or her an outcast in the society but also ostracises his/her entire family. While the Disability Act ensures job reservations for people with physical disabilities, people with mental illness run the risk of losing whatever employment they may have if their condition becomes known!

From small towns to metros, how many of us have seen mentally ill men and women roaming the streets and obviously vulnerable to exploitation? How many of us have read about people with mental illness being locked up like animals? Despite the undisputable fact that it leads to such obvious ‘handicaps’, this is what President, Parivaar, J.P. Gadkari had to say. “Mental illness is not a disability; it is an illness, a disease. It was a mistake to include it in the Disability Act!”

However, mental health activists strongly differ from this point of view.

“If you compare autism, cerebral palsy and treatment resistant mental illness, they all fall in the same category and need guardianship,” said Akhila Charagi of Nodal Association for Mentally Ill (N.A.M.I.). Gadkari feels that people with mental illness already have the Mental Health Act of 1987. In doing so, he neglects the fact that this Act is a medical one and not a rights based one.

While the National Trust provides guardianship and supported decision making structures, there is no legislation or statutory body at present that provides this to people with mental illness.

“Where do mentally ill people who are thrown into the streets – women, elderly, men included, go?” questioned Charagi. “Is anyone trying to understand the enormity of the problem?” she added.

So, why is there such a resistance to including mental illness in the National Trust Act?

“It is probably because the leadership of the intellectual disability sector is feeling threatened and believe that it will reduce their cause,” said Charagi.

Or, is it because of the Rs. 100 crore corpus fund of the National Trust that a few already in control do not want to share? If so, then all the paradigm shifts that the so called disability sector leaders do not tire of crediting themselves with, will come to a naught. If so, then the sector will be pushed back another 20 years, when cross disability was unheard of and each disability would look at the other as a possible competitor for grants and money. And if so, then it would be nothing short of a travesty.

In the last few months, the demand to include mental illness in the National Trust Act has become louder. Along with this, the pressure on National Trust to not include mental illness is also increasing. The National Trust has more than 800 N.G.O.s registered under it and all with voting rights. Apparently, these organizations are pulling the strings real hard, especially with the elections to the Board being in process! Although organizations working for mental retardation, autism, cerebral palsy, etc., vehemently refute this allegation, popular feeling in the sector seems to be telling a different story.

Disability sector leaders opposing the inclusion are now engaged in futile academic delusions and discourses which serve no other purpose but fill reams of papers with tongue twisting words and irrelevant information. And while the debate rages on, the National Trust has put up an opinion poll on its website with the question “Should National Trust Act include mental illness?” This has left people fuming.

“Is this a cruel joke or is it supposed to be a participatory exercise? It is a discriminatory question. It is against the spirit of U.N.C.R.P.D. National Trust is not an insensitive television channel. Fate of people with mental illness has to be a considered legal and policy decision and not the outcome of some public voting,” said Dr. Achal Bhagat, Director, Sarthak, in a strongly worded letter to Poonam Natarajan, Chairperson, National Trust.

Will the National Trust not include mental illness under its Amendments if there are 101 votes opposing inclusion against 100 votes advocating for it? And what about engineered votes? While the jury is still out, it is time for the disability sector to introspect. We lament the lack of inclusion in our society but have we risen above our own inherent prejudices? We talk about U.N.C.R.P.D. and jargons like ‘inclusion’, ‘social model’, etc., but have we ourselves moved beyond ‘We, the hearing impaired’, ‘We, the visually impaired’, and so on to ‘We, the disabled people of India’?

We want to be safely cocooned in our own bubbles, afraid that the other would take away our share of the pie. Isn’t it time for us to demand that the ‘pie’ be made bigger?

Yes, indeed it is time. Time to rethink, time to be less hypocritical and time to practice what we preach. After all, the only place a myopic vision will take us is a place the sector has been through decades ago. And a place no one wants to be now!

DNIS

Tourism e-accessibility and e-inclusion

Thursday, September 03, 2009

In their effort to find niche markets, the tourist destinations have finally realised that disabled people constitute an advanced market with advanced needs and lot of perspectives; a market that belongs among the most loyal groups of clients. Let’s not forget that Europe is getting older and the obligations of the countries members of the European Union (http://ec.europa.eu/information_society/activities/einclusion/index_en.htm) increase, therefore more and more opportunities are given to the disabled individuals to travel under the same circumstances as the rest of the citizens.

The journey starts from their house, from their personal computer, usually by searching Google. However, as Abbott (2001) argues, even though internet provides opportunities of democratization of society through freedom of expression, sometimes of even radical opinions, it is still predominated by websites which usually reverberate the dominant ideology and stereotypes, or it is rich in advertising websites which rarely consider disabled individuals as a remarkable market. Therefore, the trip of a person with disabilities is mandatorily continued only on those websites of suppliers or tourist services which can cover their first need of accessibility, by following the various protocols of accessibility for the web design and content, like the ones developed by the World Wide Web Consortium, known as W3C.

Most of the Cypriot and Greek websites of the big tourist enterprises do not meet those criteria and therefore are not accessible, also evidenced by the research of Zafiris and Zacharias (2001 and 2003). The high importance given on the artistic design and not on the usability and accessibility of a website, lefts disabled individuals out of the online marketing. To avoid any possible misunderstandings, at this point we need mention that most of the criteria defined by W3C are easy to achieve, since clear guidelines are given. Those criteria do not necessarily deprive the artistic design of a site. On the contrary, they strengthen good design and facilitate the designer to avoid any possible excesses and mistakes which without realizing may affect the success of the website. The various accessibility protocols include special design guidelines of the web material with regards to accessibility for particular disabilities (e.g visual disability, motor disabilities, etc.) but at the same time include general instructions as to the usability of the website, its readability, the content presentation, the search engines, the easy and well understood reservation systems, like www.sybelio.com, and many more, which contribute in the creation of a human oriented website, which is easily accessible to every citizen of the modern society. Research findings have shown that the accessible design of a website can increase at least 10% the number of the people visiting the website.

If the tourist enterprises of Greece and Cyprus want to attract, and please allow us to repeat here the word want, an inclusive market which doesn’t exclude disability, they should not only build ramps next to the staircases, or create rooms with special equipment, and doors suitable for wheelchairs etc., but they should also give the possibilityof accessibility next to their well designed websites, so that online material, advertising and information will be appropriate and accessible to people with for visual, hearing, motor and learning disabilities, etc. Everybody has the right and we have the obligation to offer exactly the same and equal services we offer to the rest of the community.  The website accessibility should belong in the same legal framework as the physical accessibility. If one organisation offers internet services to the public, the legislation should have enforced it to offer the same services in accessible websites, as has already started in a number of European and other countries with the guidelines of Universal Design.

If Greece and Cyprus become leading markets through accessible internet and offer their tourist services in accessible websites, and this is well advertised, then we “endanger” to become accessible destinations. After all, the conviction of the European Union is that by 2010 all the public websites to become accessible then why not all the tourist websites, too? Of course it is not enough our websites to be accessible. We are obliged to have our towns, villages, beaches and mountain resorts accessible and inclusive, and this is only achieved though real and feasible human oriented plans and strong political decisions by the local authorities, decisions that can be materialized quickly.  My recent experience, in teaching an e-commerce course to 10 young people with hearing disabilities, under the Synergia Programme of the European Union, has confirmed the many opportunities those people have in online marketing.

Petros Mavros is a Business Development Director of Avantless ltd

Travel and Daily News

Women with Disabilities and Health Care: What the Research Shows

A recent study by the National Council on Disability (NCD) titled “The Current State of Health Care for People with Disabilities” provided sobering statistics regarding all aspects of health and healthcare for women with disabilities.

Notes the report,

Recent research reveals that women with disabilities experience poorer health than women who do not have disabilities, despite the fact that both groups report the same types of health problems. Nearly a third of women with extensive functional limitations rate their overall health as poor compared with less than 1 percent of women with no limitations. [“Improving the Health and Wellness of Women with Disabilities: A Symposium to Establish a Research Agenda,” Center for Research on Women with Disabilities (CROWD), Baylor College of Medicine]

In addition,

As they age, women with disabilities tend to have poorer health than women who do not have disabilities. They are more likely to be overweight, smoke, have high blood pressure, and experience mental health problems. Women with more significant disabilities are more likely to live alone, be unemployed, have less education, be divorced, and live in poverty. [Susan L. Parish and M. Jennifer Ellison-Martin, “Health-Care Access of Women Medicaid Recipients: Evidence of Disability-based Disparities,” Journal of Disability Policy Studies 18, no. 2 (2007), pp. 109–116]

Women with Disabilities Can Control Some Health Outcomes

Two of the issues most critical to the health of women with disabilities, however, are “lifestyle” issues that with the right encouragement, motivation, and information, they may be able to address themselves: specifically, smoking and obesity. According to a 2008 study from the National Center for Health Statistics, “about 30 percent of women with basic actions difficulties were overweight, and 31 percent were obese. Among those with complex activity limitations, almost 30 percent reported being overweight, and over 34 percent were obese. Slightly over 23 percent of women with complex activity limitations smoke, compared with 22.5 percent of women with basic actions difficulties. [Altman and Bernstein, Disability and Health in the United States, 2008]

But Getting Decent Reproductive Health Care is Still a Problem

Reproductive care for women with disabilities seems to prove especially problematic. The NCD researchers found that although women with disabilities require the exact same health services related to sexuality, reproductive care, and childbearing as do women without disabilities, …..social misperceptions and stereotypes about disability can make it difficult for women with disabilities to obtain information, medical care, and services to ensure that their reproductive needs are met. Such needs include routine gynecological and breast examinations; screening for sexually transmitted diseases (STDs); contraception; consultations about sexuality and sexual function; fertility consultation and support; obstetrical care during pregnancy, labor, and delivery; and information about healthy parenting and about issues related to menopause, including osteoporosis, loss of libido, and insomnia.

The types of barriers encountered by women with disabilities in need of reproductive health care, according to the NCD report, included:… limited professional training and competency of primary care and reproductive care specialists; inadequate or no health insurance coverage for visits to specialists; poor physical access to usable and adapted or specialized examination and diagnostic equipment; and negative or discriminatory provider attitudes. Although the source of this statement, Sandra A. Welner’s “Gynecologic Care and Sexuality Issues for Women with Disabilities,” (Sexuality and Disability, v. 15, no. 1, 1997) is now more ten years old, anecdotal evidence among Disaboom’s members indicates that not much has changed since Ms. Welner undertook her research.

Decent HealthCare for Women with Disabilities: Where to Start

For starters, we’d send every legislator and local politician the link to the NCD’s outstanding and comprehensive report, “The Current State of Health Care for People with Disabilities”. Next, we’d send the same link and report information to the American Medical Association to inquire as to what steps their members are taking to help remedy these appalling statistics. (We just e-mailed them to ask about their progress on insisting on accessible doctors’ offices and diagnostic equipment.) Next, you may want to take a look at the health issues that are within your control: stop smoking, start a modest exercise program with the counsel of your medical professional, and learn what to eat and what not. True, these are just starting points to address a big and complex challenge, but starting somewhere is better than not starting at all.

Disaboom