REBECCA YEO Action on Disability and Development
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REBECCA YEO Action on Disability and Development
Including Disabled People in Poverty
Reduction Work: ‘‘Nothing About Us, Without Us’’
REBECCA YEO Action on Disability and Development, Frome, Somerset, UK
KAREN MOORE * University of Manchester, UK
Summary. — This article argues that the exclusion of disabled people from international development organizations and research reflects and reinforces the disproportionately high repre- sentation of disabled people among the poorest of the poor. The paper commences with a brief exploration of the links between impairment, disability, poverty, and chronic poverty, followed by a discussion of ways in which disability is excluded from development policy. Evidence of the incidence and distribution of disability is then presented. In the final section, the ways in which different institutions challenge poverty and exclusion among disabled people is reviewed. Survey evidence of the limited inclusion of disabled people within development institutions and policies is presented. � 2003 Elsevier Science Ltd. All rights reserved.
Key words — poverty, disability, discrimination, developing countries, international organizations,
Because disability and poverty are inextricably linked, poverty can never be eradicated until disabled people enjoy equal rights with nondisabled people.
(Lee, 1999, p. 13)
This article argues that there is widespread exclusion of disabled people
1 from interna-
tional development organizations and research. This reinforces the disproportionately high representation of disabled people among the poorest of the poor. Such exclusion reflects the wider social, economic and political exclusion of disabled people within household, commu- nity and state. It is unlikely that the millennium development goals (MDGs) will be met unless disabled people are included in every aspect of international development work. Furthermore, an emphasis on these targets may lead to an increased focus on the transient poor. Those living in chronic poverty, among whom evi- dence suggests disabled people are dispropor-
tionately represented, may become even further excluded. In the first section of the paper, the links
between impairment, disability, poverty and chronic poverty are reviewed. The second part of the paper discusses the ways in which dis- abled people are routinely excluded from in- ternational development policy, practice and research. Existing evidence of the incidence and distribution of disability is then presented, within the context of these limitations. The final section examines the different ways in which poverty and exclusion among disabled people are challenged by a range of institutions: gov- ernment; private sector; disabled people�s or- ganizations; international organizations; and
World Development Vol. 31, No. 3, pp. 571–590, 2003 � 2003 Elsevier Science Ltd. All rights reserved
Printed in Great Britain 0305-750X/03/$ – see front matter
*The authors would like to thank two anonymous re- viewers and several of the staff and trustees of Action on
Disability and Development and the Chronic Poverty
Research Centre for helpful comments on an earlier
nongovernment organizations (NGOs) and donor agencies. Survey evidence of the limited inclusion of disability and disabled people within development institutions and policies is presented. This article supports a right-based, social
model approach to disability. This defines dis- ability as the loss or limitation of opportunities to take part in the everyday life of the com- munity on an equal level with others due to physical and social barriers. An impairment is a functional limitation within the individual caused by physical, mental or sensory impair- ment (Barnes, 1991). Impairments need not lead to exclusion and inequality if inclusive policies are implemented.
2 In contrast to this, tradi-
tional medical and charitable approaches to disability focus on the disabled individual, rather than on the need for societal change. Disability is defined as loss or reduction of functional ability, and disabled people are de- fined by their impairments. Medical or techni- cal interventions may be offered by ‘‘experts’’ to alleviate some impairments. In this model, disabled people are to be pitied and helped, but issues of the right to full inclusion and partici- pation are not addressed.
- THE VICIOUS CIRCLE OF POVERTY AND DISABILITY
Figure 1 illustrates the reasons why disabled people experience disproportionately high rates of poverty, and Figure 2 displays the ways in
which being poor dramatically increases the likelihood of getting an impairment, and be- coming disabled.
(a) High rates of poverty among disabled people
(i) Forms of discrimination Disabled people have a higher likelihood
of experiencing poverty because of the institu- tional, environmental and attitudinal discrimi- nation faced, from birth or the moment of disablement onward. Institutional discrimination is the process
by which disabled people are systematically marginalized by established laws, customs or practices. Discrimination against disabled peo- ple is rooted in widely shared attitudes, values and beliefs. Discrimination can occur, however, irrespective of the intent of the individuals who carry out the activities of the institution. Insti- tutional discrimination exists in many different guises, for example: many NGOs make no at- tempts to include disabled people in their work; in many countries disabled children are not required to go to school and there is no special provision for their needs if they do enroll; banks often do not accept disabled customers; employers often do not consider the needs of disabled applicants. In most countries the physical environment
also excludes disabled people. This has been referred to as ‘‘apartheid by design’’ (Imrie, 1996). Buildings with steps and narrow en- trances, inaccessible ‘‘public’’ transport, edu-
formal/informal education and employment
Limited social contacts Fewer skills
Low expectations from community and of self Low self esteem
Impairment Discrimination & Disability
Excluded from political/legal processes
Excluded from even basic healthcare
Lack of ability to assert rights
High risk of illness, injury and Impairment
(see figure 2)
Lowest priority for any limited resources e.g. food/clean water/ inheritance/land
Lack of support for high costs directly associated with impairment
Poor health/ physically weak
Figure 1. Disability/poverty cycle.
cation and health facilities, a scarcity of infor- mation transcribed into Braille or available on audio tape, and a lack of Sign-Language translators all serve to keep disabled people out, pushed to the margins and without the information they need to participate equally. Prevailing attitudes are the third aspect of
disablement. People rationalize the exclusion and ostracism of disabled people and their families in many different ways. Beliefs that disability is associated with evil, witchcraft, bad omens or infidelity persist in many parts of the world (see Lwanga Ntale, Ndaziboneye, & Nalugo, 2002, pp. 7–8 for a Ugandan example). Disabled people also often experience suffo- cating overprotection and exclusion from everyday challenges. Low expectations of dis- abled people are often held by wider society as well as by themselves. Russell and Malhotra (2002) have criticized
approaches to disability that focus exclusively on attitudinal change. They argue that chang- ing attitudes alone cannot lead to equality. Disability, as they see it, is ‘‘a product of the exploitative economic structure of capitalist society: one which creates (and then oppresses) the so-called �disabled� body as one of the conditions that allow the capitalist class to ac- cumulate wealth.’’