Coping with Disability in the Developing World


The World Health Organization (WHO) estimates that one billion people worldwide need one or more assistive products due to disability. This number is expected to more than double by 2050. Currently, only one in 10 people who need these products have access.

  • 80 percent of disabled people living with a disability in the developing world have no access to healthcare.
  • 20 percent of the world’s poorest have some type of disability.
  • Women are at a special disadvantage in the developing world; a 2004 study conducted in India found that nearly all disabled women and girls had been beaten at home, 25 percent had been raped and 6 percent had been forcibly sterilized.
  • Children with disabilities are often stigmatized and left out of society; the estimated mortality rate for children with disabilities is a staggering 80 percent.
  • Only 45 countries throughout the world have laws that specifically protect the disabled.

People with disabilities living in developing countries are largely invisible. Data is not collected on their conditions, a standard of living or needs. Many countries lack the resources to take care of the healthy and are light years away from addressing the needs of the disabled.

People from the poorest areas must rely on donations or charitable organizations providing used and sometimes substandard products that can cause secondary conditions and sometimes death.

Governments and organizations of the world working to address this problem must start with a standard framework and method for collecting data on disabled populations as well as a common and accepted definition of disability.

Differing definitions and methods are hindering uniform data collection and action, providing no clear path to coping with disability in the developing world.

A Start: The Priority Assistive Products List
Assistive products are defined as any external device, equipment or software used to improve a person’s ability to function with independence and dignity and promotes well-being. A product is listed as “priority” if it’s a basic necessity for an individual to function.

At the United Nations General Assembly on Disability and Development in 2013, a side event dubbed Assistive Technology Opens Doors requested that the WHO create an initiative to ensure access to assistive technology. In response, the WHO created Global Cooperation on Assistive Technology (GATE) which has a singular goal: to improve access to quality, affordable assistive health products for all.

The Priority Assistive Products List (APL) was developed to provide a guideline of 50 products that are most commonly needed by the most people while providing the most benefit. The list is not intended to be exhaustive, but rather a guideline. The list includes items such as hearing aids, wheelchairs, glasses, pill organizers, artificial limbs and memory and communication aids to name a few.

The products list is intended to help the elderly, mentally ill, people with non-communicable diseases, people with physical disability and people with gradual functional decline. The goal is to increase functional capacity, minimize the need for caregivers, prevent secondary conditions, lower health and welfare costs and provide access to employment, education, mobility and freedom.

More Good News: SafariSeat
In East Africa, where one in 200 people need a wheelchair, the SafariSeat offers an all-terrain, open source wheelchair made from bicycle parts. The suspension imitates that of a car to minimize bumps and resulting sores from difficult terrain.

The designer, Janna Deeble, was raised in Kenya and was inspired to go back and help the disabled after a car accident left him in a wheelchair. He now hopes to provide a manual in pictographs to eliminate language barriers and plans to have local workshops build and repair the wheelchairs to create jobs.

Next Steps
The WHO is working with member states on three tools to implement assistive practices. This framework is intended to instruct on the issues of procurement, financing and delivery of services and products.

  1. Assistive Technology Policy Framework: Guidance for financing, insurance and access.
  2. Assistive Technology Training Package: Developing capacity among the health workforce in assessment, fitting, training, follow-up and repair.
  3. Assistive Technology Delivery Model: Designing delivery suited to specific countries and users and connecting referral to healthcare infrastructure.

Coping with disability in the developing world is a complex puzzle and the stakes are high. Although the WHO has taken steps in the right direction and is followed in suit by innovations such as SafariSeat, it remains to be seen how these practices can be carried out in countries lacking infrastructure, healthcare and effective government.

Mandy Otis

Photo: Flickr


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