26 October 2010

Poverty and Disability

I have been a development researcher for the past 26 years. And yet not until I heard a lecture by Raymond Lang in 2009 did I think about disability and development all that much. I had not even thought about the definition of disability.

I was asked by Leonard Cheshire Disability to review their latest book: Poverty and Disability which is out now.

This book describes disability as a social construct--the result of society's reaction to a person with an impairment. In other words it is not the impairment that is disabling, it is the interaction with societal norms, culture and institutions.

In this sense there is much familiar about disability. We know that most of the poor are excluded, marginalised, disempowered. So we can guess that the disabled--defined in this way--are more likely to be poor--it is almost tautological. But I did not know that so many of the poor were disabled. The book quotes some statistics from the World Bank to suggest that one in 5 of the poor are affected by disability. That is staggering.

It is doubly staggering that the international development community has, for the most part, ignored this issue. I have done a lot of work with household surveys, but I can't recall any that have looked at disability. I have done a lot of work on impact evaluations of aid interventions, but I cannot recall any on disability. This is shocking because several of the papers in the volume note that when it is assessed, disability is a greater excluder of participation than gender and ethnicity. My guess is that this is not widely known or appreciated. I would also guess that for most aid donors disability is a very marginal issue in terms of spend. Certainly it does not account for 20% of ODA resources.

The book is very clearly written, with most chapters being about work, assets, livelihoods and social protection. This is important, as it would be easy for a non-specialist to see disability primarily as a social sector issue. The refusal to treat disability as a health issue is particularly admirable, but also slightly stubborn--surely health systems are the source of much of the exclusion and stigmatisation. I enjoyed the chapter on aid and disability by Roger Riddell, especially his no holds barred critique of the development agencies and their partners. The calls for inclusive development in the final chapter strike a chord with me and with IDS. Much of our work is about generating knowledge about the importance of and ways for building inclusive states and inclusive societies.

The crucial role of disabled people's organisations (DPO's) in claiming spaces to rebalance power for the causes they represent in the development discourse is vital and I would have liked to have seen a bit more on strategies and tactics for moving this issue up (and into) the development agenda. Mobilising disabled people ("never about us without us" is a key principle) is one strand to a strategy and mobilising resources is another. But towards what action? What is the balance between interventions that are specifically disability-deconstructing interventions and those that change to the rules of the game that prevent further construction? What is the balance between establishing new divisions within aid agencies to address the issues and the pursuit of greater embeddedness within existing divisions? Who are the key partners to form alliances with: social movements, private sector, research organisations or media?

It is clear that there is not much evidence to guide those who have to make these strategic and tactical choices. Despite being one of the more visible manifestations of exclusion, stigma and lack of power, disability is hidden from sight most of the time in development research discourses. And yet its study offers the potential of so much learning for everyone working in development. This book has raised the profile of this set of issues in a context that sadly is new to many development researchers. I hope IDS can work with others in the DPO and development fields, to form new alliances to co-construct new knowledge to deconstruct disability as we know it.

This book is well written, with excellent chapters from many different contexts providing a rounded set of perspectives. It is conceptual, analytical and thoughtful.

In short, this book deserves to be the benchmark by which all future books on disability and development are assessed.

9 comments:

D. Sridhar said...

I'm really glad to see a post on disability and development. During my doctorate, I wanted to focus on this area in India, and the main source was Barbara Harriss-White's, 2002 Outcaste from Welfare : Adult Disability in Rural S. India. A must-read for those wanting to pursue research.

Lawrence said...

Dear D.Sridhar, many thanks for this. Another useful reading is bny Ann Elwan at http://siteresources.worldbank.org/DISABILITY/Resources/280658-1172608138489/PovertyDisabElwan.pdf

claudia said...

Dear Lawrence,

We read with great interest your comment on Poverty and Disability posted to Development Horizons. We would like to share with you the link to a publication that UNICEF prepared in collaboration with the School of Medicine and Public Health of the University of Wisconsin in 2008.

To address the need for data on children with disabilities, UNICEF-supported Multiple Indicator Cluster Surveys (MICS), included in 2000 a module on Child Disability, based on the Ten Questions Screen (TQ). The third round of the MICS, implemented in 2005-2007, collected data on disability for 26 of 50 countries participating in this survey programme. These data have been included in several UNICEF publications, including State of the World’s Children, Progress for Children (n. 6 and n.8) and the thematic report mentioned above. This latter includes a discussion of the medical model of disability vis-a-vis the biopsychosocial model, which integrated both factors of the individuals and their environment. The report also addresses some of the challenges of collecting data on child disability using the TQ tool within the context of international household surveys. Our work in data collection and analysis for this area continues, and we are now in the process of gathering new data in some of the countries that are have joined the current round of MICS (2009-2010). I would be happy to provide additional information and to discuss some of the issues addressed in your comment and in our publication.

With best regards,

Claudia Cappa

http://www.childinfo.org/files/Monitoring_Child_Disability_in_Developing_Countries.pdf

claudia said...

Dear Lawrence,

We read with great interest your comment on Poverty and Disability posted to Development Horizons. We would like to share with you the link to a publication that UNICEF prepared in collaboration with the School of Medicine and Public Health of the University of Wisconsin in 2008.

To address the need for data on children with disabilities, UNICEF-supported Multiple Indicator Cluster Surveys (MICS), included in 2000 a module on Child Disability, based on the Ten Questions Screen (TQ). The third round of the MICS, implemented in 2005-2007, collected data on disability for 26 of 50 countries participating in this survey programme. These data have been included in several UNICEF publications, including State of the World’s Children, Progress for Children (n. 6 and n.8) and the thematic report mentioned above. This latter includes a discussion of the medical model of disability vis-a-vis the biopsychosocial model, which integrated both factors of the individuals and their environment. The report also addresses some of the challenges of collecting data on child disability using the TQ tool within the context of international household surveys. Our work in data collection and analysis for this area continues, and we are now in the process of gathering new data in some of the countries that are have joined the current round of MICS (2009-2010). I would be happy to provide additional information and to discuss some of the issues addressed in your comment and in our publication.

With best regards,

Claudia Cappa

lawrence said...

here is the link to the article claudia mentioned

http://www.childinfo.org/files/Monitoring_Child_Disability_in_Developing_Countries.pdf

Peter said...

No issue that disabled people typically always get the rough end of life; and with >20% of people worldwide with disabilities of one kind or another (and many, many more people affected as carers, dependents and so on) these may be one billion plus. No Cinderella this one - for that story has a happy ending - but there is much that can be done with small effort. Followed an interesting debate mid-year from FAO/FSN; available at: http://km.fao.org/fsn/forum-discussions/en. Check out discussion #58 'Promotion ... PWD ... Policies' - and references in the 'summary'. Note work undertaken in Thailand and the 'Agriculture & PDW-Guidelines for Getting People Involved'. Sure, more words, but it may encourage more action from the best resources available to PWD - the people themselves. Salute. Peter Steele. Phnom Penh. 01Nov10

K Preibisch said...

Some new research from Haiti: http://focal.ca/images/stories/Haiti_Reaching_the_cocobai_Phillips_January_2011_e_sm.pdf

Unknown said...

We must also take in consideration people who live in dire poverty who has developmental disabilities. They are the most vulnerable.

M. Iwabuchi said...

We are also very excited at your comment on disability and development!! Let me add a comment on the use of technology for this.

Our team promotes the success of individuals with disabilities using technology as an empowering tool in developing countries. Our approach includes the use of mainstream ICT, such as mobile phones and PCs, as a form of assistive technology. We believe technology empowers not only physical aspect of the users but also change the view of them and the others in the society; helping them to find their potential of greater success, which will also increase positive views toward diversity in the society.

Let me introduce one of our booklets, “Mobile phone strategies to support learning for students with disabilities”
http://at2ed.jp/sbm/mp.pdf

We see the mobile phone as one of the most widespread ICT. This includes developing countries, although the devices are shared among people there. The booklet is not only about the latest/smart phones. Commodity phones can cover many features in the booklet. Even phones without a SIM card that are no longer used by parents can be given to and used by the students for their learning and communication.

Unfortunately, it may probably be too early for people in less fortunate financial positions for us to talk about mobile phones. Yet at the same time, we hope to create success practices using inexpensive every-day ICT for the future that gives good opportunities to everyone.

Thank you very much.