Today (Dec. 3rd) is the International Day of Persons with Disabilities. The one day every year set aside to promote an understanding of disability issues and to promote disability rights on an international scale. This year’s theme is Disability and the Millennium Development Goals (MDGs).
The Millennium Development Goals (MDGs) were established by the UN and its partners in the year 2000, in an effort to drastically reduce extreme poverty and to improve living conditions for the world’s poorest and most vulnerable groups. They include 8 goals with the target completion date of 2015.
The Millennium Development Goals are:
1. Eradicate extreme poverty and hunger
2. Achieve universal primary education
3. Promote gender equality and empower women
4. Reduce child mortality
5. Improve maternal health
6. Combat HIV/AIDS, malaria and other diseases
7. Ensure environmental sustainability
8. Develop a global partnership for development
The debate about disability and the MDGs is essentially one about inclusive development. If we are going to truly promote and respect the rights of people with disabilities around the world, they must be included in mainstream development programs. In order to have inclusive societies, we must have inclusive development. But beyond that, with the MDGs focus on the poorest and most vulnerable groups, we simply cannot meet the Millennium Development Goals if we do not address the needs of people with disabilities. People with disabilities make up 10% of the world’s population, but they make up 20% of the world’s poorest people. And therein lies the problem – Despite being a significant portion of the world’s poor, marginalized and vulnerable, there is no mention of disability or inclusive development anywhere in the MDGs, or in its related texts. And, although the MDGs are currently being rewritten, almost 10 years later and in a “more enlightened time”, there is still no mention of disability being written into the new text.
Here are my thoughts on a few of the goals in which the exclusion of disability is most obvious and detrimental (to the achievement of the goals):
1 Eradicate extreme poverty and hunger
Target 1: Halve, between 1990 and 2015, the proportion of people whose income is less than $1 a day
Target 2: Achieve full and productive employment and decent work for all, including women and young people
Target 3: Halve, between 1990 and 2015, the proportion of people who suffer from hunger
With people with disabilities making up 20% of the world’s poorest, and with unemployment rates of adults with disabilities over 80% in many countries, it’s hard to imagine how we can eradicate extreme poverty and hunger if we don’t address disability and disability-specific needs. Also, families of children (and adults) with disabilities tend to be poorer, as disability can be a vicious cycle: lower-income groups are more likely to be affected by disability and disability often leads to further impoverishment (due to lack of adequate supports). For example, with the kids we work with in Peru, one parent needs to stay home to care for the child with a disability, meaning the family has a lower income. Therapies and assistive devices are also VERY costly (when they are available at all), so those families who can access these things once again suffer additional financial stresses and setbacks. Really, looking at it this way, it is not surprising that 90% of the kids with disabilities in developing countries won’t receive the services or supports they need – and yet without these they will certainly become the next generation of impoverished adults.
2. Achieve universal primary education
Target 1: Ensure that, by 2015, children everywhere, boys and girls alike, will be able to complete a full course of primary schooling
Ok, this one hits particularly close to home for me, since I do work with children with disabilities. And, of course, it’s obvious that you need to include the 10% of kids around the world that have disabilities if you want to achieve universal education. But I see some additional problem here with the statistics. Recent stats suggest that between 75 and 150 million children around the world are not in school. Yet, there are over 250 million children with disabilities in developing countries, and 90% of them (or 225 million!) are not in school...hmmmm....Are these kids not included in the first statistics? I certainly need to look into where these statistics come from (once again). I know they are both approximations that are quoted often and that such statistics are problematic, but is nobody else picking up on this incongruity?
Another important issue for me with regards to education is quality vs. quantity. The measure of progress towards this goal includes levels of enrolment in primary school as well as literacy rate. I would suggest that the emphasis should be put on literacy rate and similar measures, as oppose to enrolment. This is because there is, in fact, a significant push towards inclusion happening around the world; the inclusion of girls, minorities, children with disabilities, etc. in mainstream schools. However, as I have seen here in Peru, increasing the quantity of children in school often comes at the cost of decreasing the quality of education. In terms of children with disabilities (in Peru), indeed many more children are now included in mainstream schools. There is a relatively new inclusion program that has been fervently pushed forward in the last few years. However, the program does not have the needed resources behind it to make it work. So, while there are now more children with disabilities in school, most of them are simply occupying a seat and aren’t learning a thing. They may be more or less well integrated socially (depending on the school), but the teachers have no idea what to do with them and they have no support whatsoever. In fact, some of these kids were previously in special-education schools and were actually getting a better education.
Lastly, I believe it’s important to note that there are certain groups (within the disability gamut) that are not yet benefiting from the push towards "Education for all". For example, while the numbers of children with intellectual disabilities and autism spectrum disorders in schools has increased steadily in the last 5 years, I’ve seen no similar increase in the number of kids with physical disabilities such as Cerebral Palsy going to school. In fact, most special education schools have few (if any) children with Cerebral Palsy (CP) in attendance, and I’ve yet to see a child with CP included in a regular primary school (in Peru), despite the fact that I know MANY bright kids with CP.
3. Reduce child mortality
Target 1: Reduce by two thirds, between 1990 and 2015, the under-five mortality rate
2. Achieve universal primary education
3. Promote gender equality and empower women
4. Reduce child mortality
5. Improve maternal health
6. Combat HIV/AIDS, malaria and other diseases
7. Ensure environmental sustainability
8. Develop a global partnership for development
The debate about disability and the MDGs is essentially one about inclusive development. If we are going to truly promote and respect the rights of people with disabilities around the world, they must be included in mainstream development programs. In order to have inclusive societies, we must have inclusive development. But beyond that, with the MDGs focus on the poorest and most vulnerable groups, we simply cannot meet the Millennium Development Goals if we do not address the needs of people with disabilities. People with disabilities make up 10% of the world’s population, but they make up 20% of the world’s poorest people. And therein lies the problem – Despite being a significant portion of the world’s poor, marginalized and vulnerable, there is no mention of disability or inclusive development anywhere in the MDGs, or in its related texts. And, although the MDGs are currently being rewritten, almost 10 years later and in a “more enlightened time”, there is still no mention of disability being written into the new text.
Here are my thoughts on a few of the goals in which the exclusion of disability is most obvious and detrimental (to the achievement of the goals):
1 Eradicate extreme poverty and hunger
Target 1: Halve, between 1990 and 2015, the proportion of people whose income is less than $1 a day
Target 2: Achieve full and productive employment and decent work for all, including women and young people
Target 3: Halve, between 1990 and 2015, the proportion of people who suffer from hunger
With people with disabilities making up 20% of the world’s poorest, and with unemployment rates of adults with disabilities over 80% in many countries, it’s hard to imagine how we can eradicate extreme poverty and hunger if we don’t address disability and disability-specific needs. Also, families of children (and adults) with disabilities tend to be poorer, as disability can be a vicious cycle: lower-income groups are more likely to be affected by disability and disability often leads to further impoverishment (due to lack of adequate supports). For example, with the kids we work with in Peru, one parent needs to stay home to care for the child with a disability, meaning the family has a lower income. Therapies and assistive devices are also VERY costly (when they are available at all), so those families who can access these things once again suffer additional financial stresses and setbacks. Really, looking at it this way, it is not surprising that 90% of the kids with disabilities in developing countries won’t receive the services or supports they need – and yet without these they will certainly become the next generation of impoverished adults.
2. Achieve universal primary education
Target 1: Ensure that, by 2015, children everywhere, boys and girls alike, will be able to complete a full course of primary schooling
Ok, this one hits particularly close to home for me, since I do work with children with disabilities. And, of course, it’s obvious that you need to include the 10% of kids around the world that have disabilities if you want to achieve universal education. But I see some additional problem here with the statistics. Recent stats suggest that between 75 and 150 million children around the world are not in school. Yet, there are over 250 million children with disabilities in developing countries, and 90% of them (or 225 million!) are not in school...hmmmm....Are these kids not included in the first statistics? I certainly need to look into where these statistics come from (once again). I know they are both approximations that are quoted often and that such statistics are problematic, but is nobody else picking up on this incongruity?
Another important issue for me with regards to education is quality vs. quantity. The measure of progress towards this goal includes levels of enrolment in primary school as well as literacy rate. I would suggest that the emphasis should be put on literacy rate and similar measures, as oppose to enrolment. This is because there is, in fact, a significant push towards inclusion happening around the world; the inclusion of girls, minorities, children with disabilities, etc. in mainstream schools. However, as I have seen here in Peru, increasing the quantity of children in school often comes at the cost of decreasing the quality of education. In terms of children with disabilities (in Peru), indeed many more children are now included in mainstream schools. There is a relatively new inclusion program that has been fervently pushed forward in the last few years. However, the program does not have the needed resources behind it to make it work. So, while there are now more children with disabilities in school, most of them are simply occupying a seat and aren’t learning a thing. They may be more or less well integrated socially (depending on the school), but the teachers have no idea what to do with them and they have no support whatsoever. In fact, some of these kids were previously in special-education schools and were actually getting a better education.
Lastly, I believe it’s important to note that there are certain groups (within the disability gamut) that are not yet benefiting from the push towards "Education for all". For example, while the numbers of children with intellectual disabilities and autism spectrum disorders in schools has increased steadily in the last 5 years, I’ve seen no similar increase in the number of kids with physical disabilities such as Cerebral Palsy going to school. In fact, most special education schools have few (if any) children with Cerebral Palsy (CP) in attendance, and I’ve yet to see a child with CP included in a regular primary school (in Peru), despite the fact that I know MANY bright kids with CP.
3. Reduce child mortality
Target 1: Reduce by two thirds, between 1990 and 2015, the under-five mortality rate
In 1990, when the MDGs were established, the under-five mortality was about 10%, with most deaths occurring in developing countries. This number has already been significantly reduced and 17 years later (in 2007) the rate was down one third to approximately 6.7%. As you can see, however, if we are to decrease this original number by two thirds by 2015, we have a little over 5 years to reduce by half the under-five mortality rate around the world. Once again, I think we must address the health and mortality rates of children with disabilities in order to meet this goal. This is yet another area where statistics related to disability are lacking or incongruent, but what is certain is that children with disabilities in developing countries have a disproportionately high (and likely shockingly so) mortality rate. In fact, some studies indicate that under-five mortality rates for children with disabilities may be as high as 80% in some areas.
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All that said, I think it is quite clear that, while reaching the Millennium Development Goals will in-and-of-itself reduce the prevalence of disability (since reducing poverty, improving child and maternal health and addressing HIV/AIDS and other diseases should lead to a decrease in disability), it is also true that we cannot reach the MDGs if we do not include and address the needs of people with disabilities. After all, these goals are aimed to improve the lives of the world’s poorest people, the most marginalized and most vulnerable, and people with disabilities certainly form a disproportionately large part of these groups.
Here's an example: I recently read the story of a young boy named Jaron, who lives in India but who is very representative of many vulnerable, marginalized and poor children with disabilities around the world. His story, as told by Sarah at Sarah’s Covenant Homes, is heartbreaking but is one that happens more often than any of us would like to think. I know that I have seen it too many times.
Jaron is an 8 year old Indian boy who (apparently) has Cerebral Palsy. He has just come into the custody of Sarah Rebbavarapu, who runs homes for abandoned children with special needs in India. Prior to coming into Sarah’s custody, Jaron spent 6 months in a hospital while the police investigated his abandonment. Now, first of all there is the fact that Jaron was abandoned, something that is all too common for kids with disabilities (in developing countries). But let’s consider the fact that he spent 6 months in a hospital and yet at 8 years old he is severely malnourished (he weighs less than 11 kg, which is the weight of a typical 18 month old!), he had diarrhea and a head full of lice and has bed sores. He seems to be a bright boy, but is miserable for obvious reasons.
Jaron
Jaron (left, age 8) next to Victora (age 5)And just how common are kids like Jaron? Once again, we don’t have any really good indicators, but it is certainly higher than most people think or would like to admit. In the 2 years since she began Sarah's Covenant Homes, for example, Sarah has taken in over 80 abandoned children with disabilities, all of whom were living in government orphanages or hospitals in the area and the majority of whom were in very, very poor health (and, of course, were not were attending school, receiving therapy, etc). Indeed, several of the children she was meant to care for passed away before they came under her care, and a few more passed away shortly afterwards, due to their poor condition and related complications.
Tell me, how many other kids are out there dying in homes or hospitals because they are not on anyone’s “agenda”? And how can we possibly put so much money and effort into meeting the Millennium Development Goals without considering the needs of these children, and the adults with disabilities they will grow into? (If they do grow up at all.) These goals were, after all, meant to address the needs of the most vulnerable. How could we possibly not include these children (and adults) when addressing extreme poverty, lack of education and child health?
I see that there is now a movement to have disability included more explicitly in the MDGs. I certainly do hope that happens and that it happens soon. If it doesn’t, I don’t think we can reach the goals and we will have excluded (once again) a significant and important group of individuals from one of the key global development tools of our time...Sometimes not stating or acting is the most damning action of all.
