Disability is physical or intellectual condition that restrict person’s movement or daily life activities
Disability in person may remain for some duration or also can be permanent. There are some examples of Disability which include visual impairments, physical and intellectual.
“When you hear the word ‘disabled,’ people immediately think about people who can’t walk or talk or do everything that people take for granted. Now, I take nothing for granted. But I find the real disability is people who can’t find joy in life and are bitter.”Teri Garr says
According to WHO, there are three dimensions of disability:
- Impairment (structural and functional): impairment is any loss or abnormality e.g. vision, hearing, physical and intellectual impairment.
- Activity limitation is difficulty in daily life activities or the condition which restricts movement e.g. Pain and decreased in strength, range of motion, balance, and endurance.
- Participation restriction is how a hindrances (person’s health issue, environmental or personal factors) limit that person’s involvement in valued life events.
Physiotherapy helps to rehabilitate the human body which is affected by injury illness or disability.
On the other hand, Occupational therapy helps to treat injured or disabled people with the help of therapeutic use of everyday activities to improve or maintain the daily routine work.
Disabled people need to attend occupational therapy and physiotherapy on a daily basis. Family responsibility to motivate the patient while providing these services. Thus, it is important to take the opinion from parents toward the services which the patient receives.
The aim of study is to prevent the physical, and social disabilities of all ages and to help and restore the functional independence in daily routine
Disability is a topic which needs to be dealt with carefully because in especially rural areas the society look down upon the disabled people.
According to Prevalence of Disability and Disability Types by Urban-Rural County Classification – United States, 2016 ,the percentage of disabled people is highest in rural areas and lower in urban areas because many people face difficulties to access the adequate transportation, educational system, employment, hospital, and many other healthcare programs which may be limited in the rural side.
- 9% more likely to report having any disability;
- 24% more likely to report having three or more disabilities; and
- More likely to report specific disability types (ranging from 7% more likely to report a cognitive disability to 35% more likely to report a hearing disability)
The prevalence of disability is almost half of total disabilities due to disease, more than a third are by birth, and round about 15% due to accidents.
There are more than 650 million people in the world with disabilities which is estimated by the US nation, in which the majority of disabled people live in such countries which are underdeveloped, which means that a lot of people face every day inequality and discrimination as compared to people who are not disable.1981 declared as International year of disabled people by the UNF for the awareness of rights for disabled people. On December ,13,2006 United Nation adopt /approve “Convention on the Rights of Persons with Disabilities (CRPD)” that aimed to provide equal rights for disabled people. The special persons gained more significance in the social setup but the policies made for them by governments of developing countries are not satisfactory. In 2002, the Pakistan government introduced the “National policy for persons with disabilities” to gain equal opportunities and to access education, social and medical for fulfillment of their requirements. In 2019, State Bank of Pakistan launches concessionary small enterprise financing and credit guarantee facility for special person for the improvement of socio economic life by providing financing facilities.
Recently in Dawn News “Punjab Approves System for Online Registration of disabled,SC”
Pubjab government approved a management information system for online registration and assessment for disabled people ,the data will help them to find jobs in public or private sectors according to their capacities.
Magnitude of disabled people in Pakistan
Last Updated: 24-08-2020
Types of disabilities
There are different types of disabilities which are stated in Schedule [Section 2(h)] of the Sindh Empowerment of Persons with Disabilities Act of 2018.
- Physical disability is restriction of physical function and mobility
- Locomotor disability(mobility disability)
- defines limits the movement of limb e.g. paralysis,muscular dystrophy(weakness or loss of muscle mass) or amputation of limb(removal of limb).
- Visual impairment means the eye does not see objects as clearly as usual.
- blurred vision which includes nearsightedness,farsightedness and presbyopia.
- low vision when visual acuity not exceeding 6/18 or less than 20/60 up to 3/60 or up to 10/200 (Snellen)
- Hearing impairment
- Deaf means when 70 DB hearing loss in speech frequencies (both ears)
- Hard of hearing is a loss between 60 DB to 70 DB in speech frequencies (both ears)
- Neuro developmental disorder is abnormal brain growth and development, which affects memory and learning, difficulty in speaking and understanding.
- Intellectual disability (also called mental retardation) refers to a condition in which there are limitations in intellectual functioning like learning, reasoning and problem solving.
- Autism spectrum disorder is a developmental condition that affects the person’s ability to nonverbal communication, speech and social interaction. The term spectrum means a wide range of symptoms and severity. This condition typically appears in the first 3 years of life.
- Attention deficit hyperactivity disorder (ADHD) is the condition which typically begins in initial years of life, characterized by inattention, hyperactivity (inability to be calm)and poor impulse control.
- Specific learning disorder (learning disability) include reading, writing and calculation disorders, begins during school age, although not recognized until adulthood.
- Communication disorder means that patient has trouble communicating with others, patient unable to comprehend and recognize language during communication.
- Disabilities caused due to chronic neurological conditions
- multiple sclerosis is disabling disease of brain and spinal cord in which immune system attach myelin sheath,cause communication problem between brain and body.
- Parkinson disease affects nerve cells of CNS which is responsible for movement by producing dopamine.When these nerve cells die, it cause tremors, balance and speech problem, impaired posture and stiffness.
- Dementia and Alzheimer disease Alzheimer is the type of dementia, a term for memory loss, affects cognitive behavior(thinking, remembering, problem- solving).
Society’s attitude toward disabled people:
For many people with disabilities the biggest challenge is not the disability itself, but the response of society to that disability.
According to scholars, disability is not specified list of disease but a product of society’s attitude.
People of society thought that disabled people are unhealthy, unhygienic and defective. They treated these people as object of pity. That’s why a person with a disability is unable to participate and contribute in society. As a result most of disabled people live in community rather than institution.
Some of the issues that affect the daily lives of people with severe disabilities are:
Community living: is there housing available that accommodates their disabilities? is financial help available?
Transportation: is transportation available? is it convenient? who will pay for it?
education: is special education available? will it result in marketable job skills?
will employers hire a person with a disability? are employers willing to make necessary accommodations? is reliable and affordable transportation available?
health care: is medical and dental treatment available in the community? does the public health department provide care? is financial assistance available? is transportation available?
Health facilities in rural areas of Pakistan
The doctor work in urban areas don’t want to work in these areas because of lack of proper residential and many other reasons. Even the building of these facilities are in not good condition. In some areas they don’t have any ambulance facility during emergency situations. Non availability of staff and medical equipments or medicine and also the shortage of physiotherapist and occupational therapist leads to increase the incidence of disabilities. The government is not providing the medical support where there is lack of sanitation and proper sewerage. They have long struggled to maintain the quality health services. Poor economic condition in large part of population in rural areas in addition to unhygienic conditions.
The biggest problem which is faced by organizations in this regard is lack of awareness, this one is also a reason for lack of facilities.
Treatment for disabled people
Role of Occupational therapy for disabled people
- Occupational therapist helps patient with motor skill development, the learning ability to improve
- writing, dressing and feeding abilities
- assist in participation and build confidence
- for memory loss patient, the occupational therapist use memory aids and tricks.
- for daily activities they use many devices and equipments for communication, bathing, and dressing so that the patient can participate.
In short, occupational therapy can be helpful for all types of disablity of all ages.
people who seeking occupational therapy treatment often able to avoid to stay in
For example, the patient with impaired posture the occupational therapist provide sit to stand desk.
although occupational therapy is great treatment choice who want to live functionally. Occupational Therapist enable the disabled people to participate in daily life activities without any support.
Role of Physiotherapy for disabled people
Disabled people spend their time in same position which affect their range of motion,when body is not mobile,that sedentary life style can affect the health and also weight of disabled people.With the help of physiotherapist the person with disability can stretch and strengthen muscles,this will help to give them more mobility and give positive impact on overall body.
- Decrease Pain: physiotherapist not only help the people to keep them fit but also help to reduce pain and stress.
- Physiotherapist prescribed mobility equipments to help disabled people stand and walk without help of other people like family members or friends.
- Physiotherapist asses, diagnose and provide exercise programs to strengthen the muscles.
Strengthening exercises improve function, quality of life and reduce risk of injury.
Balance exercise helps in preventing falls
Relaxation exercise helps patient to calm mind and progressive muscle relaxation (PMR) relax muscle and reduce tension.
Flexibility exercise increase range of motion, decrease pain and stiffness.
“During exercise endorphins release to energize mood, relieve stress and also boost self esteem”.
The Equality Act 2010 states “that disabled people should be treated equally, and protection from discrimination applies in many situations such as education, employment, exercise of public functions, goods, services, facilities and transport”.
Should have the right to quality education at all levels of disabled people.
Disabled people have the right to work in an open and accessible environment.
- Health care:
They have right to highest standard of health care without discrimination.
People with disabilities have a higher rate of needs than non-disabled. The result indicates the importance of needs and wants of parents and patients should be respected so that the parents play an active role. There is a need to increase the rehabilitation center and staff to make them accessible for their needs in rural areas. Disabled people face problems in dealing with healthcare facilities, the barriers increase when a person is disabled and it can be decreased by giving them education and facilities which are easily accessible.
Occupational therapists ensure the people recovering from disability and promote physical and mental health through therapeutic use of everyday activities. They teach self care skills (cooking, eating, dressing) and enable them to return to their life.
On the other hand, Physiotherapists help the disabled people through exercise, manual therapy, electrotherapy, mobilization, manipulation for the management of pain and improve the range of motion.
Find the techniques for better health with the help of community participation. Following facilities should be apply for disabled people:
- – Free therapy
- – Free artificial limb
- – Free wheelchairs and hearing aids
- – Financial assistance