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Editorial

The real obstacle to development

by Eleonore von Bothmer
Chronic illness and disability complicate the life of affected persons, no matter where in the world they are. However, in countries where the daily life of fully operational, healthy people is full of obstacles, a disability implies a double hardship, burdening entire families to the limit of what they can bear.

The sense of shame and social exclusion, with which the parents of a child with a discridity often struggle, are only part of the problem. In many cases, families in developing countries have no means of sending their children to school, and even less of attending to their special needs.

Women are especially hard hit, as they already face specific challenges in normal circumstances. In a developing country, a disabled woman has even less chances, and faces even more problems than would otherwise be the case. She must cope with multiple forms of discrimination – sociologists speak of “intersectionality” – as she is a female, disabled and in many cases poor. Disabled women are often denied basic human rights, and they often become victims of sexual and other forms of abuse.

Failure to integrate people with disabilities into society and to allow their full participation has consequences that go far beyond personal woes, thwarting the development of entire countries. The World Health Organisation estimates that around 650 million people have a disability and that 80 % of them live in developing countries. Obviously, their exclusion from social life has an impact on society as a whole.

In this issue, David Whiting (p. 66) uses the example of diabetes to calculate the economic costs and implications of a chronic disease. Such costs do not only arise from the untimely death of people at working age, but also from treatment costs and affected people being unable to work. In rural areas, appropriate prevention and early treatment are often not feasible. Insulin, moreover, is not even readily available in many urban hospitals in Africa – and where it is, its costs far too often exceed what needy people can afford. The situation is hardly different for people who have to cope with other disabling conditions, including mental health problems.

Families with ill or disabled family members are often among the poorest of the poor. These families not only have to feed a person who does not earn an income. In many cases, the family member concerned requires special attention and care. Much hardship could be alleviated if people with disabilities had adequate access to education and employment. Both is possible; sensible measures work, but they are rarely implemented – and not only in developing countries.

Many disabilities and chronic illnesses could be prevented. Often, even the causes could be suppressed. The fact that ever more people in the Sahel region are going blind, for instance, results from malnutrition. On the other hand, a lot could be gained by providing timely therapy and rehabilitation.

Disability issues are increasingly being discussed in terms of human rights – and that includes industrialised countries. In Germany, the UN Convention on the Rights of Persons with Disabilities became national law this year. Implementing the Convention is not something charitable, it makes economic sense and, more importantly, is a demand of human dignity.