Week 3

Question 1

Give the WHO definition of the term ‘Rehabilitation’.

Answer 1

“A set of measures that assist individuals, who
experience or are likely to experience disability, to
achieve and maintain optimum functioning in
interaction with their environments” - WHO, 2011

Question 2

What is the relationship between injury and impairment?

Answer 2

Those with an injury may be at risk of it developing into an impairment.

Question 3

What will an improved emergency response result in with regards to the balance between mortality and disability?

Answer 3

Decreased Mortality

Increased Disability

Question 4

What issue faces disabled people in less developed countries?

Answer 4

Disabled people are more likely to have health needs but are less likely to have their need met. - WHO, 2011, Handicap International

Question 5

What are the 3 main points from the WHO’s Essential Trauma Guideline (2004) when in regards to disability and impairment?

Answer 5

1. Much of the disability from extremity injuries in developing
   countries should be eminently preventable through
   inexpensive improvements in orthopaedic care and
   rehabilitation.
2. The consequences to the individual of injuries that result in
   physical impairment are minimized by appropriate
   rehabilitative services.
3. Basic physiotherapy/occupational therapy for those
   recovering from extremity injuries (especially fractures and
   burns) is deemed essential at all hospital levels.

Question 6

What are the 3 main points from the SPHERE Humanitarian Standards when in regards to disability and impairment?

Answer 6

1. Surgery provided without any immediate rehabilitation can result in a complete failure in restoring functional capacities of the patient.
2. Early rehabilitation can greatly increase survival and enhance the quality of life for injured survivors.
3. Patients requiring assistive devices (such as prostheses and mobility devices) will also need physical rehabilitation.

Question 7

What is the Global Disability rate of prevalence?

What percentage of the world’s poorest people disabled?

Answer 7

a. 15%

b. 20%

Question 8

Describe the 3 historical approaches to disability.

Answer 8

1. Treatment provided through through specialist institutions: Resulting in Segregation and social isolation.
2. Community-based rehabilitation - Increase social contact between disabled people, their families, local communities, wider civil society institutions – and increasingly, governments
3. Shift to bio-psychosocial model/ human rights model - Increasing emphasis on “mainstreaming” disability service provision within public services to facilitate facilitates social inclusion

Question 9

How is the topic of disability addressed?

Answer 9

Through attitudinal change.

Question 10

What does attiudinal change to disability encompass? (6)

Answer 10

1. Changing mindsets of policy-makers, service providers, communities, families, friends and neighbours
2. Dismantle deeply entrenched physical, attitudinal and institutional barriers to effective social inclusion
3. Increase levels of social capital and relational bonds for persons with disabilities
4. Ensure adequate governance infrastructure for effective implementation of services
5. Support rule of law and effective implementation of human rights principles
6. Improve knowledge about what works – including improved data

Question 11

Describe the 3 stages of prevention (public health).

Answer 11

1. Primary prevention – actions to avoid or remove the cause of a health problem in an individual or a population before it arises. It includes health promotion and specific protection (for example, HIV education/polio vaccination efforts)
2. Secondary prevention – actions to detect a health problem at an early stage in an individual or a population, facilitating cure, or reducing or preventing spread, or reducing or preventing its long-term effects (for example, supporting women with intellectual disability to access breast cancer screening; glaucoma surgery for older adults)
3. Tertiary prevention – actions to reduce the impact of an already established disease by restoring function and reducing disease-related complications (for example, rehabilitation for children with musculoskeletal impairment)

Question 12

Name 3 areas that disabled people experience a denial to equal access.

Answer 12

1. Healthcare
2. Employment
3. Education

Question 13

Name 1 way in which some disabled people are denied autonomy.

Answer 13

1. Being subjected to involuntary sterilization, or when they are confined in institutions against their will
2. When they are regarded as legally incompetent because of their disability.

Question 14

What does the UN Convention on the Rights of Persons with Disabilities (2006) define as a person with a disability?

Answer 14

“Persons with disabilities include those who have long-term physical, mental, intellectual or sensory impairments which in interaction with various barriers may hinder their full and effective participation in society on an equal basis with others.”

Question 15

Give 3 examples of international events that compose The International disability policy environment.

Answer 15

UN International Year of the Disabled (1981)

UN Decade of Disabled Persons (1983-1992)

UN Standard Rules on the Equalisation of

Opportunities of Persons with Disabilities (1993)

UN Convention of the Rights of Persons with Disabilities (2008)

Question 16

What percentage of disabled people live in developing nations?

Answer 16

80%

Question 17

What were the 2 main aims of the WHO’s World Report on Disability (2011)?

Answer 17

1. To provide governments and civil society with a comprehensive description of the importance of disability and an analysis of the responses provided, based on the best available scientific information;
2. To make recommendations for action at national and international levels.

Question 18

What are aim of the Washington Group Short Set Questions?

Answer 18

The WG was constituted to address the urgent need for cross-nationally comparable population based measures of disability.

Question 19

List the Washington Group Short Set Questions.

Answer 19

1. Do you have difficulty seeing, even if wearing glasses?
2. Do you have difficulty hearing, even if using a hearing aid?
3. Do you have difficulty walking or climbing steps?
4. Do you have difficulty remembering or concentrating?
5. Do you have difficulty (with self-care such as) washing all over or dressing?
6. Using your usual (customary) language, do you have difficulty communicating, for example understanding or being understood?

Question 20

What is double discrimination and what group of people experience it and why?

Answer 20

Double discrimination refers to disabled women in regions such as India, where there is an onus on the woman as a home-maker. Disabled women are discriminated against for their disability and gender and are less likely to benefit from and receive health-care.

Question 21

Name 2 things that disabled women are subjected to.

Answer 21

Sexual violence and abuse leading to an increased risk of HIV/AIDS

Question 22

Why is Article 11 of the UNCRPD significant?

Answer 22

Describes that states will honour international law (human rights and humanitarian) to ensure safety and protection of disabilities including situations of armed conlfict and humanitarian emergencies.

Question 23

What does article 11 mean in practice?

Answer 23

Disabled people must be identified as key target group across all intervention processes
NGO’s must take into consideration disabled people when constructing shelters camps, needs involving access, water/sanitation, food distribution, health, education – they must actively seek out disabled individuals to identify them and whether they are registered. And ensure post conflict funding includes disabled people.

Question 24

Name 3 social impacts of violence and conflict.

Answer 24

1. Social structures/networks destroyed
2. Poverty and social exclusion
   Loss of infrastructure i.e. homes, health care facilities, schools
3. Loss of essential skills/personnel
4. Lack of security (physical and psychological)
5. Increased civilian injuries and deaths
6. Small arms circulation
   ‘Normalisation’ of violence

Question 25

Give an example of a sudden and a slow onset humanitarian crisis (type).

Answer 25

Earthquake

Famine

Question 26

Give 3 impacts of disability on a household.

Answer 26

1. Increased risk of poverty and social exclusion
2. Lack of access to food/jobs/healthcare/other essential services
3. Lack of security (physical and psychological)
4. Increased risk of displacement/separation
5. Exclusion/discrimination
6. Effects on children and families

Question 27

How is inclusion of disabled people ensured? (4)

Answer 27

Through following standards and guidelines such as SPHERE

Training

Advocacy and awareness

Legislation

Question 28

What can health professionals do as their part of ensuring inclusion?

Answer 28

1. If you are not seeing disabled people in your work, ask yourself why not
2. Ensure that any and all programmes you work on have a disability-inclusive component (e.g. HIV/AIDS programmes, women’s health outreach efforts etc)
3. Ensure that all efforts are made to ensure health care facilities are accessible – (ramps, sign language interpreters, transportation, ability to provide information to individuals who are intellectually disabled etc)
4. Support the inclusion of students with disabilities in training as health professions

Learn about and establish alliances with disabled people and their organisations (“Nothing about us without us”)