KMA Public Health Committee
Dr. Leon Ogoti - Public Health Convener KMA
Theme: Building back better: towards an inclusive, accessible and sustainable post COVID-19 world by, for and with persons with disabilities.
Today marks the 29th anniversary of the ‘International Day of persons with Disability’ and in a COVID-19 year where most if not all of us, have had our ability to conduct activities as we would like hampered or restricted. It is as good a time as any to take a moment to really think about a life in the day of a person with a disability.
A disability as defined by the WHO, is a continuing condition that results in substantially reduced capacity in communication, learning, social interaction or physical movement among others; and that necessitates continuous support in aids and services to the individual for him to sufficiently overcome the functional impairments that are often compounded by attitudinal and environmental barriers.
Statistics
Globally, The World Health Survey and The Global Burden of Disease, using a population estimate of 7 Billion people found that approximately 800million people aged 15 years and above had a significant disability and 150million people had a severe disability, defined as an impairment that severely limits necessary functional capacities.
Preliminary statistics obtained from the 2019 Kenyan census show the number of people living with disability as only 2.2% of the population (1 million people) with more disabled women than men, and an overwhelming majority of the disabled (0.7million) living in rural areas, these figures were a far cry from the postulated 15% (6 million people) Kenya Statistics on Disability.
This gross under reporting of people with disabilities in the census data will doubtless have a negative impact for the next decade on the design of policies and programmes targeting PWDs (People living with Disabilities), will result in under funding of programs and efforts aimed at inclusivity of PWDs in education, health and employment and overall result in a persistence and an inevitable worsening of the challenges faced by this group of Kenyans.
Disability and Health
When it comes to Health care and disability there exists great opportunity. Often times, it is as a result of preventable health care allied reasons that people end up disabled and yet it requires the presence of equitable, accessible, low-cost and quality health care services to ensure that all people with disabilities are able to live their most productive lives in spite of the extent of the disability.
A WHO multi-country study in Africa found the common causes of disability were largely preventable ranging from infectious diseases such as Polio, meningitis, Otitis, Trachoma, Tuberculosis and Malaria, to trauma, malnutrition from micronutrient deficiencies and Birth related complications.
Aside from the risk factors, persons living with disabilities are often at risk of secondary illnesses that may arise as a consequence of their poor physical and social environments such as; anxiety, depression, physical injuries from falls and road accidents, chronic malnutrition and respiratory illnesses. These represent their unmet health needs as they tend to receive insufficient attention and information commensurable with their conditions to allow for proper prevention and management. Further, due to their increased vulnerability they are prone to being victims of violence which is increased 6-fold if a mental health condition is present. The increased risk also translates to children with the violence being both physical and sexual and may result in teenage pregnancies and other reproductive complications. There is also a higher substance abuse problem due to co-occurring illnesses in depression and anxiety orchestrated by stressors such as unemployment, solitude and poverty, and conversely, they are less likely to receive treatment for the addiction.
Treaties
Kenya is a party to the Convention on rights for disabled persons that was adopted in 2008 and whose tenets are mirrored in articles 27, 28 and 43 of the Constitution of Kenya, 2010. These binding agreements demand that the Government works to ensure that all persons with disability in Kenya are treated equally, with respect and dignity and that they receive their fair share of economic and social rights. This requires that the issues they face are mainstreamed, prioritized and funded, and not left to specialized groups and organizations, who are meant to complement existing efforts.
Focus areas in Health
Most urgent action is required in establishing accurate and reliable data on all people with disability in Kenya, prioritizing their needs and allocating resources towards supporting programs and efforts dedicated to improving the quality and access to education, health care and employment.
Full implementation of Universal Health Coverage to ensure the preventable causes of Disability are combated through effective immunization programs and campaigns, high quality antenatal and perinatal services, access to diagnostic equipment, medicines, treatment technologies and proper rehabilitation services distributed equitably across the 47 counties and increased health promotion activities in our communities led by Community health extension workers and volunteers.
Educating the communities and demystifying misconceptions around various forms of disability, on reducing the stigma associated with persons or families to which disabled persons belong. Educating the communities on their needs and exposing them to the capabilities they possess more so for children.
Facilitating easy access to health care facilities for those with disabilities as well as ensuring the infrastructure at health facilities caters to the diverse range of disabilities in the region, minimizing financial stress to services for the disabled, enhancing access to information both preventive and as pertains their health and ensuring respect and dignity is accorded to those seeking health services by all health professionals.
Lastly, establishment and strengthening of community based rehabilitation (CBR) which has a role in identifying people with unmet needs in the community, providing community health and rehabilitation responses and referring complicated cases to the mainstream health system. CBR has shown great benefits in overcoming barriers to health access as well as offering inclusion for education, livelihoods and social life alleviating poverty and discrimination which are drivers of poor health among those living with disabilities.
As we celebrate this day, it is the responsibility of each one of us to act favorably and warmly towards those living with disabilities, to offer not only compassion, warmth, care and attention but also to champion for their rights locally and globally. Ensuring that our work environments and health facilities are disability-friendly and working together with communities to protect, educate, nurture and promote social and physical environments designed to include everyone in the post-COVID world.
