Poverty and Disability

Poverty is a complex multidimensional issue. An Overview of Poverty in Uganda shows that poverty is a multilayered issue that requires action to be taken in many different social and economic areas. Before looking in more detail at poverty and disability in Uganda it is necessary to get an overview of disability and poverty.

The 2005 report Disability, poverty and the new development agenda notes that an estimated 10,000 disabled people die every day as a result of extreme poverty. There are many reasons for this lamentable situation. This blog has shown that people with disabilities are more likely to live in poverty (see Poverty and Disability In Uganda). Poverty is a cause of disability and likewise disability is a cause of poverty. This is the cycle of poverty. 

The poverty cycle works like this: People who live in poverty have less access to healthcare and are more vulnerable to malnutrition and preventable diseases. The Cycle of Poverty and Disability web page says persons with disabilities (PWDs):

are also more likely to live and work in dangerous or polluted environments with low quality housing, reduced access to safe drinking water and sanitation; and are more likely to live in areas which are prone to the effects of natural disasters, dangerous traffic and higher rates of violence.

Further more disability is a cause of poverty. Negative attitudes like stigma and prejudice, (see Summary of findings of the Uganda Disability Review Part 1 of 2) severely limit educational and employment opportunities. The Cycle of Poverty and Disability web page continues to describe the position of PWDs:

Stigma and shame lead to isolation from families and communities, so that they are less likely to be members of self-help groups, religious organisations or community initiatives, including development programmes.

There are many other reasons that disability is linked to poverty. Discrimination caused by prejudice against individuals with disabilities, also called ableism (see What is Ableism?) significantly impacts on PWDs. Wikipedia continues saying that further:

forms of discrimination may lead disability to be more salient in already marginalized populations. Women and individuals belonging to certain ethnic groups who have disabilities have been found to more greatly suffer from discrimination and endure negative outcomes. Some researchers attribute this to what they believe is a “double rejection” of girls and women who are disabled on the basis of their sex in tandem with their special needs. The stereotypes that accompany both of these attributes lead females with disabilities to be seen as particularly dependent upon others and serve to amplify the misconception of this population as burdensome. In a study done by Oxfam, the societal consequences of having a disability while belonging to an already marginalized population were highlighted, stating, “A disabled women suffers a multiple handicap. Her chances of marriage are very slight, and she is most likely to be condemned to a twilight existence as a non-productive adjunct to the household of her birth… it is small wonder that many disabled female babies do not survive.” Additionally, women with disabilities are particularly susceptible to abuse. A 2004 UN survey in Orissa, India, found that every women with disabilities in their sample had experienced some form of physical abuse. 

Health care is another significant factor impacting on poverty:

Another reason individuals living with disabilities are often impoverished is the high medical costs associated with their needs. One study, conducted in villages in South India, demonstrated that the annual cost of treatment and equipment needed for individuals with disabilities in the area ranged from three days of income to upwards of two years’ worth, with the average amount spent on essential services totaling three months worth of income. This figure does not take into account the unpaid work of caregivers who must provide assistance after these procedures and the opportunity costs leading to a loss of income during injury, surgery, and rehabilitation. Studies reported by medical anthropologists Benedicte Ingstad and Susan Reynolds Whyte have also shown that access to medical care is significantly impaired when one lacks mobility. They report that in addition to the direct medical costs associated with special needs, the burden of transportation falls most heavily on those with disabilities. This is especially true for the rural poor whose distance from urban environments necessitates extensive movement in order to obtain health services. Due to these barriers, both economic and physical, it is estimated that only 2 percent of individuals with disabilities have access to adequate rehabilitation services.
The inaccessibility of health care for those living in poverty has a substantial impact on the rate of disability within this population. Individuals living in poverty face higher health risks and are often unable to obtain proper treatment, leading them to be significantly more likely to acquire a disability within their lifetime. Financial barriers are not the only obstacles those living in poverty are confronted with. Research shows that matters of geographic inaccessibility, availability, and cultural limitations all provide substantial impediments to the acquisition of proper care for the populations of developing countries. Sex-specific ailments are particularly harmful for women living in poverty. The World Health Organization estimates that each year 20 million women acquire disabilities due to complications during pregnancy and childbirth that could be significantly mitigated with proper pre-natal, childbirth, and post-natal medical care. Other barriers to care are present in the lack of treatments developed to target diseases of poverty. Experts assert that the diseases most commonly affecting those in poverty attract the least research funding. This discrepancy, known as the 10/90 gap, reveals that only 10 percent of global health research focuses on conditions that account for 90 percent of the global disease burden. Without a redistribution in research capital, it is likely that many of the diseases known to cause death and disability in impoverished populations will persist.

Bringing clean water and a smile to people living with disabilities in Uganda

Insitutional barriers are further contributory factors to the poverty of PWDs. Wikipedia says:

Accessibility: Physical environment may be a large determinant in one’s ability to access ladders of success or even basic sustenance. Professor of urban planning Rob Imrie concluded that most spaces contain surmountable physical barriers that unintentionally create an “apartheid by design,” whereby individuals with disabilities are excluded from areas because of the inaccessible layout of these spaces. This "apartheid" has been seen by some, such as the United Kingdom Disabled Persons Council, as especially concerning with regard to public transportation, education and health facilities, and perhaps most relevantly places of employment. Physical barriers are also commonly found in the home, with those in poverty more likely to occupy tighter spaces inaccessible to wheelchairs. Beyond physical accessibility, other potential excluding agents include a lack of Braille, sign language and shortage of audio tape availability for those who are blind and deaf.
Education: The roots of unemployment are speculated to begin with discrimination at an early age. UNESCO reports that 98 percent of children with disabilities in developing countries are denied access to formal education. According to the World Bank, at least 40 million children with disabilities do not receive an education thus barring them from obtaining knowledge essential to gainful employment and forcing them to grow up to be financially dependent upon others. This is also reflected in a finding obtained by the World Development Report that 77 percent of persons with disabilities are illiterate. This statistic is even more jarring for women with disabilities, with the United Nations Development Program reporting that the global literacy rate for this population is a mere 1 percent.... It is important to note that the deprivation of education to individuals with special needs may not be solely an issue of discrimination, but an issue of resources. Children with disabilities often require specialized educational resources and teaching practices largely unavailable in developing countries.
Employment: Some sociologists have found a number of barriers to employment for individuals with disabilities. These may be seen in employer discrimination, architectural barriers within the workplace, pervasive negative attitudes regarding skill, and the adverse reactions of customers. According to sociologist Edward Hall, "More disabled people are unemployed, in lower status occupations, on low earnings, or out of the labour market altogether, than non-disabled people." The International Labor Organization estimates that roughly 386 million of the world's working age population have some form of disability, however, up to eighty percent of these employable individuals with disabilities are unable to find work....
Sociologists Colin Barnes and Geof Mercer demonstrated that this exclusion of persons with disabilities from the paid labor market is a primary reason why the majority of this population experiences far greater levels of poverty and are more reliant on the financial support of others. In addition to the economic gains associated with employment, researchers have shown that participation in the formal economic sector reduces discrimination of persons with disabilities. One anthropologist who chronicled the lives of persons with disabilities in Botswana noted that individuals who were able to find formal employment “will usually obtain a position in society equal to that of non-disabled citizens.” Because the formal workplace is such a social space, the exclusion of individuals with disabilities from this realm is seen by some sociologists to be a significant impediment to social inclusion and equality....

In summary there is good evidence that disability is linked to poverty principally in a the cycle where disability creates poverty and poverty creates disability. This feedback loop has severe effects on the life of a disabled person. Furthermore living in already resource poor areas PWDs often have to endure facilities that are less accessible than for non disabled counterparts. Access to Education, employment and work facilities become significant barriers. All this has major effects throughout the lifetime of PWDs.