Abilities 256 Planning Meeting

A planning meeting was held on Wednesday 26th October for Abilities 256.

Abilities 256 , Showcasing the talents of persons with
disabilities

A road map for the event was drawn up for a grand even in the middle of next year.

From left to right: Jacqueline Atugonza, Jullian Kamwesigye and Keneth Kigozi

Proposals will be sent out in November and assessed early next year.

HIV and Violence Against Women

A video about activists working with women to help resolve domestic abuse. The poster says:

Violence against women touches everyone's lives. We tend to believe that this violence - rooted in the inequality between men and women - must be very difficult to prevent. But an approach called SASA! makes us think again. This short video documents SASA's systematic phases for organising communities to take on the prevention of violence against women and HIV. At its core, SASA! is a way to discuss and transform power. Community activists engage at many levels - from individuals to families to leaders and institutions - to infuse a community with new ways of thinking and behaving.

Poverty and Disability in Uganda 3: Women and Politics

This is the third part of a series of blog posts examining the experiences of persons with disabilities (PWDs) living with poverty in Uganda. In Poverty and Disability in Uganda 1: Definitions we saw how PWDs define disability and poverty and further how PWDs understand the interaction of poverty and disability. Poverty and Disability in Uganda 2: Employment and Marginalization looked the issues of employment, isolation, exclusion, fear and neglect. This blog post will look at issues that affect women, it will also consider the effects of politics and stereotyping on chronic poverty and disability.

The 2015 report Women in Poverty: The Key to Breaking the Cycle? notes that: "The feminization of poverty – or the growing number of women in poverty – has been ongoing for the past 4 decades. It means that the proportion of women in the world who suffer from poverty keeps growing and that it is becoming a problem that affects more women than men." It is hardly surprising that being a woman compounds the effects of disability and chronic poverty.

The 2003 report Chronic Poverty and Disability in Uganda talks about women who give birth to children with disabilities are seen as being responsible for causing disability. The report talks about these issues under the heading of feminization of disability:

(a) Disability a “curse” to the family: Among some people in three out of four districts (Mbarara, Mukono and Iganga) disability was considered to be “a curse” brought to the family through the woman (mother of the disabled child). Thus it was evident in these districts that if disabled children are borne to a family, not only does the burden of care fall on the shoulders of the woman, but she too is often blamed for bringing “kisirani” (a curse) to the family. In Mbarara and Iganga disability was believed to be “transmitted” by a mother, who was sometimes blamed for failing to perform some marital rites or simply “looking at the wrong people” during the course of pregnancy. The common remedy when a woman, therefore, produces a disabled child, is for the man to “find another wife (woman) who does not produce disabled children”.

(b) Disability diminishes a woman’s chances to marry: Disability for female children, it was observed, created additional challenges. Communities’ expectation that girl children will be married off at puberty to start their own life - working for their husbands and bringing forth babies - was noted not to hold for disabled girls. Having a disability often meant that one was unable to cultivate, prepare food for self and others, do household chores or even have personal care. This tended to “reduce the value of disabled girls” which further condemned them to exclusion and poverty. For such young women no marriage meant no livelihood and hence very marginal survival. Since access to prime resources for survival, such as land, are through a husband or male relative, being a disabled girl meant at the outset that there would be no access at all to any important resources.

(c) Disabled co-wives more resented than other women: In Iganga District it was revealed that disabled women who are married as second or third wives faced particular resentment from “first wives” who could not come to terms with a disabled person being their co-wife. Such disabled women, once they came to the household, faced intra-household exclusion and were at times discriminated against. The situation was not, however, the same for all disabled co-wives, especially those who were successful in business.

The report moves on to discuss the role of PWDs in politics. Following this discussion, the report moves on to discuss stereotyping and concludes with a discussion about women with disabilities:

Issues of political exclusion took on a slightly different dimension during the research. Disabled respondents from Bwaise, Mbarara and Iganga complained that they are rarely invited to community meetings, and on a few occasions when they are invited, their views are not taken into consideration. But there was also insufficient organisation of disabled people at Village, Parish and Sub-County levels, with the consequence that no discussed agenda were ever developed in a bottom-up manner. Indeed many of the disabled people that the research team talked to bemoaned the top-heavy nature of the National Union for Disabled Persons of Uganda (NUDIPU), arguing that its much acclaimed national profile was not matched with results on the ground.
Intra-disability politics was noted to be the other factor leading to confusion and hence exclusion of particular categories of disabled from the mainstream of disability politics. Many disability unions, especially at district level, were led by physically disabled persons. Most of these were themselves people with very minor disabilities. This relegated people of other disabilities to second rate consideration in the activities and programmes developed by the unions. As a result many disabled people who are not physically disabled generally feel that there is marginalisation even withing the disability movement itself.
Given the now much acclaimed affirmative action for disabled people it was assumed that articulation of disabled people’s needs in existing governance structures through disabled people’s representatives had now taken root, and was beginning to yield positive results. The reality on the ground was rather different. In nearly all sites that the study team visited disabled councillors were unclear about the role that they were supposed to play. For many preoccupation was with what appeared like “peripheral issues” in disability, such as obtaining some mobility appliances for members (Gamba, Mukono and Ibanda, Mbarara), or having some money voted for supporting disabled persons in undertaking their livelihood (income generation) activities (Iganga). Once a vote was created in the Local Council’s budget, any disabled councillor trying to raise an issue regarding the welfare of their constituents would be quickly rebuffed with such words as: “your budget already exists - use that”. Sadly, too, even when votes have been created there is little evidence to suggest that such monies are ever realised.
The limited focus by disabled people’s councillors, has led to budgeting for resources at the local level to continue to be carried out in traditional fashion. Focus has been on the same old priorities, the only difference now being that some monies are voted for disability. In addition the monies voted for disability have not only consistently been negligible but their expenditure focus has also been peripheral. Popular expenditure items include “celebrating the day for the disabled” and awareness raising workshops for disabled people. The missed opportunity at the political level is for issues of disabled people to be mainstreamed into all aspects of planning and budgeting, regardless of whether a vote on disability exists or not.
An important aspect of exclusion for disabled people was noted to be in the justice system. While the law does not deliberately exclude disabled people, in practice many are excluded from having a fair hearing. The research team observed that in nearly all lower courts there were no sign language interpreters, which rendered such courts inaccessible to deaf persons.

Stereotyping disability: A recurrent finding in all districts that the research team went to was that disabled people were not only being lumped together as one homogeneous group that needed similar assistance, but that most were also stereotyped as helpless, unworthy and “lacking in substance”. First, the homogeneous lumping together of all disabled people envisioned physical disability, mostly of those challenged by mobility, walking with crutches or in a wheelchair, as the central definition of disability. This perception completely ignored the diversity of disability and the variety of needs experienced by people with different types of disability. Even disabled people’s organisations at both grassroots and national level tended to downplay or even be unaware of the diversities that exist among people with disabilities. Similarly some categories of disabled people experienced greater exclusion. People with different disabilities faced different levels of exclusion. This had implications not only for how disabled people organise themselves or seek services, but also for specific targeting. Categories of disabled people that faced greater exclusion among others include:

• Women with disabilities
• Children with disabilities
• People with severe mental and intellectual disabilities
• People who are disabled by epilepsy
• Elderly people with disabilities
• Youth with disabilities
• People with multiple disabilities

Women with Disabilities: Ugandan society is still very patriarchal and discriminatory. Although attitudes are changing, women’s social role is primarily defined through motherhood and homemaking. With little or no opportunity to live up to the demanding ideals of womanhood that are imposed by society, disabled women experience more discrimination than other women. As a result of exclusion, disabled women are more likely to be poor or destitute and also have a lesser chance of founding a family or benefiting from social capital and protection that are often associated with family relationships. Asked for an opinion, disabled men in Namulesa, Mukono asserted that “one sure way of entrenching poverty in your household, particularly if you are a disabled man yourself is to marry a disabled woman”. Thus the stigma of disability, its myths and fears are likely to increase women’s social isolation in society, and hence poverty.
But women with disabilities, especially widows, are also more vulnerable to poverty because in addition to having to look after their children single-handedly, such children have fewer opportunities for inheriting properties since they would be considered to have been borne out of wedlock.

Margaret was stricken by polio in childhood and has no use of her legs. She moves around by crawling on hands and knees... She was married, but her husband has most likely left her... She has three children aged 17, 13 and 11, all of them able-bodied.

This section of the report highlights the issues for women with disabilities living in chronic poverty. It further discusses issues of PWDs in politics and the stereotyping of disability. Women - whether disabled or not - must face the stigma of giving birth to a disabled child. This quote about women with disabilities sticks in my mind: "one sure way of entrenching poverty in your household, particularly if you are a disabled man yourself is to marry a disabled woman”. This article Disabled women remain largely ignored by society, sums up the position of disabled women in Ugandan society:

If you are not a disabled woman, pray to God that you remain that way for the rest of your life. You will have been saved the double discrimination which disabled women face in this country.
Generally speaking, disabled persons in this country suffer discrimination from all sectors of society. They are also more likely than their able counterparts, to live in abject poverty and exclusion. While this is true for them all, disabled women suffer double discrimination of being women and disabled women. This double discrimination makes the achievement of the Millennium Development Goals a far cry for this segment of our society.
If a woman is sighted on wheelchair, she is looked upon with condescending pity, if those women do not use a wheel chair, it is assumed that she is not disabled, and if she uses a wheel chair and still has some mobility, it is assumed that she does not really need it in the first place.
It is shocking that in the enormous list of sub-groups of the disadvantaged population, seldom is any mention made of disabled women. Disabled women, therefore, comprise one of the most neglected, if not, almost totally ignored segment of the society. Being a woman with physical disability can be very challenging. Though many are affected by physical disabilities, there is little understanding of their feelings and concerns among the population as a whole.
The first major limiting factor responsible for their plight is lack of accurate data on the extent of disabled women in the population provided in recognised local sources or international data for one to appreciate clearly why and how disabled women are at greater disadvantage compared with disabled men; in this scenario of data gaps on the nature and the extent of disability, sex disaggregated data is even more difficult to obtain. As a result, disabled women remain invisible in the arena of planning, formulation of policies, and programmes of poverty eradication and development.
While the representation of disabled persons in our Parliament should be lauded as a major step, this is downplayed by lack of data or any serious research which seeks to capture the voices of the poor in decision making and policy implementation needed to shape the destiny of the country.
Then we have the issue of lack of transportation for disabled persons which limits their accessibility to education, health, employment and leisure activities. Disabled women remain often isolated in their homes. They are also discriminated when it comes to marriage, being unable to have sufficient exposure to potential suitors and who, after all, are always on the lookout for able-bodied and hardworking women.
They are perceived as a problem rather talented people with creative minds who can make a contribution to development. We must realise that continuing to deny women with disabilities their rights is not acceptable. The United Nations Convention on the Rights of Persons with Disabilities of 2016 in Article 9 requires countries to identify and eliminate barriers and obstacles to accessibility and to ensure that people with disabilities can regularly and conveniently access transportation, public faculties and services, and information and communication technologies.
Article 9 wants these persons to live independently and participate fully in all aspects of life, which cannot be possible where issues to do with transportation are ignored.

This part of the survey of disability and poverty in Uganda discussed  various issues associated with women and disability. Being a woman and disabled is significant, but for a non disabled woman giving birth to a child with a disability can lead to chronic poverty. This section also noted how the opinions and contributions of PWDs are consistently undervalued and ignored. It also brought to life the consequences for PWDs of negative stereotyping discussed so many times in this blog.

Poverty and Child Birth

This video looks at the work of the Bwindi hospital in the south west of Uganda. Bwindi hospital works with some of the most deprived women in Uganda. The poster says:

Bwindi's Babies (2011): Meet the brave Ugandan women bringing vital maternity care services to the country's poorest areas.
Deep within Uganda's impenetrable rain forest, there is a remarkable maternity unit run by extraordinary women. It is in such remote and impoverished places that millions of pregnant women die as they struggle to access medical care. "Mothers would come with dead babies inside because they were really delayed." Yet against all odds, this hospital is determined to offer the same quality care as Uganda's richest receive."We have taken a vow: if you can't save life, you are in the wrong profession".

Poverty and Disability in Uganda 2: Employment and Marginalization

This is the second part of a series of blog posts examining the experiences of persons with disabilities (PWDs) living with poverty in Uganda. The blog post Poverty and Disability in Uganda 1: Definitions presented definitions of disability and poverty. This post begins to investigate the complex interactions that link chronic poverty and disability. The basis for this investigation is the 2003 report Chronic Poverty and Disability in Uganda which is a qualitative study that discusses the experiences of PWDs and their carers in Uganda. 

This blog post begins by looking at one of the major drivers of chronic poverty, employment; then looks at exclusion and isolation. Other drivers of chronic poverty and disability will be discussed in subsequent posts. What work activities do PWDs do?

Overall, the respondents that the research team talked to in Kampala and the rural districts observed that the type of activities that disabled people carry out in pursuit of their livelihoods differ for urban and rural areas and between men and women. They also differ depending on the nature of disability that a person faces. In the majority of cases, however, the activities were closely related to what able-bodied persons do in similar geographical areas, although it should be added that involvement often tended to be at the marginal ends of the activities in question. In some communities where the growing of grains was pronounced, such as in Iganga for example, disabled people were sometimes confined to “keep birds away from eating seeds put out for drying”. Similarly, in urban areas a number of “disabled entrepreneurs” stopped at repairing shoes at street corners. Table 1 below summarises the activities that disabled persons carry out, as recorded by the research team.

Table 1: Activities carried out by disabled persons

Nature of disability	Urban (Kampala)		Rural (Mbarara, Mukono and Iganga)
	Male	Female	Male	Female
Blind	-Begging -Switchboard operator	-Petty Trade -Handouts	-Agriculture -Crafts making	-Agriculture -Handouts
Deaf	-Carpentry	-Left at home	-Casual Labour	-Left at home
Physically Handicapped	-Petty trade -Shoe making/ repair -Welding -Carpentry -Begging	-Tailoring -Home/roadside selling -Hand crafts	-Agriculture	-Agriculture -Petty trade -Hand crafts

Many PWDs experience discrimination. An important thread in the study was the experience of marginalisation. The study continues:

Exclusion, isolation and neglect were observed to be among the leading causes of marginalisation, failure to access resources, and hence chronic poverty among disabled people. There is fundamental ignorance around disability at all levels of society. In Mukono and Iganga witchcraft was blamed, especially if mental illness was involved, in which case individuals and their families were likely to be rejected by both their families and by communities. Widespread fear of disability, especially of mentally ill individuals, is based on a common perception that disability and mental illness are contagious. The perception is even more deep-rooted for epilepsy. Evidence from Mulago in Kampala revealed that even within the medical profession, disability is given little time in training and negligible allocation of resources hence ignorance is very widespread outside of the tiny number of people that are trained specifically in this area. Approaches that are used by traditional practitioners in dealing with disability follow the “curative medical model”, but often lend themselves to physical and sexual abuse in “treatment”. Awareness raising appears to be an urgent need for all community members and professionals.
(a) Attitude-based exclusion: Exclusion was noted to happen in three different ways: economic, social and political. Economically, exclusion centred around obstacles to participation in livelihood activities, especially those of an income generation nature. Access to financial resources was noted to be a major factor in this regard. While there was no evidence of official policy by financial institutions to exclude disabled people from accessing loans, most disabled were on record for having been denied credit facilities in nearly all such financial institutions “simply because managers thought they had no ability to pay back”. People with disabilities were excluded from joining credit groups by able-bodied group members. In such instances members of the groups feared that if allowed disabled people would never be able to pay back their loans. In one instance, in Iganga, this left only the specifically designed ADD-IDIWA Income Generation programme to serve disabled persons. But income generation opportunities were not the only challenge. The majority of disabled people interviewed by the research team in rural areas themselves seemed to prefer being given grants to obtaining loans. The preference is in conformity with the age-old practice of seeking for handouts.
At the community level, also, attitude-based exclusion remains a major problem. In Bwaise a disabled food vendor who moves on her fours revealed that she could not compete with other women as some customers referred to her as “dirty” (because she has to crawl on the ground to move from one place to another.).
There were, however, other challenges too. Disabled people meet high levels of overheads whenever they try to engage in income generating activities.

“The physical facilities in markets are not conducive to disabled people’s work. In order, for example, to be able to make bulk purchases from the market a disabled person needs to take along with him/her an assistant, which increases the operating costs for disabled persons”. - Disabled workers, Bwaise-Mulago, Kampala
“When I need to travel, I will have to put into consideration the cost of transporting my wheelchair. Often taxi drivers will reject this, citing lack of space”. - Disabled person in Iganga
“We work in direct competition with able-bodied colleagues who are also involved in informal trade activities. Whenever, however, Law Enforcement Officers make a raid on informal sector workers, everyone else runs off and saves their wares, except disabled persons who are unable to run”. - Disabled informal sector workers from Bwaise-Mulago.

But negative attitudes are not confined to simple exclusion of disabled people from participating in economic activities. In certain instances it was clear that able-bodied community members “sympathised with the condition of disabled persons” to the extent that they “pitifully excluded” them. Evidence from Nkokonjeru Providence Home in Mukono revealed that community members who live around the home complained of disabled children being involved in agriculture as part of their routine schedules. To the majority of such people disabled children should never, in the first place, have been “subjected to hard tasks” such as agriculture. The story from the disabled children themselves was however quite different:

“By participating in agriculture we have shown the world that we are able to do things by ourselves” - Disabled Children at Nkokonjeru Providence Home
“Growing crops and doing work towards personal livelihood has been an empowering process for us." - Disabled Children at Nkokonjeru Providence Home

A common problem expressed by respondents in nearly all districts was the inappropriateness and lack of access of information on agriculture, especially that which comes via radio waves. Disabled farmers in Mbarara complained about not getting information on agricultural development projects, such as that on availability of clonal coffee seedlings. First, certain categories of disabled people, specifically deaf persons, simply cannot access such information. Yet even in instances where information is available the content of the messages assumes that users (the farmers themselves) are all able-bodied and hence the examples given can only be used by able-bodied persons. Other disabled persons are themselves so poor that they cannot afford a radio, and hence cannot benefit from radio messages. It was further remarked that agricultural extension services only go to those that can afford them, completely leaving out disabled farmers who are often struggling to get started. Further, there were complaints about agricultural practices not being adapted so as to fit the needs of particular people with disabilities. Similarly, disabled people in Gamba, Mukono wondered why no Government agency had ever conceived a type of agriculture that is suitable for people with disabilities, and which took account of the different disabilities.

Uganda, city Kampala, a mentally handicapped
child is all alone in the shadow of his home.
His parents are so poor that they have to
 work and have no time to care for the boy.

 (b) Social exclusion Evidence on this took different forms. Disabled children, it was noted, were rarely given an opportunity to go to school, hence their socialisation was limited at an early stage. Reasons for this varied considerably. In a few instances, such as in Namulesa, Mukono, some parents “felt ashamed” to show their disabled children. In other instances children taken to schools also found little or nothing to do there as schools lacked trained teachers, appropriate equipment or the disabled children even met with outright negative reactions from other children. This discouraged them (the disabled children) from participating in school activities.

In Ibanda and Iganga children with disabilities could not easily access education because schools were at least 5km away from home and parents were unable to pay the requisite transport money. Some children also lacked mobility appliances. However another limitation were the unusually high fees at special needs schools, such as Mbarara, which charges Shs. 40,000/- per term in fees, 38 kg of maize flour and 8kg of beans as opposed to between 8000/- and 21000/= in UPE schools. In Ntinda school of disabled school fees is 80000/= per term. Failure to benefit from educational opportunities condemned disabled children to perpetual poverty. To many parents of disabled children, therefore, their children’s disability was quite expensive.
The architecture in most schools continues to be a major physical barrier to participation of disabled children in education. In Wandegeya Muslim School, for example, disabled children supported by Salvation Army cannot be promoted to higher forms simply because upper classes are physically located “upstairs”. Similarly, deaf and blind children are sometimes excluded from enrolling in UPE Schools because teachers lack the necessary skills to teach. In all districts visited, these children are not enrolled at all.
Involuntary exclusion was also noted with some special categories of children. In Ibanda (Mbarara), Nalukolongo (Kampala) and Nkokonjeru (Mukono) children suffering from Ostomolisis and epilepsy were kept at home “to avoid them getting problems while at school”. Regrettably, when such children are kept away from school no compensatory lessons are held for them.
Other types of exclusion are not so easy to note. Children with motor neuron challenges, children that are blind or those that are deaf cannot sit the same types of examinations as do other children. Similarly, in instances where concepts have to be translated into sign language the mode in which such translation is done, including time that is allocated to perform tasks, need to vary. But perhaps the greatest obstacle to further education of disabled children is the stereotyping of children with disabilities as best only for “vocational skills” - shoe making, carpentry, tailoring, etc.
Disabled teenagers on the other hand, especially as they explore and discover their sexuality, find it extremely difficult to find boyfriends or girlfriends, which in turn makes them vulnerable to “any willing sexual partners”, sometimes carrying with them the risk of HIV/AIDS. Several reports, however, also mentioned men who only want to “explore” the sexuality of a disabled person but have no intention of entering into long-term relationships. Adult disabled persons, also, neither had genuine friendships nor fully participated in social activities.
Exclusion from health services was noted to be a widespread problem in nearly all the research districts. While overall disabled people believed that the quality of health service delivery to disabled persons had generally improved in the last years, cases of alienation from the service were still many. In Iganga a case was mentioned of blind persons being skipped “because they had not come with proper guides” (apparent reference to corruption money). Distance was also a critical factor, with journeys being as long as 2-5 kms. This problem aside disabled people even when they turned up at local dispensaries with certain ailments were automatically referred to bigger hospitals as at the lower levels staff were unsure how to handle disabled persons.
On the other hand the research team observed that most health facilities lacked specialised health personnel such as ENT clinical officers or psychiatric nurses (Kamwokya) which sometimes led to aggravation of the disability conditions of some people. The priority given to specialist psychiatric drugs was also noted to be very low with only drugs for well-known illnesses such as Malaria being put on the purchase list of essential drugs. As a consequence many children with disabilities in Mukono and Ibanda were either being given local herbs, or taken to traditional healers.
Most disabled women were observed to be particularly vulnerable because:

• They lack permanent marriage partners
• They are unable to defend themselves in case they are attacked sometimes raped.
• They may themselves be seeking to have a child at any cost and with anybody able and willing to father the child.
• They are unable to make firm decisions on matters of sexuality due to powerlessness resulting from various forms of social discrimination
• Many are made to believe that they are “simply being helped to satisfy their sexual desires”.
• Communication materials that are prepared on important health messages such as HIV/AIDS are either inaccessible or the mode in which they are transmitted unfriendly.
• They lack sensitisation on reproductive issues

The implications of social exclusion ranged from missed opportunities in education, to seclusion and non-participation in development activities. Many disabled persons also missed out on development-oriented information in health, governance, etc. which further marginalized them from participation in mainstream activities.

PWDs experience poverty for many reasons. Employment is in marginal and unskilled work. Common ways of earning money were begging and handouts, some PWDs were left at home. This was contrasted with the issues of marginalisation and exclusion that PWDs are commonly subjected to. 

The following article, No borders: Hiring the disabled can still get you results, discusses the experiences of the hearing impaired. Of particular note is the use of the derogatory "deaf and dumb" to describe the hearing impaired in this report:

Like any other Ugandans, the skills, experience and educational qualifications of the deaf and dumb are widely varied, but they tend to be an under-utilised talent pool.
If companies look beyond someone’s disability and seize the potential of everyone who wants to work for them, they could benefit immensely.
A recent report from the International Labour Organisation: Disabled persons and employment, indicates that disabled persons comprise of more than 600 million of the seven billion people that make the global population.
“While many disabled persons are successfully employed and fully included in society, as a group, they face disproportionate poverty and severe unemployment,” the report reads in part.
“A lack of global data about their numbers and situation is only one piece of evidence supporting the discrimination and exclusion they often face. National data, when it exists, verifies the fact that people with disabilities, and especially women, are less likely to access education, training and employment of any kind.”
Some companies in Uganda are adopting employment of disabled persons in their policies.
“We strongly adhere to our human resource policy that does not discriminate against job seekers and employees on any grounds. We believe that including people with physical impairment in our workforce increases our pool of talent and skill,” Ms Brenda Kyasiimire, the human resource manager at Rwenzori Bottling Company Limited, says.
Recognised: Ms Barbra Gwosusa and MsFlorence Aguti have not had a fair share of life because both are deaf and dumb.
It is with their current job placements at Rwenzori Bottling that they are starting to realise their worth.
Ms Aguti studied in Arua District but later moved to Jinja District where she studied a tailoring course.
Tailoring was not earning her enough money to buy “beautiful shoes and jewelry” as the 29-year-old says through an interpreter Isaac Lukyamuzi. She later joined the teaching profession at Gayaza School for the Deaf tutoring primary one and two in sign language.
However, she did not give up on the job search. She applied for a vacancy at the company last September and luckily there was a vacancy that she is currently filling.
“My life is better now because of the good working conditions and relations I have with other employees. Everyone loves and cares for us,” Ms Aguti says. “I am more confident now and have realised that I can do anything that a normal person can do or even better.”
For the future, Ms Aguti dreams of meeting a good man who will love her for who she is.
Bitter side: Her colleague Ms Gwosusa has tasted the bitter side of being employed with a disability.
She studied in Ntinda School for the Deaf. However, she did not go beyond Senior Four because of school fees constraints. She was previously working as a caterer in a hotel in Wandegeya but could not stomach the oppression she was facing from some of her workmates and the Shs60,000 per month was so meagre.
“I was reduced to rubbish in that place. No one believed in me not even the managers,” she said, engrossed in deep thought.
She threw in the towel early this year and a visit to her former school cast good luck upon her.
It is her former headteacher in Ntinda who told her about the openings at Rwenzori.
“My mother passed on when I was still very young. I am thankful to God that I can now look after myself. I am no longer a burden to my father, who also hardly manages on his own,” says the 29-year-old whose dream is to board a plane and become a manager at the company.
“I am glad that I took on these people in my department because they are my best employees. They are diligent and hardworking,” Mr Innocent Obong, the quality manager at Rwenzori says, lashing at those who look at employing the deaf in bad light.

This survey of disability and poverty in Uganda discussed the employment of PWDs. Besides the begging, handouts and being left at home being, it is also noted that most work available to PWDs is unskilled manual labour. PWDs also commonly face discrimination that leads to isolation and neglect. It was shocking as to read about attitudes of stigma and prejudice that have been discussed many times in this blog. Stigma and prejudice are feeding into chronic poverty through discrimination and are compounding the already precarious position of PWDs. Perhaps these barriers are greater than the problems of disability?

Old Age and poverty in Uganda

Elderly poor and disabled: These women speak about the help that they need. See how precarious their lives are and how everyone is affected by poverty. The poster says:

Video about the ADA Age Demans Action Campaign - Masaka District Uganda - supported by Cordaid and partners.
The story is about Agatha and Christine, who are in their eighties. Help Age International initiated the ADA Campaign to raise awareness about the rights and lives of older people in developing countries.

Poverty and Disability in Uganda 1: Definitions

The blog posts Poverty and Disability and Poverty and Disability Around the World highlight the complexity of any solutions to poverty. The Overview of Poverty in Uganda showed that poverty is a multidimensional problem affecting everyone throughout their lifetime. Disability predisposes persons with disabilities (PWDs) to poverty (see Poverty and Disability In Uganda), therefore, when disability is combined with poverty a complex problem is compounded. 

This is the first part of a series of blog posts examining the experiences of PWDs living with poverty in Uganda. This blog post describes how PWDs in Uganda understand chronic poverty and disability. It first asks what are their definitions of disability and chronic poverty then explains how PWDs see their relationship.

The 2003 report Chronic Poverty and Disability in Uganda is qualitative research that provides an insight into what Ugandan people understand by disability and poverty. The report provides an overview of many of the issues faced by PWDs living in poverty. The report opens by asking what is disability and who is disabled? These are the answers to those questions:

Evidence from the field revealed different, but complementary, types of definitions and conceptualisation of poverty. Different respondents defined disability in the following ways:

• “You are disabled if you are missing any one of your limbs or body parts, or if one of your limbs is deformed” - Group of disabled persons in Ibanda.

• “A disabled person is one who cannot look after himself or herself due to physical or mental limitation”. - Disabled women in Iganga.

• “A person is considered disabled if any one of the senses that were given by God are missing. These may include lack of sight, hearing, touch or reasoning” - Group of Youth Kalerwe

• “Disability is when your life is not in your hands - when your physical or mental state is such that other people have to decide for you what to do, where to go, what to eat and who to associate with. You are just an object of pity, and whatever opinion that you give can never be taken seriously. Some people will treat you as if you are a child, even when you are well over 30 years”. - Disabled Cobbler, Kansanga, Kampala.

The above definitions marry two important aspects: physical limitation and powerlessness (attitudinal). First they bring out the stereotypic view among some people that disability is the absence of a limb or that it is defined by a person missing “any part of the (normal) body”. It is a view that begins from a supposition that there is such a thing as a “normal physical outlay of a person”, and that any form that differs from this “norm” is disability.
On the other hand, the definitions from Iganga and from Kampala (Kalerwe), of a disabled person being one who is not able to look after himself or herself, was echoed in Mukono and Mbarara. It emphasises the helplessness of people with disabilities with respect to livelihood and their dependence on others for survival. In one response in Kalerwe, one disabled person summed up this challenge by pointing out that “…. if you are disabled, and you are looked after by people who are poor themselves, there is no way you can break out of that poverty yourself, even if you had the will to”.
The definitions that were obtained seemed to focus on the medical model of disability, glaringly leaving out the social model that looks at disability as a condition in the environment and among society that impedes particular categories of people from accessing basic facilities and resources.

Having defined disability, the report moves on to define chronic poverty:

The concept of chronic poverty among disabled people was easily understood by all respondents that the research team interviewed. Various examples were given to illustrate this. The overriding concept was one of poverty that stays with disabled people for a very long time. Some groups of respondents argued that the period sometimes extended for up to 15 or 20 years or more. In Kamwokya and Mulago (Kampala) groups of disabled people observed that their (disabled people’s) failure to acquire education in their earlier years meant that they could neither build skills nor obtain formal employment opportunities. This, they argued, in turn “condemned them to perpetual income poverty”. Similarly, because of its menial nature, most informal sector employment was unsuitable for severely disabled persons or for particular categories of the disabled, such as the blind. As such disabled people were obvious candidates for being edged out of both formal and informal employment.
Elsewhere, in Iganga, Kampala and Mbarara disabled women respondents observed that they, as disabled people, were often unable to care for themselves and their children (when they had them), often resulting into disablement for the children as well. This was particularly the case for disabled women that lived off begging but who also bore children “on the street”. The result for such offspring was deprivation of social amenities, proper parenthood, psychosocial support and hence poverty.
Definitions and concepts of chronic poverty that were derived from various respondents are best summarised by the following quote from Nkokonjeru in Mukono District:

Obwavu obwolutentezi bwe bwaavu obutavaawo. Ekyalo kyammwe kyonna bwekiba nga kyaavu, nammwe muba baavu ebbanga lyonna. Obwaavu obumu buba buzaale. Abaana babuyonka ku bazadde baabwe, ate nabo nebabugabira ku baana. Ate bwoba nga tewasikira ttaka, oba nga toil mukulembeze oba mukulu wa kika, ate nga tewasoma, era nga n’ekika tekikwenyumirizaamu, okwo bwogattako obutakola, awo obwavu buba butuuse okukuluma emirembe nemirembe nti amiina.Kati nno jjukira nti omulema tasikira ttaka. Waakiri basisa omwana wa mugandawo mu kifo kyokusisa omulema. Ate era omulema taweebwa bukulembeze. Ate ekirala abalema tebasoma. Kati obunkuseere n’obwavu kakongoliro obusingako awo obusanga wa? - Group of disabled people in Nkokonjeru Providence Home, Mukono.
(The words above are translated into English).
Chronic Poverty: Chronic poverty is that poverty that is ever present and never ceases. If the whole of your village (community) is poor, then all its residents will be perpetually poor. Some poverty passes from one generation to another. (It is as if) offspring suck it from the mother’s breast (inherited), and they in turn pass it on to their children. IF you did not inherit land; And you are not a political leader; And you did not go to school (no education); And your relations do not feel proud of you; THEN poverty will bite you for ever and ever - amen Now remember that a disabled person cannot inherit land. A brother’s child may even be preferred in inheritance if he is not disabled. Similarly disabled people do not get to leadership positions, and most are not even educated. Where else can you find this dire poverty and pauperism? - Group of Disabled Women in Nkokonjeru Providence Home, Mukono 

The above conceptualisation brings to light the issue of multi-dimensionality and compounding factors in determining the poverty circumstances and status of disabled people. Seen from the point of view of the “key capitals” - natural (land?), human (education/skills?), social (networks and confidence of family members in disabled person), and political (opportunity to lead others), one may argue that it is the depletion of all the capitals that further entrenches disabled people into poverty.

What then is the relationship between disability and chronic poverty?

Having defined disability and chronic poverty, respondents were asked to describe the relationship, if any, between chronic poverty and disability. A clear relationship was established by groups of disabled people in Mbarara, Kampala and Mukono,between disability and chronic poverty. Most argued that the two are mutually reinforcing, as captured in the following quote from a disabled youth from Kansanga in Kampala:

Obwavu n’obulema kyekimu, era bikolagana. Bwoba omulema oteekwa okuba omwavu, kuba tewali kyosobola kwekolera ate era n’embeera tekuganya. Abo abalema abasobola okubaako kyebakola beebatono ddala, ate mpozzi nga bali mu bitundu bya bibuga. Omulema tosobola kulima kuba tolina busobozi, ate tosobola kukola mirimu gya kkalaamu kuba tewasoma. Bwoba omwavu kyenkana olemala mu byonna - omubiri n’omwoyo. Tosobola kweriisa, era bwoba n’abaana bagongobala bugongobazi olwendyambi. Ekivaamu nga nvunza mu bigere ne ku ngalo. Ekiddirira kufuuka masikini na bulema. - Ahmed Kimbugwe and family , Kansanga.

English Translation: “Poverty and disability are similar and mutual. If you are disabled you must be poor, because you are incapacitated and cannot look after yourself, yet the conditions around you (environment) may not be favourable. You cannot grow crops because you are physically weak to cultivate. You also cannot do skilled work because you did not go to school. If you are poor, it is similar to being disabled in many ways - body and soul. You cannot feed yourself, and if you have children, they all become disfigured and physically disabled due to bad feeding (malnutrition and under-nutrition). The next thing you see are jiggers in one’s feet and fingers, followed by pauperism”. - Ahmed Kimbugwe and family , Kansanga.

In Ibanda (Mbarara) and Gamba (Mukono) disabled people pointed out the very limited range of opportunities that are open to them, either because of discrimination, or lack of skills, or simply absence of an enabling environment. At the Ibanda School for the Deaf, for example, it was pointed out that many deaf children were unable to get to schools simply because there were no teachers of deaf children. Similarly physically disabled children who lacked assistive devices could not access schools, and even when they did the attention that was given to them was not adequate enough to keep them in school. As a consequence, many disabled children grew into illiteracy, absence of skills and totally alienated from the socio-economic development of other peoples. This, they argued, was a clear recipe for perennial poverty.

Paul Tibaboneka and Theopista Babilaba at their home in Naluko village, Nabitende Sub-county, Iganga District

With these definitions in mind it is possible to get a deeper understanding of the issues discussed in the following article which describes the experiences of 2 Ugandan PWDs living in poverty. Read this carefully, A life of poverty, disability, blindness, and remember the definitions given above:

What does it mean to be an impoverished, elderly, disabled and blind couple?
Only Paul Tibaboneka and Theopista Babilaba, both residents of Naluko village in Nabitende Sub-county, Iganga District, can tell the joy or sadness that they have rode through the years. The couple is a signature feature for those seeking for direction of any place in the area surrounding their semi-permanent house.
It is not alien to hear people saying: “That place is just next or after the blind couple or bamuzibe [in reference to their lack of sight]”. At 60 years, Tibaboneka can just second guess how his wife looks now ever since he got a visual infection last year that gave him permanent blindness.
His wife, in contrast, does not have a single idea of how his husband looks like since her blindness is a childhood problem.
Their defects have spread through the family’s core and are visible among some of their children and grandchildren.
The couple spends much of their time seated helplessly seeming to wonder when their daughter, who does odd jobs, will get back home to whet their knurling stomachs. Their semi-permanent house seats on a small piece of land inherited from Tibaboneka parents.
Babilaba became blind at childhood when she was about eight months old.
Her husband who looks frail seems to be getting weaker everyday but holds onto her as a strong consolation that gives him the energy to push him on.
Tibaboneka got crippled after he fell ill immediately after he had married Babilaba, who was already blind.
“I became crippled at about 22 years shortly after marrying her. This is when we started suffering,” he throws us back into the couple’s youthful years.
The family seems to lack everything from food, medicine; beddings are scarce resources in their household.
To add insult to injury, the family has no pit-latrine but such reality is out of their reach as seem to blame their misfortune on evil spirits in their clan.
The couple had been blessed with three children but all had disabilities.
Two of them have since passed on but Alayisa Nanangwe, who quit her marriage to look after them now holds their hope together. She is 37 and has four children but three of these are physically disabled.
From her casual work, she looks after herself, her children and the seeming frail parents.
“Life is hard for us and as you can see, it is already lunch time but I have not yet got food to prepare. I am from working in somebody’s garden where I have been paid only Shs1,000,” she says with a twinge of poverty and sadness written on her face.
The misfortunes in this family seem to grow on and as we learn after the one-hour we have been talking that the couple has urinary problems but with no medication.
Babilaba has fistula while her husband can hardly pass urine.
Steven Mudhasi, who lives in the neighbourhood, narrates this families story with a sad face, saying it is really hard to explain what they go through.
“Most of the days they sleep on empty stomachs. It is their daughter who tries to look for food but nothing much is done given the fact that she also has disabilities,” he says.
But with a fighter’s spirit its only God who can change this family’s story as they seem to be held together by optimism that better days are probably ahead.

The above article picks up on the sense of helplessness used to describe disability in the research article. Furthermore the chronic poverty seems to overshadow the whole of their lives. It is almost as if the writer of the article had read the words of the research above. 

The Importance of Good Sanitation

This video looks at the impact of bad sanitation on the vulnerable, elderly and persons with disabilities. Clean water, sanitation and good hygiene are a right for all people. Water Aid works to make access to clean water more easy. The poster says:

This video highlights the early impact of the Undoing Inequity: Water, sanitation and hygiene programme. The programme provides water delivery for all based on a research project in the districts of Amuria and Katakwi north east Uganda. The project is being implemented by Water Aid in collaboration with Leonard Cheshire Disability, Water.Engineering and Development Centre. The project has generated evidence on how community access to information and design options can help in breaking down barriers for people living with disability, older people and those living with chronic illness can access water, sanitation and hygiene services, using local materials to make simple adaptation on standard facilities.

Poverty and Disability Around the World

Poverty is a complex issue which  has dramatic effects throughout the lifetime. When disability is added into the equation (see Poverty and Disability) the effects on persons with disabilities (PWDs) are compounded. Before investigating the impact of poverty in Uganda in greater detail it is interesting to see the effects of poverty on PWDs in other similar nations. 

The World Bank report Disability and Poverty in Developing Countries: A Snapshot from the World Health Survey (WHS) 2011 provides an overview of some of the most important issues for PWDs. The report notes that there are many factors involved in disability and poverty and it is important to understand the country where where poverty is to be tackled. Disability and poverty may arise because of many factors which include:

(i) the ways how the underlying health conditions reduce the productivity of disabled people for the types of jobs that are available in the labor market; (ii) the lack of access to assistive devices or personal assistance; (iii) contextual factors, for instance, a physically inaccessible work environment or negative attitudes with respect to the ability to work of persons with disabilities; and/or (iv) the rules related to disability benefits which may create incentives for disabled people to drop out of the labor market. Once the main causes for low employment rates for persons with disabilities in a particular country are better understood, it becomes possible to introduce adequate, and preferably evidence-based, programs and policies to promote employment among persons with disabilities. 

The report surveyed 15 countries and notes that there are large discrepancies in the numbers of PWDs reported. Disability rates vary from 3% in Lao to 16% in Bangladesh. However the report does offer some interesting results. A selection from the results is given here:

In each of the 15 countries, disability prevalence is found to be higher among women than men. For most countries, the gender gap, i.e. the difference in disability prevalence between females and males is between three and five percentage points. The gender gap is the largest in Bangladesh: disability prevalence stands at 23 percent among women, compared to 10 percent among men, which gives a gender gap of 13 percentage points...
In 11 out of the 15 countries under study, disability prevalence is higher in rural areas than in urban centers. A higher prevalence in rural areas has been found in earlier studies in developing countries (for example, World Bank 2009 for India), but further research is needed to understand if this is a systematic finding...

Ugandan patients at the Out-Patient Department of Apac Hospital in northern Uganda. The majority are mothers of children under 5 years old with malaria.

The report notes that measuring disability by economic status was only significant in 3 out of the 15 countries studied. However:

When poverty status is measured using the PPP (purchasing power parity see Overview of Poverty in Uganda for an explanation) US$1.25 a day international poverty line, disability prevalence is significantly higher among the poor than the nonpoor in four countries: Malawi, Zambia, the Philippines, and Brazil. When poverty status is measured using the PPP US$2 a day international poverty line, disability prevalence is higher in all countries except Pakistan and the Dominican Republic. However, the difference is significantly different from zero in only three countries: Zambia, Lao PDR, and Brazil. When poverty is measured through a multidimensional measure, disability prevalence among the poor, i.e. persons who experience multiple deprivations is significantly higher in 11 out of 14 countries included in this analysis (Table 4.3, Disability Prevalence (Base Measure) among Working-Age Individuals, by Poverty Status). Here, disability prevalence rate among the poor ranges from a low of 3.5 percent in Lao PDR to a high of 29.5 percent in Mauritius. In several countries (Kenya, Bangladesh, and Brazil), disability prevalence among the multi-dimensionally poor is close to two times higher than among the non-poor. The disparity in disability prevalence is the most pronounced in Mauritius, where prevalence among the multi-dimensionally poor is three times higher than among the non-poor. Overall, it can be said that there are significant disparities in disability prevalence in most countries by poverty status, when poverty is measured multi-dimensionally.

Persons with disabilities have significantly less years in education than nondisabled people. The percentage of people that have completed primary school education is also significantly lower for PWDs. When combining education and employment factors the following results are noted:

Overall, the estimates suggest that in most of the countries included in the study, persons with disabilities as a group have significantly lower educational attainment than persons without disabilities. Comparatively, they have fewer years of education and lower primary school completion rates. Similarly, they have lower employment rates than persons without disabilities. In majority (60 percent) of the countries the difference in employment rates to the detriment of disabled people was statistically significant.

With the results above in mind a picture of disability begins to emerge based on the multidimensional statistical analysis:

• First, looking across all five dimensions of economic well-being explored in this study (education, employment, assets/living conditions, household expenditures, and household expenditures on health care), one finds in all the countries that persons with disabilities as a group are significantly worse off in two or more dimensions in 14 out of 15 countries.
• Second, disability is significantly associated with multidimensional poverty in 11 to 14 of the 14 developing countries under study. In other words, persons with disabilities are more likely to experience multiple deprivations than persons without disabilities. This result holds when different multi-dimensional poverty measures and poverty thresholds (within and across dimensions) are used.
• Third, at the individual level, in most of the countries included in the study, persons with disabilities have lower educational attainment and experience lower employment rates than persons without disabilities. In education, they have fewer years of education and lower primary school completion rates. Similarly, they have lower employment rates than persons without disabilities. In a majority (60 percent) of the countries the difference in employment rates to the detriment of disabled people was statistically significant.
• Fourth, at the household level, in most of the countries (11 out of 15), households with disabilities have a significantly lower mean asset index. Also, a higher percentage of households with disabilities belong to the bottom asset quintile; this difference was statistically significant in six out of 14 countries. Households with disabilities, on average, also report spending a higher proportion of their expenditure on health care: the mean ratio of health to total household expenditures was significantly higher for households with disabilities in two thirds of the countries.
• Fifth, descriptive statistics suggest that in most countries households with disabilities are not worse off when their well-being is measured by mean non-health PCE (per capita expenditure). Similar results were obtained for the poverty headcount, gap, and severity based on the PCE as welfare aggregate. This result should be treated with caution given that it might be influenced by the limitations of the WHS sampling design when it comes to identify the disability status of a household and its small set of questions on expenditures.

Poverty when combined with disability becomes a multifaceted complex system. Various factors like education, employment, assets and living conditions, household expenditures, and household expenditures on health care interact with disability compounding the effects of poverty. The evidence from this 15 nation study is by no means consistent across all nations. However it is clear that poverty interacts with disability in a detrimental way. Any attempted solution to poverty must be tailored to the needs of the PWDs, there is no one size fits all remedy.

Sanitation in Schools

Sanitation presents many problems for children with disabilities (CWDs) in Uganda. Lack of good latrines and washing facilities is one of the major reasons CWDs stop their education. This video highlights the problems CWDs face in schools. The poster says:

In October 2014, GDPU and AP Peace Fellow Kathryn Dutile conducted an assessment of 10 schools to

1. Understand the need to children with disabilities (CWDs) in school in terms of water and sanitation
2. Gather important data which can be used by GDPU to write proposals and present at conferences on this issue
3. Determine locations of accessible latrines they plan to build.

This video examines one of those schools and the sanitation challenges students with disabilities there face. Video by AP Peace Fellow Shannon Orcutt

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.

The Uganda Poverty Assessment Report 2016

This video begins with the release of the The Uganda Poverty Assessment Report 2016 by the Honourable David Bahati and Christina Malmberg Calvo. Uganda is one of the most successful African countries at reducing extreme poverty in Africa. The poster says:

Uganda has experienced an impressive rate in poverty reduction in the last two decades making it the second fastest percentage point reduction in Sub-Saharan Africa.
According to the World Bank poverty assessment report for 2006-2013 the Ugandan population living below the national poverty line declined during the period although northern Uganda registered an increase in poverty levels over the same period.

Abilities 256 Organizing Committee

The organizing committee for the Abilities 256 festival met today.

From left to right: Keneth Kigozi, Jacqueline Atugonza and Jullian Kamwesigye

The Chairman was Keneth Kigozi

Jullian Kamwesigye, Secretary

Disability Support Uganda President Jacqueline Atugonza

Overview of Poverty in Uganda

In the Poverty blog post it was found that poverty is a multidimensional problem that has many effects throughout the lifetime. This blog post will give an introduction to Poverty in Uganda.

The Uganda Poverty Assessment Report 2016 outlines Uganda's progress in the past 20 years at reducing poverty. It says that Uganda is the 9th most successful country in Africa at reducing poverty. In the past 2 decades Uganda has been particularly successful at reducing poverty. The report goes on to explain how extreme poverty is defined:

The poverty line was set in 1998 using 1993 data by estimating the amount of expenditure needed to satisfy the minimum daily calorie requirements and basic non-food needs. Appleton et al. (1999) identified the 28 commonly consumed food items and the corresponding amount consumed to meet 3,000 calories per adult equivalent. Calorie requirement varies by age and gender, and hence the 3,000 calories is per adult equivalence. Based on the population structure then, the average per capita calorie need was 2,283 calories.
The minimum expenditure on basic non-food needs was estimated using the classic approach of Ravallion and Bidani (1994) by identifying the non-food expenditure of households that are just on the food poverty line. The justification for using these households’ non-food expenditure as a reference is that the poor have sacrificed some of their need for calories to buy the non-food items. Therefore, these non-food expenditures should also be regarded as meeting essential needs. The non-food expenditure was allowed to vary by region and rural/urban areas to account for spatial differences prices (Appleton et al. 1999).
The poverty line is the sum of expenditure on basic food and non-food items. Since 1993, the CPI (consumer price index) has been used to update this poverty line.

The Poverty line is currently set at US$1.90 per person per day. The poverty line is said to have purchasing power parity (PPP). This value was set on 30 September 2015 (see World Bank: FAQs: Global Poverty Line Update), it is based on 2011 exchange rates. This means that US$1.90 will buy the same amount of food in Uganda as say America based on the exchange rate in 2011. US$1.90 is the equivalent of 4794 Ugandan shillings (see World Bank: Official exchange rate). This figure means it is possible to compare all the countries of the world on an equal basis.

The Uganda Poverty Assessment Report 2016 opens optimistically, detailing Uganda's successful history of poverty reduction.

Uganda’s progress in reducing poverty over the last two decades is a remarkable story of success. From 1993 to 2006, annual reduction in the national poverty rate of 1.9 percentage points a year resulted from the restoration of peace and stability to much of the country after Yoweri Museveni came into power, the series of economic liberalization reforms that were implemented, and the investments of households and firms that these encouraged.

The success in poverty reduction is not without controversy:

However, Uganda’s success is not without caveats. In 2013, more than a third of its citizens lived below the international extreme poverty line of US$1.90 a day. What’s more, the low national poverty rate of 19.7 percent is based on a poverty line that was set over twenty years ago and is now too low, and not reflective of a reality in which too many Ugandans live today. Vulnerability has also remained high. For every three Ugandans that moved out of poverty, two fell into poverty. Poverty has also become increasingly concentrated in the Northern and Eastern regions of the country.

The report argues, in chapter 2, that poverty is multidimensional (this has been shown in Poverty). As a consequence monetary indicators alone cannot be relied upon to show poverty. It is necessary to look at housing; infrastructure like drinking water supply, sanitation and electricity; mobile phones, bicycle ownership and education; as well as health and nutrition. All these areas need to be investigated in greater detail.

Chapter 3 looks at the factors that have lead to successful poverty reduction from 2006-2013. Agriculture, migration to cities and small gains in education have had important benefits on reducing poverty. Chapter 4 looks in more detail at agriculture:

Agricultural incomes grew because the government got some key fundamentals right that provided the incentives to invest in agriculture. Luck was also on Uganda’s side: good weather benefited many households and positive price trends in international and regional markets aided real crop price increases.

It should not be overlooked that Uganda is vulnerable to fluctuations in climate because it is dependent on good weather.

Chapter 5 looks in detail at growth out of poverty in urban areas. Chapter 5 discussed how:

Uganda has experienced high growth in industry and services when compared to the regional average. However, high growth in value-addition in industry and services has not been accompanied by a higher share of the workforce being employed in these sectors, limiting the degree to which these sectors contributed to poverty reduction. The growth in these sectors did not result in job creation faster than population growth. The net changes in the percentages of the bottom 40 percent of households, which engage in both non-agricultural wage employment and self-employment, are negative, because more households in the bottom 40 percent exited non-agricultural wage employment and self employment than went into non-agricultural wage employment and self-employment. 

Research was done on what hindered and what improved poverty reduction:

Those that were able to increase their self employment and wage income were more likely to live in households that were headed by young, educated men with better access to finance. Results of impact evaluations suggest that poor women can benefit from cash grants and business training, as they are the most financially constrained. Randomized controlled trials provide a clear indication of the types of interventions that work; however, they are often implemented on a small scale. It is not clear whether these interventions will also work at scale for growing self-employment and encouraging income diversification among the poor. More empirical evidence is needed on programs implemented at scale.

Chapter 6 looked at how migration within Uganda affects poverty and chapter 7 explored regional differences throughout Uganda. The regional differences are highlighted in the article below.

The teacher to pupil level is one teacher to 136 in northern Uganda, 90.5 in eastern Uganda, 47 in central region and 53 in western Uganda.

This newspaper article from September 2016 Poverty level in Uganda down by 11 percent summarizes the findings of the report. In particular it focuses on regional differences:

The World Bank poverty assessment report for 2006-2013 shows increasing poverty in Northern Uganda, despite increased international government public investments in the region.

In Summary

• In Northern Uganda, 64% of citizens were living blow poverty line in 2006 but currently 84% now live below poverty line on the National scale 
• The teacher to pupil level is one teacher to 136 in northern Uganda, 90.5 in eastern Uganda, 47 in central region and 53 in western Uganda 
• Only 35% of residents in Northern Uganda have mobile phones, 52% in eastern Uganda, 83%in central Uganda and 63% in Western Uganda. 

The World Bank poverty assessment report for 2006-2013 shows that the proportion of the Ugandan population living beneath the national poverty line declined from 31.1 percent in 2006 to 19.7 percent in 2013.
Similarly, the country was one of the fastest in Sub-Saharan Africa to reduce the share of its population living on $1.90 PPP per day or less, from 53.2 percent in 2006 to 34.6 percent in 2013.
However, there has been increased poverty in Northern Uganda, despite increased international government public investments in the region.
The report reveals that regional inequality persists and appears to be on the rise.
"Progress was slower in the country's north and eastern regions which have least well-off, and marginalised population," the report reads.
In relation to Northern Uganda, 64% of citizens were living blow poverty line in 2006 but currently 84% now live below poverty line on the National scale.
The report further shows that in education, the teacher to pupil level is one teacher to 136 in northern Uganda, 90.5 in eastern Uganda, 47 in central region and 53 in western Uganda.
In social sector, only 35% of residents in Northern Uganda have mobile phones, 52% in eastern Uganda, 83%in central Uganda and 63% in Western Uganda.
The report continues: "poverty incidences are also higher in north at 43.7 per cent and the east is at 24.5 per cent compared to the central region which is 4.7 per cent and west at 8.7 per cent."
While launching the report the World Bank country director Christina Malmbrerg Calvo said that the report envisages inequitable development which must be addressed.
"Increasing investment in agriculture will help the country to achieve middle income status, there is also need to reduce income poverty gap through fiscal policy programmes."
In response, the minister for planning David Bahati said that government is aware of the imbalance but this was caused by insecurity in these areas for over two decades.
Poverty in Uganda is not a simple issue. When combining poverty with disability the issues will be even more complex. This report serves to highlight the complexity of the issues faced by Uganda. In the coming weeks these will be explored in more detail.

This overview reveals the complexity of poverty in Uganda. That poverty affects someone throughout their lifetime and that poverty also feeds back on itself compounds an already complex problem. Combine this with the strong link between poverty and disability (see Poverty and Disability In Uganda), and the issue of poverty in Uganda is of great importance. In future blogs I will discuss poverty and disability in Uganda.