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What do disabled people do to survive in rural India? Researchers from Queen Elizabeth House, Oxford, examined the daily social and economic realities of rural disabled Indians in the Chingleput District of Tamil Nadu in southern India. From answers to questions like: How do disabled people and their carers gain livelihoods and which types of services do they use? It emerged that most disabled adults contribute economically to the household through paid or unpaid work. But disabled people have insufficient access to key services and this lack increases the costs of disability to their communities. Large numbers of people in rural India regard themselves as disabled when they find their ability to work impaired because they have lost some degree of physical or manual dexterity. According to clinical estimates, up to 3.7 percent of India's people are thought to suffer some from of physical or mental disability. This is a larger figure than the percentage of people estimated to be severely malnourished. Perhaps four to five times as many (about 130 million people) are partially or indirectly affected by the disability of members of their households. However, the authorities apply a restrictive, Western medical definition of disability to judge which people are eligible to receive social welfare: in effect only very severely blind, deaf, locomotor disabled, or mentally handicapped people. This severe eligibility criterion has meant that nearly three-quarters of people with disabilities in rural India are excluded from official provision of key services, such as specialised treatment for their disabilities. Within a total population of 60 million, Tamil Nadu contains about 1.5 million disabled individuals. In the villages studied most disabilities are not severe: impaired sight and hearing are typical. However, the costs of disability to rural disabled people, their carers and their communities are multiple. First, there are 'direct costs' such as medical care and transport to treatment centres. In order to afford these the disabled often have to sell assets. However, disabled women and people from lower castes are less able to gain access to medical treatment and households spend less on such treatment for women than they do for men. Next, there are 'opportunity costs'. A majority of disabled men and women either completely lose, or suffer reductions in, their income at the onset of their disability. This permanent loss of income often drags down the overall income of the household and can lead to increased poverty. Finally, there are 'indirect costs' incurred when other household members (usually women) who care for disabled people lose income on account of the extra time household tasks absorb. There is a big gap between services offered by government and voluntary agencies, and the needs of rural disabled people as they see them. Disabled adults and their carers described these as:
The main implications of these findings for policymaking are that health authorities should:
Source(s): Funded by: DFID, UK (1995-1996) id21 Research Highlight: 1998-Apr-14
Further Information: Tel:
+44 (0) 1865 273 613 International Development Centre, Queen Elizabeth House, UK
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