health and social care

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Visual Impairment In Pakistan Health And Social Care Essay

“A disability is an umbrella term covering, impairments, activity limitations, and participation restrictions. Impairment is a problem in body function or structure; an activity limitation is a difficulty encountered by an individual in executing a task or action; while a participation restriction is a problem experienced by an individual in involvement in life situations. Thus disability is a complex phenomenon, reflecting an interaction between features of a person’s body and features of the society in which he or she lives.” (WHO)

Most people in this situation live in poor conditions lack of access to basic needs, including rehabilitation services. An estimated 10% of the world’s population lives with a disability. Persons with disabilities have the same needs of living, sexual and reproductive health as other people. They face barriers to information and services. (UN, 2007) This includes persons who are blind, deaf, mental or physical disabilities.

Disable or handicap Persons can be found in every age group and both men and women. An estimated 30% of families live with an immediate family member who has a disability (Nations, 1990). Majority of persons with disabilities are part of the 80% of the world’s population that lives in developing countries (UN, 2007). The needs of persons with disabilities are not as much of to be expected to meet in developing countries. Developed countries also continue to face considerable challenges.

Two kinds of discriminations faced by persons with disabilities:

Direct Discrimination

Direct discrimination is related to the disability and the restrictions are linked to the physical and social surroundings of the person with disability.

Indirect Discrimination

The indirect discrimination comes from the stereotypes and stigmas from the society towards disability as the disabled are branded by others as persons with lower capacities and especially as being less intellectually able e.g. unemployment and living alone.

Gender and disability

People with disabilities experience violations of their human rights. Disable men and women faces many of the issues equally but some issues are gender specific. Women with disability face more special issues then men such as forced marriage, domestic violence, physical, emotional, and sexual abuse, the burdens of household responsibilities, labor, delivery, and childrearing. A woman and a person with a disability are doubly marginalized in comparison with a normal women and a person.

Pakistan and disability

Pakistan has a number of social issues as low literacy rate, deficiency of health facilities, and access to safe and clean water, environmental degradation and unemployment like other developing countries. Some of these issues are to some extent are addressed by government, NGOs interventions and international policies, ratified or signed by government, such as the Millennium Development Goals (MDGs). Disability is one of the serious issues that have not received serious attention which it deserves. Persons with disabilities and the issues of disabilities have not been high on the priority unfortunately.

Disability is a serious social problem in Pakistan. Actual figures of disable population are limited. We have data available from 1998 census. It is estimated that at least one in every eight families have a member who suffers from some form of disability. Percentage figure estimates the range to be from anywhere between 2.5% to 10% of the total population. It is a depressing fact that disability is not properly understood on Pakistan and disabled persons are not treated with the attention they really deserve. (Pakistan 1998 Census)

Percentage Population by Disability 1998, Pakistan

 

All

Blind

Deaf & Mute

Crippled

Insane

Mentally Retarded

Having More than one Disability

Both Sexes (Urban)

2.59

8.32

7.24

15.81

7.82

8.15

8.22

  Male

2.88

7.93

7.02

16.83

7.18

7.50

7.25

  Female

2.26

8.88

7.56

14.34

7.44

9.62

9.60

Both Sexes (Rural)

2.52

7.92

7.53

20.52

5.94

7.32

8.23

  Male

2.83

7.44

7.40

21.40

5.72

6.78

7.37

  Female

2.19

8.59

7.71

19.30

6.23

8.07

9.41

Census Report of Pakistan 1998, Pakistan Census Organization, GoP

*State of World Refugees and UNHCR Global Report 2002,

It is undeniable that Persons with disabilities suffers from many kinds of discrimination. Being disable means dependent on others. Disability means to experience restrictions and limitations towards activities and access to services. This result in inequalities which becomes in form of certain types of inequity and discrimination that affect all spheres of life such as employment, access to buildings and public transport, social participation, physical health, and psychological well-developed framework to integrate them in the normal life .

Literature review

Effects of discrimination in persons with disability fallout in lowered sense of self-esteem and inability to mix up with people.

As Nemiah summarized:

Hopes and aspirations must be modified income and security for his family and himself are threatened; his position in the social structure is altered; feelings of helplessness and weakness replace his former sense of strength and competence. All that...forms a person's concept of himself is jeopardized...loss may involve physical objects...and psychological entities — self-concepts, ideals, social status, etc. (JC, 1961)

Physical and mental disabilities are perceived as handicaps that effects on employment possibilities for educated disabled persons. Linda and Arthur state that Negative attitudes towards the disabled on the part of employers reduce the chances that a disabled person will be hired for a given job. (Linda & Arthur, 1976)

Discrimination towards disabled is not only because of the disability other factors are also involved for instance race, gender etc. A study has been conducted by American Psychiatric Association which fined out that discrimination based on group characteristics other than mental illness does not diminish the impact of stigma associated with mental illness. Anti-stigma programs need to target not only discrimination related to mental illness but also that associated with other group characteristics, such as race, gender, sexual orientation, and physical disability. (Corrigan, Thompson, Lambert, sangster, Jeffery, & Campbell, Augusts, 2003)

Persons with disabilities often find themselves socially isolated. Stigma, poverty, and lack of support systems take a charge on such families. A study demonstrates the significant physical disability and psychosocial problems as perceived by patients affected by chronic filarial lymphoedema in an endemic urban area of Sri Lanka. Twenty five percent of the patients found it difficult to get along with the community and 36 percent felt they were totally rejected by society (laughed at, not included in social activities, isolated). Even within their own families, 24 percent patients had problems interacting with them. (Wijesinghe, Wickremasinghe, Ekanayake, & Perera, 2007) A person becomes disabled through any severe injury they go through the denial and mourning before adjusting to their disability. Disability is perceived negative in the society which perpetuates ideology of normality; there dependence is seen as negative aspects.

The level of bias against people with disabilities in many Western societies has decreased a lot over the past 20 to 30 years. People with disabilities have emerged recognition of their right to participate in society, and have equal access to the basic needs such as education, employment, sports activities, personal relationships and parenthood through the efforts of disability activists. (Asch, Gillam, 1990,1999)

In the article Structural Levels of Mental Illness Stigma and Discrimination authors apply the concepts of structural discrimination to understanding of stigmatizing processes directed at people with mental illness using a sociological paradigm. They apply the concepts Structural, or institutional, discrimination includes the policies of private and governmental institutions that intentionally restrict the opportunities of people with mental illness. They found major institutions' policies that are not intended to discriminate but whose consequences nevertheless hinder the options of people with mental illness. (Corrigan, Patrick, Fred, Waston, & Amy, 2004)

Research Question

Explore the challenges and coping mechanisms of persons with visual impairment in terms of mobility in Pakistan.

Operational Definition

Disability is a lasting physical impairment experienced by an individual who considerably interferes with functioning in social structure of life such as self care, communication, social interaction, participation etc. (Bhagi, Sharma, 1992)

"Visual impairment" or "vision impairment" is vision loss (of a person) having reduced vision as to constitute a handicap or a significant limitation of visual perception/visual capability resulting from disease, physical trauma or a congenital or degenerative condition that cannot be corrected by conventional means, including refractive correction, medication, or surgery. (Columbia light house for blind and visually impaired, 2009)

Objectives

To identify the challenges of adult persons with visual impairment in terms of mobility in Pakistan.

To explore the effects of discrimination toward disability.

To explore the challenges and coping mechanism with a gender perspective.

Methodology

To fulfill the above objectives the Qualitative research methodology is designed:

In this research, the research methodology includes selection of key informants, participant observation, sampling and interviews. Area of study for this research will be Islamabad and Rawalpindi. Fifteen to twenty open ended semi structured interviews will be conducted with, adult persons with visual disability, to find out the objectives of research.

Time line of the study is divided toward tasks in following table:

Dates

12-27 March

28Mar-10 Apr

11 -24 Apr

25 Apr-15 May

16 May-5th June

Literature study

Selection of respondents

Conduction of Interviews

Content analysis

Report writing and submission of first draft

Significance

The social construction of gender establishes man’s dominancy and provides the basis for gender based discrimination in society. There is first choice for male child in our society. The major hindrance towards social identification of women in Pakistan is patriarchy, lack of awareness about their rights, traditions and customs existing in the society. In countries like Pakistan women and particularly disabled are vulnerable section who generally are given no importance in the overall development. Their contribution in various sectors can be seen as remarkable but it finds no place when the matter of recognition comes into discussion at any level. Significance of my research is as there is dearth of work on this topic in Pakistan. Women are discriminated but disability increase discrimination and inequality overwhelmingly. I am specifically working on challenges and coping mechanisms with a gender perspective.


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