Connecting disability and equality: Beyond recognition to the challenges of implementation

5th February 2013 By: In On Africa IOA

Recognising equal human rights for minority groups has been on the rise in the past several decades, especially following World War II when the United Nations (UN) adopted the Universal Declaration of Human Rights on 10 December 1948.(2) In the wake of the war’s devastation, world leaders wanted to create a guide that would be the basis for protecting the rights of, and ensuring equality for, every individual regardless of his or her background.(3) This document served as a precursor to the later discussion surrounding the rights of marginalised groups, whether discriminated against on ethnic, physical, religious or linguistic grounds. The result of this work has been the creation of specific human rights conventions for marginalised groups, including the UN Convention on the Rights of Persons with Disabilities.(4)

People with disabilities have perhaps been one of the populations most in need of greater recognition regarding ensuring equal rights for all in the past 20 years. The UN Convention is recognition of that need, and nations across the globe have been making strides towards addressing the issue. In Africa, since the Organisation of Africa Unity (OAU) unanimously approved the 1981 African Charter on Human and Peoples’ Rights, many countries on the continent have made efforts to pass legislation and recognise the needs and rights of individuals with disabilities.(5) However, identifying and then actually addressing the rights and needs of this group, has, at times, been a challenging task in government and society.

This paper begins with a brief overview of Africa’s record regarding the recognition of the rights of people with disabilities. Using South Africa as a case study to contextualise and expand on the problems surrounding achieving equal rights for people with disabilities in Africa, this paper discusses the history of recognising and defining the meaning of disability in that country. The challenges to acknowledging these rights, as well as the particular barriers the country has faced in implementing them are also discussed.

Africa’s record of defining disability and recognising rights

According to the World Health Organisation (2011), an estimated 785 million people over the age of 15 worldwide live with a disability, and, as populations age and poverty and instances of chronic disease increase, so does this estimate.(6) Of this number, an estimated 60-80 million people living with disabilities reside in Africa, with that growing number attributed to factors like conflict and injury.(7)

A need to define and understand the needs of this growing population, and what disability actually entails, is being addressed on both global and regional scales. At the international level, the UN has tried to universally recognise the rights of this population through the Convention on the Rights of Persons with Disabilities, which was adopted in December 2006.(8) This is the first human rights convention to be open for signature by regional integration organisations.(9) Many African nations have also furthered their efforts to address disability rights and equality through the signing and ratification of the UN convention and its protocols. Below is a map depicting the continental distribution of where countries are in their adoption and signing of the convention.

Figure 1: Map of signatures of UN Convention on the Rights of Persons with Disabilities (10)

Further continental efforts have included the African Charter on Human and Peoples’ Rights, which came into effect in 1986 as one of the first acknowledgements of the special needs and protections of this population.(11) In 1999, the charter expanded to include special measures protecting the rights of children with disabilities.(12) Additionally, from 2000-2009, African communities celebrated the African Decade of Disabled People, in order to promote awareness and inclusion for persons with disabilities across the continent.(13)

In spite of these efforts to move forward, among the biggest difficulties leaders face is how to best define disability, and to change the view of people with disabilities as objects with needs, to individuals with rights.(14) To begin addressing this dilemma a comprehensive definition was created through the World Health Organisation’s (WHO) International Classification of Functioning, Disability and Health (ICF). The WHO defines disability as “an umbrella term for impairments, activity limitations, and participation restrictions. Disability refers to the negative aspects of the interaction between individuals with a health condition (such as cerebral palsy, Down syndrome, depression) and personal and environmental factors (such as negative attitudes, inaccessible transportation and public buildings, and limited social supports).”(15) This umbrella term and definition are vital because disability is not limited to a physical or mental condition alone, but includes the contextual and environmental factors that determine the limitations associated with having a disability. Furthermore, they recognise the vast number of disparate groups represented within the definition. Such a definition is the first step in helping to determine and inform legislation and policies addressing the rights of this population.

However, recognising and addressing the rights of individuals with disabilities can still prove difficult because the characteristics of those living with disabilities are so diverse. Typical views of disability are still based on a medical model, and extend to actual physical conditions, such as visual or hearing impairments,(16) and do not take into account the context surrounding the limitations imposed by a disability. This way of viewing disability brings the impairment into the foreground and pushes the person into the background.(17) By focusing on certain disabilities, rather than on the person with the disability, here is, at times, a failure to address the varying effects of a disability, as people have very different experiences. Some people with disabilities experience less difficulty while others, such as women with disabilities, experience the effect of being classified as a member of two frequently-discriminated-against groups, which may increase their barriers to access.(18)

A more useful approach to understanding disability is offered by the social model of disability. The social model puts the person at the forefront, instead of emphasising the disability.(19) Disability is a social construct and the central concept of the social model is that “society disables people.”(20) In other words, “how we organise things in our culture limits and restricts what some of its members can do.”(21) Looking at disability from a social model perspective changes the focus of the issues of disability from the person to the society, and it further broadens the definition of disability.(22)

Due to its social and economic diversity and political history, South Africa represents a compelling case for examining the utility of the social model of disability in moving toward securing equal rights for all.

Disability and equality in South Africa

South Africa’s history regarding disability and equality has been shaped by its social and political past. In comparison to other African Nations, South Africa was slow to get off the mark in addressing the rights of people with disabilities. The South African Government did not initially recognise or sign the original 1981 OAU charter.(23) It was not until 1986, a year declared the National Year of the Disabled, that efforts were made to address the needs of the disabled and inform government policymaking on the issue, through the establishment, by the government, of the Inter-departmental Co-ordinating Committee on Disability (ICCD).(24) Following the first free elections in 1994, enshrined in the new Constitution was the right of every citizen to security, social services and the ability to support him or herself.(25)

Since that time, the government has also put into place several pieces of legislation addressing disability rights, thus promoting the participation in society of marginalised groups. These include, for example, the Promotion of Equality and Prevention of Unfair Discrimination Act (2000), which states that “neither the state nor any person may unfairly discriminate against any person on the ground of disability,”(26) and the South African Schools Act (1996), which provides for the inclusion in the education system of learners with special educational needs.(27) The country also became one of the first developing nations to provide disability grants and assistance for those that became too incapacitated to work.(28) This was in stark contrast to the previous treatment of marginalised groups under apartheid, in which all disabled people, white or black, were discriminated against and often denied access to education, health and welfare services because they were viewed not as equal citizens, but as societal dependants.(29) In 2007, South Africa also signed and ratified the UN Convention and Protocol on the Rights of Persons with Disabilities, and instituted the South African Disability Alliance to represent disability needs in the country.(30)

Despite these efforts, however, South Africa still faces the same issues as other nations in defining disability, as the social context in the country impacts the definition of disability and equality. Something that is considered a disability in one context may not be considered so in another. An example of this is a medical condition such as epilepsy. For South Africans who can access healthcare services and treatment to the extent that their symptoms are limited or eliminated, epilepsy may not be considered a disability. However, in cases where access to treatment is minimal or non-existent, it can become classified as a disability because it causes impairment to an individual’s ability to function in day-to-day life.(31) While healthcare access for all is enshrined in the South African constitution, considerable inequities remain, largely due to distortions in resource allocation.(32) “South Africa's apartheid past still shapes health, service, and resource inequities.” Racial, socio-economic and rural-urban differentials in healthcare access and health outcomes still exist.(33) Thus, in South Africa, an individual’s race, socio-economic status and geographical location are more important factors in determining whether he or she has a disability, than the simple presence of a physical or mental condition such as epilepsy.

Despite the problems with definition, the country has made a first step in providing social assistance for marginalised groups, but it is noted that despite legislation targeting disabilities, there is no legislation aimed at the specific daily requirements of people living with disabilities.(34) There is also a marked difficulty for many disabled people in South Africa to access services frequently required in everyday life. In parts of the country up to 80% of the population relies on public transport, but because it is crowded and difficult to access, many disabled people cannot even board trains or buses. Some of those using an assisting device like a wheelchair may then not be able to get to work, to healthcare facilities, or even to banks or supermarkets. In 2012, the South African Deputy Minister for Women, Children and People with Disabilities also noted that approximately 467,000 children with disabilities were not in school and getting an education.(35) In addition, those needing assistance or sign language interpreters to access public services do not have access because the assistive services are simply not available in many cases.(36)

The way forward

Both in South Africa and globally much has been done to raise awareness about the plight of the disabled, and the need to protect their rights to equal citizenship. However, the fact remains that legislative promises and recognition of rights still do not fully translate into actual change in people’s daily lives, and may still seem like a set of abstract promises with little meaning.(37) The WHO World Report on Disability (2011) highlights the widespread nature of barriers to the practical implantation of these promises, which include negative attitudes, inadequate policies and standards, lack of services and service delivery, poor funding, lack of accessibility and consultation, and lack of proper data and evidence.(38)

The results of these barriers are poorer outcomes for this population, including worse health, lower educational achievements, reduced economic achievement and increased poverty.(39) More still needs to be done to carry out these promises and remove barriers to access. Fortunately there are ways to overcome such barriers. In line with the social model of disability, the WHO report notes that recognising and addressing barriers to healthcare, rehabilitation, services, education and creating enabling environments are the best ways to improve outcomes for people living with disabilities.(40) Recent efforts in this direction are evident in South Africa in, for example, the North West province Provincial Legislature’s creation of an opportunity for representatives from the disability community to raise, with suitable portfolio committees, issues and barriers they are facing,(41) rather than them being told what issues and barriers all people with similar disabilities face. Additionally, the Sheltered Employment Factories arm of the Department of Labour is working to change its company culture and open new factories especially designed to encourage people with disabilities to seek employment with them.(42)

Concluding remarks

More stories like those mentioned above about the continued and rising inclusion and involvement of people with disabilities, in both political and economic life, are encouraging to the movement towards better implementation of equal rights. Discussions about disability and equality continue to be on the rise around the world. However, it is clear that much more needs to be done to make public services and activities accessible if, for example, all disabled children are going to be able to go to school, and those using assistive devices like wheelchairs will be able to board public transport and go to work.

Enabling legislation must continue to be identified and implemented if the right to equal citizenship of this growing group is to be realised. The social model of disability tells us that only disabled people can know how their ability to participate in society in the way that they desire is affected. This cannot be easily identified from outside. Thus, in order to make the changes necessary to ensure equality for people with disabilities, disabled people need to be given the opportunity to make their voices heard, and they must be listened to. That will put the people for whom the legislation is drafted at the centre of the discussion. It is not disability per se which needs to be addressed, but rather the way in which we organise ourselves and our environments that needs to be changed in order to limit the impairment created by a disability and to ensure equality.

Written by Shannon Rupp (1)

NOTES:

(1) Contact Shannon Rupp through Consultancy Africa Intelligence's Africa Watch Unit ( africa.watch@consultancyafrica.com). This CAI discussion paper was developed with the assistance of Claire Furphy and was edited by Nicky Berg.
(2) ‘The Universal Declaration of Human Rights’, United Nations, http://www.un.org.
(3) Ibid.
(4) ‘Convention on the rights of persons with disabilities’, United Nations, http://www.un.org.
(5) Kane, I., ‘Protecting the rights of minorities in Africa: A guide for human rights activists and civil society organizations’, Minority Rights Group International, 2008, http://www.minorityrights.org.
(6) ‘The world report on disability’, WHO, 2011, http://whqlibdoc.who.int.
(7) ‘Health and disability news and statistics for Africa’, Disabled World, http://www.disabled-world.com.
(8) ‘Convention on the rights of persons with disabilities’, UN, http://www.un.org.
(9)Ibid.
(10) ‘UN Convention on the Rights of Persons with Disabilities: Map of signatories in Africa’, HEARD, 2011, http://www.heard.org.za.
(11) ‘International norms and standards relating to disability’, UN, http://www.un.org.
(12) Ibid.
(13) Ibid.
(14) ‘Disability and human rights resources’, HEARD, 2011, http://www.heard.org.za.
(15) ‘The world report on disability’, WHO, 2011, http://whqlibdoc.who.int.
(16) Ibid.
(17) ‘The social model of disability’, The British Red Cross, http://www.redcross.org.uk.
(18) Ibid.
(19) Ibid.
(20) Ibid.
(21) Ibid.
(22) Eide, A.H. and Loeb, M.E., ‘Data and statistics on disability in developing countries’, Disability KAR, 2005, http://www.dfid.gov.uk.
(23) Ibid.
(24) Dube, A.K., ‘The role and effectiveness of disability legislation in South Africa’, Disability KAR, 2005, http://www.dfid.gov.uk.
(25) Heap, M., Lorenzo, T. and Thomas, J., 2009. “We've moved away from disability as a health issue, it's a human rights issue”: Reflecting on 10 years of the right to equality in South Africa. Disability & Society, 24(7), pp. 857-868.
(26) Dube, A.K., ‘The role and effectiveness of disability legislation in South Africa’, Disability KAR, 2005, http://www.dfid.gov.uk.
(27) Ibid.
(28) Heap, M., Lorenzo, T. and Thomas, J., 2009. “We've moved away from disability as a health issue, it's a human rights issue”: Reflecting on 10 years of the right to equality in South Africa. Disability & Society, 24(7), pp. 857-868.
(29) Dube, A.K., ‘The role and effectiveness of disability legislation in South Africa’, Disability KAR, 2005, http://www.dfid.gov.uk.
(30) ‘Health and Disability News and Statistics for Africa’, Disabled World, http://www.disabled-world.com.
(31) Heap, M., Lorenzo, T. and Thomas, J., 2009. “We've moved away from disability as a health issue, it's a human rights issue”: Reflecting on 10 years of the right to equality in South Africa. Disability & Society, 24(7), pp. 857-868.
(32) Harris, B., et al., 2011. Inequities in access to health care in South Africa. Journal of Public Health Policy, 32, pp. S102–S123.
(33) Ibid.
(34) Ibid.
(35) Moeketsi , S., ‘Many disabled kids not in school’, IOL News, 21 November 2012, http://www.iol.co.za..
(36) Heap, M., Lorenzo, T. and Thomas, J., 2009. “We've moved away from disability as a health issue, it's a human rights issue”: Reflecting on 10 years of the right to equality in South Africa. Disability & Society, 24(7), pp. 857-868.
(37) Ibid.
(38) The World Report on Disability’, WHO, 2011, http://whqlibdoc.who.int.
(39) Ibid.
(40) Ibid.
(41) ‘N West legislature to host persons with disability’, SA News.gov.za, 15 November 2012, http://www.sanews.gov.za.
(42) ‘Hope for disabled As Sheltered Employment factories are to undergo major facelift to revive its business’, South African Department of Labour, 14 November 2012, https://www.labour.gov.za.