Negligence and malnutrition, known to cause disability, can be easily prevented.
There are some 15 lakh disabled people in Karnataka, 75 per cent of whom live in rural areas. Only two per cent have access to community-based rehabilitation, 51 per cent of them are illiterate and a predominantly large number live below the poverty line. These and more statistics indicate that the situation of People With Disabilities (PWDs) is not at all impressive in the state. If the government is struggling to reach the existing disabled population, its primary endeavour should be to engage in methods that reduce additions to the number of PWDs. Yet it is astounding, if not infuriating, to see the negligence and lackadaisical attitude causing new cases of disability that could easily be avoided.
One part of the vulnerable population with the potential to join the ranks of disabled are the malnourished. The government admits that 84.3 per cent of rural children and 79.4 per cent of urban children aged 0-6 years in the ICDS are anaemic. It is not uncommon for workers doing community-based rehabilitation (CBR) to find children with low vision and night blindness caused by vitamin A deficiency, or malnourished children becoming hearing impaired due to recurring ear infection.
As these children come from poor economic backgrounds, their parents cannot afford to improve the child’s diet or seek timely medical help. Yet the government and the community leisurely spend months discussing, debating and arguing whether lakhs of these poor children should be given fruit, egg or milk in their diet. If this isn’t a negligent attitude, what is?
Causes of disability
Awareness of the causes of disability is still abysmal. According to the National Family Health Survey 2005-06, 59.5 per cent of pregnant women aged 15-49 were found to be anaemic — an important cause of disability in newborns. Another prime cause for the birth of children with cerebral palsy (CP) is a prospective mother consuming “over the counter” drugs, unaware that they will affect the foetus. Others, unable to access medical facilities, have home deliveries and complications which lead to the child getting CP. Shockingly, the state health budget has declined from 5.85 per cent of the total expenditure in 1998 to 3.73 per cent in 2005-06.
Yet another cause of children being born with disabilities is a delivery mishandled by a doctor. With District Government Hospitals overburdened, private nursing homes are springing up to meet the growing health needs of people and many doctors are over-worked and stressed. It is under circumstances such as these that doctors make errors that condemn an innocent child and its family to lifelong misery. However, this does not mean that government doctors do not have lapses. Despite doctors coming under the Consumer Protection Act, getting one to take responsibility for these lapses is a tedious task. Consequently, there is need for clear protocols to initiate action and for families to claim compensation.
Screening the problem
Thus far the government has only paid lip service to the screening of newborns for birth defects. Child screening not only helps detect and stem the progression of physical disabilities and CP, it also helps detect metabolic disorders and hormonal defects that can cause CP and mental retardation. In Karnataka the neonatal mortality is 38 per 1,000 and the infant mortality rate is 51.5 per 1,000, a needless loss of life that could have been prevented by newborn screening centres in district hospitals.
When it comes to disability related issues the government relies heavily on non-governmental organisations. But it is essential to realise that these NGOs are based in urban areas and large cities like Bangalore, while the majority and the poor live in rural areas. There is thus an urgent need for a Disability Policy for Karnataka that focuses primarily on prevention and early detection of disability. There is also a need for greater financial investment in disability awareness and prevention. NGOs and disability groups must put pressure on the government to train primary health centre staff, such as doctors and auxiliary nurses and midwives, in disability prevention and detection besides creating public awareness on the causes of disability.
This article was published in the B’lore edition of the Deccan Herald on 8th March 2007