Addressing Disabilities from the Ground Up

The first human rights treaty of the 21^st century, the 2006 Convention on the Rights of Persons with Disabilities, was a milestone in the UN’s efforts to build the groundwork for fundamental human rights and freedoms. With the highest number of signatories on its opening day, the Convention carried the responsibility of not only affirming the essential human rights retained by persons with disabilities, but also changing attitudes regarding their value as autonomous human beings.  A shift in how people with disabilities are perceived by organizations and governments is vital in addressing the unique barriers faced by them, which encapsulate not only physical and environmental limitations, but the distillation of language for clear communication, the political and regulatory norms that may impact them differently, and the preconceived notions that stigmatize and misinform. As the WHO estimates that up to 1.6 billion people worldwide may be afflicted with lifelong disabilities, efforts undertaken by organizations to acknowledge and address their unique circumstances are essential in achieving good health and wellbeing for all, the central pillar of SDG 3.

The core tenets of the Convention – inclusion and autonomy – have facilitated the development of exemplary institutions such as the Special Olympics, an organization that supports Olympic-style sports training services for persons with disabilities across 170 countries. The provision of extensive and in-depth support for people with disabilities enables greater access to opportunity, and enables dynamic participation in communities. Additionally, oftentimes the initial health screening, from Special Olympics and SightLife for example, is the first opportunity disabled individuals have for a holistic health analysis.

The following GlobalWA members demonstrate their dedication to solving the significant crises faced by people with disabilities all over the world.

Tangible Solutions

The impact of the war in Ukraine has drawn the efforts of UNICEF USA in their endeavors to provide emergency services to civilians, ranging from medical assistance and sanitation to remote schooling and providing support for refugees. With over 14 million displaced persons as a result of the war, UNICEF’s efforts in relocation, rehabilitation and care have been vital to their recovery. Among these groups are children with disabilities – making up nearly 50% of displaced children in Ukrainian institutions before the war – with whom UNICEF has worked closely to foster stability and development.

27 children have been relocated from Ukraine to a residential placement center in Baicoi, Romania, ranging from 5 to 18 years of age. UNICEF has also supported the treatment of children with disabilities at the Dzherelo Children’s Rehabilitation Center in Lviv, where some refugees from Ukraine have also sought shelter. With a range of intellectual disabilities to address, such as autism spectrum disorder, primary rehabilitation goals have been to foster clear and effective communication strategies – such as the Picture Exchange Communication System (PECS), using visual cards to convey complex messages.

These examples underline the grander efforts undertaken by UNICEF to create safe and nurturing environments for children with disabilities impacted by the war. Mobile teams in government-controlled regions in Ukraine are providing physiological care to vulnerable groups, ranging from families with children to unaccompanied children. Specialized support teams with experience in assisting children with disabilities have worked with the government to establish easy access to vital services for children housed in institutions or returned to their families.

Working with UNHCR, UNICEF has organized Blue Dot hubs – transitionary safe spaces for displaced and unidentified victims of the war – which have been vital in assisting and registering children with disabilities, unaccompanied or with families. Proper registration enables support workers to connect these children with the appropriate services and institutions designed with disabilities in mind, reincorporate them into schools and make arrangements for care and treatment.

World Vision has also conducted multinational efforts to build better infrastructure and address the matter of disabilities. From 2014-2017, widespread efforts to address healthcare demands for persons with disabilities were encapsulated in the Accelerating Core Competencies for Effective Wheelchair Service and Support (ACCESS) program, implemented in Nicaragua, India, Kenya, El Salvador, and Romania. With the goals of working with local authorities and institutions to increase the service capacity of wheelchairs, broaden the range of wheelchair types available, and involve wheelchair users as active participants in society to a greater extent, World Vision connected persons with disabilities with trained and qualified service providers to increase quality of life and strengthen support infrastructure for disabilities. Through widespread data collection and qualitative evaluations of results, the program brought about a marked increase in mobility, independence, empowerment, and social participation. Tangible aspects – like the improved design of a wheelchair to be more versatile and easier to use, for instance – led to developments in the perceived efforts undertaken by persons with disabilities and their families, as ease of mobility enabled a reduction in caregiving commitment due to an increase in autonomy. In all five countries, statistical data revealed that social exclusion scores had decreased as a result of the ACCESS program, leading to greater inclusion of persons with disabilities in areas of work and communal participation.

World Vision has also been active in addressing disability challenges in other areas, such as the education sector. The Learning Roots and Unlock Literacy programs utilize USAID’s universal design approach to deliver education through multiple means of engagement, presentation of information, and versatile means of action and expression, allowing children with disabilities the freedom and flexibility they need to learn in ways that are best suited for them. The implementation of universal design in Malawi, for example, doubled the number of children with disabilities attending school.

In Columbia, World Vision’s Training, Economic Empowerment, Assistive Technology and Physical/Medical Rehabilitation (TEAM) projects led a comprehensive advocacy initiative for 2,749 persons with disabilities. Breaking down the precise challenges faced by those with disabilities – including delays and lack of appointments in healthcare, inaccessibility in public infrastructure and reduced career opportunities – a total of 175 measures were taken by Columbian authorities to address the concerns voiced through World Vision’s advocacy efforts.

Another organization using a multi-sector approach is The Rose International Fund for Children (TRIFC), providing a variety of solutions for children with disabilities in Nepal. Through sponsorship programs, TRIFC funds medical aid, surgery and therapy, visual and hearing aids in educational settings, iPads with specialized software for non-verbal students, easily accessible sanitary products, and collaborations with local organizations, TRIFC aims to fortify and develop the education sector with a current focus on 75 sponsored children.  

Beyond solutions to help children with disabilities thrive, TRIFC has also worked to address the prevalent stigma against disability in Nepal. Partnering with Rotary International, the three-year advocacy campaign that began in 2008 has worked to eliminate stigma and ensure a more supportive and welcoming community for children with disabilities.

TRIFC’s tactile learning solutions for visually impaired children, for example, introduced a series of braille-incorporated educational tools, puzzles, and learning games for blind students through partnerships with the Rotarack Club of Damak and AdSoN. The initiatives aim not only to improve quality of life and education for students, but encourage instructors to become more aware, and incorporate disabilities into their teaching methods. In other areas of focus, TRIFC has partnered with local hospitals to deliver over 75 crucial surgeries for children, in addition to physiotherapy and counselling services.

In the education sector, there is also the prevalent issue of bullying, where children with disabilities are particularly prone to being targets for harassment. The University of Washington, partnered with UNESCO, has inquired into the experiences of children with disabilities targeted by violence. Through multiple surveys conducted in the US, Canada, China, Sweden and other states, consistent patterns reveal that children with disabilities are more likely to experience bullying, harassment and violence from their peers and instructors. To combat this problem, the report recommends a nine-component model to education. Starting with political advocacy for awareness around disabilities through strong leadership, the model promotes the training of instructors to be more conscious and aware of disabilities in their classrooms – including redesigning curricula to better accommodate students. Safety in the classroom, both physical and psychological, may be improved through robust mechanisms for reporting harassment, with adequate support from authority figures, including instructors, parents, and the community at large. Finally, students should be empowered to succeed by opening opportunities via multiple partnerships between the education sector and other organizations.

Disability due to trauma and injury is a field of concern for SIGN Fracture Care,  which works across 57 countries to provide comprehensive orthopedic services, surgeries, and medical aid to injured persons who are unable to access healthcare. SIGN partners with local hospitals to provide innovative, low-cost solutions for medical equipment (such as surgical instruments and implants) needed to treat bone injuries, and orthopedic training for surgeons in low-capacity hospitals to broaden their healthcare proficiencies. By working with established hospitals and developing their capacities to treat patients with long-term injuries, SIGN has directly impacted over 400,000 patients.

In their most recent developments, SIGN has supplied 12 hospitals in Ukraine with crucial surgical equipment, supporting the recovery of up to 100 patients injured by shrapnel or gunfire. In the training and development sphere, SIGN Spine is a program to train surgeons on spinal surgery through hands-on seminars. Their exemplary work in providing effective surgical equipment – like the SIGN Nail – has not only broadened the capacities of medical institutions across the world, but also improved the health and livelihoods of individuals who were otherwise unable to access adequate healthcare.

Ocular disabilities call for the specialized approach provided by SightLife, with a mission to eradicate corneal blindness by 2040 – a condition affecting 12.7 million people across the world. Through training healthcare workers in the prevention of corneal blindness, providing effective corneal transplant programs to treat patients, and taking a systemic approach to revitalize the global healthcare approach to corneal blindness, SightLife employs a cross-sector focus. As of 2021, SightLife has facilitated over 27,000 corneal transplants, and trained 123 medical personnel in clinics and up to 900 frontline workers.

Policy and Philanthropy

Policy tools that state reasonable conduct standards are essential in constructing programs that serve children with disabilities. To that end, Save the Children’s Disability Inclusion Policy highlights the organization’s approach in nurturing children with disabilities worldwide. By advocating for the adoption of sensitive language when discussing or speaking to persons with disabilities, inculcating communication habits to employ at home, and promoting the enthusiastic advocacy for awareness around persons with disabilities, Save the Children takes a comprehensive stance in promoting values that make communication, inclusion, and social dynamics easier. As an example in practice, Save the Children Philippines has implemented Project SCOPE, an initiative to educate children with disabilities of their rights through interactive online learning.

Philanthropic initiatives by GlobalWA members have generated high-impact change in rebuilding traditional education networks for students with disabilities, especially in the wake of the pandemic. The Bill & Melinda Gates Foundation’s philanthropic lens has focused on addressing concerns around disabilities through their work with the National Center for Learning Disabilities (NCLD). Through extensive research, the NCLD offers insight on modern-day inclusive infrastructure, and how disparities in education delivery methods may be mitigated for children with disabilities. This includes the formulation of specific tools, such as the learning disability (LD) checklist, an interactive online exploratory tool designed to identify signs of potential learning disabilities in children in a broad range of age groups. Their research assess the current state of modern education and how LD considerations play a role, and provides essential insight for addressing shortcomings in a traditional education structure.

The NCLD promotes the inclusion of children with disabilities in school through academic awards such as the COVID-19 Impact Scholarship, the Allegra Ford Thomas Scholarship, the Everyday Champion Award, and the Anne Ford Scholarship. These awards are meant to not only allow greater opportunities for students, but also to encourage educators and administrators in schools to adopt LD considerations into their curricula, make an effort to connect with students, and create lasting impacts in their lives.

Advocacy also forms a cornerstone of the NCLD. In 2021, their endorsement of the Respond, Innovate, Succeed and Empower (RISE) Act – a document which, if passed, would allow for greater ease of access to post-secondary education for students with disabilities – demonstrates their commitment to driving real change. The RISE Act would generate more funding for assistance centers, enable a wider range of acceptable documentation to be considered for college accommodations, and create greater transparency in reports showing the number of accepted students with disabilities in colleges, and the accommodations granted to them. The RISE Act is one example of the NCLD’s advocacy work, which ranges from issues in literacy and mathematics to educator workforce development.

The Bill & Melinda Gates Foundation’s contributions to the NCLD, with the specific context of peak-pandemic distance learning for students with disabilities, have totaled $75,000 in April, 2020. The NCLD is also one of many institutions to receive funding from the Foundation: a sector-wide philanthropic initiative known as the Charter Students with Disabilities Pilot Community was granted $10 million in funding to improve educational infrastructure for students with disabilities across the US, with recipient organizations such as Ednovate, Eye to Eye, the Center for Special Education in Charter Schools, Uncommon Schools,  Strive Prep, STEM Prep Schools, Summit Public Schools, the Noble Network of Charter Schools, and others.

GlobalWA members demonstrate the importance of including not only tangible, on-the-ground solutions for persons with disabilities, but widespread advocacy and infrastructure development to create a society more welcoming and inclusive. Initiatives have shown that the empowerment of persons with disabilities not only assists them in their personal struggles, but also enables them to become more active participants of society, thereby stimulating general growth and prosperity at a collective level.

In addition to the above organizations, the following GlobalWA members are working on disability healthcare, rights, and inclusion in communities where they work through their programs, addressing Good Health and Well-Being (SDG 3).

Adara Development

To support families and children with disabilities, Adara Development implements the Baby Ubuntu programme across three districts in Uganda. Baby Ubuntu aims to improve quality of life for children with moderate to severe disabilities and their caregivers.

In Uganda, there are very few resources for children with a disability. Parents often feel the difficult reality of raising a child with a disability such as isolation from community and coping with fewer resources. The programme provides emotional and practical support, empowering caregivers to maximise child development, health and quality of life. This community-based programme is led by healthcare workers and expert parents that have a child with a disability.

Baby Ubunutu was developed with the London School of Hygiene and Tropical Medicine. Baby Ubuntu sits in the ‘follow up and early intervention’ arm of our AdaraNewborn model.

In 2022, together with our collaborators, we published a paper on a trial of the Baby Ubuntu programme. The programme was found to be feasible and acceptable to children, caregivers and healthcare workers in Uganda.

We’re thrilled to see the positive impact that the Baby Ubuntu programme is having on children with neurodisabilities and their families, and are excited to see the programme grow and evolve.

Amplio

The Amplio Talking Book was designed with and for users with low literacy, but it also includes features to support people who are visually impaired. The device uses audio prompts and visual icons to guide the user. The audio can be recorded in any language. In addition, the icons on the user interface are embossed with a dot to aid listening in the dark or help guide people with visual impairment. When we attended the SBCC Summit in Morocco, a team from SightSavers asked to take a device home to field test. SightSavers – as the name would imply – works to eliminate avoidable blindness and promote the rights of people with disabilities. SightSavers Nigeria is considering the use of Talking Books to improve access to family planning for people with disabilities.

SIGN Fracture Care

Traffic accidents injure more than 20 million people every year, according to the World Health Organization. Without medical attention, injuries like bone fractures can easily turn into lifelong disabilities that cause pain and prevent people from returning to the workforce.

SIGN Fracture Care empowers surgeons in low-and middle-income countries to provide healing surgery for people with long bone fractures. SIGN provides orthopaedic education opportunities for surgeons, then manufactures and donates the orthopaedic instruments and implants needed to put the education into action.

The SIGN Nail is a stainless steel rod that is inserted into the fractured bone canal and fastened with screws. This stabilizes the broken bone so that it heals in the proper alignment and provides support so the injured person can walk the day after surgery. SIGN’s set of surgical instruments is designed specifically for austere hospital environments and does not rely on expensive hospital equipment or even electricity in the operating room—making orthopaedic surgery possible in rural clinics.

SIGN has trained more than 7,000 local surgeons and donated orthopaedic implants for more than 400,000 injured people since 1999.

World Vision

World Vision places a strong emphasis on people with disabilities. Disability inclusion is part of our overall gender equality and social inclusion approach for global health and other sectors. Our work on disability inclusion considers how gender and other social norms impact the situation for persons with disabilities. This means a focus on access to services and assets as well as enhanced well-being – by ensuring that protection and GBV prevention systems mitigate the increased risk of violence towards children and adults with disabilities. WV encourages participation within social, economic and political processes in their community and nationally. WV looks at decision-making at household, community and societal level – by raising up persons with disabilities and facilitating their ability to engage in decisions. Finally, we advocate for equal systems – by addressing stigma towards persons with disabilities in their communities and supporting community and national level advocacy. World Vision currently serves nearly 15,000 children with disabilities worldwide, with a goal of tripling that number in the next three years. World Vision is an inaugural member of the Excellence in Development and Disability Inclusion group. World Vision signed the Global Disability Summit Charter for Change and made 11 specific commitments to address disability inclusion.

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