DIsABIlIty AnD povErty A global cHAllEngE Edited by Arne H. Eide and Benedicte Ingstad Disability anD poverty A global challenge Edited by Arne H. Eide and Benedicte Ingstad First published in Great Britain in 2011 by Policy Press North America office: University of Bristol Policy Press 1-9 Old Park Hill c/o The University of Chicago Press Bristol 1427 East 60th Street BS2 8BB Chicago, IL 60637, USA UK t: +1 773 702 7700 t: +44 (0)117 954 5940 f: +1 773-702-9756 [email protected] [email protected] www.policypress.co.uk www.press.uchicago.edu © Policy Press 2011 An electronic version of this book [978-1-84742-886-8] is freely available, thanks to the support of libraries working with Knowledge Unlatched. KU is a collaborative initiative designed to make high quality books Open Access for the public good. More information about the initiative and links to the Open Access version can be found at www.knowledgeunlatched.org. Knowledge Unlatched British Library Cataloguing in Publication Data A catalogue record for this book is available from the British Library. Library of Congress Cataloging-in-Publication Data A catalog record for this book has been requested. ISBN 978 1 84742 885 1 hardcover The right of Arne H. Eide and Benedicte Ingstad to be identified as editors of this work has been asserted by them in accordance with the Copyright, Designs and Patents Act 1988. All rights reserved: no part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise without the prior permission of Policy Press. The statements and opinions contained within this publication are solely those of the editors and contributors and not of the University of Bristol or Policy Press. The University of Bristol and Policy Press disclaim responsibility for any injury to persons or property resulting from any material published in this publication. Policy Press works to counter discrimination on grounds of gender, race, disability, age and sexuality. Cover design by Policy Press Front cover: image kindly supplied by www.istock.com Printed and bound in Great Britain by TJ International, Padstow. Contents List of tables and figures iv Notes on contributors v Introduction Disability and poverty: a global challenge 1 Benedicte Ingstad and Arne H. Eide one Social inclusion of people with disabilities in poverty reduction policies 15 and instruments: initial impressions from Malawi and Uganda Margaret Wazakili, Tsitsi Chataika, Gubela Mji, Kudakwashe Dube and Malcolm MacLachlan two Disability, poverty and healthcare: changes in the canji (‘disability’) 31 policies in the history of the People’s Republic of China Heidi Fjeld and Gry Sagli three Living conditions among people with disabilities in developing countries 55 Arne H. Eide, Mitch E. Loeb, Sekai Nhiwatiwa, Alister Munthali, Thabale J. Ngulube and Gert van Rooy four “No disabled can go here…”: how education affects disability and 71 poverty in Malawi Stine Hellum Braathen and Mitch E. Loeb five “We too are disabled”: disability grants and poverty politics in rural 93 South Africa Camilla Hansen and Washeila Sait six Displacement, mobility and poverty in northern Uganda 119 Herbert Muyinda and Susan R. Whyte seven Where culture really matters: disability and well-being in Yemen 137 Benedicte Ingstad, Arwa Baider and Lisbet Grut eight Disability and barriers in Kenya 153 Lisbet Grut, Joyce Olenja and Benedicte Ingstad nine Disability and social suffering in Zimbabwe 171 Jennifer Muderedzi and Benedicte Ingstad ten “My story started from food shortage and hunger”: living with 189 landmines in Cambodia Merete Taksdal eleven Poverty as trauma: methodological problems when reality gets ugly 207 Hans Husum and Odd Edvardsen Epilogue Some concluding thoughts: the way ahead 225 Arne H. Eide and Benedicte Ingstad Index 233 iii Disability and poverty list of tables 3.1 Size of survey samples 58 3.2 Some demographic comparisons 58 3.3 Education and literacy (age five years or older) 59 3.4 Highest grade achieved (age five years or older) 60 3.5 Type of impairment among those who never attended school (age five 61 years or older) 3.6 Employment situation 62 3.7 Household access to information: % of households without access to 63 information by disability status of household and urban/rural location 3.8 Mean number of household possessions by disability status of the 64 household (weighted by size of household) and urban/rural location 3.9 Gap in service delivery 64 4.1 Scoring factors and means for variables included in the PCA of the 76 household portion of the Malawi survey 4.2 Mean asset index by household disability status 76 4.3 Experienced difficulty going to school and/or studying (capacity and 79 performance) by type of impairment among children aged 5-18 with a disability 4.4 Experience with the provision of educational services by type of 79 impairment among children aged 5-18 with a disability 4.5 Asset group by school attendance for children/youth aged 5-18 with a 80 disability iv notes on contributors Arwa Baider is a paediatrician, and has previously worked at the University Hospital in Sana’a, Yemen as director of the Child Health Directorate, at the Ministry of Health in Yemen and as national coordinator of Integrated Management of Childhood Illness, American Red Cross. She is currently working as a medical officer at UNICEF in Yemen. Stine Hellum Braathen is a research scientist at SINTEF Global Health and Welfare, and a PhD student at the Department of Psychology, University of Stellenbosch, South Africa. She holds a Master’s degree in international community health (University of Oslo), and a Bachelor’s degree in arts (anthropology) from the University of Western Australia. Her area of expertise is disability research, with a focus on equity in health and service delivery, as well as issues of sexuality and gender. Tsitsi Chataika is a post-doctoral research fellow at the Centre for Rehabilitation Studies, Stellenbosch University, South Africa, and a research fellow at the Centre for Global Health, Trinity College Dublin, Ireland. Her research interests are in disability and development, postcolonial theory and inclusive education. Kudakwashe Dube’s background is in business studies and development studies, with an MBA from Business School Netherlands. He is currently Chief Executive Officer of the Secretariat of the Africa Decade of Persons with Disabilities (SADPD) based in Cape Town, South Africa, with programme activities in 25 African countries. Odd Edvardsen is Associate Professor of Nursing Science, Faculty of Health Science, Tromsø University College. Edvardsen is also a board member of the Tromsø Mine Victim Resource Centre, University Hospital North Norway. Since the 1980s he has been working with popular movements and local hospitals in the Middle East, Afghanistan and South-East Asia. He has published extensively in international medical journals on trauma management. Arne H. Eide is Chief Scientist at SINTEF and Professor in Rehabilitation at Sør-Trøndelag University College, both in Norway. He is also a visiting professor at Stellenbosch University, South Africa. Eide has 20 years of research experience in low-income countries, and in particular in southern Africa. He has been in charge of a number of large collaborative projects in the fields of disability and rehabilitation, including national and representative studies on living conditions among people with disabilities in eight countries in southern Africa. v Disability and poverty Heidi Fjeld is a postdoctoral fellow in the Section for Medical Anthropology and Medical History, Institute of Health and Society, University of Oslo, Norway. Her background is in social anthropology and Tibetan studies, and her research interests include poverty, disability and access to social welfare in China and Tibet. Heidi contributed equally to the research and writing of Chapter Two with co-author Gry Sagli. Lisbet Grut is a sociologist working at SINTEF, Norway. Grut has long experience in research on disability issues, with a special interest in research questions on disability, life course and rehabilitation. She has participated in research in Norway and in several African countries. With respect to disability and poverty issues, she has undertaken research regarding people’s experiences of barriers to public services and income. Camilla Hansen is a research fellow/PhD candidate at Section for Medical Anthropology and Medical History, Institute of Health and Society, University of Oslo. She is a social anthropologist and a nurse with two long ethnographic fieldwork and research projects in South Africa. Her research interests include poverty and disability, interconnections and, in particular, the role of disabled people’s organisations in this regard. Hans Husum is Associate Professor of Surgery in the Institute of Clinical Medicine, University of Tromsø, Norway, and centre head at Tromsø Mine Victim Resource Centre, University Hospital North Norway. Since the 1980s he has worked with popular movements and local hospitals in the Middle East, Afghanistan and South-East Asia. He has published extensively in international medical journals on trauma management. Benedicte Ingstad is a social anthropologist who has specialised and written extensively in medical anthropology. She is Professor in Medical Anthropology at University of Oslo and has been engaged by SINTEF in southern Africa and the Middle East. Together with Susan Reynolds Whyte she published Disability and Culture and Disability in Global and Local Worlds (both University of California Press). Both books are said to be classics in the field of cross-cultural disability studies. Benedicte Ingstad has carried out fieldwork on disability issues in Botswana, Kenya, Tanzania, Zimbabwe, Malawi, South Africa, Yemen, Cambodia and China. Mitch E. Loeb is a health scientist, currently at the National Centre for Health Statistics in Hyattsville, Maryland, USA.