International Day of Persons with Disabilities: Disability Rights Successes in South Asia

The image shows a man with a prosthetic leg sitting on the ground. In his hand is a volleyball, on which he is writing something with a marker.
“Disabled men play volleyball” by World Bank Photo Collection is licensed under CC BY-NC-ND 2.0.

December 3rd marked the International Day of Persons with Disabilities – a day to raise awareness of disability rights, the benefits of inclusion, and the challenges society poses for individuals with disabilities. The theme for this year is “Leadership and participation of persons with disabilities toward an inclusive, accessible and sustainable post-COVID-19 world.” In honor of this occasion, we wanted to highlight a few of the many instances in recent times where strides have been made in inclusion and accessibility. This post will focus on the progress made in south Asia, while the post by Danah Dib will speak to the achievements that have been made in the Middle East. There have been numerous successes in the efforts to push disability rights forward in south Asia, particularly in the spheres of politics, health, and education.

Political Rights

Efforts to secure the political and civil rights of individuals with disabilities in south Asia passed a milestone in 2015. The “South Asia Regional Disability Rights Dialogue on Political Participation” convened for the first time in October of 2015, bringing together over 80 representatives from disabled people’s organizations and election management bodies across south Asia. The conference aimed to advocate for increased access to elections for people with disabilities by providing recommendations to the Forum for South Asian Election Management Bodies (FEMBoSA) during its annual conference. After three days of deliberation and advocacy work, the participants in the South Asia Regional Disability Rights Dialogue on Political Participation produced a nine-point charter on disability inclusion in elections and managed to get the Columbo Resolution modified to include language that was inclusive of people with disability. The Columbo Resolution was the culminating document of the conference, setting forth the Forum’s priorities and commitments for the future. In the same document, FEMBoSA also resolved to develop appropriate standards to ensure that people with disabilities are included in elections.

Numerous changes occurred in the wake of this resolution, in part due to continued advocacy by disabled people’s organizations in implementing the recommendations. Smitha Sadasivan, a member of the Disability Rights Alliance India, described the work of the organization in the implementation process in the state of Tamil Nadu, India: “Persons with intellectual and psychosocial disabilities were enrolled in electoral rolls after the Colombo Declaration”. Numerous additional steps were taken, starting with the appointment of officers specifically responsible for disability inclusion. Electors with disabilities were mapped, and reasonable accommodations were identified. Inclusive voter educational material was developed, and election officers and volunteers were trained on inclusive practices. In 2016, the Election Commission of Sri Lanka included a unit regarding disability in its strategic, four-year plan, with the intent to research barriers to inclusion and increase the participation of people with disabilities. These changes are key steps in ensuring that individuals with disabilities are afforded their civic liberties and can take part in shaping their community.

The image shows a stethoscope placed on a surface covered by cloth. The length of the stethoscope is coiled.
India has made progress in improving clinical care for individuals with disabilities by reforming medical education. Source: Unsplash

Rights to Health and Healthcare

A second important development for disability rights takes us from the polling booths to hospital clinics. The impacts of healthcare providers holding negative attitudes towards disability, and a lack of knowledge on appropriate communication, is well documented. It not only impacts the doctor-patient relationship and decreases quality of care, but also results in individuals with disability utilizing healthcare services less frequently. It goes without saying that this contributes to worsened health outcomes for those who are disabled. In recent times, the Medical Council of India has taken steps to bridge this deficiency in clinical care. Starting from August 2019, medical schools in India are required to conduct a month-long training on disability rights that covers culturally appropriate communication and optimum clinical care for people with disabilities. This change came after numerous disability rights advocates, and doctors with disabilities, raised their voice regarding the lack of disability related competencies in the new medical curriculum designed by the Medical Council of India in 2018. Spearheading these efforts was Dr.Satendra Singh of the University College of Medical Science in Delhi University.

Collaborating closely with people with disabilities and educators across the country, Dr.Singh and his colleagues developed 27 disability competencies based on the human rights approach to disability, as enshrined in the UN Convention on Rights of People with Disabilities. While more can be done to make education on disability rights increasingly comprehensive and immersive, such as inclusion of experiential learning where medical students spend time with individuals with disabilities outside of the hospital, these actions are undoubtedly a much-needed step in the right direction. India, like many other countries, also faces challenges in increasing medical student diversity in terms of disability – significant, structural barriers still exist for competent medical school applicants with disabilities. Disability rights advocates like Dr.Singh continue to challenge inaccurate and negative stereotypes regarding the abilities of individuals with disabilities, hoping to further improve medical care and education for people with disabilities.

The image displays gold medals stacked in pairs. Engraved on the medals is writing and a logo signifying the Special Olympics.
The Rising Sun Education and Welfare Society of Lahore, Pakistan, has trained numerous athletes with developmental disabilities who went on to win international competitions like the Special Olympics. “SPECIAL OLYMPICS EUROPEAN SUMMER GAMES 2014” by Special Olympics Oesterreich is licensed under CC0 1.0.

The Role of Non-Governmental Organizations

Another area of development is the not-for-profit sector, organizations that are working at the grassroot level to offer support to individuals with disabilities and to help implement and further systemic policy changes. An example of such an organization is the Rising Sun Education and Welfare Society in Lahore, Pakistan, which aims to encourage the independence of individuals with disabilities through education and training. One noteworthy aspect of the organization is their training in sports. Sports training is offered as a way to develop capabilities and life skills of individuals with disabilities and to allow them to compete at the highest level in international competitions like the Special Olympics. Over the years, athletes from the organization have won 91 medals in numerous events across the world.  The organization also provides vocational training in cooking through their “Special Chef” program – individuals who participated in the program went on to not only work for the Education and Welfare Society, but also join other organizations as chefs and start their own business ventures. Lastly, another crucial role the organization plays is in raising awareness amongst parents regarding the support services available to their children with disabilities. These efforts attempt to combat the stigma surrounding disability and promote the inclusion of individuals with disabilities as equal members of society.

Future Directions

Despite these accomplishments, there is a lot more work that needs to be done. A study by Paul Chaney of Cardiff University revealed that ableism is still pervasive in Indian society. Educational programs for individuals with disabilities are not funded adequately, and private schools often ignore the minimum supports for students with disabilities as required by the law. Individuals with disabilities in rural areas are particularly disadvantaged in terms of educational opportunities, leading to much higher likelihood of unemployment and poverty. Concerns continue regarding the accessibility of the healthcare system for people with disabilities. Still, efforts are being made to combat forced institutionalization and forced sterilization of individuals with disabilities, issues which compound at the intersection of gender discrimination.

The successes discussed in here are just a few examples of the change created by the disability rights movement across the world and the driving force behind it: namely, the advocates who work tirelessly to push society forward in its inclusion of individuals with disabilities. Although more progress is yet to be made, these testimonies give us hope that transformational change can occur, however gradually it may come about. This is our letter of gratitude to those who continue to work to ensure the equitable and rightful treatment of individuals with disabilities and our call to action to all others.

Injustice in the Justice System: Disability, Schools, and Incarceration

The image depicts rows of wooden benches in a well-lit classroom.
The image depicts a school classroom. The experience of individuals with disability in schools often contributes to their disproportionate incarceration. Source: Unsplash

Freddie Gray was killed as he was being transported in a police vehicle because the police did not take appropriate safety measures. Gray’s encounter with the police undoubtedly involved racial biases held by the officers due to their perceptions of African American men. However, another aspect of Gray’s identity, which lead to him being disproportionately impacted long before his encounter with the police, played a role in his untimely demise at the hands of an unfair system. Gray had a developmental disability as a result of growing up in a house with lead paint, which meant he was unable to understand multi-step instructions. This, however, was not identified early enough for Gray to receive accommodations in school. Due to this lack of support, Gray had a difficult time in school, ultimately leading to suspensions and dropping out of high school. Since then, Gray came in contact with the criminal justice system multiple times. Gray’s story displays the complex, intersectional impact of various factors that lead to an individual being disadvantaged by our society, including race, socio-economic status, and disability. Moreover, it displays how lack of appropriate identification and accommodation for students with disabilities increases their likelihood of entering the school-to-prison pipeline.

My previous post investigated accessibility of the criminal justice system to people with disabilities. This article will focus on the factors that lead to individuals with disabilities being incarcerated at a disproportionate rate, with a special focus on individuals with intellectual and developmental disabilities. This disproportionately impacts children and individuals with developmental disabilities, both through the school-to-prison pipeline and through either exploiting or ignoring them in proceedings.

The School-to-Prison Pipeline for Individuals with Disabilities

It has been shown that dropping out of high school increases the likelihood of a child encountering the criminal justice system. This tendency is reflected in the prison and jail population as well. A paper by Respect Ability on disability and criminal justice reform reported that high school completion rates amongst incarcerated individuals is low – two-thirds of people in state prisons and seven out of ten people in jail have not completed high school. The literacy rates of incarcerated individuals also demonstrate the connection between education and incarceration. The National Assessment of Adult Literacy Survey, carried out by the U.S. Department of Education in 2003, reported that prison inmates had lower literacy rates than their counterparts that have not been incarcerated. While disparities found in the survey have decreased since the 1990’s, there were significant differences in literacy.

This relation between educational attainment and incarceration means that people with disabilities, who have a lower high school graduation rate than their peers who are not disabled, are at disproportionate risk of being incarcerated. While 84.6% of individuals without disability graduate high school in 2019, only 67.1% of students with disabilities graduate high school. The cause of this may be three-fold. Individuals with disabilities are not always provided accommodations to allow them flourish in the classroom. While 1 in 5 children differ in their learning abilities, with conditions like dyslexia or ADHD, only 1 in 16 children have IEPs, which are plans to provide accommodations and supplemental instruction. They also do not always receive a diagnosis that allows them to get accommodations in classes. This disproportionately impacts girls with developmental disabilities. For example, autism spectrum disorder is less likely to be identified in women than in men due to lack of knowledge about differences in presentation in males and females. This issue intersects with race as well – individuals in minority communities may find it particularly difficult to get a diagnosis. Moreover, people with disability are twice as likely to receive an out of school suspension as people without disabilities, and students who are suspended are more likely to drop out of school. Male African American and Latino students with disabilities have the highest suspension rates, once again showing how intersectionality leads to a more severe worsening of outcomes.

The image shows coiled, barbed wire on top of metal fences found in prisons. There is a partly cloudy sky in the background.
“Prison security system” by x1klima is licensed under CC BY-ND 2.0.

People with Intellectual and Developmental Disorders

People with intellectual and developmental disorders (IDD) are further disadvantaged in the criminal justice system due to multiple reasons, often leading to the person with the disability being ignored or coerced in proceedings. One of the foundational issues is that people with intellectual and developmental disorders are not appropriately identified. The determination of whether an individual has an IDD varies by state, with a judge making the decision in some states and a jury in others. One commonality, however, is that the evaluators chosen to assess the status of developmental or intellectual disability are often not qualified to do so. They lack a nuanced understanding of the conditions they are to assess – for example, they are not aware that people with IDD sometimes deny their disability. In the Hall v. Florida case, the supreme court made the important ruling that individuals cannot be diagnosed solely based on the results of an IQ test, but more needs to be done to ensure IDD is accurately identified. False stereotypes about the abilities of individuals with disabilities systematized through unqualified evaluators often means people with disabilities do not receive the full protections offered to them by the law.

However, an accurate determination alone is insufficient to guarantee that the rights of people with IDD are upheld in the criminal justice system. During the judicial proceedings, individuals with IDD may be coerced or left out completely, both of which are problematic. Individuals with IDD may be forced or manipulated into making false admissions of guilt, at times due to their desire to please the questioner. Individuals with IDD may also waive their rights, such as when the Miranda warnings are read out by police officers, without fully understanding their privileges because the information was not presented in a comprehensible manner. The inappropriate assessment discussed in the previous paragraph also applies to deeming individuals with IDD competent to stand trial when they do not have an understanding of the proceedings. This offers further opportunities for individuals with IDD to be exploited. On the other hand, individuals with disabilities are left out of proceedings when they are capable of participating and when their testimonial is crucial. The silencing of competent individuals with disabilities is particularly detrimental when they are the victims of crime, who are seeking justice.

People with IDD are denied opportunities for redress due to stereotyped views of their disability, leading to higher likelihood of incarceration. They are also denied opportunities to correct the behaviors that lead to incarceration because they are not allowed alternatives to incarceration, such as rehabilitation. Once incarcerated, individuals with IDD cannot make use of the same opportunities to reduce their sentencing, as the process for doing so is not communicated in an understandable way. The American Association on Intellectual and Developmental Disabilities advocates for the full participation of individuals with IDD in proceedings, as well as the provision of accommodations that allows them to do so. They also recommend that an advocate specialized in disability be present at all times, in addition to the person’s lawyer, to bring a better understanding of the condition to the proceedings and ensure that the rights of the individual with IDD are upheld.

Fortunately, advocates are working to secure the rights of people with disabilities and ensure fair treatment in the judicial system. The Alabama Disability Advocates Program is one of 57 federally mandates protection and advocacy (P&A) programs which provide legal services and representation for people with disabilities. However, systemic efforts need to be taken to correct currently existing, crucial shortcomings like inadequate methods of identifying disability in courtrooms and schools. Accurate identification of disability and provision of accommodations is crucial in a society where schools are not doing enough to set all students up for success and the criminal justice system does not enforce the protections that people with IDD are entitled to. As mentioned in my previous article on the criminal justice system, it is possible, and necessary, for all of us to create change in this space by contacting local legislators and making our priorities as constituents clear to those who represent us.

 

 

 

Injustice in the Justice System: Issues of Access for People with Disabilities

The image shows the sculpture of a women holding scales, which is supposed to represent justice. In the background are the pillars of the Supreme Court of the United States.
Lady Justice before the Supreme Court of the United States, symbolizing impartiality and fairness. “Lady Justice” by justindc is licensed under CC BY-NC-SA 2.0

As Brady Mistic got out of his car, he was immediately met with the blinding glare of  police lights. Being a person with deafness, Brady relied mostly on his sight to interact with the world around him, so the bright light was confusing to say the least. He moved towards the light to inquire about the disturbance. Within the next seven seconds, Brady would find himself shoved to ground and tased by the police as they barked commands that were completely inaccessible to him, even as he tried to communicate that he was deaf. Within seven seconds, Brady acquired three charges, including resisting arrest, and was sentenced to four months in prison. Within seven seconds, the police officers’ inability to identify the need for, and establish, alternate forms of communication lead to a physical altercation and incarceration. Although these charges were waived after almost two years, Brady’s story is indicative of a widespread, disproportionate impact of the justice system on people with disabilities.

In fact, while only 20% of Americans have disabilities, 32% of federal inmates and 40% of jail inmates report at least one disability. The difference in these numbers is no coincidence. In this and a subsequent article, we will see that people with disability are not only overrepresented in prison and jail systems, but also treated unfairly at every step in the process of incarceration and reintegration into society. This article connects Mistic’s inaccessible encounter with the police with a broader, systemic lack of accommodations in the criminal justice system; the second will focus on the school-to-prison pipeline for kids with disabilities and the experiences of people with intellectual and development disabilities.

Mistic and Accessibility in the Criminal Justice System

Mistic’s encounter with the police was not the only incident of law enforcement getting into a violent altercation due to their inability to communicate with a disabled individual. In 2017, Oklahoma City police fatally shot Magdiel Sanchez, an individual with deafness, after he failed to respond to verbal commands to drop the stick in his hand and get on the ground. He was later found to have not been involved in the hit-and-run case for which the police were called. Witnesses who were present at the time of the event were even yelling to the police officers, saying that Sanchez was deaf and could not understand their spoken words. The lack of appropriate communication and the haste in action which is evident in both of these cases points to an underlying deficit in police training. Despite the fact that individuals with any type of disability are legally entitled to receive the same access to legal enforcement services as people without disabilities, most of the training around disability and crisis intervention training programs are not mandatory and are focused on psychological disabilities. Law enforcement training is not comprehensive with regards to disability and fails to equip officers with the necessary skills to interact with people who have intellectual, developmental, or other types of disabilities, which can potentially lead to fatal consequences.

Sadly, the lack of access in Mistic’s interaction with the criminal justice system did not end at his encounter with the police. Mistic was denied an interpreter when interacting with his lawyer while in jail. Like other aspects of Mistic’s case, this too points to an institutionalized barrier that prevents people with disabilities from being treated justly. Inaccessibility in the court and prison system is rampant. This was evident in the case of Abreham Zemedagegehu, an Ethiopian man with deafness whose first language was Ethiopian Sign Language. He was not allowed an interpreter during his six weeks in jail, making it very difficult for him to hear announcements for meals, contact his friends and family, and receive medication for his back pain.

Through multiple lawsuits over the years, prisoners with deafness reported not being able to understand the prison-wide safety instructions, to take part in classes in prison, and to defend themselves in disciplinary proceedings because a sign language interpreter was not present. In 2010, a prison in Virginia became the first in the country to have a videophone after it settled a lawsuit by a group of deaf inmates. It is difficult to imagine that this basic mode of accessible communication for people with deafness was unavailable at one point in any prison in the US and is still not available in many prisons. The lack of accessible communication methods impacts the success of people with disability as they reintegrate into society as well. One individual with blindness had the opportunity to enroll in community college courses but did not receive appropriate accommodations during classes. Another individual with a disability sought to find out how to apply for social security benefits but was denied information by their counselor, who believed they should apply for a job instead.

The image shows a corridor lines on either side by prison cells. There are two levels of prison cells. The prison cells have metal bars from the floor to the ceiling, and also some metal bars running along the length of the cells. Some of the entrances to the cells are open. There are no people in the image. The image has a very grim and foreboding atmosphere.
Prison cells in Alcatraz, San Francisco. Source: Unsplash

Access to Health Services

Decreased access to medication and health services in prisons, as Zemedagegehu experienced, disproportionally impacts people with disabilities, risking the deterioration of health problems. When 91% of jailers report they have in their facilities individuals with serious psychological disabilities who are at risk of committing suicide, it becomes imperative – a matter of life or death – to ensure adequate health services are delivered in time. The status of accommodations is no better, as many prisons deemed essential accommodations (including wheelchair, prosthetics, exercise equipment, other assistive technology) as no longer “medically necessary” in order to cut costs. Health services are placed further out of the reach of inmates due to exorbitant co-pay rates, which can be as high as a month’s labor, and additional fees incurred by prosthetics and other accommodation.  The results of these factors is best portrayed in a Bureau of Justice System study which looked into health issues of prisoners and jail inmates. Only two-thirds of participants reported receiving necessary medical treatment, whereas 11% reported that their illness was not being treated because they were not being given medication. While the overrepresentation of people with disabilities in jails and prisons may largely be attributed to unjust treatment of people with disabilities, it is possible that the conditions within the jails and prisons, including the lack of access to health resources, are contributing to the development of disabilities in inmates.

Perhaps the most shocking experience of Zemedagegehu during his time in jail is that he was forced to receive an injection, which he later found out was a tuberculosis test, after refusing to sign a medical consent form because it was not presented in a way that he could comprehend. This blatant human rights violation, of forced medical procedures and ignorance of patient autonomy, underscores the necessity of sweeping changes in the jail and prison system’s treatment of individuals with disabilities.

Inaccessibility in the justice system, however, is an issue not only for arrested and incarcerated individuals with disabilities, but also to citizens seeking justice. According to a Bureau of Justice study, people with disabilities are victims of violence at twice the rate as people without disabilities. Clearly, individuals with disabilities stand to benefit from the services offered by the court system, services which they are entitled to but cannot always access due to the failure of the criminal justice system in being inclusive to all members of the community.

The issues of inaccessibility discussed in this article violate the rights afforded to all individuals, including article seven of the Human Rights Declaration which promises that everyone is “entitled without any discrimination to equal protection of the law”. Reforms to the criminal justice system need to take into account the needs of people with disabilities at every level, from law enforcement to court systems to jails and prisons. Individual citizens can contribute to pushing for such reforms as well. Find your local legislators and advocate for issues of access in the criminal justice system by writing to or phoning their office. Recent prison reforms in Alabama, including a bill allocating approximately $800 billion to the construction of two new facilities that will reduce overcrowding in prisons, offer hope for progress. Whether or not accessibility becomes a priority in the future depends on you and I to organize, stand as allies, and demand change.

 

 

Disability Rights under the Taliban

Pictured is the Bamyan Band Amir road in the Bamyan province of Afghanistan. It is a black, winding path in the middle of pale yellow hills.
Bamyan Band Amir road in the Bamyan province of Afghanistan. Source: Unsplash

Imagine being confined to your home. Imagine not being able to go to work or attend school or play sports. Over the course of the past year, individuals across the world have experienced such limitations. While many are inching closer towards glimpses of life before these restrictions, for Afghans with disabilities, particularly women with disabilities, this is more likely to become an enduring reality.

Almost twenty years after their first regime, the Taliban is back in control of Afghanistan, raising concerns that the same violations of the rights of women and other minorities will be committed again (for a brief history of Afghanistan and the Taliban, visit a previous article on the IHR blog linked here). While no longer a minority in terms of numbers, the 80% of adults in Afghanistan who are disabled are already seeing these concerns materialize. Disability rights advocates are being targeted, with many fleeing the country out of a fear for their lives and many more desperately trying to do the same. In light of these events, this article explores the status of individuals with disabilities in Afghanistan before and after the Taliban came into power, and how their future might look.

Disability in Afghanistan

The war in the 1990’s devastated health systems in Afghanistan, leading to individuals with disabilities being neglected. After the Taliban was overthrown by the U.S. in 2001, there was an influx of international funding to help rebuild the infrastructure of the country. NGOs and other international organizations attempted to fill the gap in the health system by offering medical services, although the demand did, and continues to, exceed the supply. Moreover, reconstruction efforts in the country were not inclusive of people with disabilities, as bus transports, buildings and bathrooms were inaccessible which made it difficult for individuals with disabilities to navigate their daily lives outside of their homes. Afghanistan ratified the Convention on Rights of People with Disability in 2012 and even passed legislation in 2013 that was meant to safeguard the rights of individuals with disabilities to be included in society. Although awareness regarding disability has increased over the past two decades, and disability rights have been named a priority by the former government, much of the work towards this end has been carried out by NGOs, international organizations, and dedicated activists.

In addition to systemic barriers, the societal attitudes and stigma pertaining to disability is also a significant factor impacting the lives of disabled individuals in Afghanistan. Different kinds of disability are viewed differently, receiving varying degrees of negative attitudes. Congenital disability, or developmental disability, is considered a punishment to the parents for their past deeds. This problematic perception leads to discrimination against the individual with the disability, as well as their family, to such an extent that the parents tell others that their child acquired the disability as a result of the war. Amputees, on the other hand, do not face the same discrimination because they are assumed to be war veterans. One individual with a physical disability described to the Human Rights Watch her experience of this stigma: “Some time ago, my friends and I decided to go to the market in our own wheelchairs and shop ourselves. But people called us ‘grasshoppers,’ which is why we decided to stay at home.” Such accounts depict how the freedom and independence of individuals with disabilities is being curtailed not only by structural barriers, but also by regressive attitudes.

Disability under the Taliban

Benafsha Yaqoobi, a blind disability rights advocate and a commissioner at the Afghanistan Independent Human Rights Commission (AIHRC), stated in multiple interviews that individuals with disabilities will be discriminated against under the Taliban rule, experiencing severe neglect and even death. She is concerned about their access to basic human rights like food and shelter. Yaqoobi had to flee Afghanistan when the Taliban takeover seemed imminent. She described her traumatic experience in attempting to escape, as she heard gun fire but could not see where the guns were pointed or who got shot – or if it was her husband who was wounded. Her experience also highlights just one way in which war can have a disproportionate psychological, and physical, impact on people with disabilities.

Isabella Hodge, executive director of the United States International Council on Disability (USICD), told The Nation that there is also concern that stipends will no longer be provided to individuals who were disabled in war and that rehabilitation centers will close. Hodge strongly believes that individuals with disabilities will not be valued by the Taliban, saying that the “Taliban wouldn’t think twice about killing someone with a disability.” These concerns are reflected in reality when considering that 80% of suicide bombers of the Taliban had either a physical or psychological disability of some kind. Dr.Yusef Yadgari of Kabul Medical University attributed this statistic to societal stigma, due to which people with disabilities struggle to find employment to support their family. Out of both necessity for money and resentment, according to Dr.Yadgari, they are more likely to become suicide bombers.  However, one cannot help but question how much value that the Taliban attributes to the lives of people with disabilities when they were willing to sacrifice so many for their cause.

With the Taliban’s rise to power, people with disabilities will likely have less opportunities to flourish. One stark example of this is that Tokyo 2020 Paralympic athletes from Afghanistan almost lost the opportunity to participate in the event because of the dearth of flight transport created by the turmoil in August. Fortunately, with the help of the international community, these athletes did manage to finally make it to Tokyo, although one athlete missed the event he was preparing for. Opportunities and freedom of people with disability does not seem to be a priority. Afghanistan’s National Sports Director for the Special Olympics Mohammad Jawed Hashmi echoed similar concerns in an interview with Reuters – that people with disabilities will be confined to their homes and isolated from the rest of society due to the loss of programs and initiatives like the Special Olympics (which works specifically with people with intellectual disabilities). Sports for individuals with intellectual disabilities is a great way to develop essential life skills like walking and eating. Zala Hashmi, a women’s coach in the country’s special Olympics organization, believes that the Taliban does not care enough for the success of these individuals to ensure the continuation of such programs. The grim situation is put best in Jawed’s own words: “we cannot support them, we lost them.”

A girl with a prosthetic limb, donning a black dress and a determined expression, walks through the ward of a rehabilitation center in Afghanistan. The ward has light blue walls, and there are other individuals with disabilities sitting on benches that line the wall. There is a support beam in between the girl and people sitting on the benches.
“Learning to walk again with support from UK aid” by DFID – UK Department for International Development is licensed under CC BY-NC-ND 2.0

Women with Disabilities

Women with disabilities experienced intersectional discrimination in Afghanistan long before the Taliban came into power. They are often considered a burden to the family and are considered not fit for marriage, consequently increasing their likelihood of being subject to violence both in and outside the household. Women with disability are also more likely to be sexually harassed when seeking government assistance or employment. One individual in an interview with the Human Rights Watch said, “the ministry employee told me that I can get this certificate only if I agree to be his girlfriend”. The status of education of girls with disabilities is not any more promising. In a Human Rights Watch report, a disability rights advocate describes the pushback from schools in accepting girls with disabilities: “The schools do not want girls [with disabilities] to go to the classes. Usually, they argue that they are not normal people so they cannot sit in the classrooms and learn like other students.” In addition to this stigma, public schools are not wheel-chair accessible, leaving some kids out of the classroom and other school related activities, while few private schools enroll people with disabilities at all. Moreover, schools are also often far and difficult to reach without dedicated transportation, which is often not available.

These inequities for women with disabilities are likely going to be exacerbated under the Taliban. While the Taliban promises that they will uphold the rights and freedom of women, their actions so far have not conveyed the same message. Women have been removed from their jobs, which has been particularly devastating in cases where they are the sole earners in the family. Women have already been told to stay at home for security reasons, an excuse that sounds eerily similar to the one they provided during their time in power in the late 1990s as they imposed oppressive restrictions on women. This confinement will be particularly detrimental for women with disabilities, compromising their access to rehabilitative services and other beneficial activities like sports. Nilofar Bayat, a women’s rights activist and captain of national wheelchair basketball team, expressed deep concern about girls with disabilities not being allowed to play sports, saying their disability will become more severe without the activity. In addition to this, the barriers to education for women with disabilities will also increase under the Taliban, who completely banned education for women during their previous regime.

Support for People with Disabilities

Disability rights activists in Afghanistan are being targeted due their association with the United States, leading to a decline in supportive services offered to individuals with disabilities. The United States International Council on Disability (USICD) reported that around 50 disability rights advocates are currently in danger of being attacked by the Taliban and are in urgent need of evacuation. Many of them participated in a conference on disability rights organized by USICD and the Afghanistan embassy in 2017 and received grant funding from the U.S., putting them in a precarious position. One advocate describes severe persecution, being forced to move from one house to another to avoid being captured after the Taliban launched a grenade into his house and attempted to find him at his organization’s office. He told The Nation that the Taliban believes advocates are spying for the US because they received grant funding from the U.S. The evacuation plan of the US did not account for the needs of people with disabilities either, as multiple disability rights advocates were unable to make their way around Kabul airport. One amputee had to return home due to extreme pain. Afghanistan’s National Sports Director for the Special Olympics Mohammad Jawed Hashmi believed the Taliban was searching for them as well, coming to their offices and damaging their property. All this points to the fact that disability advocates will find it increasingly difficult to play their crucial role in supporting the disabled community. For example, initiatives to make bathrooms more accessible, to provide rehabilitation, to conduct vocational training, and to provide trauma care service for land mine victims all are at risk of being lost. The champions of the rights of individuals with disability are being silenced.

Disability rights activists are not the only ones facing difficulties in continuing operations – humanitarian organizations too are struggling to continue providing their essential services. The United States Agency for International Development (USAID) reported that approximately three-quarters of organizations faced challenges in providing aide since August. The Taliban has a history of actively clamping down on organizations providing humanitarian aid and health services as well, banning the Red Cross and WHO in 2019 from operating in its territories after claiming they were carrying out “suspicious” activities and not sticking to their mission. They have since lifted the ban, and Red Cross is providing services currently, but this incident sets a chilling precedent to the relationship we can expect to see in the future between the Taliban and international aid organizations. In addition to this, a Human Rights Watch review reported that the increase in conflict since 2016 has led to increased difficulty in collecting data from rural areas. This is likely to be the case in Afghanistan’s current state of turmoil, making it difficult to assess the needs of people with disability and whether they are being addressed.

In a recent report, the International Committee of the Red Cross stated that health systems in Afghanistan are on the brink of collapse, partly due to a decrease in funding. While the services provided by aide organizations and advocates are far from being able satisfying the immense demand, and by no means replace systemic efforts to rectify the situation, the role of advocates and aide organizations is undoubtedly more important than ever to ensure people with disabilities are not neglected.

The Taliban take-over might deconstruct the existing structures, but there is no guarantee that that they will build them back, let alone build them back better. It is disheartening to know that the violations minorities experienced under the Taliban occurred for more than five year and would have continued for longer if the US did not invade in 2001. My point is not to comment on the merit of the “war on terror” but to point out the more prolonged, devastating consequences that could have occurred in the past, and that very well may occur in the foreseeable future, due to insufficient action by the international community. The international community needs to mobilize resources to aid those who are disproportionately impacted by this transition. You and I can contribute to bettering the situation in Afghanistan as well. Consider donating to trusted humanitarian aid organizations, like the Red Cross, UNICEF, and UN Women, that are doing essential work on the ground. Humanitarian aide itself, however, is insufficient – foreign governments need to increase pressure on the Taliban to guarantee the rights and well-being of marginalized communities.

 

The Shift from “Autism Awareness Month” to “Autism Acceptance Month”

The Autism Society of America, the United States’ oldest leading grassroots autism organization, is celebrating Autism Acceptance Month (AAM) in April 2021. This month was previously known as Autism Awareness Month, but this year, the Autism Society is taking to social media to assist it in changing the title to Autism Acceptance Month.

AAM
Autism is a developmental disorder that affects 1 in 59 Americans as of 2020. (Source: Yahoo Images)

In 1970, the organization launched an ongoing national effort to promote autism awareness and to assure that all autistic people are able to achieve the highest quality of life possible. The first annual National Autistic Children’s week commenced in 1972, which evolved into AAM. This year’s campaign is titled “Celebrate Differences,” and it is “designed to build a better awareness of the signs, symptoms, and realities of autism.” The 2021 focus is to “provide information and resources for communities to be more aware of autism, promote acceptance, and be more inclusive in everyday life.” With the prevalence of autism in the United States rising from being 1 in 125 children (2010) to 1 in 59 children (2020), the need for AAM is greater than ever.

So why the shift from Autism Awareness Month to Autism Acceptance Month? Christopher Banks, President and CEO of the Autism Society of America, puts it like this: “While we will always work to spread awareness, words matter as we strive for autistic individuals to live fully in all areas of life. As many individuals and families affected by autism know, acceptance is often one of the biggest barriers to finding and developing a strong support system.” The shift in terminology fosters acceptance to ignite change through improved support and opportunities in education, employment, accessible housing, affordable health care, and comprehensive long-term services. Acceptance is so integral that the Autistic Self Advocacy Network (ASAN) has been referring to April as Autism Acceptance Month since 2011, expressing that accepting autism as a natural condition is “necessary for real dialogue to occur.” The Autism Society of America is also advocating the federal government to officially designate April as “Autism Acceptance Month” since there has never been a formal designation for AAM.

The United Nations has, however, designated April 2nd as World Autism Awareness Day that is commemorated internationally. This year, the UN plans on hosting a virtual panel discussion titled “Inclusion in the Workplace: Challenges and Opportunities in a Post-Pandemic World” on April 8, 2021. The panel will consist of individuals on the autism spectrum who have personally experienced challenges in the employment market, especially in light of the COVID-19 pandemic.

AAM
The UN designated April 2nd as World Autism Day. (Source: Yahoo Images).

 

Acceptance is something the global population has been and continues to struggle with, but engaging in conversation and learning about one another’s perspectives, we can individually become accepting. And if the global population decides to embrace such a philosophy, our world can be filled with more love and acceptance and less hatred and stigmatism. Let us all aim to be aware and accepting of the global autism community as well as others. It starts with you and educating yourself.

Inclusivity in Education: Cooperative Learning with Special Education

Students sitting in a classroom.
“classroom.” Source: Lead Beyond. Creative Commons.

In 1954, the United States Supreme Court overruled the “separate but equal” clause of Plessy v. Ferguson with the case of Brown v. Board of Education of Topeka, declaring that “separate” educational facilities are inherently unequal. While Brown v. Board was aimed at addressing racial segregation, it is worth noting the implications of this view of separate educations because students with learning disabilities are often educated separately from their peers.  Our current education system divides students into different categories and programs based on their perceived levels of academic ability under the assumption that this is the best way to help students reach their fullest potential.  This is problematic and leads to students’ missing the benefits of an inclusive classroom.  Though it would not be a simple task, students who have learning disabilities should be educated alongside students who do not, using cooperative classwork, where students work together to complete an assignment or task, whenever possible.

The Americans with Disabilities Act defines a person with a disability as “a person who has a physical or mental impairment that substantially limits one or more major life activity.” For this blog, I will be focusing on learning disabilities, particularly those that do not completely inhibit functions that are vital in a traditional classroom, such as communication. However, I do recognize that the line that I am drawing between which disabilities/experiences of disabilities my proposal would apply to and those it would not is not completely clear, as no two people with the same disability have the same experience. The degree to which a person is able to participate in inclusive and cooperative learning would have to be determined on a case by case basis.

Article 26 of the United Nations’ Universal Declaration of Human Rights (UDHR) states that everyone has a right to an education.  Article 24 of the UN’s Convention on the Rights of Persons with Disabilities (CRPD) states that all people with disabilities have the right to “an inclusive education system at all levels and lifelong learning.”  The use of cooperative classwork among students with and without disabilities would hopefully help more effectively access these rights for both parties.  Additionally, by helping the members of each group become more accustomed to interacting and being part of a common social group, this can also help individuals with the types of disabilities that are focused on in this blog to access their right to employment (which is given in article 23 of the UDHR and article 27 of the CRPD) and their right to participation/inclusion in their communities (article 27 of the UDHR and article 19 of the CRPD).

Our Current System

When discussing whether students who have disabilities should be educated separately from students who do not, it is helpful if we begin by considering why we use the system we currently have.  A literature review titled “Implicit Assumptions in Special Education Policy: Promoting Full Inclusion for Students with Learning Disabilities” was published by Moira Kirby in the Child Youth Care Forum in 2016.  In the review, Kirby aimed to find special education trends relating to “inclusive practices, Response to Intervention (RTI), and student achievement.”  She argues that the educational system currently used in the United States, while meant to increase access to education, perpetuates certain students’ isolation from others, as it is based on problematic assumptions about disabilities.  The first assumption is that disabilities are deviant conditions that should be “eradicated.”  The second is that “all special services should be delivered in a separate environment.”  These assumptions inform the implicit biases about degrees of educational ability.  Kirby also argues that these assumptions must be changed in order to “promote access and equality for students with learning disabilities.”   In her article, she states, “The question is not, how can we fix a disability, but how can we make our classroom environments a place where all students can learn, regardless of their need.”

The educational system that is currently in place in the US involves separating students with learning disabilities, “low-performing” students, students who meet “average” expectations, and “high-performing” students.  This system is well-intentioned, theoretically giving each group of students the unique resources they need to reach the height of their personal capabilities.  In practice, however, this system is quite flawed.  It is a system based on expectations (typically informed by assumptions and implicit bias), which become harmful to many students, especially those with learning disabilities, due to stereotype threat.  Stereotype threat is “the risk of confirming negative stereotypes about an individual’s racial, ethnic, gender, or cultural group” and the effect that that risk can have on the individual’s performance.  Many people assume that students with disabilities will do poorly in school, and when students with disabilities know this, they often adopt those same expectations for themselves.  If academic success seems unlikely or even impossible, this can become a barrier to the motivation and access to resources that can lead to it.  Stereotype threat also leads students with learning disabilities to underestimate the quality of their academic performance overall, even at times when they are doing well.  They can start to assume that they simply cannot do well in school.

This sort of negative self-evaluation can also be damaging to a person’s mental health and well-being.  If one consistently sees themselves as not good enough, smart enough, or strong enough to do things well, it can be easy for them to fall into depression, anxiety, or another struggle with mental health.

Another problem that comes with stereotype threat is that it takes up precious cognitive resources.  Students spend part of their cognitive resources thinking about the expectations they are held to, distracting them from the work they are trying to do, and preventing them from using all of their resources to their advantage, which contributes to a decreased ability to perform well.

In her research, Kirby found that teachers who had been asked about inclusion in the classroom tended to attribute the success of attempts at inclusion to the students’ physiological traits rather than the value of inclusive practices.  She points to this belief as one that could potentially lead a teacher to believe that students with disabilities could be taught only separately from others.  They were also often found to lack confidence in their abilities to teach students with disabilities.  Parents also either had negative or neutral views on the impact of inclusive education.

In 2015, “68.2% of students with learning disabilities spend 80% or more of their day in the general education classroom, while 24.1% spend 40-70% of their day in the general education classroom.”  This in no way aligns with the idea that students with learning disabilities need to be educated separately from other students, and it highlights a point of concern.  If many general education teachers do not feel like they are able to teach students with disabilities, and most students with disabilities spend a large part of their day in general education classrooms, what implications do these things have regarding those students’ education?  Ideally, students would be educated by someone who felt they were qualified to teach them rather than someone who is uncertain about it.  If students with different educational needs were consistently taught in the same classroom, teachers would all need to go through the training necessary to teach students with special educational needs, allowing them to better support their students.

Students listening to teachers in a classroom.
“Classroom.” Source: PAL LTER, Creative Commons.
An Inclusive Educational Environment Can Be Beneficial For All Students

The negative impact that a segregated educational system can have on students with disabilities is not the only reason to move towards a more inclusive system.  Evidence that suggests that inclusive classrooms can lead to positive outcomes for all of the students involved.

In their article “The challenges of implementing group work in primary school classrooms and including pupils with special educational needs,” Ed Baines, Peter Blatchford, and Rob Webster review the results of two research projects: the SPRing (Social Pedagogic Research into Group-work) project and the MAST (Making a Statement) project.  Realizing that most studies regarding collaborative work in education that had previously been performed had been on a small-scale and short-term basis, the authors reviewed the results of these two projects to come to a better, more reliable understanding of the challenges of inclusive group-work in primary schools.

The SPRing project was a five-year-long project that aimed to “develop and implement with teachers a programme of principles and activities that incorporated group work  into curriculum and everyday school activities” and “to evaluate this programme relative to a control group in terms of academic progress, behavioral interaction and dialogue, and attitudes and motivation towards learning.”  The developed program included a handbook and six training sessions where teachers could develop the skills that they need to incorporate group work into their lessons.  The four main areas covered by the program included “preparing the classroom and group context for group work,” “preparing lessons and group-work activities,” “preparing adults to support pupils and groups,” and “preparing pupils for group work.”

The results of the SPRing project show that, relative to the control group, the students that participated in the program made more progress in general science tests, “were more actively engaged in task interactions,” had more sustained interactions, and “engaged in more high-level reasoning talk.”

The MAST project “involved systematic observation and case studies” of students with known special educational needs that were being taught in general education classrooms. This project’s results provided Baines and his co-authors with information about the interactions between students with special educational needs and adults/peers.  The project found that students with special educational needs “were half as likely to work with or alongside peers” as other students.  It was also found they were often isolated from the other students.  Some of the reasons for this isolation included a student with special educational needs choosing to sit away from the others, and other students being afraid of or nervous about working with them.  One factor that may contribute to each of these reasons could be that the students with special educational needs that were a part of the study may have had poor social and communicational skills.  While difficulties with communication are an aspect of many learning disabilities, inclusive group work may give these students an opportunity and a safe environment in which they can develop these skills (though a student should never be pushed to do group work if it causes them an amount of stress that is genuinely detrimental to their well-being).

This isolation of students with special educational needs may also result from traditional students and school faculty viewing people with disabilities as “the other” as being outside of normal.  This would help to explain why traditional students may be hesitant to associate with students who have disabilities.  It could also explain why students with special educational needs isolate themselves from other students, as they may have internalized their peers’ view of them.  They may feel like they are on the outside looking in, unable to be a part of the rest of the group.

In her literature review, Moira Kirby also addresses some of the benefits of inclusive educational settings, as suggested in different case studies.  In one study, elementary school students scored higher in reading and writing when taught in a general education classroom rather than a separate special education classroom.  Another study found that eighth-graders with learning disabilities had “significantly higher scores in math academic achievement tasks and self-concept” when taught in an inclusive classroom. Students from another study scored higher in math, science, social studies, and language arts.

Students without learning disabilities may also benefit from inclusive educational environments.  Students who perform well could potentially benefit from working with students with disabilities and helping them understand the topics they are learning about and the group work they might do.  Re-wording and explaining a concept to another person can

help cement one’s understanding of it.  Additionally, if all teachers have to teach classes with children with different educational needs, they would have to be prepared to work with students with disabilities, which would improve the support that those students receive and broaden teachers’ perspectives.  This could allow teachers to develop skills that would be beneficial in teaching all students, with or without disabilities.

 Concerns and Challenges

Though there are many advantages to adopting a more inclusive educational system, there are still concerns and challenges that also come with it.  One concern is that students with learning disabilities may face social rejection from their peers.   For their article “The Social and Emotional Situation of First Graders with Classroom Behavior Problems and Classroom Learning Difficulties in Inclusive Classes,” Johanna Krull, Jürgen Wilbert, and Thomas Hennemann surveyed 2,839 first graders and found that students with “classroom learning difficulties” (CLD) and “classroom behavioral problems” (CBP) were at a greater risk for social rejection than their peers.  However, the authors found several outliers in their data, where students with CLD or CBP had higher rates of social acceptance, and they interpret this to mean that, under the right circumstances, an inclusive education system is possible.  In their article, Baines and his co-authors suggest that social rejection in this context can decrease over time when students are involved in inclusive group-work (if the students remain in the same groups throughout that time). Group work allows students with disabilities who struggle with social skills to develop those skills. It will enable other students to better understand people’s experiences who are different from them, which may lead them to be more willing (and happier) to be inclusive and build friendships with other students.  If a student has no/little prior experience with students with learning disabilities, it would not be surprising to find that they are nervous or uncomfortable interacting with them.

When discussing the possibility of an integrated classroom, people are also concerned with the impact of having children with severe behavioral issues in general education classrooms, as they may become distracting or disruptive to the point of preventing any productivity in the class. This may be a factor that needs to be considered on a case-by-case basis. Some children that are deemed as being too disruptive have the potential to become less disruptive with exposure to a traditional classroom setting.  There are likely situations where students truly are too disruptive to allow for a productive classroom, but that is certainly not always the case.  It is important that, if a student is found to behave in a distracting way, that they are not immediately moved into another classroom after a single incident (although consideration should be given to the severity and the nature of the interruption). They should be given the opportunity to try and adjust to the traditional classroom environment before they are placed in a different one.

Another concern is that educating students at such a range of degrees of ability in the same classroom might prevent both students with learning disabilities and students that are currently in advanced programs from reaching their fullest academic potential. This concern is largely connected to the assumption that being in the classroom means that students would all be learning from the exact same curriculum, but that is not necessarily true.

In her article, Kirby suggests that a completely inclusive classroom might not involve basing lesson plans on the categories that students have been assigned to.  Instead, each student would have an Individualized Education Plan (IEP). In our current public education system, children in special education programs must have an IEP, a “map that lays out the program of special education instruction, supports, and services kids need to make progress and thrive in school.” Each child has an IEP team, including their parents, at least one general education teacher (unless the child does not work with any), at least one special education teacher, a school district representative, a school psychologist/specialist, and the child.  After the IEP is developed, the team regularly meets to discuss progress and possible changes for the plan.  If every student, whether they have general or special educational needs, has an IEP, then (in theory), each student could have their personal needs recognized and met in the classroom.  Kirby also suggests that making IEPs standard for all students could reduce the impact that the stigmatization of learning disabilities has on students, as school faculty would be less reliant on separating students into different/broad categories to teach them.

Of course, creating an IEP for every student in the public school system is much easier said than done and is a much more attractive idea in theory than in practice.  It would require a significant shift in the allocation of resources in education, which may not be practical with the financial resources we currently have access to.  It would also be asking many teachers, as they would no longer be able to teach with a singular lesson plan. It is unrealistic to expect teachers to carry this burden themselves, as they are already spread too thin, given more responsibilities than they can reasonably handle.  Having IEPs for every student would likely require a serious increase in the number of teachers at each school or at least an increased/reinforced support system for school faculty. Perhaps a more feasible solution could be developing IEPs for students with a clear need for increased educational support that involves their being more present in the traditional classroom than in a separate one.  While this is still likely to feed into the stigmatization and othering of students with disabilities, there do not seem to be any strong alternatives that are both practical and successful in avoiding stigmatization altogether.

Conclusion

In short, we should aim to educate students with and without learning disabilities together whenever possible, even though it will take a lot of time and effort to do so.  We currently separate students based on expectations of their academic abilities, and these expectations are informed by and reaffirm problematic assumptions about people with learning disabilities.  This can be harmful to people with learning disabilities and prevent students with all degrees of educational needs from accessing the benefits that can come from an inclusive classroom.  However, it is important  that we recognize and genuinely consider the concerns and challenges that arise when we look to put inclusive education ideals into practice.  It is also important to recognize that the conclusions that can be drawn based on the resources used to support this argument are limited, as many gather data from anecdotal situations and small samples sizes.  These factors prevent the results of sources from being reliably representative of experiences with inclusion and students with learning disabilities on a larger scale.  The application of my argument is also limited, as I have focused on students with learning disabilities that do not completely prevent them from effectively learning or functioning in a general education classroom.  While an integrated school system is generally optimal, there are some students for which that kind of system genuinely would not work.  We cannot treat all students with disabilities as if their experiences are the same by assuming that all would do poorly in an inclusive classroom or that all would be unquestionably better off in an inclusive classroom.  Overall, even though it will not be easy, even if we can never achieve a perfectly integrated educational system, it is an important goal which we should work towards for the benefit of all students and their educational rights.

World Diabetes Day

A hand pointing to text underneath it which reads "World Diabetes Day"
World Diabetes Day. Source: Ashley Huslov, Creative Commons

World Diabetes Day is recognized globally on November 14th. It’s important to recognize the progress we’ve made in managing diabetes. In the past, a diagnosis of diabetes was devastating in many ways: type I and insulin-dependent type II diabetes were often fatal until the discovery of insulin in 1921; gestational diabetes drastically worsened pregnancy outcomes for women and their babies; and other types of type II diabetes resulted in severe complications. Diabetes now has become known as a serious, but treatable, disease. While medically we’ve come a long way with the treatment of diabetes, there are still improvements that need to be made in relation to the social treatment.

Despite the great strides made in the medical community in regard to diabetes, people with diabetes still face hardships and discrimination in the workplace, the classroom, and in the health sector. Many people with diabetes need accommodations in the workplace that are protected by the Americans with Disabilities Act (ADA). For example, many people with diabetes have rapid drops or spikes in blood sugar—hypoglycemia and hyperglycemia, respectively—and they need to take time to remedy it. If an employer does not accommodate these needs, they are in direct violation of the ADA. There are exceptions, such as when hyperglycemia, hypoglycemia, or the breaks make the employee unable to do the essential function of the job. However, in many workplaces, these breaks are possible.

Kristine Rednour was hired as a reserve paramedic for the Wayne Township Fire Department (WTFD). When she was hired, she let the WTFD know that she had type I diabetes. She was promoted to full time, and during work had two hypoglycemic episodes within the same year, which affected her ability to respond as a paramedic. She was put on paid leave, during which she was required to have the medical director clear her. He cleared her for restricted duties and with workplace accommodations, which the WTFD refused to put in place and instead fired her. She sued the WTFD for violating the ADA and won. This is just one of many examples of workplace discrimination that people with diabetes face.

The ADA also protects children at school that have disabilities, including diabetes. However, like with employment discrimination, discrimination at school still occurs. Schools that receive federal funding are required to be able to make accommodations for students with diabetes, such as allowing them to have snacks and having staff that is qualified to administer care.

Some schools don’t offer these accommodations, especially the latter, which can put children at risk for life-threatening medical complications. Some schools even tell parents that their children will not receive medical assistance from staff even if the complications have become so severe that they are unconscious. Often, parents have to put their jobs on hold to be able to make trips to school to check on their children, potentially placing them under increased financial strain.

Blood Glucose Monitors can send blood sugar levels to an app that the child can download and have more immediate updates on their blood sugar. For some children with severe type I diabetes, they can find out life-saving information about what would otherwise be a severe drop in blood sugar. However, many schools are unwilling to accommodate students by letting those with diabetes access their phones or the Wi-Fi, which puts them at risk for missing a life-threatening drop in blood sugar.

Some children have been denied entrance into schools because they have diabetes, which violates the ADA if the school receives federal funding. Many students are sent to schools that they are not zoned for because the schools closest to where they live do not have staff trained to take care of them, despite the requirement of this accommodation. This means that parents have to drive their students to a school farther away, potentially disrupting their ability to get to work. Some schools participate in this type of discrimination knowingly, while others do not understand enough about diabetes or the ADA. Regardless, denying entry into a school because of a disability is a direct violation of the ADA.

Due not only to the discrimination those with diabetes face, but also the stress and anxiety of not knowing when they’ll have a drop or spike in blood pressure, people with diabetes often suffer from worsened mental health, which according to many sources, including the UN, is a human right. This lessened mental health takes many forms: people with diabetes are two to three times more likely to suffer from depression; diabetes distress can occur when a person with diabetes feels controlled by their illness instead of the other way around; and when physical health gets worse, mental health often follows. It is important for people with diabetes to know they can seek medical attention for their mental health as well as their physical health.

The final place people with diabetes face a violation of their human rights is in the healthcare setting. Healthcare is expensive even without taking into account chronic diseases, especially medication. Insulin is a relatively cheap and easy medication to make. In the 1990s, a one month supply was less than $50, whereas now it’s upwards of $200, which is not accounted for by inflation. For people without insurance, or those that are underinsured, this can put a huge financial burden. This has led to people with insulin-dependent diabetes to ration their insulin, which can lead to death. For example, a nurse, who knew how to manage her diabetes, was found dead due to not using enough insulin. For people with insulin-dependent diabetes, insulin is a human right, which is being denied to many by the sharp increase in prices.

People with diabetes now are able to live happy and healthy lives, especially compared to a hundred years ago. However, they are still set back due to discrimination and human rights violations. It is important as a society to work towards removing the barriers that people with diabetes, among other disabilities, face so that they have access to health, both mental and physical.

Breathing Lessons: Disability Rights in the Wake of COVID-19

The novel coronavirus (COVID-19) has provoked an unprecedented reality for much of the global population by streamlining widespread bureaucratic frustration, health anxiety, and social distancing. Most people know that older adults and people with underlying health conditions are disproportionately affected by COVID-19, although many people fall under both these categories and identify with a disability. Also, due to the limited resources available to treat people with COVID-19, concerns have emerged about who receives what type of care. This would force health providers with the grim task of dictating whose lives are worth saving. This blog addresses concerns about rationing care amid the influx of COVID-19 patients and how this might affect the largest minority group in the United States (26%) and world (15%), people with disabilities.

Word Health Organization suggests COVID-19 is particularly threatening to people with disabilities for a list of reasons: (1) barriers to implementing proper hygienic measures, (2) difficulty in social distancing, (3) the need to touch things for physical support (e.g. assistance devices; railings), (4) barriers to accessing public health information, and (5) the potential exacerbation of existing health issues. These issues add insult to injury because, even without COVID-19, people with disabilities by-and-large receive inadequate access to health care services. This is largely due to the competitive nature of health systems which value profit maximization and, thus, disadvantage people with disabilities as consumers in the health care market.

Recently, select states and hospitals have issued guidelines for health providers that would potentially deny people with disabilities treatment for COVID-19. Two entities, Alabama Department of Public Health (ADPH) and Washington State Department of Public Health (WSDPH), have recently come under scrutiny because of their efforts to fulfill such guidelines.

ADPH’s Emergency Operations Plan suggests that ventilator support would be denied to patients with “severe of profound mental retardation”, “moderate to severe dementia”, and “severe traumatic brain injury”. This controversial protocol has recently grabbed the attention of Alabama Disability Advocacy Program and The Arc thus leading to a complaint with U.S. Department of Health and Human Services Office for Civil Rights (OCR) regarding discrimination toward people with intellectual and cognitive disabilities.

With Washington notoriously being one of the first COVID-19 hotspots, WSDPH and the University of Washington Medical Center have come under fire for their plans to develop a protocol that would allow health providers to access a patient’s age, health status, and chances of survival to determine treatment and comfort care. These efforts have been confronted by Disabilities Rights Washington with their own complaint to OCR that declares any medical plan that discriminates against people with disabilities effectively violates the their rights and is, therefore, unlawful.

OCR swiftly responded to these concerns, as well as those from Kansas and Tennessee, by stating that, even in the case of pandemics, hospitals and doctors cannot undermine the care of people with disabilities and older adults. OCR Director Roger Severino exclaimed, “We’re concerned that crisis standards of care may start relying on value judgments as to the relative worth of one human being versus another, based on the presence or absence of disability,” and “…that stereotypes about what life is like living with a disability can be improperly used to exclude people from needed care.”

Also, with New York currently having most of the U.S.’s confirmed COVID-19 cases, they may very well be the first state to face the imbalance of available ventilators and patient demand. Disability advocates have recently decried verbiage in New York’s Public Readiness and Emergency Preparedness (PREP) Act that could provide immunity from civil rights for some patients. Thus, U.S. state and federal powers are playing tug-of-war with the status of disability rights during the COVID-19 crisis.

Not Today #COVID19 Sign Resting on a Wooden Stool.
Not Today COVID-19 Sign on Wooden Stool. Source: Pexels, Creative Commons.

However, these concerns are not limited to the U.S. In the developing world, many people with disabilities are segregated from their communities in overcrowded facilities, while thousands of others are shackled and incarcerated. This weak enforcement of disability rights positions people with disabilities, in countries such as Brazil, Croatia, Ghana, India, Indonesia, and Russia, at-risk of further inhumane treatment by receiving limited or no appropriate care related to COVID-19. As a result, Human Rights Watch urges state and local authorities to return these populations to their families and demand they provide needed support and services within their communities.

Nearly every country in the world has ratified the United Nations’ Convention on Rights of Persons with Disabilities (CRPD) which aims to fulfill the human rights and fundamental freedoms of people with disabilities. More specifically, Article 25 of CRPD suggests people with disabilities have the right to non-discriminatory health care and population-based public health programs. Thus, nearly every person with a disability around the globe is associated with a governmental power that claims to be dedicated to fulfilling the promise of CRPD. However, in the wake of COVID-19, will these words be put into action?

These unprecedented events are a turning point for how we view our bodies, health, and communities. This is also an opportunity to view the world through the perspective of those in your community such as people with disabilities who represent an array of impairments, challenges, and experiences. Despite boredom and apathy being at the forefront of many people’s isolation, images of life versus death surround others, and for a good reason. In these decisive weeks, and likely months, there has never been a greater time for people in the U.S. and abroad to acknowledge that disability rights are human rights.

Golf and Life Lessons: The Dennis Walters Story

On Wednesday, February 5th, the Institute for Human Rights co-sponsored an event alongside College of Arts and Sciences and Lakeshore Foundation to present World Golf Hall of Fame inductee Dennis Walters. During his lecture, he addressed his passion for golf, experience with disability, and journey of perseverance.

Raised in New Jersey and playing college golf at the University of North Texas, Walters had dreams of being on the PGA Tour. Amid his burgeoning career as a professional golfer, Walters experienced a golf cart accident that left him paralyzed from the waist-down. Following the accident, Walters underwent four months of excruciating rehabilitation, peering at the golf course across the street with a desire to drive a ball across the green. Although his doctor claimed he would no longer play golf, but Walters’ vision suggested otherwise.

Following his rehabilitation, Walters moved back home with his parents in New Jersey while he became accustomed to his new way of life. One day, he finally mustered the courage to swing a golf club. With help from his father, they had a makeshift system that included a pillow, waist strap, rope, and a tree to assist with Walters’ swing. As a result, Walters was hitting golf balls as he did before which kept his golfs dreams alive. The first time Walters played on a course after his accident, he received cheering support from fellow golfers and, soon after, a re-purposed bar stool for his golf cart. Thus, The Dennis Walters Golf Show was born.

However, not everyone was originally thrilled about Walters’ show. After his father wrote a letter to Jack Nicklaus and told him of his son’s ambition, Walters’ career took off. Although Walter’s show is not just any golf exhibition, it’s a performance! His show includes golf shots with a three-headed club, fishing rod, radiator hose, gavel, left-handed club, crooked club, and tall tee as well some bad jokes and a four-legged sidekick. After more than 40 years, Walters has traveled over 3 million miles and done over 3,000 golf shows for fans near and far.

Walters exclaimed, “There’s no expiration date on your dreams” and offered the crowd his five P’s for success:

    1. Preparation (establish a plan)
    2. Perspiration (hard work pays off)
    3. Precision (stay focused)
    4. Passion (live what you do)
    5. Perseverance (stay on the path or else the other four don’t matter)
This is a picture of Walters posing with members of UAB Men's and Women's Golf teams.
Walters with members UAB Men’s and Women’s Golf teams. Source: UAB Institute for Human Rights

Walters asked himself, “Why have this dream?”. At times, he felt entirely hopeless about golfing again. However, golf was like therapy to him, both mentally and physically, which he claimed was better than medicine. He then closed by expressing, “The good about golf is the people you know”, which highlights the importance of inclusion and acceptance of people with disabilities on and off the green.

Thoughts on Homelessness in Birmingham

Image of shelter made of cardboard boxes.
David Hilgart. Home. Creative Commons for Flickr.

During the winter break, I spent a lot of time in Birmingham, staying with my sister and with friends, far away from my farm and home in Columbiana. Our farm is more like an animal rescue or sanctuary that does not generate much income but enough to accommodate. Besides hundreds of animals being surrendered or abandoned, we have even had strays walk up our driveway. Our goat, Fred, was the first I remember as we were in disbelief that a goat was just walking the streets and checking out the very sparse neighborhood, curiously coming up to us with some twine wrapped around his neck. For Fred and everyone to follow, my parents and family members have never refused taking in, rehabilitating, or rehoming an animal in need, so maybe that’s why it was so much more obvious of how much worse the picture I have seen in Birmingham is, or what this article is about. In Birmingham, it is people living in the streets witnessed by a city full of people. Walking through five points and down 20th, there is so much evidence and example of homelessness.  Passerby witness but rarely realize that they are seeing many at their most vulnerable or the harsh, daily routine.

Image of street and tunnel wall lined with bags and boxes and evidence of someone's home
Chris Yarzab. Creative Commons for Flickr.

Responsibility of the State

People experiencing homelessness face violations of many human rights, such as inaccessibility to safe and secure housing, an inadequate standard of living, education, liberty and security of the person, privacy, social security, freedom from discrimination, voting, and more which are interconnected.  These human rights are protected by several international human rights treaties. The International Covenant on Civil and Political Rights (ICCPR), the International Covenant on Economic, Social and Cultural Rights (ICESCR), and the Convention on the Rights of the Child (CRC), which bind the state to legal and moral obligations in realizing and protecting the rights of all people. Also, the right to housing recognized by international human rights law doesn’t just mean a right to shelter. It must be adequate and accessible. Battling and overcoming homelessness is not a task of charity as much as an act of justice. Our Public policy and structures should facilitate or lead to a dignified life in the United States. As one of the wealthiest nations in the world, we should figure out how to shelter or house those who are homeless.

No one is asking what happened to all the homeless. No one cares, because it’s easier to get on the subway and not be accosted.- Richard Linklater

More recently, I saw many cops parked in the middle of five points as they held up traffic to address some of the people I have seen more statically living there, which brought up the thought of criminalization of homelessness and left me wondering if those cops offer rides to shelters before the ride to a cell.

A look at more vulnerable populations

The most visible type of homelessness is what we see when we walk through Birmingham: people living on the streets or sleeping in the parks or street tunnels. However, more move between shelters and temporary homing maybe with their friends or relatives and more long-term shelter where their experience may not be included in the conversation of homeless persons.

Within 2018 records reported by Continuums of Care to the U.S. Department of Housing and Urban Development, there were almost 3,500 people homeless on a given night (280 were family households, 339 were Veterans, 158 were unaccompanied young adults (aged 18-24), and 540 were individuals experiencing chronic homelessness). Over 900 of those were concentrated in the Birmingham area. Over the year, there were 14,112 students who faced homelessness in Alabama.

A large portion of the homeless population is affected by mental illness. People with mental illness or other disabilities may face social isolation and may face chronic homelessness. Such individuals may require special types of accommodation or support that may be an obstacle to rehabilitation.  Health issues may cause a person’s homelessness as well as they may be intensified by the experience where poverty and lack of access to care contribute to disparities in health. Another thing to think about is when someone handicapped by a disability loses their parents or caretaker, who will take care of them or will they find tools to live? They could become homeless.

Through the lingering effects of systematic denial of equal rights and opportunities, African American are particularly overrepresented in this system facing a higher risk of poverty, housing discrimination, and incarceration than White Americans

Indigenous people face greater social and economic disadvantage such as lower levels of education or higher levels of unemployment which contribute to higher levels of homelessness in their communities

Women may make up a big portion of those forced to leave their homes fleeing domestic violence or sexual assault. Homeless women may become more isolated for fear of violence, rape, or other abuse. Further, a woman may be separated from her children if she is unable to care for them which challenges her parental rights.

Children and young people are disproportionately affected by homelessness. I have known many classmates and friends who have been homeless as they pursue their education at UAB. Also, Covenant House proclaims that every year, more than 2 million kids in America will face a period of homelessness (The link provides more enlightening and harder-to-swallow statistics). Youth like those emancipated from the foster care system may not have another option. In addition to general human rights laws, children are protected under special rights, like those afforded in the Covenant on the Rights of a Child which describes a higher standard of living and right to protection against neglect, cruelty, exploitation, etc.

Untreated depression and mental illness, self-medication and addiction, childhood trauma and chronic PTSD, abuse and any circumstance that may lead one to homelessness may also create a loop to imprison them. For example, where abstinence is a prerequisite or requirement for homelessness assistance programs, one may not receive help unless they quit, but one cannot quit without relief.

Image of person sitting on roadside
Pedro Ribeiro Simões. Creative Commons for Flickr.

A veteran should not have to stand on the asphalt with a cardboard sign begging for a living in a nation they helped secure and people should not be in the position to be turned down asking for food that was about to be thrown out. In fact, everyone has made contributions and continues to contribute to their society. Homelessness includes people who have paid or pay taxes and those who are paid less than a living wage. It includes people of all labels fleeing abusive conditions or facing escalating housing and living costs. It includes parents and it includes their children who have not had a chance. It also includes all students who are trying to pursue an education to hopefully get a job that will afford them housing. Besides all these achievements, many, including those facing chronic homelessness have endured full lives and have witnessed different forms of trauma. Still, they have survived the circumstances of homelessness, maintaining their humanity and resilience and- intentionally or unintentionally- being that example for others.

Also, keep in mind that going from place to place and not knowing what to do or where you will end up could understandably create a lot of pain and anger. Desperation or frustration may be harder to deal with. Being homeless could even make you apprehensive of ownership or pursuing certain routes that could be encouraged. However, everyone should be afforded options and certain securities.

10 Strategies to End Chronic Homelessness posted by the United States Interagency Council on Homelessness:

https://www.usich.gov/tools-for-action/10-strategies-to-end-chronic-homelessness

More immediate examples for anyone to help everyday

If it’s raining or about to, offer the warmth and privacy of an umbrella.

Offer to pay for an uber ride to a nearby shelter as some cannot walk to or have no means of transportation to one.

If you are not comfortable lending cash, you may offer supplies. You could keep these care bags of everyday products, essentials (maybe small shower things you could find in the travel section, gloves, hats, etc), or resources to offer or pass out at crowded shelters.

Invite others to the restaurant you are on your way to and share a meal if they are up for it. The conversation may also allow you to understand, accept, or appreciate their life and vice-versa. Once, a man I invited to eat with me on campus (in an environment where I felt safe enough to) proclaimed his version of Islamophobia (as that was the summation of a popular sentiment in America, especially during those Trump Campaign days) as he explicitly said he didn’t like Muslims when I revealed that of my identity. But it turns out, I was the first Muslim he had personally interacted with and realized he liked before the word “Muslim” exited my mouth. That could happen with anyone of course and homeless (or only hungry in this case) people are not to be “enlightened” and should not be expected to praise our deed, but the conversation and gesture can open this opportunity

Additional Resources:

Federal Links Relevant to homelessness:

https://www.hhs.gov/programs/social-services/homelessness/resources/federal-links/index.html