In the Covid era, physical distancing and isolation may be impossible to follow for those who rely on the support of others to eat, dress and bathe
Disability is an issue which has been the least researched. According to the Global Burden of Disease (GBD) study, disability ranges from five per cent in children, to 15 per cent in people between 15-59 years of age and 46 per cent among those aged 60 years and above. In India, 2.21 per cent of the total population is physically challenged as per the 2011 census. However, it is a matter of great worry that those in the age group of 10-19 years form the major part of the disabled population (17.23 per cent). This implies that India may be losing out on the demographic dividend because divyang (physically challenged) children are not found to be at par with their counterparts when it comes to completing primary and secondary education. It is seen that almost a third of the children without primary education suffer from some degree of disability. This has a ripple down effect on their employment opportunities. In fact unemployment rates among the divyangs are as high as 80 to 90 per cent in some countries. Not only does this leave a damaging effect on the household, a higher unemployment rate of the divyang population increases a country’s social expenditure. Moreover, family members may have to cut down their work hours or opt out of the labour market to care for them, further adding to the financial burden.
Amartya Sen argued the economic loss due to disability through two ideas: ‘Earning handicap’ and ‘Conversion handicap.’ “To achieve the same level of opulence, a disabled person may find it harder to get a job or to retain it, and may receive lower compensation for work,” he says. This is an ‘Earning handicap.’ “To do the same things as an able-bodied person, a person with physical disability may need more income than the able-bodied person. To move easily or at all, a person who happens to be, say, crippled by an accident or by illness may need assistance, or prosthesis, or both. The ‘Conversion handicap’ refers to the disadvantage that a disabled person has in converting money into good living,” he adds.
To ensure inclusiveness of the divyang population such that Universal Health Coverage (UHC) is attained and no one is left behind, the World Health Organisation (WHO) and the World Bank realised the need for health interventions to promote equity. The UN refers to assistive technologies (ATs) as pre-conditions to achieving equal opportunities, enjoying human rights and living with dignity. Without the aid of ATs, employment opportunities for divyangs are significantly reduced. Even when employed, labour productivity of divyangs is significantly lower than that of others.
So far, the Indian Government does not have a plan on ATs and they are not built-in as basic requirements within the medical system. But time to time, ATs are distributed as part of media programmes of politicians. There is little or no planning on how the beneficiaries would maintain or repair the ATs in case of a problem. To the best of our knowledge, Indian data on ATs, their procurement procedures, and the financial hardship in acquiring and maintaining those are absent. Policymakers need to realise that making universal access to ATs is not a charity but a major need to reduce GDP loss.
We are living in a Covid era and most likely, we have to live with the virus till a vaccine comes into the market. In effect, this implies that one has to continue living with the new norms and maintain social distancing. While the Government’s diktat on social distancing applies to all and imposes financial as well as physical costs, it significantly affects divyangs. The crucial question is whether they are in a position to follow the “stay safe” manual as advocated repeatedly by the Government? Physical distancing and self-isolation may be impossible to follow for those who rely on the support of others to eat, dress and bathe. The WHO has stated that divyangs may be at a greater risk of contracting COVID-19 as frequent washing may not be possible for them due to mobility issues. Divyangs who require additional support may find it difficult to practise physical distancing; it is unlikely that divyangs with intellectual impairments may cope with self-isolation; people with visual disabilities rely on “touch functions for mobility and work”, thereby increasing their risk of infection. Further, most of the information about the new social norm or on social distancing, health information is being distributed through normal media, which may not be accessible to people with hearing/visible impairments.
To take care of the needs of divyangs, just like the financial package for migrant workers, the Government should provide financial compensation for families and care-givers who need to be self-isolated and are prone to infection. At present, the Arogya Setu app, the principal front for disseminating information on COVID-19 and coping with the same, does not address the special needs of divyangs even after activists flagged it. This goes against the Rights of Persons with Disabilities Act, 2016 where it is mandatory to provide all information in accessible formats to divyangs. Till now, the rules do not make any exception for these people. This must be rectified at the earliest.
(Chowdhury is Associate Fellow and Pohit is Professor at NCAER)