COVID-19: Exclusion, isolation nothing new for the differently abled

Meenu is an individual who has cerebral palsy. So does her husband Samuel. Wheelchair users, inaccessibility of roads and public transport combined with various other factors means they spend most part of their lives within the confines of the four walls of their home.

Residents of Arjun Nagar in Delhi’s Green Park area face exclusion and isolation their entire lives. While the lockdown is a new experience for those who are not differently abled, for those who are, it only means an aggravation of existing issues.

The Rights of Persons with Disabilities Act, 2016 recognises 21 conditions as disabling. The differently abled, however, are not a homogenous group.

Both the issues and their solutions are diverse. The World Health Organization puts that the world’s disabled population at around 15 per cent. The 2011 census in India estimated 2.21 per cent of the country’s population to be differently abled.

It is obvious there was undercounting, something that also brings faulty methodology into question.

Physical distancing and hand washing are advocated as the key to keep the novel coronavirus (SARS-CoV-2) that causes the COVID-19 disease at bay. Practicing this, however, may be problematic for the differently abled.

For Tapas Bharadwaj, a visually impaired student at Amity Law College in Noida, it is virtually impossible to move around his two-story home without touching surfaces.

In the situation of the COVID-19 pandemic, this poses a real challenge, forcing him to be dependent on someone. For those who require the assistance of a caregiver even for daily needs, maintaining physical distance becomes unfeasible.

There are several dimensions to this issue. A news report emerged of a father killing his 45-year-old differently abled son in Kolkata in April 2020. The father was unable to convince his son to not leave the house without wearing a face mask.

A shortfall in blood donations impacts several people. The National Blood Transfusion Council reported a shortfall of nearly half. People who have thalassemia and sickle cell disease need periodic blood transfusion. This scarcity of blood can, thus, be life threatening.

Discrimination in healthcare

When the priority of the entire health system is attending to people affected by COVID-19, other health conditions face neglect. Most of those who are differently abled have some health-related issue.

With hospitals not entertaining other cases, this is a great risk for them. The health system was never accessible in terms of physical access and attitudes. This situation has worsened for the differently abled.

There is a fear of discrimination against the differently abled when there is a scarcity of beds, ventilators, etc. Their lives may be considered disposable. This has happened in the United States and Italy.

Women with disabilities are the worst-affected. Most of them even otherwise suffer a ‘locked-down’ situation with very little opportunity to go out. Apart from other issues, they are subject to increased violence at home. They will find it even more difficult to seek help during a lockdown.

Another issue that usually goes unnoticed is the unavailability of information in accessible formats. This, despite numerous methods employed to provide information to people on COVID-19 related issues.

For people with visual impairment, information needs to be in Braille or audio, while for people with hearing impairment, it needs to be in sign language, etc. This does not get recognised.

Economic compulsions

While addressing the concerns of the disabled population, we need to bear in mind that 69.49 per cent of them are in rural areas. There are around 2 million families in the country that have more than one person with a disability in their house.

In such a situation, an earning family member has to give up work to take over as a caregiver.

This leads to a further squeeze in the family income, where the overwhelming majority come from poor economic backgrounds. Disability also entails extra spending towards aids and equipment, accessible transport, medicines, etc. Poverty contributes to disability, while disability accentuates poverty further.

Considered non-productive, around 64 per cent of the differently abled population who are of working age are unemployed. Meagre opportunities in the government / public sector where reservations exist have seen a drastic fall in the last three decades because of policies of liberalisation and privatisation.

There is negligible employment in the private sector. Many are engaged in hawking / vending on trains, bus stops or doing odd jobs in the informal sector. With promised aid and rations failing to reach large sections, they are left at the mercy of civil society organisations. It will not be long before starvation takes over.

Even the reach of social protection in the form of pensions is far from wanting. The Indira Gandhi Disability Pension of a miserly Rs 300 is given to a mere 1,021,906 people, around 7.6 per cent of the differently abled population in the working age.

The ex-gratia of Rs 1,000 announced by Union Finance Minister Nirmala Sitharaman will reach only one million-odd people. That this is a cruel joke, is underlined by the fact that that this remittance is spread over three months, averaging Rs 333.33 per month.

Bleak outlook

When there is continuous lockdown, there is bound to be boredom, loneliness, fear and anxiety. The loss of employment, livelihood, loss of housing, etc, has an adverse impact on mental health.

This may also lead to an increase in deaths by suicide. Unfortunately, our mental health systems are ill-equipped to handle this challenge.

The treatment gap in India is as high as 83 per cent, according to the National Mental Health Survey 2018 undertaken by the National Institute of Mental Health and Neurosciences, Bengaluru.

The same survey also found that the number of mental health professionals per 100,000 population is low as 0.05 in Madhya Pradesh to 1.2 in Kerala.

Overall, this is a grim situation for the disabled, compounded by the total absence of any serious measure from the government to address these concerns.

The unplanned manner with which the lockdown was imposed has increased suffering and misery. Many became beggars overnight, with their dignity and self-respect compromised.

But this crisis situation also provides us an opportunity to holistically address issues faced by the differently abled, when society as a whole faces issues the differently abled encounter in their daily lives.

The International Labour Organisation in its Persons with disabilities in the COVID-19 response put it aptly: “All crises bring opportunities, and the opportunity of the moment is to make inclusion of all previously marginalized groups — including persons with disabilities — a central element of all responses.”

Some changes were forced on society. Concepts like work from home, flexible working hours, use of video conferencing for judicial purposes, doorstep delivery of services, etc are the norm in the lockdown situation. We will have to build on these as we move out of the pandemic situation.