Persons With

Disabilities
Jeriel Reyes De Silos, MD,
MPM-HSD
December 7, 2015

Disabled? <yes/ no>

1) A 5-year old girl with cerebral palsy
2) A 70-y.o. female, diagnosed with St. IV Lung
CA. She is currently a presidential candidate
in a certain Southeast Asian country.
3) A 90-y.o. male with Alzheimers disease. He
cannot recognize his grandchildren
anymore.

What is Health?
State of complete physical,
mental, social well being and not
merely the absence of disease
(WHO)

What is Disability?

Disability - Definition
There is no universally accepted definition of
disability
Different definitions across cultures
Different interpretations across history

Disability is a socially created problem and not

an attribute of an individual (The World Programme of Action
for Disabled Persons and the Standard Rules on the Equalization of
Opportunities for Persons with Disabilities)

Disability - Definition
WB/WHO International Classification on Functioning,
Disability and Health (ICF) Disability refers to
difficulties in any or all three (interconnected) areas of
functioning:
Impairments problems in body functions or alterations
in body structure
Activity limitations difficulties in executing activities
Participation restriction problem with involvement in
any area of life

Disability (Cont.)
May be a result of or predispose one to disease
or injury
Economic implications may manifest either loss
of productivity or income that can lead to SOCIAL
DEPENDENCY

Persons with Disabilities (PWDs)

Those suffering from restriction of different
abilities resulting from a mental, physical or
sensory impairment or restriction in performing an
activity in the manner or within the range
considered normal for human beings.

Disability Phenomenon
Disease/ Disorder
Impairment
Disability
Handicap

IMPAIRMENT: any loss or abnormality of

psychological, physiological, or
anatomical structure or function
DISABILITY: Any restriction or lack of
ability to perform an activity in the
manner or within the range considered
normal for a human being

HANDICAP: A disadvantage for a given

individual, resulting from an
impairment or disability, that, limits or
prevents the fulfilment of a role that is
normal, depending on age, sex, social
and cultural factors, for that individual

Review
Impairment physiological/ anatomical/
psychological loss
Disability functional loss or limitation
secondary to an impairment
Handicap loss or limitation of a normal
role in the society due to impairment or
disability

Key Facts on Disability and Health

Over a billion
people, about
15% of the
world's
population,
have some
form of
disability

Key Facts on Disability and Health

Between 110 million

and 190 million adults
have significant
difficulties in
functioning.

Key Facts on Disability and Health

Rates of disability are
increasing due to population
ageing and increases in
chronic health conditions,
among other causes.

Key Facts on Disability and Health

People with disabilities
have less access to
health care services and
therefore experience
unmet health care needs.

The United Nations Convention on the Rights of

Persons with Disabilities (UNCRPD)
Module 2

UNCRPD Purpose:
1. To promote, protect and ensure the full
and equal enjoyment of all human rights
and fundamental freedoms by all persons
with disabilities
2. To promote respect for their inherent
dignity.

What are the principles set out

in the Convention?

Respect for dignity and individual autonomy

Non-discrimination
Participation and inclusion
Respect for difference and diversity
Accessibility
Equality of opportunity
Equality between men and women
Respect for the evolving capacities of children with
disabilities

PWD in the Philippine

Context

PWD in Numbers: Philippines

Population
Persons with
Disability
(PWDs)
% of PWDs

2010
92.1 million
1.443 million

2000
76 million
0.935 million

1.57%

1.23%
National Statistics Office
(NSO), 2010

PWDs by Age (2010)

Age Group
0-14
15-49
50-64
>65

Percent (%)
18.9
40.0
19.0
22.1
National Statistics Office
(NSO), 2010

PWDs by Sex
PWDs (2010)

Female; 49%

Male; 51%

National Statistics Office

(NSO), 2010

Existing Laws on PWDs in the

Philippines
Magna Carta of Disabled Persons (RA 7277)
Provisions on employment, transport, public
services
Incentives for employers
Amended Magna Carta (RA 9442) included
other incentives like 20% discounts for
certain services and goods
Accessibility law (BP 344) Addresses access
to buildings, institutions and establishments
through facilities suitable for PWDs

UNCRPD Implementation in the

Philippines

On employment of PWDs
5% of positions reserved for PWDs
Uncoordinated efforts to provide
employment
PWDs in vulnerable employment
Social Insurance
Disability benefits and pensions
Coverage is only for the employed PWD or
employees who acquired disability while
working

UNCRPD Implementation in the

Philippines
On Children with Disabilities
DepEd zero rejection policy
97 % not reached by public
school system

Disability: Concepts

Modern Concept of Disability

An interaction between two factors:
Personal condition (being in a wheelchair; having a visual
impairment)
1. Physical
2. Socioeconomic
Environment (negative attitudes; lack or poor access to services or
facilities)
1. Accessibility
2. Legal/ policy
3. Socioeconomic
4. Services

Factor 1: Personal Conditions

Physical

Gender
Ethnicity
Impairment (physical, intellectual, mental)
Size and weight

Socioecono
mic

Wealth (rich, middle class, poor)

Class
Inclusion in society
Education level

Factor 2: Environment
Accessibilit
y

Legal/
Policy

Socioecono
mic

Services

Geography

Social
protection

Rich / poor

Education

Antidiscriminati
on

Negative
attitudes
and
prejudice

Healthcare

Supportive
Measures

Positive
awareness

Good/ poor
enforcemen
t

Open to
change /
closed

Transportati
on access

Building
facilities

Communitybased
rehab
Social
support
Social
insurance

How Disability Works?

Personal

Environment
Interaction

(-)

Social participation

(+)

Examples
1. A wealthy PWD might be able to access tertiary
education and so find a job
Increases participation in society
Can also alleviate disability to an extent

2. A school might be made accessible by including ramps

and elevators. However, public transport is still not
common in the area.
Still low accessibility for PWDs with no private vehicles
Decreases participation in society
Magnifies disability

Four Approaches to Disability

1. Charity approach
2. Medical approach
3. Social approach
4. Human rights approach

Charity Approach
Under this model persons with disabilities are:
1. Disempowered
2. Not in control of their lives
3. Have little or no social participation.
4. Considered a burden on society.
5. Because charity comes from goodwill, the quality of
care is not necessarily consistent or even important.

Charity approach
How this approach sees disability:
Persons with disabilities are in a tragic situation
Persons with disabilities cannot take care of
themselves
Persons with disabilitiesinspire compassion
Persons with disabilities are objects of benevolence
How this approach proposes to treat
disability:
They need our help, sympathy, charity
Collect and give money to provide for persons with
disabilities.
The quality of the care is less important
Who is the duty bearer on disability
issues:
Benevolent persons, charity houses, homes,
foundations, religious institutions

Charity approach
Charity
house

Poor people, we should

help them, if we can and
want to

Medical approach
How this approach sees disability:
Persons with disabilities need to becured
Persons with disabilities play thepassive role of
patients
Persons with disabilities are considered abnormal
Persons with disabilities are unable tolive
independently
How this approach proposes to treat
disability:
Persons with disabilities need as much rehabilitation
as possible to reach the best extent of normality, in
order to access rights and participate in society
Who is the duty bearer on disability
issues:
Doctors and health authorities
Often health ministry

Medical approach
Rehabilitati
on centre

Poor people, we should fix

them, so they can
participate.

Consequences of Charity and

Medical Approaches to PWDs
Optional benevolence (instead of duty/rights)
Stigmatization
Submission / Disempowerment
Forced institutionalization
Segregation
Dependence
Image disparagement
Low self-esteem

Social approach
How this approach sees disability:
Disability is the result of a wrong way of organizing society: thus,
persons with disabilities face bias and barriers that prevent their
equal participation
Disability is not anindividual problem and mainlylies in the social
environment that can be limiting orempoweringdepending on
many factors
How
Personswith
disabilitiescan
and should
participate in society
this approach
proposes
to treat

disability:

Eliminate environmental barriers that constrain the participation

of persons with disabilities, including attitudinal barriers
Enable the participation of persons with disabilitiesin public
policymaking
Make all public services and polices accessible and inclusive
Ensure accessibility

Who is the duty bearer on disability

issues:

State, all ministries, society

PWDs are part of human diversity

Being human has a broad spectrum of

possibilities
MANY WAYS
MANY WAYS
MANY WAYS
OF
OF
OF SEEING
WALKING
THINKING

MANY WAYS MANY WAYS

OF
OF
COMMUNI- INTERACTIN
CATING
G

Etc.

Social approach
We need to eliminate the barriers to
enable the participation of persons
with disabilities.

Hospital

School

Human rights approach

How this approach sees disability:
Ensures full and equal enjoyment of all human rights to persons
with disabilities, and promotes respect for their inherent dignity
Focuses onequal opportunities,non-discrimination on the basis
ofdisabilityand participation in society
Requires authorities to ensure rights and not restrict them
Views personswith disabilities as rights-holders

How this approach proposes to treat

disability:

Enforce laws to ensure full inclusion in all social aspects (school,

family, community, work, )
Apply policies to raise awareness
Respect equal recognition before the law
Regulate the private sector

Who is the duty bearer on disability

issues:

State, all ministries and society

Human rights approach

We, persons with and without
disabilities, are part of the same
society and we have the same rights
and obligations
Equal
participatio
n

Co
on nv
No ent
w i
!

dis No
cr i nm
on inat
i

State

Key principles of a human rights

approach
Inclusion

Participatio
n

Respect for
difference
and
diversity

Accessibilit
y

Equality of
opportuniti
es

Nondiscriminati
on

Respect for
inherent
dignity

Four approaches to disability

Convention
Time
Charity approach
Medical approach
Social approach
Human rights
approach

Terminologies Associated with PWDs

Outdated

Suggested

Victim of

Person with

Suffering from
Afflicted by

Person who has

Person with

Invalid

Person with disabilities

Mentally handicapped

Person with an intellectual or psychosocial

disability

Mentally ill

Person with a mental or psychosocial disability

Manic depressive

Person who is bipolar

Epileptic

Person with epilepsy

Spastic

Person with cerebral palsy

The blind

Person who is blind, person with sensory disability

Disabled parking/disabled
toilet

Accessible parking/accessible toilet

Sources
Convention on the Rights of Persons with Disabilities
A/HRC/4/75
A/HRC/10/48
Department of Economic and Social Affairs; United Nations Population Fund; Wellesley
Centers for Women, Disability Rights, Gender and Development: A Resource Tool for
Action. Available from
www.un.org/disabilities/documents/Publication/UNWCW%20MANUAL.pdf (accessed 2
August 2012)

The National Strategy for Improving Adult Literacy and Numeracy Skills;
Its not as simple as you think: Cultural viewpoints around disability. 2006
www.specialolympics.org (accessed 8 January 2015)
National Statistics Office