Rethinking care from the perspective of disabled people.

Excerpt] Although it is now two decades since the United Nations’ International Year of Disabled People, disabled people across the world still encounter severe economic, cultural and social deprivations. The problem is generally worse for those living in rural areas and is especially acute for all disabled people living in low income states. Clearly, health and rehabilitation can no longer be understood solely in terms of orthodox medical interventions and conventional notions of ‘care’. These centre almost exclusively on the perceived limitations of individuals rather than on society’s failure to accommodate disabled peoples’ needs. There is, therefore, an urgent need for an approach that cares not simply about disabled people but also about society and the way it is organized. Responding to this insight, the WHO ‘Rethinking Care’ initiative and Conference brought together disabled people and other stakeholders from high and low income countries to identify key issues and propose recommendations for member states to address this need. Recommendations included the recognition that member nations must adopt a holistic approach that includes the introduction of policies to eliminate poverty and secure equal access to all community based services and facilities. These include medical services, education, employment, housing, transport, public amenities etc. This must be accompanied by the introduction of comprehensive and enforceable anti-discrimination laws and policies to secure the active and meaningful involvement of disabled people and their organizations in all future policy developments. States must adopt a truly inclusive approach to these issues that addresses the needs of all disabled people equally. This includes disabled women, disabled children, and people with complex and/or multiple impairments with potentially high dependency needs. Access to medical and related services is a basic human right must not be determined by the ability to pay. With this in mind several important and practical recommendations were devised for the future implementation of the first four UN Standard Rules on the Equalization of Opportunities for Persons with Disabilities. These concern medical, rehabilitation, and support services and awareness raising campaigns. Finally, the responsibility for introducing and financing these developments rests with national governments. But where necessary high-income states, international monetary institutions and transnational organizations, should make resources available to the governments of low-income countries to secure the successful implementation of these initiatives.