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Time to Refocus Development Aid?

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If you head to the Department for International Development's website you'll find a link on its front page to "policies" - and if you click through that you'll find the twenty-two policy areas in which the Department is spending its ring-fenced budget. Having read through most of them, I have to say there is one glaring omission - helping people with disabilities.

Actually, DfID shouldn't be blamed for this. Back in 2000, when the Millennium Development Goals (MDGs) were adopted, it was widely acknowledged that they did not explicitly address disability. Back then, however, it was well recognised that the scourges of disease, poverty, inequality, and discrimination impact people with disabilities at alarming and disproportionate rates and unfortunately this is still the case today.

A decent chunk of UK aid goes to getting children in developing countries into school and improving their education. Unfortunately, across the developing world, the vast majority of children with disabilities do not attend school. While this is obviously detrimental to their ability to grow academically, socialise and integrate into society; the negative impact goes far beyond education. Schools are also more often than not the primary venues for immunisation drives and health education initiatives. If people with disabilities are not in school, they are highly unlikely to receive these services. Where medical services exist in the wider community, people with learning disabilities are routinely denied care or given substandard treatment due to the lack of training of healthcare professionals.

Alas statistics prove that those with disabilities are also much more likely to be abused both physically and sexually. Studies have shown that up to 83% of women with learning disabilities have been the victims of sexual assault and shockingly 68% have been abused before the age of 18. In addition to the psychological and social consequences, this abuse also puts them at increased risk of severe health problems including HIV/AIDS.

Disability is both a cause and an effect of poverty and disease, creating a cycle of poor health and poor opportunities, compounded by poor understanding amongst policymakers. More often than not, people with learning disabilities are simply ignored, left to endure more physical pain, more social isolation and ultimately a premature death.

Consider just one story told by Tim Shriver, the head of the Special Olympic movement worldwide: In 2012 in sub-Saharan Africa, Special Olympics volunteers found Aaron, a nine-year-old boy, tied to a tree like an animal outside his family's home. He was held there because there was nowhere for him to go and no one to help his impoverished mother. In fact he had been "tied" by his parents for seven years. It was their only method for managing the demands of their child while also raising four other children. Aaron's parents did not tie him out of malice; they tied him out of desperation. For too many parents across sub-Saharan Africa, this is the only standard of care they can offer to their children. The impacts on Aaron's health, development, and social skills, essentially his future, do not bear thinking about.

Aaron is not alone. People with learning and developmental disabilities are disproportionally represented on virtually every indicator of hardship, disease and discrimination.

Numbering more than 200 million globally, people with learning disabilities are the largest disability group in the world. To tackle the problem of extreme poverty without taking into account this population is to disregard their rights and limit the chance of successfully fighting disease, poverty, intolerance, and injustice. If we truly aspire to meet the real goals behind the MDG targets, then surely our efforts must focus on those who need them met the most -- people with learning disabilities.

As a Brit, I am proud that our government is spending 0.7% of our GDP on international development; but I am concerned that we have failed to understand the pervasive inequality facing people with learning disabilities. We must commit to correcting this failure and bringing about the more just world that the architects of the MDGs had in mind... but how?

Reversing the age-old prejudice and inequality faced by people with learning disability will be an arduous journey, but there are specific actions that we can and should take now as the first steps that will help us along the way:

We should fully embrace the "UN Convention on the Right of Persons with Disabilities." Ratified in 2006, this convention marked significant progress in recognising that people with disabilities have the same inalienable rights as all other members of the human family. It calls for all nations to utilise all the tools available, including legislation, budgets, and social tools, to bring into the mainstream debate disability issues as an integral part of development plans and push for inclusion of people with disabilities into all aspects of society. Whilst acknowledging we still have some way to go at home, we should be ensuring that the spirit of this convention is the golden thread that flows through all our development policies.

We should ask those countries we assist make people with disabilities count. Very often statistics can mask moral and practical failures in policy. How many people in a particular developing country have intellectual disability? How many of them are left without education? How many of them are infected with the "big three" -- HIV, Tuberculosis, and Malaria? The answer to these three questions, tragically, is we don't know. A good start would be to include people with disabilities in censuses, research efforts, and tracking mechanisms. DfID should be using its influence to encourage and support countries to gather and use good, disaggregated data, to better track the status of those with learning disabilities and focus on those still being denied the help and the care that they need.

Sensibly the UK gives less money directly to governments nowadays and instead uses partner organisations. It's well known that I am a long-standing supporter and advocate for the Special Olympics movement - not just for the excellent work it does domestically for those who are learning disabled and their carers, but because I have seen first-hand the amazing work it does across the world.

Special Olympics offers extensive health programming, providing free health screenings and follow-up care in more than 100 mostly developing countries. Since the inception of its "Healthy Athletes" program, Special Olympics has become the world's largest public health organization specifically for people with learning/intellectual disabilities and maintains the largest database anywhere on the health status and needs of this population. Of course, the Special Olympics Movement is just one organisation with the willpower and resources to help; there are many many others we could and should partner with to help reach this normally unseen and widely forgotten group.

As the new development goals are developed, they should focus not just on general targets, but rather on how to get to the hardest to reach, the poorest of the poor and how to improve the lives of those with disabilities.

To make this happen people with disabilities need to be heard: whether it be a UN committee helping draft the post-2015 MDG framework or a social justice or health-related committee advising on the national or regional level, people with intellectual disabilities should have a seat at the table. Yes, this might well mean we will need to slow down the meetings a bit, but if that means the voices of those at the bottom can properly be heard, then so be it.

Currently, it is election time here in the UK and every now and then on the doorstep I'll encounter someone who raises legitimate questions about the amount of money we spend on development aid - especially at a time when we are having to trim our public sector spending at home. How can I justify this, I'm asked?

My answer is to tell them about Aaron and then I ask my questioner if their money, paid in taxes at their current level and spent correctly, meant those with disability never have to suffer like that again; indeed, allows those with disabilities to become integrated into society and eventually, potentially, begin to help themselves out of poverty - would it be money well spent?

Without fail, the reply I get is "yes".

Now is the time for the UK to refocus development aid, so that wherever we target British taxpayers' money, we ensure that we are helping those with disabilities. Who could argue with that?

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With thanks to Tim Shriver at the Special Olympic movement, on whose work this article is based.

References:
Johnson, I., Sigler, R. 2000. Journal of Interpersonal Violence.
Frohmader, 2002. UNICEF, 2012 Towards an AIDS Free Generation, Promoting Community Based Strategies for and with Children and Adolescents with Disabilities.