Thursday, February 4, 2010

Disabilities in Uganda

In the short time that I have been here, I am beginning to realize how overwhelming the issues affecting the disabled community in Uganda are. People with disabilities (PWDs) are among the poorest and rampant poverty contributes greatly to disability. It’s a vicious circle.

Using the World Health Organization’s world-wide estimate of 10% of population as a benchmark, there are 3.2 mill people with a disability in the country. This is perhaps an underestimate.

Causes of Disabilities

A number of factors have led to large-scale disabilities. Following independence from Britain in 1962, Uganda was torn apart by ethnic and tribal conflicts. Then came Idi Amin’s reign of terror from 1970 to 79 during which thousands of people were killed or severely injured. Another civil war broke out in 1982 under the banner of National Alliance for Liberation of Uganda (NALU). That uprising was squashed in 1986 by the National Resistance Movement (NRM) which has been the ruling party since. However, violent agitation occurred again between 1996 and 2002, led by the Alliance for Democratic Front (ADF).

These civil wars have left thousands of Ugandans maimed, homeless and orphans. In addition, 57 areas, many in the Kasese district, have been affected by land mines planted during the conflicts adding large numbers of people to the ranks of PWDs.

Many children are born with a disability: hydro cephalous (a big head), club feet (twisted feet), deafness, blindness, speech impediments, cerebral palsy, polio, etc. When a woman gives birth to a disabled baby, chances are that her husband/partner will leave her or react violently towards her accusing her of bringing such a baby in the family as if he may have had absolutely nothing do with the disability.

Furthermore, abduction of children has resulted in thousands of orphans. Between 1990 and 2001 alone, an estimated 20,000 children were abducted in conflict areas, and only 5,000 were returned to their communities. These children suffer from psychological problems and high-risk behaviours. Thousands of more children have been rendered orphans and vulnerable due to malnutrition, limited access to food and medical care, difficulties in eating balanced diets, and, stunted growth. The issues of these young Ugandans are of so monumental that the national government has established a special program for orphans and vulnerable children (OVC)

Polio Victims

Chronic diseases like malaria, cholera and meningitis add to the rolls of the disabled as do accidents. Ugandan diet, women’s difficult labour at child-birth, and, poor health care are other contributing factors. And, preference for large families adds to the misery.


Overall, Uganda has fared better than some other African countries. The prevalence of HIV among Ugandans 15-49 years varies from as low as 2.3% in the northwest to a high of 8.6% in the central region where Kampala is the major centre. In the western region which includes Kasese, the incidence is 6.9%. However, in the Kasese district the prevalence is 11.5% and it has been rising. This district is on the border with DRC and there is very heavy traffic carrying goods back and forth. Drivers of these lorries are known as “geographical bachelors”, i.e. married while at home, but bachelors on the road. There are also a couple of big industries, cobalt and cement, which attract workers, mostly men, from the villages. In these circumstances, HIV keeps spreading.

There is no information on HIV among PWDs, but it is suspected that the figure will be much higher because PWDs are more susceptible to the virus. They tend to readily succumb to the human need. Most of them are isolated, poor and lonely, and extremely vulnerable. With the slightest hint of love and attention, even from complete strangers, they submit. This is particularly true of disabled women shunned by partners and family members.

Many children inherit HIV from their mothers. Numbers of HIV-positive children of mothers carrying the same virus is not known. But, a recent newspaper item suggested that although the situation has improved, it could still be as high as one in six children.

A lack of HIV/AIDS education is another factor. There are community workers who strive to raise awareness and urge people to undergo testing. But, their reach is very limited and sporadic. Adding to the difficulty is non-availability of educational material in Braille and sign language teachers.

Since HIV/AIDS’ victims are mostly in the income-earning age bracket, the impact on families is devastating. The care and medication for an HIV/AIDS patient takes a heavy financial toll and the responsibility for looking after the family is often thrust upon children who lack maturity, knowledge and skills. As well, psychologically, these children are under heavy stress as they watch their sick and suffering parents day after day until their death.

Social Attitude

Above all, social attitude towards disabilities inhibits adequate care and rehabilitation of PWDs. A disability is considered a stigma or a curse, something a disabled person deserved, something to be ashamed of. Some mothers are so traumatized by a disabled child, they hide them lest others might see them. Community members tend to avoid PWDs.

KDP delegation meeting with District Commissioner (squatted, 2nd left)

Social attitude towards disability and the disabled has led to widespread systemic bias against PWDs. They cannot attend schools most of which are inaccessible and do not have teachers to teach sign language or Braille or meet other special needs. Many hospitals are not easily accessible either and hospital beds and latrines are not suited to meet the needs of PWDs. Hospital staff members also do not have the skills to interact with PWDs. As well, there are cases of abuse of PWDs by health care workers themselves. In the work place, the chances of securing employment are virtually non-existent for PWDs. There is a national law, The Persons with Disabilities Act 2006. It provides for equal access to employment for PWDs. But, the law is only like a statement of good intentions. Its implementation and monitoring leave lots to be desired.

The consequence of these factors is that PWDs are looked upon as useless. Even many disabled individuals see themselves as good-for-nothing. And, in the long list of government priorities and limited resources, issues of PWDs seem to fall by the way side.

This is the context in which KDP and other similar organizations serving PWDs are carrying on their work. Their task is huge and the challenge is immense.

Women with disabilities at a tailoring class

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