Chapter 1
Understanding Disability
and Vulnerability
Chapter contents
• Definitions of disability and vulnerability
• Causes of impairments and vulnerability
• Types of impairments and vulnerable groups
• Historical background of modalities moving towards
inclusion
Handicap
impairment
Disability
• The word “impairment,” “disability,” and “handicap,” are very
common words, each having different meanings.
• Impairment, disability and handicap are all related to conditions that
make it hard or impossible for an individual to function in a normal
capacity and the effect of those conditions.
Impairment
• Simply we can say that Impairment is the abnormality itself, it is
the weakness or damage of the organ.
• Impairment is a loss or abnormality of psychological, physiological,
or anatomical structure or function.
• 'Impairment' is concerned with the abnormalities of body
structure and appearance or of organ and system functioning,
resulting from any cause.
• Impairments are disturbances at the level of the organ which include
defects in or loss of a limb, organ or other body structure, as well as
defects in or loss of a mental function.
• Examples of impairments include blindness, deafness, paralysis of a
limb, amputation of a limb; mental retardation etc.
Disability
• Disability: any restriction or lack (resulting from an
impairment) of the ability to perform an activity in the manner
or within the range considered normal for a human being.
• Disability' is the functional consequence of impairment.
• Disability is the term used to define a restriction in the ability to
perform a normal activity of daily living which someone of the
same age is able to perform.
• “Disability” means the lack of ability to perform an activity in a
manner that is considered to be normal.
Handicap
• Handicap is a social construct / concept.
• 'Handicap' relates to the disadvantages
experienced in society by the individual, as a
result of his/her disability.
• It is basically society and the physical
environment what makes people handicapped.
• A handicap is a "disadvantage for a given
individual, resulting from an impairment or
disability, that limits or prevents the fulfillment of
a role that is normal, (depending on age, sex and
social and cultural factors) for that individual".
• Examples of handicaps include being
restricted or confined / limited to home; being
unable to use public transport; being socially
isolated.
• It is evident from the definitions above that a
handicap is the result both of an impairment
and of environmental conditions.
• If environmental barriers are taken away, the
person will still be impaired, but not
necessarily handicapped.
• Simply we can say that, impairment
refers to a problem with a structure or
organ of the body; disability is a
functional limitation with regard to a
particular activity; and handicap refers to
a disadvantage in filling a role in life.
1.1. Definitions of disability and
vulnerability
• Disability is not uncommon and it is part of human diversity.
• It is estimated that 15 % of the world’s population has a disability, a
percentage that is expected to grow because of poor health care and
nutrition early in life, growing elderly populations and violent civil
conflicts.
• Among the population of people with disabilities, approximately 80 %
live in developing countries and are disproportionately
represented among the poor.
• For instance, of the total population of Ethiopia, 17.6% are estimated
to live with some sort of impairment (WHO and World Bank, 2011, p.
272).
• Understanding the concept of disability varies between cultures
and evolves within a culture over time.
• People are using the two key terms, impairments and disability
interchangeably but there is a visible conceptual distinction
between these terms as described below:
1.1.1. Impairment
• Impairment is the “purely factual absence of or loss of
functioning in a body part.”
• Hence, the term impairment is used to notify the physical
condition of a person such as visual, physical, hearing, and
intellectual disabilities.
• It may result in activity limitation based on the degree/ severity,
type and onset of the impairment.
1.1.2. Disability
• The concept of disability is defined as “the interaction between
persons with impairments and attitudinal and environmental
barriers that hinders their full and effective participation in a
society on an equal basis with others” (UN CRPD, 2006).
• Disability is, therefore, a negative reaction of people towards
persons with impairments that results in “participation
restriction.”
• Disability, as a concept is referred: as an umbrella term that
include impairment, activity limitation and participation
restriction.
1.1.3. Vulnerability
• On the other hand, the term vulnerability refers
to state of being exposed to the possibility of
being attacked or harmed, either physically or
emotionally.
• Accordingly, vulnerable groups belong to the
people who are physically and emotionally hurt
and attacked as a result of various forms of
social injustice and malpractices.
Vulnerability is classified into four categories as described below:
A.Physical Vulnerability:
• The physical vulnerability of an area also depends on its geographic
proximity to the source and origin of the disasters e.g. if an area lies
near the coast lines, fault lines, unstable hills etc.
B. Economic Vulnerability:
• Economic vulnerability of a community can be assessed by
determining how varied its sources of income are, the ease of access
and control over means of production (e.g. farmland, livestock,
irrigation, capital etc.), adequacy of economic fall back mechanisms
and the availability of natural resources in the area.
• Economic difficulties/lack of financial resources: poverty, low living
standards, housing problems (e.g. too damp, too expensive, too cold or
difficult to heat) etc.;
C. Social Vulnerability:
• A socially vulnerable community has weak family structures, lack of
leadership for decision making and conflict resolution, unequal
participation in decision making, weak or no community
organizations, and the one in which people are discriminated on
racial, ethnic, linguistic or religious basis.
D. Attitudinal Vulnerability:
• A community which has negative attitude towards change and lacks
initiative in life resultantly become more and more dependent on
external support.
• This brings about disunity and individualism in the society. Thus, they
become victims of conflicts, hopelessness and pessimism which reduce
their capacity of coping with a disaster.
1.2. Causes of impairments and vulnerability
• The issue of disability/impairment is not yet being
scientifically understood and treated by the society
particularly in the low-income countries including
Ethiopia.
• As a result, the cause of impairment is not appropriately
comprehended due to the reason that people still believe
that impairment is caused by curse, sin and wrath of God.
• However, even though some causes of impairment are
unknown, scientific research conducted on the issue
confirmed that the cause of impairment is classified into 2
major categories as described hereunder:
1.2.1. Biological
• Under this category of the cause of impairment, genetically
induced factors are commonly known reasons.
• These include:
- Abnormalities in genes and genetic inheritance that may
cause intellectual disability, down syndrome and other
multiple impairments on children.
- Sometimes, diseases, illnesses, and over-exposure to x-
rays can cause a genetic disorder.
- Pre-term and underweight birth also may result in
different forms of impairment.
1.2.2. Environmental
• The adverse effect of poverty and starvation such as malnutrition, lack
of access to health care and treatment etc. may cause impairment to
the child during pre- and- postnatal period.
• The use of drugs, alcohol, tobacco, the exposure to certain toxic
chemicals and illnesses, toxoplasmosis, cytomegalovirus, rubella and
syphilis by a pregnant mother can cause intellectual and other types of
disability to the child.
• Childhood diseases such as a whooping cough, measles, and chicken
pox may lead to meningitis and encephalitis.
• This can cause damage to the brain of the child.
• Toxic material such as lead and mercury can damage the brain too.
• Unfortunate life accident such as drowning, car accidents,
falls, landmines, war, etc. can result in people losing their
sight, hearing, limbs and other vital parts of their body.
• As in the case of impairment, among several examples of
causes of vulnerability, the following are the most known
contributing factors to vulnerability:
- Poor governance;
- Poverty;
- Discrimination;
- Inequality and inadequate access to resource and
livelihood.
• Then again, children, pregnant women, elderly people,
malnourished people, and people who are ill or immune-
compromised, are particularly vulnerable when a disaster
strikes, and take a relatively high share of the disease
burden associated with emergencies (WHO, 2020).
• In general poor and socially disadvantaged people are the
most known vulnerable groups throughout the world.
• The following features depict the common
characteristics of the vulnerable groups stated above:
Less physically or mentally capable (infants, older adults,
people with disabilities);
Fewer material and/or financial resources (low-income
households, homeless);
Less knowledge or experience (children, illiterate,
foreigners, tourists);
Restricted by society to grow and develop according to
their needs and potentials.
1.3. Types of impairments and vulnerable groups
• Regardless of the existence of a number of types of impairments, the
commonly known and major kinds of impairments are listed below.
1.3.1. Visual impairment (Generic terminology for blindness and low
vision
1.3.2. Hearing Impairment (Generic terminology for deafness and
hard of hearing)
1.3.3. Specific Learning Disability (Dyslexia, Dysgraphia, Dyscalculia)
1.3.4. Speech and Language Impairments including fluency disorder
1.3.5. Autism
1.3.6. Emotional and Behavioral Disorders
1.3.7. Intellectual Disability
1.3.8. Physical /Orthopedic Impairments
1.3.9. Health related Impairments Such as:
- Heart disease;
- Cystic fibrosis;
- Acquired immune deficiency syndrome (AIDS);
- Hemophilia;
- Asthma;
- Diabetes;
- Nephrosis & Nephritis Kidney disorders;
-Sickle-cell anemia;
-Leukemia; (too many white blood cells are
produced causing weakness))
-Lead poisoning Disorder;
-Rheumatic fever;
-Tuberculosis;
-Cancer;
-Epilepsy;
1.3.10. Multiple Impairment:
-Deaf blindness.
1.4. Historical background of modalities moving
towards inclusion
• In the postindustrial period legislations and litigations created opportunities
for children with disabilities to access education in public schools.
• The following modalities were applied to teach children with disabilities.
1.4.1. Specialized and or residential schools
• These schools were established with an intention to provide educational
services in specialized approach only for children with disabilities.
• Consequently, schools for the deaf, schools for the blind etc. came into being
as separate institutions throughout 19th and 20th century.
1.4.2.Mainstreaming
• In the 1960 and 70s special needs education classes were established in public schools
with an intention to create least restrictive environment for children with disabilities.
1.4.3.Integration
• The approach was introduced and applied in 1970s with an objective to integrating
students with disabilities in general class setting without the change of regular
school/education system.
• In this situation, students with disabilities are required to fit the system.
• This approach is characterized by the following realities:
- System stays the same;
- Round pegs for round holes;
- Change the child to fit the system;
- Make the square peg round;
- Child must adapt or fail.
Integration
1.4.4.Inclusive Education
• This approach was applied as of the last quarter of 20 th
century focusing on regular education system change to
fit the special educational needs of students with
disabilities as discussed in the next section in detail.
• This approach is characterized by the following factors.
- Flexible system;
- Children are different;
- All children can learn: (Different abilities, Ethnic
Groups, Size, Age, Background, Gender, Persons with
disabilities);
- Change the system to fit the child.
Inclusive
1.5. Evolution of the concept of disability
• In order to understand how disability is currently viewed,
it is helpful to look at the way the concept of disability has
evolved over time as described below.
1.5.1.Traditional/Charity Model
• Historically, disability was largely understood in
mythological or religious terms, e.g. people with
disabilities were considered to be possessed by devils or
spirits; disability was also often seen as a punishment for
past wrongdoing.
• These views are still present today in many traditional
societies.
PWDs outside of society and society giving to
PWDs
1.5.2.Individual/Medical Model
• In the nineteenth and twentieth centuries, developments in
science and medicine helped to create an understanding that
disability has a biological or medical basis, with impairments
in body function and structure being associated with different
health conditions.
• This medical model views disability as a problem of the
individual and is primarily focused on cure and the provision
of medical care by professionals.
PWDs outside of society and PWDs should adapt to
fit society
1.5.3. Social Model/Human Rights-Based Model
• In the 1960s and 1970s, the individual and medical view of
disability was challenged and a range of social approaches were
developed, e.g. the social model of disability.
• These approaches shifted attention away from the medical
aspects of disability and instead focused on the social barriers
and discrimination that people with disabilities face.
• Disability was redefined as a societal problem rather than an
individual problem and solutions became focused on
removing barriers and social change, not just medical cure.
PWD as part of society
