Social Development Division, United Nations ESCAP

Part 3 of 7

The Main Issues

Attitudes and Images

A central reason why many women with disabilities are unable to do more to improve their own situation is their lack of self-esteem. Shown from birth, either through neglect or through over-protection, that they have little value or are unable to do much, girls with disabilities grow up with the burden of that stigma and expect little of themselves. Even a woman who becomes disabled later in life will have her own sense of self-worth eroded by the prevailing attitude that she has become a useless dependant.

While women the world over are striving for equality with men, women with disabilities struggle to be recognized first as persons and then as being female. There is a tendency for care-givers, whether at home or in institutions, to treat disabled persons as objects without feelings or the right to decide on matters concerning them. This is particularly the case with those who are extensively disabled and fully dependent on others for their daily activities. In the case of women, the gender bias in society imposes a subordinate status on them, and increases the likelihood that disabled women will have their individuality and rights ignored.

Despite rapid social, cultural and economic changes in the developing countries of the ESCAP region, the traditional role of the woman as the nurturer remains the norm. Throughout her life, a woman is to a large extent defined by her capacity as a daughter, wife or mother and, increasingly so, by the work she does and the position she holds outside the home. The disabled woman is not considered "marriageable" because her disability is seen as a "defect" and there is fear that her disability could be passed on to her children. There is doubt, too, whether she would be able to fully look after the home and family.

Universally, the incidence of marriage for disabled women is lower than that for disabled men. In Nepal, a society where marriage is the norm for women, 80 per cent of women with disabilities are reported to be unmarried.9 In China, the situation is comparatively better; 52 per cent of disabled women over the age of 18 are unmarried.10 Since women with disabilities are largely denied access to labour force participation, they are unable to acquire either the status or the social identity of being wives, mothers or workers.

Sexuality for women with disabilities is as much a part of their identity, and as important to their well-being, as it is for non-disabled women. Yet society at large is, more often than not, surprised when women with disabilities express their sexuality. Disabled girls and young women are seldom included in programmes on reproductive health education. In fact, they are commonly encouraged to repress their sexuality.

Family shame, limited mobility or lack of ability to communicate all serve to discourage a disabled woman from making contact with others outside the immediate family. Loneliness compounds the resulting sense of isolation and helplessness. In a survey of the needs of disabled men and women between the ages of 15 and 45, related to a project in Viet Nam, the most commonly felt needs – expressed by more than 80 per cent of those interviewed – were for information (about their disability), for schooling as well as for participation in family and community activities.11

Their low self-esteem has not been helped by the mass media. Positive images of women with disabilities – in roles such as exerting their rights, and contributing to the wealth and well-being of society – are rare in the mass media of ESCAP developing countries. Whenever there are reports, they usually feature the disabled woman as a victim and an object of pity, in need of help. Because the mass media plays such a powerful role in the formation of public opinion, it can be destructive when it reinforces the public s tendency to equate disability with helplessness on the part of the disabled woman and perpetuates the denial of opportunities for her to develop her capabilities. However, journalists write and project the situation of women with disabilities to the extent of their understanding. Their failure is therefore as much the failure of those promoting the interests of disabled persons to raise the awareness and understanding of journalists and others in the media.

It is obvious that the disabled woman is trapped in a vicious circle – her low self-esteem, cultivated from birth by her immediate family or care-givers and reinforced by her wider community and the media, results in her having very low aspirations. She therefore makes few demands, or none at all, of those around her and of society for her rights and opportunities to break out of this vicious circle. There is a critical need for the creation of an enabling psychological and physical environment that is supportive of the ability of the woman with a disability to function, within the limits caused by the disability itself, as an equal member of society. The main areas in which policy and practice can produce such an enabling environment are highlighted in the following sections.

Violence

Disabled girls and women are at high risk of being regularly abused physically and mentally, most commonly by those around them – family members and care-givers – at home or in institutions for disabled persons. The abuse ranges from beatings to rape. Few victims ever talk or complain, let alone press charges. Many lack confidence that they will be taken seriously, and fear of reprisals is common. In fact, most victims simply do not know where or to whom to turn for help. There is an urgent need to investigate the extent of violence against women and girls with disabilities. Public attention can then be mobilized to address the problem, and protective steps taken to assist the victims and punish the perpetrators.

Health Care and Rehabilitation

Disability implies, for a significant proportion of disabled women, the need for regular medical treatment and care. In those ESCAP developing countries and areas where public health facilities are overloaded and lack adequate resources, a disabled woman has to compete for services even if she overcomes the difficulties which are often involved in reaching the facilities. Resources allocated either by the family or the State for her health care reflect the value they place on her. To the extent that families and society believe that a disabled woman has little or no economic value, they are less likely to invest scarce resources in her. Even in countries where health care is free, either for all or for persons with disabilities, expenses are incurred for transport, food and accommodation.

Rehabilitation, as defined by the United Nations Standard Rules on the Equalization of Opportunities for Persons with Disabilities,12 "is a process aimed at enabling persons with disabilities to reach and maintain their optimal physical, sensory, intellectual, psychiatric and/or social functional levels, thus providing them with the tools to change their lives towards a higher level of independence". Rehabilitation is a time-bound activity. It may include measures such as the provision of appropriate assistive devices and the necessary training in how to use them. It may also include training in self-care and independent living. As with health care, the disabled woman s access to rehabilitation is limited by her low status.

In general, despite progress made during the United Nations Decade of Disabled Persons, rehabilitation services in the developing countries of the region are still inadequate and poorly coordinated. In order to use rehabilitation facilities, disabled women and girls must commute regularly to rehabilitation centres, normally located in the cities, or stay at residential facilities for a specific period of time. Commuting into the cities poses serious difficulties for women and girls with disabilities. It is also expensive for their families, in terms of money, time and effort. The United Nations Children s Fund (UNICEF) has reported that women and children receive less than 20 per cent of rehabilitation services, such as the provision of prosthetic and orthotic devices.13

Often, where residential facilities are available, they do not cater to women. Even if they do, for cultural and religious reasons, or simply because of over-protection by their families, disabled women are less likely than men to make use of such facilities.

As long as rehabilitation services are largely provided by institutions and centres, they will remain out of reach of the vast majority of disabled persons, particularly women. Although concern had been expressed by experts as early as the 1960s about the effectiveness of the conventional system of institutionalized rehabilitation services, leading to the introduction of community-based rehabilitation (CBR) as an alternative, the situation has been slow to improve. For most women with disabilities, their only hope for some degree of rehabilitation lies in CBR reaching them where they are, with the active involvement and support of their families and communities. While certain rehabilitation services requiring specific technology or skills will still need to be based in the cities, this is not the case for many essential types of assistance. For example, training in basic skills such as self-care (eating, drinking, dressing and personal hygiene) and mobility for visually-impaired women is better done in the environment of the home. Such assistance can make a highly significant contribution to the development of the self-reliance and dignity of a woman with a disability.

Part 4 of 7

Click here to return to the overview page about our activities in the Decade.

Home | Site Map | Feedback | UN Home Page | ESCAP Home Page
© 1997-1998 United Nations ESCAP - All rights reserved. Last update 19 December 1997