Cultural Status of People with Intellectual Disabilities in the UK and Africa
Introduction
Intellectual disability can be describe as both by a significantly below-average score a mental ability or intelligence test as well as by limitations in the different ability in order to functions in different areas and aspects of daily life, like communication, self-care as well as other social situation and getting along with other, together with participations in different school activities. It is also sometimes called as the cognitive disability or mental retardation (Centers for Disease Control and Prevention 2005).
According to the World Health Organization Report 2001, there is about 1% to 2% occurrence of intellectual disability of the global population (Pomona 2005, p. 7). There are about 130 million of people with intellectual disabilities and the world, and majority of them live in poverty (Inclusion International 2006, p. 17).
Population
In the UK, people who are suffering from intellectual disabilities compromise about 2% of its population (Cooper & Melville 2004 p. 414). Due to the changes in the demographic aspect of the country, the population of people who have intellectual disabilities have increased by 53% over 35 years from 1960 – 1995. The said numbers shows that there is about 1.2% increase in the population per year. According to the study of experts, there will be 11% increase for the next 10 years period, which is from 1998 – 2008. The said increase is the results of the different improvement and innovation in terms of socioeconomic conditions, intensive neonatal care as well as the increasing survival rate. The needs of these people in terms of medical attention have a great impact on the healthcare services as well as all of the secondary specialties in the said country (Cooper & Melville 2004 p. 414).
In 2007, out of 58.6 million populations, there are about 1,465,000 of people who are suffering from mild intellectual disorder. While there are about 586,000 who are suffering from moderate disability. Above all, there are about 175,800 cases of severe and profound disability (Pomana 2005, p. 8).
In South Africa alone, there are about 3% of the overall population of 1.4 million people has an intellectual disability. It means that there are about 30 people with disability out of 1000 people. In the said group, 80% has a mild disability, meaning there are 25 out of 1000. Furthermore, 13% of the population or 4 out of 1000 has a moderate case of intellectual disabilities. Above all, there are about 3% or 1 out of 1000 that is suffering from severe up to profound disability (2leap.com 2007).
Overall, in Africa, there are about 10 – 15 million people out of 800 million overall population, who are suffering from intellectual disability that are currently living in isolation as well as social exclusion. Most of them do have a limited access to different health services, education as well as employment (Special Olympics 2007, p. 2).
Living Condition and Social Status
Just like the condition of intellectual disable people in the world, more often than not, those intellectually disabled people in the UK has a parents that have a poor physical health that eventually lead to poverty, unemployment, inadequate housing as well as unsafe neighborhoods. The said environment leads to difficulties in relationship, high stress, poor treatment throughout life, depression and later on low self-esteem. Due to the said condition of the parents, and having child or children with the intellectual disability, it will lead to exposure to little exposure to positive parenthood (NSW Department of Community Services 2007, p. 3).
Most of the people in the UK with the intellectual disability are all reliant or dependent to the State welfare benefits. They are receiving Income Support or IS, just like the premium for the people with disabilities. The said service or program of the company helps those intellectual disable people as well as their family for their daily living. Furthermore, there are also some who are receiving the Disability Living Allowances or DLA, together with different non-disability specific benefits. Many also receive the Disability Living. More often than not, people with intellectual disabilities have the status of economically inactive that is why they can continue to receive many benefits without regular view (Open Society Institute 2005, p. 9).
On the other hand, due to the influence of traditional beliefs as well as customs, African sees disability as a curse or manifestation of sin as well as disgrace. That is the reason why intellectual disability was considered as a serious stigma. When an intellectually disabled child was born, he or she will, more often than not, be rejected by his or her father and will later on be rejected by the community (Special Olympics 2007, p. 3).
The said belief had caused discrimination towards the disabled people as well as their families; it had helped to the existence of direct correlation between intellectual disability as well as poverty. Furthermore, it had also made the intellectual disabled children to become an added financial burden on a given household, but also inactive, and experience social isolation and neglect. That is the reason why the chances of learning skills for those children are minimal (Special Olympics 2007, p. 4).
Malnutrition
Although, the UK is considered as one of those developed countries, there are also many cases of malnutrition. Children and adults in the poor family are facing health risks that are linked to the diet. There is a high rate of anemia in children as well as in adults that eventually lead to premature and low weight births, dental disease, diabetes, obesity as well as hypertension (cited in Unicef 2008).
The said situation is somewhat disturbing due to the fact that most of those people with intellectual disabilities come from poor family. Another thing is that the high rate of anemia for children and premature as well as low weight births are considered as one of the reasons for intellectual disabilities.
There have been many evidences that relate the nutritional deficiencies to the intellectual disabilities, and because, Africa is considered as third world country, the government is lacking in programs and projects that will focus on the nutritional needs of the people. In Africa, there are different vitamin and nutrient deficiencies that causes intellectual disability such as: iodine deficiency, vitamin A deficiency, Iron deficiency and other deficiencies in zinc, magnesium, copper, iron, protein and energy (Jamison & Feachmen 2006).
Furthermore, more often than not, malnourished children come from families from poor social, economic as well as environmental living conditions, together with unstable family units, with huge numbers of closely spaced children. Their parents are commonly unwell, poorly nourished as well as depressed; young with low intelligence as well as low levels of educations; unemployed or belong to the low-skilled occupations; and expected to have a low social as well as media contact. Furthermore, there are few toys and books that can be found in the homes of theses families, parents usually has little time in participating in playing activities as well as there is a low stimulations (Jamison & Feachmen 2006).
Protein-energy malnutrition or PEM, is also one of the most common cause of intellectual disabilities (Williams 2007)
Environmental and Physiological Factors Which Cause of Intellectual Disabilities
More often than not, the causes of one’s personal disabilities are unknown. In the UK, there are three categories that have identified as a cause for the intellectual disability. First are the before birth factors such as: chromosome abnormalities like Down’s Syndrome, Tuberous Sclerosis Infection; the lack of oxygen to the fetus; trauma like accidents and injuries; vaccine damage s well s poisons like drugs, alcohol, cigarettes and lead. There are about 600 babies in the UK that are born with Down’s syndrome every year. The reason behind it is that more women are having their babies at later age (UnderstandingIndividual.Needs.com 2008).
The second category is the birth complication which include: asphyxia and anoxia; obstructed birth and extended labor; instrument birth and brain damage; and extreme case of premature and very low birth weight (UnderstandingIndividual.Needs.com 2008).
The last category falls in the postnatal factors such as: infections like meningitis; trauma like accident, injury and child abuse; metabolic or lack of nutrition and growth like phenylketonuria; and social deprivation (UnderstandingIndividual.Needs.com 2008).
In Africa, there is a wide range of origins of the intellectual disability from the pregnancy, infancy as well as childhood. It occurs during the early beginning of genetic makeup of the parents as well as the status and activities of the mother during her pregnancy, together with the maternal health condition and the exposure to environmental factors (Jamison & Feachmen 2006). Figure 1 shows the different factors that might cause intellectual disability.
Congenital disorders are one of the primary factors in Africa. It is any disabling condition that arises before the birth of the child as well as different causes of environmental genetic and other unknown aspects. Africa has a high rate of congenital disorders incidents in WHO regions (see Appendix A) (Jamison & Feachmen 2006).
Prenatal, perinatal as well as the postnatal infections, is also one of the primary causes of intellectual disabilities in Africa that can cause damage to the development of the nervous system or the sensory pathways of a baby that can cause intellectual disabilities. The most common infections in the country are: Congenital Rubella, Congenital Syphilis, HIV infections, Malaria, Bacterial Meningitis, Measles and Tetanus (Jamison & Feachmen 2006).
Environmental Factors
According to Viljoen (1999) fetal alcohol syndrome is considered as the most common single preventable cause of the intellectual disabilities in the world. The said syndrome is visible in areas in Africa with low socioeconomic status. Intake of the alcohol during pregnancy can cause brain damage with the consequent lowering of the intelligence, behavioral abnormalities as well as language assimilation for the baby.
Africans are also exposed to other toxins such as drugs, nicotine, heavy metal and primarily lead that may cause intellectual disabilities for young children (Jamison & Feachmen 2006). Lead pollution may cause intellectual disability in 90% in some cities of Africa (Williams 2007).
Accidents and Injuries
Accidents and injuries can also result to an important damage in the development of the central nervous system that can result to intellectual disabilities.
In Africa, road traffic accidents, falls, burns and accidental poisoning are considered as the most common types of childhood accidents and unintentional injuries. On the other hand, the most significant number of intentional injuries was caused by war. There are many children in country that suffers from intellectual disability due to the different consequences of war especially, physical injuries and traumas (Bickler and Rode 2002, p. 829). In 2000 alone, there are total of 11 major wars that have been fought in the country that involves the 20% of the population of the subcontinent (Jamison & Feachmen 2006).
Regarding the issue of toxins, primarily lead, it had been mentioned in the first part of the paper that it is one of the most popular causes of Intellectual disabilities. One of the most important issues to be considered is the water system, particularly the safety of tap water. In the UK, independent tests have showed that tap water in the UK is considered as one of the safest in the world. The Drinking Water Inspectorate reported a 99.96% compliance with standards by UK water companies in 2006. As a result, contamination is rare, and it is usually caused by local pollution, like old pipes not the water supply (Which? 2009). On the other hand, South Africa also has a safe drinking water. In addition, the water supply in the country is not a problem because there are 19 water supply networks that are operated in separate manner (Momberg 2008).
Figure 1 Causes of Intellectual Disability
Adapted from (Jamison & Feachmen 2006)
Health Care Services and Government Policies
People with intellectual disabilities have different patterns of health need. For instance, epilepsy, gastro-oesophageal, reflux disorder, sensory impairments, osteoporosis, schizophrenia, dementia, dysphagia, dental disease, musculoskeletal problems, accidents and nutritional problems are all much more commonly experienced (Cooper, 2004). Aside from that there are also different physiological aspects that must be considered. That is the reason why health provisions or health welfare is very important.
In the UK, for the past two decades, the health care policies and services to those intellectual disabled had undergone a vital development. In the past, services for the group were mainly provided by the specialist intellectual disability professionals in segregated settings like long-stay hospital. However, after that, the UK had showed a major change in the model of care, and it focuses on the integration of the intellectual disabled people within the society. In 1990, the Community Care Act was implemented which pertains on the mixed economy of care, where in the healthcare provision for the given group had become the responsibility of the mainstream healthcare providers, but there are some distinct and significant set of specialist intellectual disability services that provide for those people with profound intellectual disabilities (Gates, 2006, p. 258). As a result, in the current setting, majority of the health services in the UK which focus on the intellectual disabilities give emphasis on the participation of the health professionals, the members of the family and the person with intellectual disability. The reason behind the said development is to support and encourage access to the mainstream service for intellectually disabled, and promote the same services that will help to improve the vital skills to accommodate the needs of each individual in the group. Thus, it focuses on two vital levels which are: self-development work and person-to-person work. In connection, UK give importance on disseminating information that are related to intellectual disabilities that can help them to be more knowledgeable and informed about the issue, with the support of health promotion and health education (Gates, 2006, p. 258 – 267).
The said issue regarding health services and system is one of the major problems in South Africa. As a result, people with intellectual disabilities or mental illnesses are particularly vulnerable confronted with the justice system and because they are living mostly in rural areas, they have a low life expectancy, because of lack of care, support and access to most basic services. Aside from that, families can seldom meet the additional financial burden of regular visits to hospitals, additional expenses for equipment and assistive devices and other important things and factors (Independent Living Institute n.d.).
Access to Education
The UK is focusing its legislation for the education of the children who are suffering from intellectual educations. That is the primary reason for the Special Education Needs and Disability Act 2001 or the SENDA 2001. It helps to extend the rights of the children with intellectual disabilities to be educated in terms of mainstream schools. The country believes that education must be provided in the mainstream school, except that it is incompatible with the wish of the child’s parents or of the provision of the efficient education for other children. Furthermore, the said law also provides protection against discrimination in the education sector in school as well as in further education on the basis of disability, like the process of admission and the provision of different services. Schools are required to create an accessibility strategy in order to facilitate the inclusion of the pupils with the intellectual disabilities as well as to make reasonable adjustments, so that they are not deprived (Open Society Institute 2005, p. 5).
The country is also providing different innovative projects and programs for the people with the intellectual disabilities in transition from school and colleges. The main aim of the said program is to improve the educational achievements of the children with intellectual disabilities. The said program had helped to increase the numbers of the children with the intellectual disabilities in the mainstream schools (Open Society Institute 2005, p. 7).
In Africa, there is an inclusion law the assures the access, permanence, quality learning as well as full participation and integration of all children as well as adolescence, more particularly those members of the disadvantaged group such as poor societies, with disabilities, homeless, workers as well as those who are suffering from HIV and AIDS, and other vulnerable children. Furthermore, protection against discrimination is also included in the education system of the continent (Tyobeka 2006).
Unlike the education system of the UK, the African education system is characterized by glaring inequality, and the area of the special needs education remains the most evident. There are many problems that are associated in the said education system such as lack of access, segregation and degradation of the learners from the vulnerable communities. Most of the sectors that are white and urban have access to a well resourced special education facilities, together with the support system, on the other hand, those poor communities, has a poor access or no access at all to the said facilities. There are an estimated 280,000 disabled children, in which 26,000 have intellectual disabilities, in South Africa alone, but there are only 400 special schools (Tyobeka 2006). However, there are policies that have been passed and implemented in order to focus on the educational needs of intellectually disabled people, primarily the White Paper on Special Needs Education in July 2001 (Health Systems Trust n.d.).
In 2006, the local neighborhood schools were implemented. The government believes that the accommodation of children with intellectual disability within an inclusive education as well as training framework would be more easily facilitated than the process of inclusion of those learners that will require intensive support and maintenance through medical interventions, structural adjustments in order to build an environment as well as assistive devices with minimal curriculum adaptation (Tyobeka 2006).
Furthermore, there are also different programs and projects that enable to train and enhance the knowledge and skills of those teachers in schools that are catering for the educational needs of learners with intellectual disability. Furthermore, the government is also focusing on the influence as well as the rights of the parents to send their children to local neighborhood schools (Tyobeka 2006).
Access to Employment
In terms of employment, although the number of employed people with intellectual disabilities is low, the country had been able to implement a law that will give them the right to work. People with intellectual disability can pursue their complain regarding discrimination in employment, and they will be guided and assisted by the Disability Rights Commission or DRC framework in England, Wales as well as in Scotland. Furthermore, it can also be pursue in the Equality Commission in Northern Ireland (Open Society Institute 2005, p. 9).
The country is also implementing different programs that help to encourage the employment of the people with disabilities including the intellectual disabilities. Furthermore, the country has been able to provide different source of development funding in order to support different employment agencies (Open Society Institute 2005, p. 10).
Furthermore, the government is also providing employment opportunities for people who are suffering from intellectual disabilities that are shown in the 2001 White Paper, Valuing People. In the said country, there are many ways for people with intellectual disability to enter the job market such as by the Jobcentre Plus. Unfortunately, the effort of the government is not that effective due to the fact that only few people with the intellectual disabilities are accessing the mainstream programs like New Deal as well as Work-based Training (Open Society Institute 2005, p. 10).
According to statistics, there is about 11% of paid employment for intellectual disability compared to 49% for the people with disabilities in general (Open Society Institute 2005, p. 10).
In South Africa, employers have short-changed the intellectually disable of the country, by employing only those employees with physical disabilities, and not those who are intellectually disable. The said event happens even though the Employment Equity Act already categorizes the intellectually disabled with the citizens with other disabilities. 0.7% of the total workforce of the region is made up of disabled people, and only 1% of it is intellectual disable.
However, the said region shows a high rate of employment for intellectually disabled who are school-leavers; this is due to the fact that 80% of the severely intellectually disabled are able to work in a number of competencies. 5% of which finds a work in the open job market, while the rest is in the protected labor (Schalkwyk 2008). But the said percentage is somewhat useless, because there are only few intellectually disabled people who go to school and finished it.
There are only small number of people who has intellectual disabilities who are given the opportunity to work because of the mentality of the people in the workforce that they are too much trouble to be employed (Schalkwyk 2008).
Conclusion
Africa has a big difference compare to the UK, from its position in the global arena as well as the different systems that are implemented regarding different aspects of the country. In terms of the current condition of the intellectual disabled, the said two countries have some similarities as well as differences in handling them.
In terms of social status, both countries show the same living conditions for the intellectual disabled. Most of them live in poor environment, where in they are being raced by unemployed or low skilled parents, and living with many siblings.
The difference between the two countries in terms of social status is that those intellectually disabled people are being financially supported by the government, more particularly those who lived in the urban areas of the country.
In terms of malnutrition, Africa has higher rate or percentage of malnourished children, more specifically those intellectually disabled children than the UK. This is due to the fact that UK is more economically stabled than Africa. On the other hand, both of the countries are lacking of programs towards those intellectually disabled from rural areas.
In terms of the causes of the disabilities, the two countries have almost the same factors that might affect the growth and development of the intellectual aspect of a person. But Africa has more factors to be considered in terms of causes of intellectual disabilities.
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Appendices
Appendix A: Estimated Birth Prevalence of Infants with Serious Congenital Disorders (WHO)
Source: (cited from Jamison & Feachmen 2006)
Appendix B: Programs for Intellectually Disabled in Africa and Europe
Africa
Europe
Disability Act
60.0%
77.8%
Education
55.0%
92.6%
Health
55.0%
72.2%
Housing
5.0%
59.3%
Human Rights
30.0%
77.8%
Family
15.0%
51.9%
Income
15.0%
55.6%
Labor
25.0%
66.7%
Mental Health
65.0%
48.1%
Social Welfare
65.0%
81.5%
Youth Protection
25.0%
40.7%
Adapted from (World Health Organization 2007, p. 26)
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