Enabling disabled: assistive tech ready, inclusion needed

Nearly 10-15% of people across the globe are afflicted with some kind of disability. In 2013, the population of people with disabilities was estimated at 841 million, or 11.7% of the world's population. But they are not distributed equally across the globe - an overwhelming 80% of these people are located in the poor and developing countries, or countries with low resources to be able to address the problem effectively.

Globally, those who suffer from hearing loss are estimated to be 61.7 million, those who suffer from loss of sight 75.8 million, and those disabled due to unintentional injury number around 37.6 million. Among these, the figures for the three categories in low-resource countries are 54.3 million, 68.1 million and 35.4 million respectively.

Ageing and disability tend to converge. Going by the growing population of the aged, the figures pertaining to the disabled people are set to soar as a high proportion of people age into disability. This number is likely to grow to 21.1% by 2050 due to age-related disabilities. Disability is both a cause and consequence of poverty. It limits an individual's ability to access health and rehabilitation services, limits access to education and employment and leads to economic and social exclusion. It may add additional costs related to healthcare or personal assistance.  

It was Senegalese judge Keba M'Baye who introduced the idea that "Every man has a right to live and right to live better", in his speech at the International Institute of Human Rights at Strasbourg in 1972. Therefore, social inclusion, access to human rights, employment support, education and health services are considered to be inalienable while conceiving programmes for the welfare of persons with disability.  

Even while programmes to attain inclusion of disabled persons keep evolving, the role of technology enabling them to seek participation in education, jobs, civic life, engagement with family and the community has found greater recognition in recent years. This is being done in order to reduce discrimination against them in accessing public facilities and civic amenities. If white canes, crutches, hearing aids, FM systems, cochlear implants, Braille typewriters, adaptive utensils, devices for buttoning pants and putting on shoes and wheelchair plus ramps came to be defined as enabling tools a few decades ago, today the discourse has moved on to motorising the wheelchair and providing electronic access in civic amenities.

Functional diversity is being sought and incorporated in products and environments to be useable by all people, to the greatest extent possible, without the need for adaptation or specialised design. Some of these could be buildings with ramps, elevators, wide hallways, easy to open doors; websites that work with screen readers and magnifiers and mobile phones that work with hearing aids.

Modern devices have helped to augment communication between caregivers and persons afflicted with disability of speech and hearing. Now, inmates of homes for assisted living are provided with tablet computers to write their queries and needs and the unlettered ones can communicate through icon-based devices. Developed countries have improved public transit systems for such persons by providing buses with even ramped entry.

Yet, the social stigma attached to disability refuses to go away. This has led to research whereby the technology could be integrated into the identity. So, we now have alternative limb projects and exoskeletons. But the questions that arise are: should we change the persons or change the environment (the toss is between exoskeletons or accessible sidewalks)? Should we aim for high-tech for a few or for appropriate technology for many (smart homes or improved social welfare systems)? and, should we adopt a disability-positive or disability-dismissive (bionic eyes and cochlear implants, or disability inclusion and acceptance) approach?

Lack of awareness, training

A study by the University of Washington's Center for Technology and Disability points out that 5-15% of those who require assistive technology have access to them. Most of those who do not have, and cannot afford them, inhabit the low-resource countries in South Asia and Africa.

Acquisition of these technologies is just one aspect. There are issues before and after acquiring them. For instance, there is a general lack of awareness of available technologies. Then, there are questions about their affordability, lack of trained personnel to provide services and challenges in production, manufacture and import. Similarly, challenges after access pertain to maintenance and repair and adjustments based on growth and changes. It is found that 50% of the devices based on alternative technology are either abandoned or discarded due to lack of training in using them.  

The answer lies in adopting appropriate assistive technologies that are acceptable, affordable, of reasonable quality (low cost should not mean low quality) and are simple and maintenance-free. These technologies should be capable of being locally repaired and should be able to be fitted rapidly so that people do not have to wait for long for the device to be delivered. Design itself is not enough, service provision is critical. Servicing should be closer to where it is needed and should not be centralised.  

The need is to develop awareness about the types of assistive technologies available so that people understand their options. The knowledge of where and how to access these should be available.

Workshops should be held to think of designs to ensure compatibility with the overall infrastructure of the country and environment. Local manufacture or production should be encouraged. There should be an all-out effort to ensure that government, businesses and people with disabilities understand their responsibilities under the law.  

(The writer is a Bengaluru-based journalist)