Equalizing opportunities for persons with disabilities

There are persons with disabilities in all parts of the world and at all levels in every society. The number of persons with disabilities in the world is large and is growing. Both the causes and the consequences of disability vary throughout the world. These variations are the result of different socio-economic circumstances and of the different provisions that states make for the well-being of their citizens. Present disability policy is the result of developments over the past 200 years. In many ways it reflects the general living conditions and social and economic policies of different times. In the disability field, however, there are also many specific circumstances which have influenced the living conditions of persons with disabilities. Ignorance, neglect, superstition and fear are social factors which throughout the history of disability have delayed the development of and isolated persons with disabilities.

Over the years disability policy developed from elementary care at institutions to education for children with disabilities and rehabilitation for persons who became disabled during adult life. Through education and rehabilitation, persons with disabilities became more active and a driving force in the further development of disability policy. Organizations of persons with disabilities, their families and advocates were formed, which advocated better conditions for persons with disabilities. After the Second World War the concepts of integration and normalization were introduced, which reflected a growing awareness of the capabilities of persons with disabilities.

Towards the end of the 1960s organizations of persons with disabilities in some countries started to formulate a new concept of disability. This new concept indicated the close connection between the limitation experienced by individuals with disabilities, the design and structure of their environments and the attitude of the general population. At the same time the problems of disability in developing countries were more and more highlighted. In some of those countries the percentage of the population with disabilities was estimated to be very high and, for the most part, persons with disabilities were extremely poor.

There are a number of fundamental concepts in disability policy. They are basically built on the concepts in the World Programme of Action concerning Disabled Persons. In some cases they reflect the development which has taken place during the United Nations Decade of Disabled Persons:

(1) Disability and handicap: The term 'disability' summarizes a great number of different functional limitations occurring in any population in all countries of the world. People may be disabled by physical, intellectual or sensory impairment, medical conditions or mental illness. Such impairments, conditions or illnesses may be permanent or transitory in nature.

Handicap is the loss or limitation of opportunities to take part in the life of the community on an equal level with others. The term 'handicap' describes the encounter between the person with a disability and the environment. The purpose of this term is to emphasize the focus on the shortcomings in the environment and in many organized activities in society, for example, information, communication and education, which prevent persons with disabilities from participating on equal terms.

This use of the two terms disability and handicap should be seen in the light of modern disability history. During the 1970s there was a strong reaction among representatives of organizations of persons with disabilities and professionals in the field of disability against the terminology of the time. The terms disability and handicap were often used in an unclear and confusing way, which gave poor guidance for policy-making and for political action. The terminology reflected a medical and diagnostic approach, which ignored the imperfections and deficiencies of the surrounding society.

In 1980, the World Health Organization adopted an international classification of impairment, disability and handicap (ICIDH), which suggested a more precise and at the same time relativistic approach. This classification makes a clear distinction between impairment, disability and handicap. ICIDH has been extensively used in areas such as rehabilitation, education, statistics, policy, legislation, demography, sociology, economics and anthropology. Some users have expressed concern that ICIDH, in its definition of the term handicap, may still be considered too medical and too centred on the individual, and may not adequately clarify the interaction between societal conditions or expectations and the abilities of the individual. These concerns, and others which have been expressed by users over the past 12 years since the publication of ICIDH, will be addressed in forthcoming revisions of ICIDH.

Based on experiences in connection with the implementation of the World Programme of Action and on the general discussion which occurred during the United Nations Decade of Disabled Persons, there was a deepening of knowledge and extension of understanding concerning disability issues and the terminology used. Current terminology recognizes the necessity of addressing both the individual needs (such as rehabilitation and technical aids) and the shortcomings of the society (various obstacles for participation).

(2) Prevention: This means action aimed at preventing the occurrence of physical, intellectual, psychiatric or sensory impairments (primary prevention) or at preventing impairments from causing a permanent functional limitation or disability (secondary prevention). Prevention may include many different types of action such as primary health care, prenatal and postnatal child care, education in nutrition, immunization campaigns against communicable diseases, measures to control endemic diseases, safety regulations, programmes for the prevention of accidents in different environments, including adaptation of workplaces to prevent occupational disabilities and diseases, and prevention of disability which results from pollution of the environment or armed conflict.

(3) Rehabilitation: This 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 may include measures to provide and/or restore functions, or compensate for the loss or absence of a function or for a functional limitation. The rehabilitation process does not involve initial medical care. It includes a wide range of measures and activities from more basic and general rehabilitation to goal-oriented activities, for instance vocational rehabilitation.

(4) Equalization of opportunities: This means the process through which the various systems of society and the environment, such as services, activities, information and documentation, are made available to all, particularly to persons with disabilities. The principle of equal rights implies that the needs of each and every individual are of equal importance, that these needs must be made the basis for the planning of societies and that all resources must be employed in such a way as to ensure that every individual has equal opportunity for participation. Persons with disabilities are members of society and have the right to remain within their local communities. They should receive the support they need within the ordinary structures of education, health, employment and social services. As persons with disabilities achieve equal rights, they should also have equal obligations. As these rights are being achieved, societies should raise their expectations of persons with disabilities. As part of the process of equal opportunities, provision should be made to assist persons with disabilities to assume their full responsibility as members of society.

The rights of persons with disabilities have been the subject of much attention in the United Nations and other international organizations over a long period of time. The most important outcome of the International Year of Disabled Persons (1981) was the World Programme of Action concerning Disabled Persons, adopted by the General Assembly in its resolution 37/52. The International Year of Disabled Persons and the World Programme of Action provided a strong impetus for progress in the field. They both emphasized the right of persons with disabilities to the same opportunities as other citizens and to an equal share in the improvements in living conditions resulting from economic and social development. Here, also, for the first time, handicap was defined as a function of the relationship between persons with disabilities and their environment.

The Global Meeting of Experts to Review the Implementation of the World Programme of Action concerning Disabled Persons at the mid-point of the United Nations Decade of Disabled Persons was held at Stockholm in 1987. It was suggested at that Meeting that a guiding philosophy should be developed to indicate the priorities for action in the years ahead. The basis of this philosophy should be the recognition of the rights of persons with disabilities. Consequently, the Meeting recommended that the General Assembly convene a special conference in order to draft an international convention on the elimination of all forms of discrimination against persons with disabilities, to be ratified by states by the end of the Decade.

The Standard Rules for the Equalization of Opportunities for Persons with Disabilities have been developed on the basis of the experience gained during the United Nations Decade of Disabled Persons (1983-1992). The International Bill of Human Rights, comprising the Universal Declaration of Human Rights, the International Covenant on Economic, Social and Cultural Rights and the International Covenant on Civil and Political Rights, the Convention on the Rights of the Child and the Convention on the Elimination of All Forms of Discrimination against Women, as well as the World Programme of Action concerning Disabled Persons, constitute the political and moral foundation for these Rules.

Although these Rules are not compulsory, they can become international customary rules when they are applied by a great number of states with the intention of respecting a rule in international law. They imply a strong moral and political commitment on behalf of states to take action for the equalization of opportunities. Important principles for responsibility, action and cooperation are indicated. Areas of decisive importance for the quality of life and for the achievement of full participation and equality are pointed out. These Rules offer an instrument for policy-making and action to persons with disabilities and their organizations. They provide a basis for technical and economic cooperation among states, the United Nations and other international organizations.

The purpose of these Rules is to ensure that girls, boys, women and men with disabilities, as citizens of their societies, may exercise the same rights and obligations as others. In all societies of the world there are still obstacles preventing persons with disabilities from exercising their rights and freedoms and making it difficult for them to participate fully in the activities of their societies. It is the responsibility of states to take appropriate action to remove such obstacles. Persons with disabilities and their organizations should play an active role as partners in this process. The equalization of opportunities for persons with disabilities is an essential contribution in the general and worldwide effort to mobilize human resources. Special attention may need to be directed towards groups such as women, children, the elderly, the poor, migrant workers, persons with dual or multiple disabilities, indigenous persons and ethnic minorities. In addition, there are a large number of refugees with disabilities with special needs which require attention.