New Delhi: Louis-Georges Arsenault, UNICEF’s representative to India, said to motivate persons with disabilities (PwD) to do better and come up in all walks of life, the government needed to focus more and more on community-based rehabilitation programmes that can teach people to accept physically-challenged persons.
“There’s always much more to be done while addressing the cause of disability. While India is doing its part to solve the issue with various policies and programmes, I think the focus should be more on community-based rehabilitation programmes,” Arsenault told IANS.
“These programmes would help teach normal society the manner to deal with persons with disabilities,” he said, adding: “Acceptance of these people by society is the most important step in empowering them.”
Asked whether India has suitable infrastructure for PwDs, Arsenault said: “It’s not about the infrastructure; the mindset first needs to be changed and then the infrastructural plans could come in.
“Creating an appropriate infrastructure is not a big deal– not that expensive either– but the way we think about the persons with disabilities is something that matters a lot,” Arsenault added.
According to the 2011 census, over 2.2 per cent of the Indian population is disabled, while the erstwhile Planning Commission placed the figure at five per cent. The World Health Organisation (WHO) estimates it to be eight per cent.
In a bid to help these people, the Narendra Modi government has launched its Accessible India Campaign that aims at building accessible government buildings for PwDs and providing them accessible transportation facilities.
Happy with the government’s initiative, Sminu Jindal, the managing director of Jindal Saw Ltd and the founder of NGO Svayam, said: “Inaccessibility of public infrastructure remains a major challenge. When people with disabilities cannot come out of their homes, use pedestrian pathways or means of public transport, all the benefits and facilities conferred by the state like right to education and three per cent reservation in public employment, among others, fail to bring desired empowerment.”
“Similarly, despite inclusive education being a legal mandate, access to education continues to be a challenge due to lack of accessible infrastructure and special educators and lack of will to include children with disabilities,” added Jindal, who was crippled after an accident in 2011.
She said the government needs to focus more on implementation of its programmes related to persons with disabilities and added: “Though the government has started various social schemes for the marginalized, there is need for a concentrated and focussed approach with stipulated timelines to ensure inclusion of persons with disabilities and the elderly in the mainstream.”
Nikhil Gupta, the co-director of the ESCIP Trust India that works for the empowerment of people with injured spinal cords, felt that persons with disabilities are “bound to live a miserable life” in the absence of proper treatment and rehabilitation.
“If a wheelchair user wants to go out with friends or family there are very few accessible restaurants, movie halls and public places. The number of these places are even less than our fingers and that too in Metro cities,” he said.
“Thus, the government needs to come up with much more programmes and most importantly implement them so that the change could take place”, said Gupta.
Armed attacks, misinformation and a growing funding gap continue to impede the response to the Ebola outbreak in northeastern Democratic Republic of Congo, with the World Health Organization warning that the situation could spiral out of control.
Insecurity leaves response teams “unable to perform robust surveillance nor deliver much needed treatment and immunizations,” the WHO reported Friday in its latest update on the outbreak confirmed last August. The health organization warned that “without commitment from all groups to cease these attacks, it is unlikely that this EVD [Ebola virus disease] outbreak can remain successfully contained in North Kivu and Ituri provinces.”
The disease could spill into other parts of the country and across the borders of neighboring Uganda, Rwanda and South Sudan, the health organization suggested.
This month alone has brought setbacks such as a violent assault on a burial team in the town of Katwa and a gunfight between at least 50 armed militia and security forces in the city of Butembo, WHO reported. Mourners also buried Richard Valery Mouzoko Kiboung, a 41-year-old Cameroonian doctor killed April 19 while working for WHO and meeting with other front-line workers at Butembo University Hospital.
The threats continue.
On Thursday, a VOA correspondent in Butembo saw a series of letters scattered on a street, each weighted down with pebbles. Written in Swahili and attributed to Mai-Mai fighters, the letters warned police, soldiers and the general public against showing any support for Ebola responders or treatment centers.
Anderson Djumah, whose 10-year-old son is being treated for Ebola at the general hospital in the North Kivu town of Beni, complained that “the lack of security has just added more suffering.”
“Even Ebola treatment centers are targeted by the assailants. We’re afraid. Ebola is killing so many people. We’re still expecting that the government would be able to protect us,” he said. “… [But] some people who are sick with Ebola are fleeing to other places for their lives and are meanwhile spreading the sickness.”
Complications for care
Violence sends people into hiding and disrupts response operations such as contact tracing, vaccination and safe burials, giving “time and space to the virus to spread within the community and make more victims,” Jessica Ilunga, spokeswoman for the DRC’s health ministry, told VOA.
“Every time we have a security incident, the number of cases and deaths obviously increases,” Ilunga said.
The health ministry, leading the response with WHO’s help, reported 1,600 total cases as of Wednesday, with 1,534 confirmed and 66 likely. This second-worst Ebola outbreak already has claimed 1,069 lives. The 2014-15 West African outbreak killed more than 11,000.
Many of the victims have died at home, potentially exposing others to the disease and leaving gaps in how — and to whom — the virus may have been transmitted.
“You don’t know who those contacts are,” said epidemiologist Jennifer Nuzzo, an epidemiologist and principal investigator for the Outbreak Observatory, a project of the Johns Hopkins Center for Health Security. “… Chances are you can’t offer them vaccines or treatment.”
Funding for the Ebola response has fallen far short of need, WHO spokesman Tarik Jasarevic said in an email to VOA Wednesday. As of May 2, WHO had received $32.5 million of the $87 million it estimated needing for six months ending in July.
“If the funds are not received,” Jasarevic wrote, “WHO will be unable to sustain the response at the current scale.”
New challenges in 10th DRC outbreak
This is the DRC’s 10th reported outbreak since the virus’ discovery near the Ebola River in 1976. The country has proved adept at snuffing out past outbreaks of Ebola, which has been found in bats, monkeys and other animals sometimes consumed as “bush meat.” The virus spreads through contact with an infected person’s body fluids.
Ebola was unfamiliar in the northeast, a region already destabilized by at least two decades of conflict. More than 100 armed groups roam the area, displacing hundreds of thousands of people.
High mobility and population density also raise the potential that the virus could cross into Uganda, Rwanda and South Sudan. (The U.S. Centers for Disease Control and Prevention has been providing technical guidance to the DRC and its neighbors, for instance, helping them ramp up surveillance and vaccination tracking.)
Skepticism also factors into the Ebola equation. The northeast is an opposition stronghold, and its residents were angered to be kept from voting in December’s general elections, as former U.S. diplomat John Campbell pointed out in a Council on Foreign Relations blog post.
A study published in The Lancet medical journal in March found low public trust in local authorities and broad acceptance of misinformation about Ebola. Just a third of the 961 respondents — adults surveyed in North Kivu’s Beni and Butembo last fall — said they had confidence that local authorities acted in the public interest. A fourth indicated they didn’t believe Ebola exists.
Mistrust and misinformation make it less likely that individuals will heed public safety directives, such as accepting Ebola vaccines, seeking formal medical care or supporting safe burial practices, the researchers noted.
That mistrust can be weaponized, as Medecins Sans Frontieres/Doctors Without Borders experienced. Two of the international aid group’s Ebola treatment centers, in Katwa and Butembo, were attacked in February. MSF suspended services there, saying its ability to respond in the outbreak’s epicenter had been “crippled.”
Anne-Marie Pegg, MSF’s clinical lead for epidemic response, said some Congolese look critically at the disparity between local clinics, which, if they exist, might lack basics such as running water and electricity, and the better-equipped Ebola treatment centers set up by international aid groups.
“Very little investment has gone into the existing health structures and the existing health system, and people notice this,” Pegg said. She said MSF, in “numerous interactions,” has heard complaints that international groups are involved “‘only because we [locals] are contagious and we’re a threat to you.’
“It’s not surprising that something like Ebola can be manipulated for any variety of reasons,” Pegg added. “… Absolutely, there are interest groups from all sides that are trying to use this.”
MSF continues to work in the region while pressing for “better integration of Ebola treatment into the health care system,” Pegg said. The virus’ early symptoms, such as headaches and muscle pain, are indistinguishable from those of malaria or other more common ailments, so “it’s difficult for someone who’s sick to think, ‘I have Ebola.’ So the capacity to isolate someone who may have an Ebola infection and test for that … needs to happen at a local level” rather than sending patients to a treatment center. “It would be nice if those people could be treated closer to home” and started on treatment while awaiting test results. If the virus is confirmed, then transfer the patient to an Ebola treatment center, “which is the best place.”
But, she said, MSF’s goal is to treat whatever ailment a patient might have.
Vaccine plans revised
As Ebola infections rise, a WHO advisory group this week recommended that an approved vaccine be distributed more widely in smaller doses and that an experimental vaccine, developed by Johnson & Johnson, also be offered. More than 100,000 doses of the approved Merck vaccine have been distributed since August, but supplies are running low. The dosage would be halved from the current 1 milliliter for the primary and secondary “ring vaccination,” which prescribes inoculation for anyone in contact with an infected person. Eligibility would be expanded through “pop-up and targeted geographic approaches” in high-risk areas.