Breaking barriers: building access for disabled people

According to the United Nations Development Programme, four to six percent of the world’s population is disabled. The prevalence of disability in many developing countries is exacerbated by poor nutrition, disease, conflict and accidents due to poor regulation. Many disabled people face numerous physical and attitudinal barriers, which contribute to their isolation and impoverishment. If development is the expansion of (and removal of barriers to) the freedoms that people enjoy, a key aspect for disabled people is improving their access to the physical environment.

The United Nations‘Standard Rules on the Equalisation of Opportunities for Persons with Disabilities’(1993) has been adopted by most countries but issues of access are stilllargely ignored by planners and development practitioners. The UN rules aim tosecure government commitment to granting equal rights and opportunities topeople with disabilities. Accessibility is a key target area for guaranteeingequal participation: changes in the physical environment would enable peoplewith disabilities to enter public buildings, use public transport andfacilities, move about in their homes and communities with ease, have access toinformation, and know what services are available to them. This issue of id21insights focuses on these matters, particularly with reference to people withphysical (mobility) and visual impairments.

Why access?

Improving accessto the physical environment results in greater social equity: it enables disabledpeople to participate in social, economic and religious activities on the samelevel as non-disabled people, resulting in a more inclusive society.Dismantling barriers reduces disabled people’s vulnerability and dependence onothers. In Ethiopia, Tamru Belay writes about how computertraining has enhanced blind Ethiopians’ employability and capacities to pursuefurther education. The training programme’s success has also raised thegovernment’s awareness of their potential and rights, and is a powerfuladvocacy tool.

Access forall

A commonmisconception is that adapting or building accessible environments is a costlyexercise. Conventional design is aimed at non-disabled people and accordinglyfails to provide for many potential users’ needs. Universal design principles,by contrast, aim to accommodate as wide a range of potential users as possible,including, but not exclusively, people with disabilities. North Carolina State University in the USA defines universal design as thedesign of products, communications and environments which can be used byeveryone, to the greatest extent possible, without the need for adaptation orspecialised design. Dave Maunder and Jo Sentinella highlight results from theirresearch on disabled access to transportation services, in which they found thisprinciple to be an essential aspect of successful projects.

Similarly, researchin Uganda by the Water, Engineering and Development Centre  and in Sri Lanka by the Intermediate TechnologyDevelopment Group (ITDG), on building accessible toilets demonstrates thatdesigns based on universal principles need not be costly and can be adopted andconstructed by local communities, with little or no outside assistance. Hazel Jones and Bob Reed, looking at water andsanitation infrastructure for poor people in Cambodia, Uganda and Bangladesh, point out that services designedfor disabled users are beneficial for other members of society, includingelderly and sick people, and mothers with young children.

Ensuringaccess

It isimportant to note, however, that solutions are about more than just design andbuilding codes. First and foremost, approaches should be centred on whatdisabled people themselves say they need and how best to achieve it. Enablingenvironments that encourage the involvement of users and ensure their views areheard are therefore a primary consideration.

ITDG’s experiencein Sri Lanka emphasises the importance of acommunity planning process that actively seeks to put disabled people at thecentre of development objectives to ensure their needs are met. HandicapInternational in Viet Nam worked with the Youth DisabledAssociation on an accessibility campaign, in which disabled young peopledemonstrated to public building managers and the public that they can, and are,actively involved in promoting measures to help them live independently.

A word ofcaution

Disabilityis becoming recognised as a development area with special needs. Numerous disability-focusedmovements are gaining visibility. However, the way forward needs to becarefully thought out. Considering that most disabled people in developingcountries are the very poorest, planners must also ask: access to what and forwhom? Rebecca Yeo provides a cautionary tale frompost-Tsunami Sri Lanka, where, despite the rhetoric ofdisabled access, the reality might mean that not only disabled people but otherpoor people as well, may be cut off from their former livelihoods asreconstruction favours business interests.

The term‘disability’ masks a wide range of types and experiences: disabled children,women and the elderly are doubly or even triply disadvantaged. The case studyon disabled women’s experiences based on research by Hazel Jones and Bob Reed emphasises that any considerationof disabled access must examine the particular needs of different groups.

More than just a medical issue

The International Classification of Functioning,Disability and Health (ICF) was developed by the World Health Organisation(WHO) in 2001 in collaboration with Disabled Peoples International, theEuropean Disability Forum, Inclusion International as well as many individualswith disabilities. Intended for use in clinical settings, by health services orfor surveys at the individual or wider community or national level, the ICF isan attempt to move away from the view that disability is simply a medicalissue. It encourages health professionals and others working with disabledpeople to look beyond the health condition of an individual and consider otherfactors that may prevent or hinder them from participating in all aspects oflife. The chart below shows this, using cerebral palsy as an example.

As the ICF illustrates, mostdisabilities are the result of a medical condition which effects ‘humanfunctions or structure’ as well as a person’s ability to carry out‘activities’; it follows that doing less will lead to reduced ‘participation’.Someone with severe rheumatoid arthritis, for example, is likely to havereduced mobility and be less able to participate in their chosen activities.Planning good access to buildings and public transport may help but unless‘participation’ is also addressed, solving access to the activity is only partof the solution.

The ICF also recognises that ‘environmental’factors such as having to live with the stigma of disability, limitededucational opportunities or not being able to get on a bus - will affectpeople’s ‘activities’ and degree of ‘participation’. The ICF also includes‘personal factors’ such as self confidence and security which will influence adisabled person’s coping strategies.

Using the ICF in planning access to facilities orservices for people with disabilities will require professionals to take risksand move away from areas where they feel confident and safe; instead they needto consider the lifestyle of their clients and how rehabilitation (ifappropriate and if requested by the client) can improve that person’slifestyle. As this issue of id21insights discusses, architects,planners and builders will need to consider how disabled people can enterbuildings and use transport or water and sanitation facilities, but they willalso need to consider how they can take part in activities of their choice.

Buildingaccessible environments

Theopportunities for and constraints to improving access to both new and existinginfrastructure will depend on the context in which improvements are undertaken,including availability of resources (human, physical, financial), culture,attitudes and laws regarding disabled people’s rights. There are likely to besignificant differences in needs and therefore approaches among and within countries,between rural and urban areas, and between formal and informal developments. Anybodyworking with disabled people to achieve barrier-free environments should alsoremember that:

• Professionalsshould be ready to hand over decision-making to disabled people, who are in thebest position to identify their own needs and concerns.
• Physicaland technical interventions are only one part of a bigger picture that also requirespaying attention to human rights and equal opportunities.
• Systematicreviews of the performance of projects, programmes and policies are necessaryto ensure that good and bad practices are identified. It is as important tolearn from mistakes as from successes and to share learning.
• Internationalframeworks such as ICF and universal standards can be useful tools forimplementation and research.