Analysis Of The Relationship Between Poverty And Disability

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5.1% of the population aged 5 years and older in South Africa have disabilities. Data released by Stats SA show that levels of poverty continues to increase in South Africa. Due to poverty and disability being common, there are people with disabilities in South Africa who are also poor. To allow for an equitable inclusive society, healthcare professions should use their skills and resources to aid poor people with disabilities. In this essay, I will reflect on the relationship between poverty and disability. I will discuss three models of disability. Secondly, I will use the biopsychosocial model and examples from my community visit to illustrate the relationship between poverty and disability. I will then be explaining the thoughts, feelings and behaviours which led to the lessons which I have learnt. Lastly, I will discuss what the above-mentioned means for me as an emerging Integrated Health Professional (IHP). Thereby, concluding that there is a dynamic interaction between poverty and disability.

The Oxford Dictionary defines disability as a condition that will restrict movement, activities and the senses of an individual. Most people with disabilities in South Africa fall within the population aged 15–49 years old. The common disabilities are physical (32%), intellectual (23.3%) and visual (14.7%). Disability can be viewed according to a specific model. There are three models of disability: the medical, social and biopsychosocial. The medical model sees disability as a health problem that needs to be cured. Thereby, requiring a health professional to use expert skills to treat the individual. This model is therefore based on the belief that health professionals are equipped to make decisions and provide interventions for people with disabilities. This inclines one to believe that health professionals know best and should be responsible for the matters concerning people with disabilities. This model influences the attitude of society by making them believe that people with disabilities need to be looked after. This model fails to acknowledge that health problems do not exist in isolation. To contrast, the social model defines disability as the as the maltreatment of people who are believed to be unworthy due to an impairment.

The social model differentiates between impairment and disability. Impairment is seen as a deformity of the body or mind. Disability only occurs when the individual’s surroundings or society does not change. When the alteration does not occur, those with impairments are denied access to opportunities because their environment or society does not allow them to. As a result, people with disabilities become disempowered and begin feeling like second-class citizens. The most comprehensive model is the biopsychosocial model. The biopsychosocial model interprets disability as the interaction between impairments, activity limitations and participation restrictions. Impairment is viewed as a problem in body function or structure, thereby making it difficult for the person to complete everyday activities. This is where activity limitation fits in because it affects the individual’s ability to take part in events. Due to the disabled persons inability to complete activities their participation is restricted. Participation restriction is problems with involvement in any area of life. This interactive understanding of disability recognises the interaction between all factors of a person’s life. The biopsychosocial model is the best when wanting to explain the relationship between disability and poverty.

The Oxford Dictionary defines poverty as the state of being impoverished. Furthermore, it can also be interpreted with respect to the revenue of an individual or the produce that they are able to consume. A visit to Khayelitsha has shown me that conditions associated with poverty are evident in certain parts of the community. These include poor nutrition, poor sanitation, low quality housing, violence and crime. Disability can occur due to poverty because impairments, as stated in the biopsychosocial model, can occur because of abovementioned the conditions associated with poverty. In Khayelitsha, I spoke to a disabled resident who became impaired due to the poor infrastructure of her home. The roof collapsed on her causing spinal cord injuries leading to quadriplegia. She said that if she was not poor, she would have a better-quality house and would not have the impairment. In addition, an elderly man told us that he is unable to afford food. As a result, he does not receive adequate nutrition which places him at risk of attaining irreparable damage. One could also become a victim of crime and sustain an injury that results in the loss of function in the part of body.

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Furthermore, disability can be a cause of poverty due to the development of an impairment, as mentioned in the biopsychosocial model. Stigma and discrimination from the community can cause a person with a disability to stop seeking education and training, resulting in unemployment. Community support is also a major factor as the behaviour of the community towards the disabled will affect their self-image. Residents of Khayelitsha said that people with disabilities are treated as useless members of the community. The disabled, therefore, shy away from interacting as they are afraid of being belittled. The residents said that this led to exclusion. According to the biopsychosocial model, this when activity limitation occurs because the person with the impairment is involved in the activities relating to their community or home. Consequently, the biopsychosocial model states that participation restrictions occur because the participation of disabled people in employment opportunities, education, political processes and healthcare services is minimal. In addition, there have limited social contacts and lack the support that they need to manage the high cost of having an impairment.

There are many thoughts, feelings and behaviours which lessons which allows me to better myself as a future IHP.When entering the community of Khayelitsha, I thought that I would be at risk of being exposed to crime. I felt unsafe and I behaved in an enclosed manner. When we arrived, I was taken aback because it looked like a community which was well-off. We had been taken to Ilitha Park which was better developed than the other parts of Khayelitsha. After much reflection and deep-thinking, I have learnt not to judge a community nor its people on what I have heard about them because I have been told distasteful things about Khayelitsha. This indicates growth in the reflective dimension of IHP. Reflection is a vital aspect of being an IHP. Furthermore, I have been immensely educated on disability. I have no previous experience with people with disabilities and I had never been informed on the issues that they face. I thought that they were all living normal lives and continued to be involved in mundane activities. I was infuriated to find out that people with disabilities, especially those in Khayelitsha, were being isolated from the rest of the community because of stigma and discrimination. I am now aware of the challenges faced by this vulnerable group.

One of the challenges is the absence of wheelchair ramps at clinic, taxi ranks and police stations. I was disturbed to find that there were programmes for those with disabilities, but they were often not informed on the opportunity. Due to this knowledge, I feel capable of vacillating positive change for their benefit. I have learnt that as an IHP I need to advocate for people with disabilities by ensuring that they have programmes which allow them to better themselves and their lifestyle. I believe that this has led to growth in the knowledge dimension of IHP because I now know so much about the experiences of people with disabilities. People in the community of Khayelitsha had varying things to say about their experience of healthcare. A young man said that if he needed healthcare he would use his medical aid scheme and attend a private hospital. Therefore, his experiences of health care were not negative. I felt enlightened to know that he was able to make use of medical aid. An elderly woman said that her experience was negative because she is ill but had to take a taxi to Mitchell’s Plain if she needed healthcare because she receives better service there. I was astonished to see the effort she goes through to receive healthcare and it showed that she is committed to her wellbeing. After hearing that I felt eager to help her to maintain her good health solely because of the effort she makes. After I had reflected, I have learnt that I should be eager to help those who try and those who do not. They deserve equal care and attention and I should not be put off if someone seemed uninterested in their health and wellbeing. This indicates growth in the reflective dimension of IHP. As stated before poverty and disability are interrelated, and it is important for me to understand this as a future IHP. This is because I have a vital role to play within the cycle between poverty and disability. The cycle showed that impairments lead to discrimination and ultimately exclusion from basic health care. With this knowledge, I need to act by either preventing the discrimination or by ensuring that people with disabilities receive healthcare. If I do not intervene, the people with disabilities will continue to be ill which will impact their employability, leading to further poverty and exclusion.

To conclude, this essay aimed to illustrate the relationship between poverty and disability, with the use of the biopsychosocial model and examples from my visit to Khayelitsha. My thoughts, feelings and behaviours has led to many lessons which will benefit me an as IHP. The relationship between poverty and disability is important to understand because they are standard in the South African context. This allows us to determine were the expertise of healthcare practitioners should be to acquire an equitable society. I would like to recommend that we, current and future healthcare professionals, should continue to understand the dynamic relationship poverty and disability, for us to provide healthcare which is relevant to South Africa.

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