Health Issues of People with Disabilities West Africa Transformation Development Conference Ghana 2010

Perfect Dream Empty Wheelchairs Symbolize No More Disabilities

Reality 600 million people live with disabilities 600 million people live with disabilities Rapid increase due to: Rapid increase due to: Population growth Population growth Increased aging population Increased aging population Malnutrition Malnutrition Chronic conditions Chronic conditions Injuries- war, violence esp. domestic violence, accidents Injuries- war, violence esp. domestic violence, accidents AIDS AIDS

Societys Impact on the Disabled 53 rd World Health Conference Societys Impact on the Disabled 53 rd World Health Conference 80% of people with disabilities esp. child population, live is low-income countries 80% of people with disabilities esp. child population, live is low-income countries Number of people with disabilities is growing faster in Africa than any other continent Number of people with disabilities is growing faster in Africa than any other continent Poverty limits access to basic health care Poverty limits access to basic health care Socio-economic inequality significantly increases disability Socio-economic inequality significantly increases disability Cultural beliefs impact acceptance Cultural beliefs impact acceptance Increased violence in the home, community and country are major causes of increase Increased violence in the home, community and country are major causes of increase

View of the Disabled Devalued Devalued Dehumanized Dehumanized Rejected Rejected Victimized Victimized Excluded Excluded Invisible Invisible Aspiritual Aspiritual

It Could Happen to You!

Motor Impairment Cerebral Palsy Cerebral Palsy Spinal Bifida Spinal Bifida Traumatic Brain Injury Traumatic Brain Injury Spinal Cord Injuries Spinal Cord Injuries Polio Polio

Cerebral Palsy Cerebral palsy is caused by injury to the brain, which occurs as the baby grows in the uterus or near the time of birth. Premature babies are at higher risk.

Types of Cerebral Palsy

Health Care Issues Nutrition – poor eaters, may need feeding tube Nutrition – poor eaters, may need feeding tube Communication Communication Seizures – medication, seizure precautions Seizures – medication, seizure precautions Spasticity – muscle relaxants, surgery Spasticity – muscle relaxants, surgery Mobility- leg braces, crutches, wheelchair Mobility- leg braces, crutches, wheelchair Scoliosis resulting in lung compression Scoliosis resulting in lung compression

Life Impact Life long disorder Life long disorder Long-term care needed for more severe cases Long-term care needed for more severe cases Normal life expectancy Normal life expectancy Social impact – long term medical care and social need Social impact – long term medical care and social need

Prevention Early prenatal care may reduce risk of premature birth thus, reducing risk of CP Early prenatal care may reduce risk of premature birth thus, reducing risk of CP

Spina Bifida Spina bifida is a congenital disorder (birth defect) in which the backbone and spinal canal do not close before birth.

Health Issues Surgery to close back Surgery to close back Hydrocephalus – water on the brain – requires a drain from brain to abdomen Hydrocephalus – water on the brain – requires a drain from brain to abdomen Urinary tract problems – catheterization Urinary tract problems – catheterization Seizures – may occur Seizures – may occur Mobility – braces, crutches, wheelchair Mobility – braces, crutches, wheelchair Scoliosis Scoliosis

Life Impact Normal life expectancy Normal life expectancy Life long health needs Life long health needs Susceptible to urinary tract infections due to daily catheterization Susceptible to urinary tract infections due to daily catheterization

Prevention Can be prevented when mother gets Folic acid before getting pregnant and during early days of pregnancy

Traumatic Brain Injury TBI Symptoms and long term effects depends on the area of the brain that is damaged.

Symptoms of TBI Lethargy Lethargy Confusion Confusion Irritability Irritability Severe headaches Severe headaches Changes in speech, vision, or movement Changes in speech, vision, or movement Bleeding Bleeding Vomiting Vomiting Seizure Seizure Coma Coma Death Death

Subtle Symptoms of TBI Long- and short-term memory problems Long- and short-term memory problems Slowed thinking Slowed thinking Distorted perception Distorted perception Concentration problems Concentration problems Attention deficits Attention deficits Communication problems (oral or written) Communication problems (oral or written) Poor planning and sequencing Poor planning and sequencing Poor judgment Poor judgment Changes in mood or personality Changes in mood or personality

Treatment Prevention Medical treatment depends on the severity of the injury Medical treatment depends on the severity of the injury Long term school issues may need to be addressed Long term school issues may need to be addressed Head gear during contact sports Head gear during contact sports Helmet when riding motorcycle or bike Helmet when riding motorcycle or bike Wear seatbelts in car Wear seatbelts in car

Spinal Cord Injuries A spinal cord injury usually begins with a sudden, traumatic blow to the spine that fractures or dislocates vertebrae A spinal cord injury usually begins with a sudden, traumatic blow to the spine that fractures or dislocates vertebrae The damage begins at the moment of injury when displaced bone fragments, disc material, or ligaments bruise or tear into spinal cord tissue. The damage begins at the moment of injury when displaced bone fragments, disc material, or ligaments bruise or tear into spinal cord tissue. Some injuries will allow almost complete recovery. Others will result in complete paralysis. Some injuries will allow almost complete recovery. Others will result in complete paralysis.

Treatment Improved emergency care for people with spinal cord injuries and aggressive treatment and rehabilitation can minimize damage to the nervous system and even restore limited abilities Improved emergency care for people with spinal cord injuries and aggressive treatment and rehabilitation can minimize damage to the nervous system and even restore limited abilities Respiratory complications indicates a severe injury Respiratory complications indicates a severe injury

Joni Erickson Tada

Polio Nigeria is one of four endemic countries worldwide where polio infections originate before they are transferred across borders; the others are Afghanistan, India and Pakistan. Globally in 2009, 328 polio cases have been reported, 240 of them in polio-endemic countries. Nigeria is one of four endemic countries worldwide where polio infections originate before they are transferred across borders; the others are Afghanistan, India and Pakistan. Globally in 2009, 328 polio cases have been reported, 240 of them in polio-endemic countries.

Impact of Polio

Prevention - vaccine In the past, resistance among conservative religious groups in northern Nigeria stymied campaigns In the past, resistance among conservative religious groups in northern Nigeria stymied campaigns Lack of preparedness or familiarity with polio vaccines is now the biggest challenge facing vaccinators. Lack of preparedness or familiarity with polio vaccines is now the biggest challenge facing vaccinators.

Sensory Impairments Visual Impairment - Blindness Visual Impairment - Blindness Hearing Impairment - Deafness Hearing Impairment - Deafness

Vision Impairment Blindness Blindness is the lack of vision that can not be corrected by glasses or contacts Blindness is the lack of vision that can not be corrected by glasses or contacts Partial vision means very limited sight Partial vision means very limited sight Legally blind is 20/200 Legally blind is 20/200

Leading Causes of Blindness in Developing Countries Cataracts Cataracts River Blindness River Blindness Vitamin A Deficiency Vitamin A Deficiency Trachoma Trachoma

Seek Medical Treatment Sudden vision loss is always an emergency Sudden vision loss is always an emergency Symptoms of a detached retina Symptoms of a detached retinaFloaters Gray curtain or veil moving across your field of vision Requires immediate medical to save vision Requires immediate medical to save vision

Cataracts Cloudy, fuzzy, foggy, or filmy vision Cloudy, fuzzy, foggy, or filmy vision Glare from lamps or the sun, which may be severe Glare from lamps or the sun, which may be severe Difficulty driving at night due to glare from headlights Difficulty driving at night due to glare from headlights Frequent changes in eyeglass prescription Frequent changes in eyeglass prescription Double vision Double vision Difficulty performing daily activities because of vision problems Difficulty performing daily activities because of vision problems

Cataract Treatment Surgery is a common procedure that involves removing the clouded lens of the eye (the cataract). Surgery is a common procedure that involves removing the clouded lens of the eye (the cataract). The lens can be replaced with an artificial lens called an intraocular lens implant (IOL) or The lens can be replaced with an artificial lens called an intraocular lens implant (IOL) or left out and eyeglasses or contact lenses can compensate for its absence. left out and eyeglasses or contact lenses can compensate for its absence.

Onchocerciasis River Blindness Caused by a parasitic worm and is spread by the bite of an infected blackfly. Caused by a parasitic worm and is spread by the bite of an infected blackfly. Multiple infectious bites are necessary for a person to get the disease. Multiple infectious bites are necessary for a person to get the disease. Infected persons may not have symptoms, but a skin rash, eye lesions and/or bumps under the skin can occur. Infected persons may not have symptoms, but a skin rash, eye lesions and/or bumps under the skin can occur. Eye lesions can progress to blindness. Eye lesions can progress to blindness.

Treatment Ivermectin is administered as an oral dose of 150 micrograms per kilogram (maximum 12 mg) every 6-12 months. Ivermectin is administered as an oral dose of 150 micrograms per kilogram (maximum 12 mg) every 6-12 months. The drug should probably not be given to pregnant women or children under 5 years. The drug should probably not be given to pregnant women or children under 5 years. Ivermectin does not kill the adult parasites, but reduce the numbers of microfilariae in skin so the disease does not progress Ivermectin does not kill the adult parasites, but reduce the numbers of microfilariae in skin so the disease does not progress

Vitamin A Deficiency Night blindness or the inability to see in dim light – Night blindness or the inability to see in dim light – Treatable with Vitamin A which can be stored in the body Treatable with Vitamin A which can be stored in the body More severe, it develops into an irreversible condition termed xerophthalmia, which is a drying of parts of the eye that will eventually result in blindness. More severe, it develops into an irreversible condition termed xerophthalmia, which is a drying of parts of the eye that will eventually result in blindness.

Vitamin A Deficiency

Trachoma The bacterium Chlamydia trachomatis that causes trachoma spreads through direct contact with the eye, nose or throat secretions of infected people. The bacterium Chlamydia trachomatis that causes trachoma spreads through direct contact with the eye, nose or throat secretions of infected people. It's very contagious It's very contagious Almost always affects both eyes Almost always affects both eyes Untreated trachoma can lead to blindness. Untreated trachoma can lead to blindness.

Transmission Hands Hands Clothing - towels Clothing - towels Insects. Insects. In the world's developing countries, flies are a major means of transmission. In the world's developing countries, flies are a major means of transmission.

Trachoma Symptoms Trachoma Symptoms Mild itching and irritation of the eye Mild itching and irritation of the eye Discharge from the eye containing mucus or pus Discharge from the eye containing mucus or pus Marked light sensitivity (photophobia) Marked light sensitivity (photophobia) Blurred vision Blurred vision Eye pain Eye pain

Trachoma Treatment Trachoma is preventable and, if treated early, the prognosis for people with trachoma is excellent. Trachoma is preventable and, if treated early, the prognosis for people with trachoma is excellent. Trachoma treatment options depend on the stage of development Trachoma treatment options depend on the stage of developmentMedicationSurgery

Untreated Trachoma If left untreated, the infection eventually causes the eyelid to turn inwards, which in turn causes the eyelashes to rub on the eyeball,

Visually Impaired Can Live a Normal Life with Support

Hearing Impairment

Ear Anatomy

Deaf Culture Nigeria Delegation

Cognitive Impairment Down Syndrome Down Syndrome Mental Retardation Mental Retardation Learning Disabilities Learning Disabilities Autism Autism

Down Syndrome A genetic disorder that causes lifelong mental retardation, developmental delays and other problems A genetic disorder that causes lifelong mental retardation, developmental delays and other problems Trisomy 21 Trisomy 21 Most common genetic cause of severe learning disabilities in children Most common genetic cause of severe learning disabilities in children Most cases of Down syndrome aren't inherited. They're caused by a mistake in cell division during the development of the egg, sperm or embryo. Most cases of Down syndrome aren't inherited. They're caused by a mistake in cell division during the development of the egg, sperm or embryo.

Risk Factors Advancing age of mother – over 35 and teen mothers Advancing age of mother – over 35 and teen mothers Having another child with Down Syndrome Having another child with Down Syndrome Carrier of genetic translocation for Down Syndrome Carrier of genetic translocation for Down Syndrome

Related Health Issues Heart defects. May require heart surgery in early childhood Heart defects. May require heart surgery in early childhood Leukemia. Leukemia. Infectious diseases especially pneumonia Infectious diseases especially pneumonia Sleep apnea Sleep apnea Obesity. Obesity. Other problems including gastrointestinal blockage, thyroid problems, hearing loss, skeletal problems and poor vision. Other problems including gastrointestinal blockage, thyroid problems, hearing loss, skeletal problems and poor vision.

Education for All

Emotional - Behavioral Impairments Attention Deficit Hyperactivity Disorder - ADHD Attention Deficit Hyperactivity Disorder - ADHD Behavior Disorders Behavior Disorders Psychiatric Disorders Psychiatric Disorders

Sharing Information Empowers the Disabled