Promoting the Rights of Children with Disabilities, UNICEF

Box 5.1 Disability and genderCountries often report higher rates of disability formales than females. The reasons for such disparitiesmay include higher rates of work-related injuriesand greater risk-taking behaviour among boys andmen. i On the other hand, girls and women are oftenmore exposed to the risk of becoming disabled thanmales because of neglect and certain forms of abuseand harmful practices, including early marriage ii andfemale genital mutilation/cutting. iii This being the case,the higher rates of disability for boys and men mayalso reflect the lower visibility given to girls, and togirls with disabilities, in many countries. In the contextof such double discrimination, girls and women mayhave limited access to essential services such ashealth care, education and vocational rehabilitation.In Nepal, for example, it was reported in 1995that the long-term survival rate for boys who hadpolio was twice that for girls, despite the fact thatmales and females have an equal chance of beingaffected by the disease. iv In Kathmandu, a seriousunderrepresentation of girls receiving treatment atthe Hospital and Rehabilitation Centre for DisabledChildren was identified as a cause for concern. vBut gender implications go further than this. Girls andwomen who do not have disabilities themselves arealso disproportionately affected by disability becausethey are often entrusted with the responsibility ofcaring for persons with disabilities in their familyand thereby unable to seek paid work and tocontribute to the well-being of the family. Similarly,female siblings may be kept at home to look afterthe child with disabilities and be prevented fromgoing to school or seeking paid employment. Suchdiscrimination against females is found in income-richas well as income-poor countries.Efforts to address the gender dimensions of disabilitymust proceed in a balanced and equitable mannerthat reflects the situation of women and men, girlsas well as boys with disabilities within integratedstrategies for all.Sources:iGroce, N., ’An Overview of Young People Living withDisabilities: Their needs and their rights’, UNICEFProgramme Division (Working Paper Series), New York, 1999.iiSee UNICEF Innocenti Research Centre, ’Early Marriage:Child spouses’, Innocenti Digest No. 7, Florence, 2001.iiiSee UNICEF Innocenti Research Centre, ’Changing aHarmful Social Convention: Female genital mutilation/cutting’, Innocenti Digest No. 12, Florence, 2005.ivCited in Groce, N., ’An Overview of Young People Livingwith Disabilities’, op. cit., p. 2.vBoyce, W., et al., ’Physically Disabled Children in Nepal:A follow-up study’, Asia Pacific Disability RehabilitationJournal, Vol. 10, No. 1 (2000), .The effect of multiple discriminations is typicallymore than merely additive. For example, a familybelonging to a minority group that experiencesdiscrimination is more likely to live in poverty andconsequently have limited access to proper medicalcare. The combination of these factors increases thelikelihood that a child will both be born with someform of impairment and have lower priority in accessto already limited support and services.The consequences of disability can be particularlyserious for women and girls because they risk beingdiscriminated against on grounds of their genderas well as of their particular impairment. As a resultthey may have even more limited access to essentialservices, including health care, education andvocational rehabilitation.Access to health, rehabilitation andwelfare servicesOf the 200 million children reported living withdisabilities, few of those living in developingcountries have effective access to health andrehabilitation or support services. For example,they may miss out on vaccinations, or treatment forsimple fever or diarrhoea, easily curable illnesseswhich can become life-threatening if left untreated.Mortality for children with disabilities under fivecan be as high as 80 per cent in some incomepoorcountries. 35 Children with severe disabilitiesmay not survive childhood because of a lack ofbasic primary health care facilities. In addition,rehabilitation services are often concentrated inurban areas and can be very expensive. 36 Even thesimplest aids and appliances to reduce the impactof a child’s impairment may not be available. Evenwhere services are largely urban based, children withdisability will often have to be left by their parentsfor weeks or months while they receive care – withprofound psychological consequences.Under article 24 of the CRC, every child has the rightto enjoy the highest attainable standard of healthand to have access to facilities for rehabilitation andthe treatment of illness. Once a child is identifiedas having an impairment, however, other normativeconditions may be overlooked, including basichealth care. In countries where access to basicmedical services is generally difficult, it is likely to besignificantly more difficult for children and adults withdisabilities to obtain proper medical treatment.Many medical decisions made around the globehave come to convey that the life of a child with adisability is considered to be worth less than that ofa child who has no disability. There are documented15 Promoting the Rights of Children with Disabilities Innocenti Digest No. 13