The World Health Organization (WHO) estimated in its World Report on Disability 2021 that fifteen percent of the global population lives with some form of disability. This translates to more than one billion people. Of these one billion-plus people, as many as four percent “experience significant difficulties in functioning.”
WHO estimates of fifteen percent signify a marked increase from previous estimates of the number of persons with disabilities. “The global disability prevalence is higher than previous WHO estimates, which date from the 1970s and suggested a figure of around ten percent,” the agency wrote. “This global estimate for disability is on the rise due to population ageing and the rapid spread of chronic diseases, as well as improvements in the methodologies used to measure disability.”
The need for rehabilitative therapy, accordingly, has increased for persons with disabilities, as well as illness and injury. Recently, The Lancet published research suggesting that the “need for rehabilitation services, such as physical and occupational therapy or speech and language therapy, has increased 63 percent since 1990, from 1.48 billion to 2.41 billion people who could benefit at least once in the course of their illness or injury…China (460 million), India (411 million), the US (149 million), Indonesia (76 million) and Brazil (seventy million) are the top five countries in terms of greatest number of people in need of rehabilitation services.” This equates to as many as one in three people worldwide who could benefit from rehabilitative therapies.
It is estimated that 2.2 percent of India’s 1.3 billion-strong and counting population are affected by some form of disability, according to a survey conducted by the National Statistics Office (NSO) last year. The survey covered the months of July to December 2018 and involved 11.8 lakh households. Prevalence of disability was projected to be higher among males than females (2.4 percent versus 1.9 percent) and more prevalent in rural areas as opposed to urban areas (2.3 percent versus two percent).
Other estimates, however, posit the number to be higher. According to a United Nations Department of Economic and Social Affairs factsheet, persons with disabilities in India could account for five to six percent of the Indian population.
The millions of persons with disabilities in India require support – but is it forthcoming?
Much is written in law about the rights of persons with disabilities in India, such as via the Rights of Persons with Disabilities Act, 2016 which replaced earlier legislation. This prohibits discrimination and also provides guidance for entitlements and other issues such as guardianship. Yet there are gaps. As a 2013 paper pointed out, “India has one of the more progressive disability policy frameworks. However, people with disabilities in India are still subject to multiple disadvantages.” Stigma, discrimination, and socioeconomic inequalities do remain.
One particular issue of contention – and one which the remainder of this article will focus upon – is so-called “hidden disabilities.” Hidden disabilities are at the crux of International Day of Persons with Disabilities this year. As IDWP notes
“The 2020 theme ‘Not all Disabilities are Visible’ also focuses on spreading awareness and understanding of disabilities that are not immediately apparent, such as mental illness, chronic pain or fatigue, sight or hearing impairments, diabetes, brain injuries, neurological disorders, learning differences and cognitive dysfunctions, among others…it’s estimated 450 million are living with a mental or neurological condition— and two-thirds of these people will not seek professional medical help, largely due to stigma, discrimination and neglect.”
India is far from a stranger to the effects of hidden disabilities. Indeed, as Health Issues India reported in 2018, the World Economic Forum exhorted the country to tackle hidden disabilities. The sheer number of those with hidden disabilities in India could up the number of those affected by disability even further. As we wrote at the time
“The World Economic Forum cites India as having more than ten million children with autism, ten million people with epilepsy and more than 150 million people with a mental illness that will at some point require the intervention of therapy or other medical treatment. This number equates to just over ten percent of the population. This is a considerable figure alone. When taking into account those with physical disabilities exclusive of, and in addition to mental illness, the number swell further. However, despite such a large portion of the population having some manner of disability, India is all but entirely unprepared to accommodate for them.”
The barriers to treatment are manifold. Social stigma, prejudicial attitudes towards those affected, lack of resources (especially in rural areas) and chronic underfunding of the health system and underinvestment in these areas are major impediments to those with hidden disabilities availing the care and dignity they need. This is not to say India has failed to make strides. It has, as noted above, a progressive framework towards providing for the needs of those with persons with disabilities. It has repealed antiquated and prejudicial legislation directed at those with conditions such as mental health disorders. But there is much more to do.