Chapter 1

Understanding Disability
and Vulnerability
P.By Ageze B
 Chapter contents
• Definitions of disability and vulnerability

• Causes of impairments and vulnerability

• Types of impairments and vulnerable groups

• Historical background of modalities moving towards inclusion

 1.1. Definitions of disability and
vulnerability
• Disability is not uncommon and it is part of human diversity.
• It is estimated that 15 % of the world’s population has a disability,
a percentage that is expected to grow because of poor health care
and nutrition early in life, growing elderly populations and violent
civil conflicts.
• Among the population of people with disabilities, approximately 80
% live in developing countries and are disproportionately
represented among the poor.
• For instance, of the total population of Ethiopia, 17.6% are
estimated to live with some sort of impairment (WHO and World
Bank, 2011, p. 272).
• Understanding the concept of disability varies between cultures and
evolves within a culture over time.
• People are using the two key terms, impairments and disability
interchangeably but there is a visible conceptual distinction between
these terms as described below:
1.1.1. Impairment
• Impairment is the “purely factual absence of or loss of functioning in
a body part.”
• Hence, the term impairment is used to notify the physical condition
of a person such as visual, physical, hearing, and intellectual
disabilities.
• It may result in activity limitation based on the degree/ severity, type
and onset of the impairment.
 1.1.2. Disability
• The concept of disability is defined as “the interaction between
persons with impairments and attitudinal and environmental
barriers that hinders their full and effective participation in a
society on an equal basis with others” (UN CRPD, 2006).
• Disability is, therefore, a negative reaction of people towards
persons with impairments that results in “participation
restriction.”
• Disability, as a concept is referred: as an umbrella term that
include impairment, activity limitation and participation
restriction.
 1.1.3. Vulnerability
• On the other hand, the term vulnerability refers to
state of being exposed to the possibility of being
attacked or harmed, either physically or
emotionally.
• Accordingly, vulnerable groups belong to the people
who are physically and emotionally hurt and
attacked as a result of various forms of social
injustice and malpractices.
 Vulnerability is classified into four categories as described
below:
A.Physical Vulnerability:
• The physical vulnerability of an area also depends on its
geographic proximity to the source and origin of the disasters
e.g. if an area lies near the coast lines, fault lines, unstable
hills etc.
B. Economic Vulnerability:
• Economic vulnerability of a community can be assessed by
determining how varied its sources of income are, the ease of
access and control over means of production (e.g. farmland,
livestock, irrigation, capital etc.), adequacy of economic fall
back mechanisms and the availability of natural resources in
the area.
C. Social Vulnerability:
• A socially vulnerable community has weak family structures, lack of
leadership for decision making and conflict resolution, unequal
participation in decision making, weak or no community
organizations, and the one in which people are discriminated on
racial, ethnic, linguistic or religious basis.
D. Attitudinal Vulnerability:
• A community which has negative attitude towards change and lacks
initiative in life resultantly become more and more dependent on
external support.
• This brings about disunity and individualism in the society. Thus,
they become victims of conflicts, hopelessness and pessimism which
reduce their capacity of coping with a disaster.
1.2. Causes of impairments and vulnerability
• The issue of disability/impairment is not yet being
scientifically understood and treated by the society
particularly in the low-income countries including
Ethiopia.
• As a result, the cause of impairment is not appropriately
comprehended due to the reason that people still believe
that impairment is caused by curse, sin and wrath of God.
• However, even though some causes of impairment are
unknown, scientific research conducted on the issue
confirmed that the cause of impairment is classified into 2
major categories as described hereunder:
 1.2.1. Biological
• Under this category of the cause of impairment,
genetically induced factors are commonly known
reasons.
• These include:
- Abnormalities in genes and genetic inheritance that
may cause intellectual disability, down syndrome and
other multiple impairments on children.
- Sometimes, diseases, illnesses, and over-exposure to
x-rays can cause a genetic disorder.
- Pre-term and underweight birth also may result in
different forms of impairment.
 1.2.2. Environmental
• The adverse effect of poverty and starvation such as malnutrition, lack of
access to health care and treatment etc. may cause impairment to the
child during pre- and- postnatal period.
• The use of drugs, alcohol, tobacco, the exposure to certain toxic chemicals
and illnesses, toxoplasmosis, cytomegalovirus, rubella and syphilis by a
pregnant mother can cause intellectual and other types of disability to the
child.
• Childhood diseases such as a whooping cough, measles, and chicken pox
may lead to meningitis and encephalitis.
• This can cause damage to the brain of the child.
• Toxic material such as lead and mercury can damage the brain too.
• Unfortunate life accident such as drowning, car
accidents, falls, landmines, war, etc. can result in people
losing their sight, hearing, limbs and other vital parts of
their body.
• As in the case of impairment, among several examples of
causes of vulnerability, the following are the most known
contributing factors to vulnerability:
- Poor governance;
- Poverty;
- Discrimination;
- Inequality and inadequate access to resource and
livelihood.
• Then again, children, pregnant women, elderly
people, malnourished people, and people who are ill
or immune-compromised, are particularly vulnerable
when a disaster strikes, and take a relatively high
share of the disease burden associated with
emergencies (WHO, 2020).
• In general poor and socially disadvantaged people are
the most known vulnerable groups throughout the
world.
• The following features depict the common
characteristics of the vulnerable groups stated
above:
- Less physically or mentally capable (infants,
older adults, people with disabilities);
- Fewer material and/or financial resources
(low-income households, homeless);
- Less knowledge or experience (children,
illiterate, foreigners, tourists);
- Restricted by society to grow and develop
according to their needs and potentials.
 1.3. Types of impairments and vulnerable groups
• Regardless of the existence of a number of types of impairments, the
commonly known and major kinds of impairments are listed below.
1.3.1. Visual impairment (Generic terminology for blindness and
low vision
1.3.2. Hearing Impairment (Generic terminology for deafness and
hard of hearing)
1.3.3. Specific Learning Disability (Dyslexia, Dysgraphia,
Dyscalculia)
1.3.4. Speech and Language Impairments including fluency
disorder
1.3.5. Autism
1.3.6. Emotional and Behavioral Disorders
1.3.7. Intellectual Disability
1.3.8. Physical /Orthopedic Impairments
 1.3.9. Health related Impairments Such as:
- Heart disease;
- Cystic fibrosis;
- Acquired immune deficiency syndrome (AIDS);
- Hemophilia;
- Asthma;
- Diabetes;
- Nephrosis & Nephritis Kidney disorders;
-Sickle-cell anemia;
-Leukemia; (too many white blood cells are
produced causing weakness))
-Lead poisoning Disorder;
-Rheumatic fever;
-Tuberculosis;
-Cancer;
-Epilepsy;
• 3.10. Multiple Impairment:
-Deaf blindness.
 1.4. Historical background of modalities moving
towards inclusion
• In the postindustrial period legislations and litigations created opportunities
for children with disabilities to access education in public schools.
• The following modalities were applied to teach children with disabilities.
1.4.1. Specialized and or residential schools
• These schools were established with an intention to provide educational
services in specialized approach only for children with disabilities.
• Consequently, schools for the deaf, schools for the blind etc. came into being
as separate institutions throughout 19th and 20th century.
 1. 4.2.Mainstreaming
• In the 1960 and 70s special needs education classes were established in public schools
with an intention to create least restrictive environment for children with disabilities.

1. 4.3.Integration
• The approach was introduced and applied in 1970s with an objective to integrating
students with disabilities in general class setting without the change of regular
school/education system.
• In this situation, students with disabilities are required to fit the system.
• This approach is characterized by the following realities:
1. System stays the same;
2. Round pegs for round holes;
3. Change the child to fit the system;
4. Make the square peg round;
5. Child must adapt or fail.
Integration
 1.4.4.Inclusive Education
• This approach was applied as of the last quarter of 20 th
century focusing on regular education system change to
fit the special educational needs of students with
disabilities as discussed in the next section in detail.
• This approach is characterized by the following factors.
- Flexible system;
- Children are different;
- All children can learn: (Different abilities, Ethnic Groups,
Size, Age, Background, Gender, Persons with disabilities);
- Change the system to fit the child.
Inclusive
 1.5. Evolution of the concept of disability
• In order to understand how disability is currently viewed,
it is helpful to look at the way the concept of disability
has evolved over time as described below.
1.5.1.Traditional/Charity Model
• Historically, disability was largely understood in
mythological or religious terms, e.g. people with
disabilities were considered to be possessed by devils or
spirits; disability was also often seen as a punishment for
past wrongdoing.
• These views are still present today in many traditional
societies.
PWDs outside of society and society giving to
PWDs
 1.5.2.Individual/Medical Model
• In the nineteenth and twentieth centuries, developments in
science and medicine helped to create an understanding that
disability has a biological or medical basis, with impairments
in body function and structure being associated with different
health conditions.
• This medical model views disability as a problem of the
individual and is primarily focused on cure and the provision
of medical care by professionals.
PWDs outside of society and PWDs should adapt to
fit society
 1.5.3. Social Model/Human Rights-Based Model
• In the 1960s and 1970s, the individual and medical view of
disability was challenged and a range of social approaches were
developed, e.g. the social model of disability.
• These approaches shifted attention away from the medical
aspects of disability and instead focused on the social barriers
and discrimination that people with disabilities face.
• Disability was redefined as a societal problem rather than an
individual problem and solutions became focused on removing
barriers and social change, not just medical cure.
PWD as part of society