Meet Carlito, in Mozambique.
Carlito receives around 4.5 USD a month as a beneficiary of a programme providing support for the elderly and people with disabilities considered unable to work. As Carlito shows us in the video, even after receiving the money he still has to rely on family and friends for food and getting about the place. And as he tells us, he is by no means unable to work. His dream, in fact, is to have a small shop.
Carlito’s story was gathered as part of research conducted by ODI and UKaid on perspectives on cash transfers in five countries. Their report on Mozambique focusses especially on persons with disabilities, some of whom are receiving the transfer and some of whom aren’t.
There were two parts of the report I found interesting. First is “informal support structures” for people with disabilities and second is the reasons identified for more people with disabilities not participating in the program.
According to the report, Carlito is like other people with disabilities in the help that he receives.
During the study it became clear that one of the most onerous aspects of disability for people of all ages was their dependency on others and their lack of independence. People referred to the fact that they were dependent on people to bring water to the house, take them to their farms or to hospital and, in some cases, to attend to their bodily functions. The only support they received was from family or neighbours (if they were living alone). There are no outreach services provided by the National Health System or the Social Welfare Services to reduce the burden of care on family or community members. (p. 34)
This isn’t as simple as being just an “onerous” aspect of disability. While focus group respondents in general thought the community was becoming less cohesive, people with disabilities and the elderly don’t think this. You can see in the smile of Carlito’s friend that there is a story here about “interdependence” and not just “dependence”.
While people with disabilities don’t report discrimination within their communities, they did report it from those of officials in the cash transfer programme and in other areas. “Don’t bother me, why do you want to live?” is one of the things that nurses said to an elderly man visiting a health centre (p. 27). When collecting the cash transfer, people with disabilities report that they “felt badly treated when the transfer is paid, that they are often insulted, have to wait for many hours, with no consideration given to their disability”. Formal systems are discriminating more than the communities in which the respondents lived.
This is connected with the reason that people with disabilities don’t access this cash transfer scheme more. The cash transfer is responding less dynamically than the community itself to the needs of people with disabilities.
Physical access to the people who fill in the application forms was considered less of a barrier than feelings of lack of entitlement by extremely poor people living with a disability. Making targeting mechanisms and criteria more transparent (easily understood) through clear and well-disseminated information would reduce the bias against applicants with disabilities. (p. vi)
This also has an interesting implication for advocacy on disability access. We are often busy fighting the endless battle of demanding ramps, and accessible toilets, and tactile surfaces, and elevators, and less-steep ramps, and then ramps with hand-rails and tactile surfaces and so on and on. This report suggests, however, that at least in this case the problem wasn’t the lack of physical accessibility but rather of people not believing the service was for them. It reminds us in the disability sector that we have to be careful of our priorities. Maybe the important question of access is inclusive policies and behaviour rather than physical infrastructure.
Disclaimer: I was involved in contributing to the literature review at the beginning of the ODI project.