According to World Health Organisation (WHO), disability is an umbrella term, covering impairments, activity limitations and participation restrictions. Impairment is a problem in body functions or structures; an activity limitation is a difficulty encountered by an individual in executing a task or action and a participation restriction is a problem experienced by an individual involving the day to day life situations.
Disability is thus, not just a health problem but rather a complex phenomenon, reflecting the interaction between features of a person’s body and features of the society in which he or she lives.
Overcoming difficulties faced by the people with disabilities requires interventions to remove environmental and social barriers as well. People with disabilities have the same health needs as physically fit people. They might experience constraints in health care, both because of poverty and social exclusion, and also because they may be vulnerable to secondary conditions. The International Day of Disabled Persons (IDDP) was decided to be celebrated internationally on December 3 every year and later promoted as an international observance by the United Nations 1992 onwards.
The major emphasis during the annual observance is given to promote the awareness about the people with disabilities as well as to encourage such people by providing a lot of training and assistance in their day to day activities to enhance their quality of life and remove the social stigma towards them.
Since 1992, it has been observed continuously every year with a lot of success all over the world including India. It also looks to involve all the persons with disabilities in the society in various walks of life such as the political, economic, social and cultural spheres. Every year, celebration of the international day of disabled persons focuses on the different issues of the disabled persons across the world.
Being an orthopaedic surgeon, I will restrict myself to the orthopaedic disabilities, their causes and remedies. The potential causes of orthopaedic impairments include genetic abnormalities, birth trauma, cerebral palsy, rickets, polio, various infections, bone tuberculosis, arthritis, fractures and amputations.
The main causes of orthopaedic disabilities are cerebral palsy, club foot and polio in children, fractures due to road traffic accidents in adults and degenerative arthritis and osteoporosis in old age.
Our ancient Indian scriptures state that, if there is birth, there is development, disease, degeneration and death. If we analyse the causes of disability, then all the four stages of life are vulnerable to disabilities depending upon the age of the individual. Most of the causes of disabilities like infection and other diseases can be and have been prevented with advancement of medical technology and skill, but ageing cannot be. Ageing and the degenerative changes associated with age are themselves the causes of the disability.
Main causes of disability in old age are senile degeneration, arthritis and osteoporosis. Osteoporosis is a silent disease. Osteoporosis is caused mainly due to disturbed calcium metabolism. Osteoporosis during old age cannot be halted completely but its pace can be reduced by keeping an active lifestyle as much as possible and supplementing the diet with calcium and vitamins.
Wrist, hip and spine fractures are commonly seen in osteoporotic bones. People become disabled for the rest of the life if these fractures are not treated well in time.
Disability is a subject you may read or hear about, but not think of as something that may happen to you. However, your chances of becoming disabled are greater than you realise today. More people live with disabilities than ever before due to our aging societies, as well as improved medical treatment.
Over a billion people of the world’s population, about 15 per cent have some form of disability. According to the Government of India census report of 2016, out of the 121 crore population, 2.7 crore persons are disabled which amounts to about 2.2 per cent of the total population.
It is increasing at an astonishing rate of about 25 per cent in each decade. However, the absolute numbers have started coming down all over the world, including in India, due to better education, health and medical services.
If the road traffic accidents are treated well in time, then firstly the patient will not at all be disabled and even if he or she becomes disabled, in spite of the best possible treatment, then the level of disability will be significantly less.
I strongly believe that surgery has played an important role in the lives of persons with disabilities. Their lives have been changed significantly and they are not only developing or improving themselves but also contributing to the growth of the society.
I once read in a book that in a particular region of Tunisia, there is a water well which the local sages believe is connected to another well in the holy city of Mecca. But ordinary people like me believe that every well is inter connected underground.
Therefore, I and my organisation are making our best efforts to spread the awareness by organising free health camps and lectures to reduce the disabilities and to make disabled people able through prompt surgical interventions. I sincerely believe that it is my duty to serve the society because we all are a part of it. There is a Zulu proverb “Umuntu Ngumuntu Ngabantu” which means that a person is a person through/because of other people.
The deformities and disabilities caused due to any reason whatsoever should be corrected at the earliest. Hence, this author always advises the patient and the patient’s family that if surgery is needed, then, the sooner the better because plants can be straightened, not the trees.
(The author is an orthopaedic and spine surgeon, and the founding president of State Chapter of Indian Orthopaedic Association)