Disability and Global Health

• How can a nuanced understanding of disability, considering lived experiences, cultural differences and intersectionality issues inform research on the effectiveness of public health intervention?
• What research methods can better measure impairments/health conditions and wellbeing?
• How person with disabilities experience access to healthcare? What are their experiences? How are they being treated in the healthcare community? Where and how does exclusion occur? What are their healthcare needs?
• How can assistive devices and ICT’s technology enhance each person’s capability? How can use technology to bridge the gaps on access to healthcare?
• Our research has conducted with persons with disabilities from Latin America, Africa and Europe exploring lived experience of disability and consequences of impairment and health. We use an interdisciplinary approach that combines quantitative and qualitative empirical research, as well as, applied philosophy. Our goal is to remove barriers and make health services more inclusive, respectful, and acceptable for persons with disabilities.

Projects

Assessing the Impact of Video Remote Sign Language Interpreting in Healthcare: Linking Disability Studies with Empirical Challenges of Public Health Research

Persons with disabilities have poorer health than the general population due to a variety of circumstances, which may differ for people with different impairments. To address these disparities, it is necessary to gain an understanding of the diversity among disabled people; including the fact that persons with different impairments face different barriers and might benefit from different types of intervention. It is also important to address ethical engagement, respect for personhood, and the rights of the individual while promoting methodological rigor. This project aims to link disability theory with empirical challenges of public health research.

The two main objectives for this project are:

To link disability theory with the empirical challenges of public health research. By gathering empirical evidence on the health needs of Deaf persons and testing an intervention that responds to the structural and societal factors that are in tune with impairments to determine how an individual experiences health and disability.

To leverage changes in health care systems, using existing and new evidence regarding good practices for remote video sign language interpreting and disability-inclusive approach assessment for public health interventions.

This will be a two-part proposal, which will use mixed methods, including participatory methodologies. The study will be conducted in Colombia. A steering committee will be created to include local and international disabled people’s organizations and leading disability scholars working in public health. Part Oneof the project will analyse the various health needs of Deaf persons and the availability of sign language interpreters using a nationwide needs-assessment survey. This survey will include items from the 2018 census regarding disability and health. To allow for comparison, it will also look at access to interpreters in the health context and on mobile devices. Part Two will involve a qualitative exploration of issues/obstacles with healthcare staff, users, and key informants to define the best possible design for the video remote interpreting intervention, this exploration will determine an adequate assessment tool and metric. I will adopt a pretest-posttest design to monitor the intervention. I will report on intervention fidelity and attribution of outcomes to intervention effectiveness by evaluating the potency of interventions, uptake, and sustainability.

The outcomes generated will include new assessment frameworks and knowledge to understand the causes of inequities, addressing structural, cultural, and societal barriers that inhibit deaf individuals with disabilities from communicating effectively within the healthcare context. It will provide empirical data looking at the impact of video remote interpreting while also contributing to building capacities for both healthcare personnel and interpreters. This study will also raise awareness about disabilities and provide progress towards understanding the role of effective communication in achieving universal health coverage and quality health care for the deaf population. The research design adopted allows for replication, further validating and constructing a body of knowledge in this area.

GlobalViewAid

This project is carried out in partnership with EPFL Essential Tech

(https://essentialtech.center/project/global-view-aid/)

Approximately 4% of the world’s population are blind or visually impaired (39 million are blind and 246 million have moderate to severe visual impairment). From this population, about 90% live in low and middle-income countries. The great majority of the visually impaired people in low and middle-income countries live in poverty with limited or no access to any assistive tools. According to the WHO, more than 200 million visually impaired people do not have access to assistive products, being the “lack of affordability in low-income countries” a major reason why people in need do not possess any assistive tools. The lack of access to assistive tools hinders the personal development of the visually impaired population by limiting their autonomy, their social interaction, academic and professional opportunities, among others. The main impact of this project will be to develop an assistive device that responds to the economic, social and infrastructural constraints faced by visually impaired people in the global south. This tool will overcome access issues by enabling autonomy and mobility.

Indigenous people, disability and climate change: A case of the Batwa community in Western Uganda.

This project is carried out in partnership with Makerere University, Kampala Uganda.  

Climate change has direct and indirect consequences for individuals and their human rights. The environmental and health consequences of climate change, which disproportionately affect indigenous people in low-income countries, profoundly impact on their response to the impact of climate change. With minimal empirical evidence about their socio-economic conditions, indigenous people living with varying forms of disability form one of the most highly vulnerable communities to climate change effects such as increased temperature, excess precipitation and droughts, extreme weather events, and increased sea level. These consequences not only adversely affect agricultural production, access to safe water and energy sources but also make land uninhabitable and uncultivable. In Uganda, the Batwa--who live in the south-western Uganda in the districts of Bundibugyo, Kabale, Kisoro and Rukungiri who are dependent on the Mgahinga and Bwindi Impenetrable Forest Conservation Trust (MBIFCT), their community members living with disability not only suffer the double jeopardy of dealing impermeant and being forced to become environmental refugees in their own settings. In this article, we explore the nexus between disability and climate change impact on indigenous people by focusing on the Batwa community in Uganda. Using data from semi-structured interviews and focus group discussions with individuals from the community, their leadership and local and national duty bearers, the paper examines the disability identities of the Batwa, their climate change vulnerabilities and the strategies to enhance their resilience to the climate change phenomenon. The study findings are largely informed by the intersectionality of indigeneity and disability and the human rights-based approach to understanding the role and status of indigenous communities. 

Disarmament, Demobilization, and Reintegration of ex-combatants with disabilities.

Conflict over resources, ideologies, ethnicities is ubiquitous in LMIC.  Every conflict leads not just to death, but also to injury and life-long disability.  Disarmament, demobilization and reintegration efforts have not addressed the difficulties of newly impaired ex-combatants in overcoming barriers and making transitions from combatant>civilian and non-disabled>disabled: data is completely lacking on this group, particularly 5-10 yrs after cessation of hostilities. 

The purpose of this study is to explore ex-combatants’ understandings of disability and the pathways for social reintegration available to them in Colombia.