Abstract
The World Health Organization extends its thanks to the International Society for Prosthetics & Orthotics (ISPO) for the opportunity to participate in this important congress for multidisciplinary orthotic and prosthetic care. The choice of Canada for this Congress is very appropriate because Canada has shown great zeal and commitment to building a truly accessible society for all; a Canada where people with and without disabilities can live to their fullest1. The Canadian pledge is further supported by their recent signing of the UN Convention on the Rights of Persons with Disabilities.
For the 650 million persons with disabilities around the world, discriminatory practices and attitudes and their exclusion from mainstream development efforts have been permitted for too long.
We have before us a great opportunity and challenge. The Convention on the Rights of Persons with Disabilities aims at making a major shift in attitudes and approaches to persons with disabilities. It takes to a new height the process initiated two decades ago by the United Nations of moving the treatment of persons with disabilities as ‘objects’ of charity, medical and rehabilitation treatment and social protection towards viewing persons with disabilities as ‘subjects’ with rights who are capable of claiming those rights and making decisions for their lives.
Articles 20 and 26 of the Convention provide clear guidance on the need for effective measures to ensure personal mobility with the greatest possible independence of persons with disabilities. The successful implementation of the convention requires that:
Prosthetic, orthotic, mobility aids and rehabilitation services are available and accessible; Programmes are based on actual needs of persons with disabilities and on the principles of full and effective participation and equality; Persons with disabilities and their families participate in the design and organization of rehabilitation services and make their own choices about their rehabilitation; and These services are available in the local community where persons with disabilities live.
The World Health Assembly Resolution 58.23 adopted in May 2005, on ‘Disability, including Prevention, Management and Rehabilitation’ also calls on member states and the WHO Director General to increase actions in these areas.
The World Health Organization is strongly committed to raising the profile of disability and rehabilitation. Our contribution focuses on those areas where we can make the greatest difference, namely, in strengthening community-based and medical rehabilitation (and access to it), improving data collection, and supporting policy development in accordance with the principles of the Convention. To do so we intend to gradually increase our staff devoted to these issues. As a first step, WHO, will in the coming months recruit a technical officer to upscale its work on mainstreaming disability across all its areas of work and will support member states to do likewise.
WHO is currently working on four core activities which all aim at encouraging and helping countries to increase their activities in disability and rehabilitation:
A World Report on Disability and Rehabilitation, based on the best available scientific evidence will be available in 2009. The report, developed jointly by WHO the World Bank and dozens of other partners, will summarize existing information on the status of disability, rehabilitation and the lived experience of persons with disabilities. It will include current data and trends on disability and rehabilitation, causes of disability, existing responses as well as broader issues such as improving access to information and environments, healthcare, education and employment. The report should be an additional high level call to action for many countries. WHO, in partnership with ILO and UNESCO, is also facilitating the development of technical guidelines on community based rehabilitation that will provide clear direction on how community-based development initiatives can work to ensure the rights of persons with disabilities and promote respect for their inherent dignity in accordance with the UN convention. The guidelines will be available in 2008. Guidelines on Wheelchair production in limited resource settings developed with support from ISPO and USAID are in the final stages of production. On 31 July, 2007, WHO and USAID will facilitate a discussion in Vancouver on what should be the next steps after the publication of the Wheelchair Guidelines and Wheelchair Consensus Conference report. Technical support to member states on the development and implementation of rehabilitation services is an important part of our work which will be evidence-based and upscaled through the use of the World Report and technical guidelines.
In all of these projects we are keen to engage as many partners as possible and take into account a large number of perspectives.
ISPO is an important partner for WHO in all the efforts that promote and reinforce mobility devices and rehabilitation services. WHO looks forward to working with ISPO in the future to further strengthen these efforts and the linkage between CBR and prosthetic, orthotic and wheelchair service provision. This conference is a necessary step in looking at how practitioners and academics can play roles in making the paradigm shift and moving beyond the old approaches and attitudes to people with disabilities.
Footnotes
1. This is a quote from the Honorable Diane Finley, PC, MP, Minister of Human Resources and Social Development taken from “Advancing the Inclusion of People with Disabilities 2006”, the Government of Canada's fourth comprehensive report on disability in Canada.