ORTHOPEDICALLY CHALLANGED / HANDICAPPED

The term orthopedically impaired refers to a broad range of disabilities. People with these impairments must often use devices such as wheelchairs, crutches, canes, braces and artificial limbs to facilitate mobility. The impairment may be either congenital or as a result of an injury or disease. Some e.g.s arthritis, amputation, blood diseases, multiple sclerosis, spinal cord injury, polio, cerebral palsy, muscular dystrophy.

PROBLEMS FACED

-          The person may have limited mobility

-          There may be difficulty in writing

-          There may be speech difficulties

-          The individual may have limited social interaction skills

-          The individual may have limited ability to perform everyday activities.

In order to over come these problems various steps can be taken like Reservation of seats or preferential seating arrangements, Flexible time limits, Larger desk, lap tray or tables, Special grip pens or pencils. Assistive technology, etc.

Apart from this, Reservations in modes of transport, Job reservations etc. will create more opportunities to enable inclusive growth.

HEARING IMPAIRED / AUDITORILLY HANDICAPPED

Hearing impairment or hearing loss occurs when you lose part or all of your ability to hear. 

Hearing impairments are categorized based on the minimum sound that can be heard with the better ear.

There are four levels of deafness or hearing impairment. These are:

·         Mild deafness or mild hearing impairment: The person can only detect sounds between 25 and 29 decibels (dB). They may find it hard to understand the words other people are saying, especially if there is a lot of background noise.

·         Moderate deafness or moderate hearing impairment: The person can only detect sounds between 40 and 69 dB. Following a conversation using hearing alone is very difficult without using a hearing aid.

·         Severe deafness: The person only hears sounds above 70 to 89 dB. A severely deaf person must either lip-read or use sign language in order to communicate, even if they have a hearing aid.

·         Profound deafness: Anybody who cannot hear a sound below 90 dB has profound deafness. Some people with profound deafness cannot hear anything at all, at any decibel level. Communication is carried out using sign language, lip-reading, or reading and writing.

Types

There are three different types of hearing loss:

1) Conductive hearing loss

This means that the vibrations are not passing through from the outer ear to the inner ear, specifically the cochlea. Most cases of this type of hearing loss can be corrected medically or surgically. This type can occur for many reasons, including:

·         Fluid in the middle ear as a result of cold

·         an excessive build-up of earwax

·         an ear infection with inflammation and fluid buildup

·         a perforated eardrum

·         a defective eardrum

·         allergies

·         benign tumors or having a foreign body in the ear

·         structural abnormalities of the outer ear, ear canal or middle ear

2) Sensorineural hearing loss (SNHL)

Also referred to as nerve Hearing loss occurs when there is damage to either the auditory nerve or the cochlea which is the inner ear. The hearing loss in SNHL is permanent, although it may be possible to treat it with hearing aids.

SNHL is caused due to:

-       exposure to excessively loud noise

-       head trauma or sudden air pressure changes

-       illnesses (like meningitis)

-       structural abnormality of the inner ear

-       tumors

-       aging

-       medication side effects

-       autoimmune inner ear disease

-       abnormal growth of the bone that is in the middle ear

3). Central Hearing Loss

This occurs when there are problems within the brain that interfere with the ability to interpret or understand sounds. This is the rarest type of hearing impairment and the hardest to treat.

The causes include

-       damage to brainstem structures

-       severe head trauma

-       damage to the auditory nerves or the pathways that lead to them

-       brain tumors

4). Functional hearing loss

This occurs when the functioning of the ears is normal, however the individual shows reduced response or does not respond to sounds. Hearing loss is caused by mental health problems such as ADHD (Attention Deficit Hyperactivity Disorder) and depression

TREATMENT FOR HEARING IMPAIRED

Removing wax blockage – earwax blockage is a reversible cause of hearing loss. The doctor may remove ear wax by loosening it with oil and then flushing, scooping or suctioning out the wax.

Surgical procedures – traumatic ear injury or repeated infections may require surgical procedures

Hearing aids – In case of inner ear damage, a hearing aid can help by making it easier to hear with increased sound. An audiologist can discuss the potential benefits of hearing aid with the patient and recommend and fit the device.

Cochlear implants – In case of severe hearing loss, a cochlear implant can be an option. This implant compensates for the damaged or nonworking parts of the inner ear.

Assistive listening devices – Hearing aids may not be useful for a particular case and so there are other accessories and assistive listening devices that can bridge the gap to enable better communication.

VISUAL IMPAIRMENT / VISION IMPAIRMENT

Visual impairment or vision impairment is a decreased ability to see to a degree that causes problems not fixable by usual means, such as glasses.

Total blindness is the inability to tell light from dark or the total inability to see.

In some cases, we also include those who have a decreased ability to see because they do not have access to glasses or contact lenses.

CAUSES OF VISUAL / VISION IMPAIRMENT AND BLINDNESS

-          Injury to the eyes – could happen due to an accident, while playing or at work. Injuries to the cornea are the most common cause of loss of vision.

-       Inherited blindness – Retinitis pigmentosa is the common cause of inherited blindness.

-    Eye infections – trachoma of the eyes may damage eyesight – common in developing and underdeveloped countries with poor water and sanitation facilities. If a pregnant mother has German measles during pregnancy the baby may be born with visual impairment or blindness.

-       Amblyopia – is impaired vision in one eye due to lack of usage in early childhood. ‘Lazy eye’ or squint in the eye can cause weakness in the eyes leading to amblyopia in that eye.

-       Cataract - is the clouding of part of or the entire lens of the eye. This condition usually affects the elderly and its symptoms include blurred vision, double vision, etc.

       Diabetic retinopathy – Diabetes affects the blood vessels in the retina which leads to visual impairment.

          Glaucoma – increased pressure in the eyes impairs vision by damaging the optic nerve. One could be born with this condition or may develop it at an older age.

-      Age relate macular degeneration (AMD) – progressive loss of the visual acuity due to damage to the macula (the more sensitive part of the retina). Risk of AMD rises in those exposed to excess sunlight and those who smoke excessively.

-     AIDS related visual impairment – caused by viral infections of the eyes (Cytomegalovirus or CMV retinitis)  

    

      Cancer of the eyes – Retinoblastoma is the most common eye cancer in children. Annually there are 300 to 400 new cases diagnosed.

TREATMENT AND MANAGEMENT OF VISUAL IMPAIRMENT

Firstly, certain conditions should be looked into for treatment and management

• The degree of impairment, disability, or handicap
• Cause of visual impairment and possible outcome
• Age of the patient and level of development
• General health of the patient
• Patient’s other impairment and adjustment to the vision loss and patient’s expectations from therapy

IF THESE CONDITIONS ARE MET THEN:

-          Control of diabetes – Prevents progression of diabetic retinopathy and slows visual impairment to some extent.

-          Cataract surgery – an artificial lens can be placed within the eye as replacement for the damaged / clouded lens through a cataract operation and vision can be restored.

-          Magnification systems – using an appropriate lens vision can be improved.

-          Glaucoma medication – eye drops / eye injections can be used to control glaucoma. In some cases, laser corrections or open microscopic surgery may help improve vision.

-          AMD – of the dry variety has no cure yet, however the wet variety can use therapies that help stop progression of blindness. Photodynamic therapy can also be used. 

There is a need to encourage more Braille Schools as well as libraries. Technology can make this easy and accessible to all through various apps. Audiobooks are also an advantage and allow for more opportunities. 

Donating your eyes to enable the blind to see is a humane gift you can make once you leave this world.

It 

It is important to be sensitive and deal with people with any form of disability in an inclusive manner.

INEQUALITY DUE TO DISABILITY

In broad terms, ‘disability’ is any continuing condition that restricts everyday activity. It is the lack of adequate power, strength, physical or mental ability or incapacity that prevents a person from living a full, normal life.

Some common disabilities are:

-          Visual impairment

-          Hearing impairment

-          Mental health conditions

-          Intellectual disability

-          Acquired brain injury

-          Autism spectrum disorder

-          Physical disability

-          Etc. 

     It is on account of disability that there is need to provide special benefits for persons with disabilities in order enable them to assimilate into the general masses. It is important to be sensitive and inclusive while provided special benefits.