Tag Archives: disability

Building eco-homes for every body

By Amita Bhakta (Loughborough University) and Jenny Pickerill (University of Sheffield) 

Hockerton Housing Project

Hockerton Housing Project, Nottinghamshire, UK. Photo Credit: Richard Croft CC BY-SA 2.0

At the end of November 2015 Paris will be host to COP21 where leaders gather yet again to debate and discuss ways forward to tackle the multitude of climate challenges we face. COP21, or the Conference of the Parties to the United Nations Framework Convention on Climate Change, will seek to find a renewed international agreement to limiting global warming to below a 2oC rise. The Guardian this week emphasised that despite the efforts being made by 140 nations around the world to reduce emissions, average temperatures are likely to rise to 2.7oC and lead to rising sea levels, floods, drought, and the extinction of species.

In response to such challenges, communities with eco-friendly housing, low running costs and shared facilities are being built across the world. These homes seek to minimise waste and use of resources, whilst promoting the use of renewable energy. Such eco-communities are part of a grassroots movement bringing people of diverse backgrounds together to live low impact lifestyles.

But at the same time with a continually ageing population, we must also consider our future selves, and how our needs will shift alongside these environmental challenges. Inaccessibility for disabled people has long been discussed as an endemic issue which typifies the British housing stock (see, for instance Imrie 2006, Hemingway, 2011).

Yet, what remains clear is that whilst eco-housing is being built as a part of the responses to environmental challenges, it is not being developed to be inclusive of all needs and abilities. In our recent article in The Geographical Journal (Bhakta and Pickerill 2015) we discuss how despite a growing recognition of the necessity to build for diverse abilities, with a need to understand the complexity of disability and the consequences of this for engaging with the built environment, eco-communities have failed to provide physical accessibility for disabled people. Such failure has arisen from not just barriers to implementing accessible features in homes (such as high perceived costs, changes in regulations over time and a notable prioritisation of being ecological over being accessible), but also the ignorance of bodily differences, manifested through barriers in both eco-homes and their surrounding community environments. As such, lessons from the past on inaccessibility in British housing have not been drawn upon in new eco-house construction.

Our paper uses the example of eco-communities to illustrate that disabled people are in effect excluded physically and socially from ecological lifestyles and practices. And so, begs the question: is inclusivity on the agenda at the COP21 summit? Where does disability ‘fit’ in sustainable practice more broadly? Through bringing attention back to the (disabled) body, our article provides a reminder that whilst we strive to mitigate the effects of climate change we still remain part of the future. In seeking to make space for differences such as disability, in a future older population, our research highlights the need to consider how to not only sustain our planet, but also to sustain our individual selves and bodies as well.

About the authors: 

Amita Bhakta is a PhD candidate within the Water, Engineering and Development Centre (WEDC) at Loughborough University. Jenny Pickerill is Professor of Environmental Geography at the University of Sheffield.

References

books_icon Bhakta, A. and Pickerill, J. (2015), Making space for disability in eco-homes and eco-communities. The Geographical Journal. doi: 10.1111/geoj.12157

60-world2 The Guardian 2015 Climate pledges by 140 countries will limit global warming – but not enough 

Who lives, who dies, who cares?

By Izabela Delabre, University of Reading

Advances in healthcare technologies and pharmaceutical breakthroughs politicise and manipulate our lives.  An article in The Guardian last week describes how French doctors are challenging the patent of a new and highly expensive drug for hepatitis C in an attempt to bring down the price (the drug, Sofosbuvir, made by the pharmaceutical multinational Gilead Sciences, costs $1,000 (£650) a pill for a 10-week course).  It is a cure for the viral infection that can lead to liver cirrhosis, cancer and death.  The struggle against health inequality persists, with large numbers of people lacking access to healthcare.

A new biopolitical regime judges an individual’s ‘worth’ through their economic productivity

A new biopolitical regime judges an individual’s ‘worth’ through their economic productivity. Image credit: Elvert Xavier Barnes Photography via Wikimedia Commons.

Writing in Transactions of the Institute of British Geographers, Emma Whyte Laurie’s article entitled, “Who lives, who dies, who cares? Valuing life through the disability-adjusted life year measurement” provides a critique of the disability-adjusted life year (DALY) measurement. The World Health Organization defines a DALY as one lost year of “healthy” life. It is a measure of overall disease burden, expressed as the number of years lost due to ill-health, disability or early death.  Emma Whyte Laurie argues that DALYs have ‘become normative because many health policy makers and their funding partners use the DALY as their only measure of disease impact in programmatic analysis’ (King and Bertino 2008, 2). DALYs have supported the emergence of an epoch in global health governance whereby resource allocation is justified on the premise of ‘cost-effectiveness’, ‘value for money’ and ‘good return for investment,’ and this is compounded with the global financial climate which has negatively impacted the available budget for health interventions.

DALYs are established on the conceptualisation of individuals as exclusively economic beings, but individuals may fail to live up to the economically productive ‘ideal.’  DALYs may be partly responsible for the devaluation of the lives of certain individuals, by asserting the values of individualism in relation to wider economic gain where, individuals lose humanness when they become poor, and also unproductive.  Emma Whyte Laurie states that the problem may be less associated with DALYs as a measurement in itself, but rather with the faith that has been placed in them by mainstream institutions.

The question of who benefits from health interventions is heavily value-laden. Priority-setting is essentially a political and social process (rather than a scientific one), involving deliberation and public accountability. Through the exact numbers provided by the DALY measurement, important questions of ethics and politics are omitted, potentially hindering important and difficult discussions of setting priorities in the health sector.

Emma Whyte Laurie considers the question posed by Farmer: ‘[if health is a human right, who is considered human enough to have that right?’ (2005, 206). According to Agamben (1998), throughout history, the humanity of living man has been judged by each society, which has decided whose lives have value. Today, these judgements are increasingly based on economic productivity or the pursuit of capital accumulation where certain (wealthier) lives are considered more valuable than others. DALYs reflect this, capturing the ‘disease burden’ through economic loss, but also addressing Farmer’s question as to who is valuable, or who is human enough, to be afforded the right to health.

References

books_icon   Agamben G. (1998). Homo sacer: sovereign power and bare life. Stanford University Press, Stanford CA

60-world2   Boseley S. (2015). Doctors challenge hepatitis C drug patent in price protest. The Guardian, 10 February

books_icon   Farmer P. (2005). Pathologies of power: health, human rights and the new war on the poor. University of California Press, Berkeley CA

books_icon   King C. H. and Bertino A-M. (2008). Asymmetries of poverty: why global burden of disease valuations underestimate the burden of neglected tropical diseases. PLoS Neglected Tropical Diseases 2 e209

books_icon   Laurie E.W. (2015). Who lives, who dies, who cares? Valuing life through the disability-adjusted life year measurement. Transactions of the Institute of British Geographers, 40:1 pp. 75–87.

60-world2   World Health Organization (WHO). Metrics: Disability-Adjusted Life Year (DALY).

Geographies of Disability – India

by Michelle Brooks

Recent headlines in India about a disabled boy who was refused entry to a temple have raised questions around the wider problem of social stigma concerning disability in India. Temple authorities in Mysore, south-west India are reported to have forcibly removed the wheel-chair bound boy and his family later claiming that issues of access and language barriers had precipitated this action. The numbers of people living with disabilities in India could be as high as 90 million (World Bank 2007), however, due to the stigma attached to disability in India this number is contested. Political will to improve the social and economic wellbeing of disabled people is evidenced in for example, landmark legislation to protect the disabled (1995) and ratification of the UN convention on the rights of persons with disabilities (2006) yet despite this many Indian states have failed to implement policy requirements and guidelines in this area.

It can be argued that implementing such policies is greatly hampered by lingering social reluctance to accept disabled people as legitimate actors in public space, forcing them to live on the margins of mainstream society experiencing a greater degree of poverty and social exclusion than others in their age /regional/caste or class grouping. Additionally disabled women are severely disadvantaged further by disability, through vulnerability to various forms of abuse and then often also lose the right to care for their children (UN Enable 2006). Much work has been done in geography on disability issues and the social separation experienced as a result. In an interesting article for Area, Edward Hall (2004) highlights social exclusion of the disabled but then problematises social exclusion policy, drawing attention to the focus on employment as a method of ‘inclusion’  in UK policy which does not address the social support that can be gained through the informal sector.  Likewise in India, policy reflects state logic the implementation of which (or lack of) in turn is a reflection of wider societal stigma. Categorising disability in India largely occurs in childhood and is determined as a condition whereby the person suffers less than 40% in any ability, a certificate is issued and the disability is rarely assessed again (Ministry of Law and Justice 1996). This hints at the assumption by the state that the disability is fixed and the problems associated with it lie in stasis throughout the persons life course. It is therefore regarded as a condition arising from the persons being or natural state, rather than polysemic or changeable and indeed having a life course of its own.

In diseases such as Polio in which symptoms worsen with time and Cerebral Palsy where assessment must take place over time until adulthood policy implementation presents the disabled person with a serious disadvantage. The aligning of the characteristics of the disability with that of the problems experienced by the individual absolves society of social impacts felt by the disabled such as abuse, exclusion, employment discrimination or educational shortfalls. This fatalist approach perpetuates commonly held perceptions in the public consciousness that disability is an affliction brought about by moral or religious shortcomings.  The headline story was in fact about someone with cerebral palsy, where sadly the ocular symptoms of the disease can mask a fully active and able mind, one for whom exclusion from the cultural and spiritual stimulus of a temple  (as sought by the parents in this case) is indeed a great injustice.