Reaching the marginalized: EFA global monitoring report, 2010; 2010

REACHING THE MARGINALIZEDGetting left behindDisabilityDisability is one of the least visible but most potentfactors in educational marginalization. Beyondthe immediate health-related effects, physicaland mental impairment carries a stigma that isoften a basis for exclusion from society and school.The impact is often worse for poorer households.Attitudes towards disability have changed overtime. Until relatively recently, the ‘medical model’was dominant: those with disabilities were seenas having a condition that set them apart fromthe rest of society. That attitude gave rise todiscrimination, isolation and stigmatization. It isnow increasingly accepted that, while disabilitiesinvolve varying levels and types of impairment,it is social, institutional and attitudinal barriersthat limit the full inclusion of people withdisabilities. Understanding disability in thisway highlights the importance of identifyingand removing the barriers. Education has a keyrole to play in changing attitudes.Poverty is both a potential cause and a consequenceof disability. In several countries, the probabilityof being in poverty rises in households headedby people with disabilities (McClain-Nhlapo, 2007).In Uganda, evidence from the 1990s found that theprobability was as much as 60% higher (Hoogeveen,2005). Those with disabilities are much less likelyto be working. Other family members may also beout of work (or school) to care for them. Inadequatetreatment, along with poor families’ inability toinvest sufficiently in health and nutrition, reinforcesthe problems people with disabilities face (Bird andPratt, 2004). These links to poverty, combined withstigma and discrimination, are a significant factorin their educational marginalization.While globally comparable, reliable data arenotoriously difficult to obtain, one widely citedsource estimates that 150 million childrenworldwide live with disabilities (WHO and UNICEF,2008). 9 Around four in five children with disabilitiesare in developing countries. In addition, manymillions of children live in households withparents or relatives who have disabilities. At allages, levels of both moderate and severe disabilityare higher in low- and middle-income countriesthan in rich countries. They are highest in sub-Saharan Africa (WHO and UNICEF, 2008). Thescale of disability and its concentration in theworld’s poorest countries contributes significantlyto marginalization in education.Box 3.12: Education destruction and reconstruction in GazaConflict in 2008 and 2009 gravely affected the education system in Gaza.The circumstances surrounding the violence are subject to claim andcounter-claim. In a report presented to the United Nations GeneralAssembly, Justice Richard Goldstone documented evidence of both sidestargeting civilian populations. What is not in question is the scale of thehuman and physical damage inflicted by Israeli military actions.Part of the damage can be counted in terms of lives lost and people injured.It is estimated that 164 students and 12 teachers were killed. Many moresuffered long-term injuries. Infrastructure was severely affected. Whileestimates vary, Justice Goldstone reported that some 280 schools andkindergartens were identified as destroyed or badly damaged. Restrictionson transport of building materials have delayed reconstruction.Less easy to document are the effects of childhood trauma. Violent conflicthas left deep scars in Gaza society. Research in Gaza has identified posttraumaticstress disorder as a major problem for young people, with 69%of adolescents affected and 40% reporting moderate or severe depression.Such conditions create severe educational disadvantage.The scale of violence experienced by civilian populations in 2008 and 2009has compounded the disadvantage. Many children have returned to schoolsuffering from anxiety, the emotional shock of losing parents or siblingsand the memory of acts of extreme violence. The consequences foreducation are likely to be far reaching and long lasting.Sources: O’Malley (2009); United Nations (2009a); Elbedour et al. (2007).Systematic under-reporting of disability is a seriousproblem. To take one example, a 2004 census inSierra Leone reported only 3,300 cases of mentalimpairment, while a detailed national survey theyear before had estimated the real figure to be tentimes higher (World Bank, 2009c). One reason forunder-reporting is that stigmatization often makesparents and children reluctant to report disability.Many impairments can be traced back to poverty,poor nutrition and restricted access to basicservices (Yeo and Moore, 2003). Asphyxia duringbirth, often resulting from the absence of a skilledattendant, leaves an estimated 1 million childrenwith impairments such as cerebral palsy andlearning difficulties (UNICEF, 2008b). Maternal iodinedeficiency leads to 18 million babies being born withmental impairments and deficiency in vitamin Aleaves about 350,000 children in developingcountries blind (Micronutrient Initiative et al., 2009).Conflict contributes to disability directly throughphysical threats and indirectly through effects onpoverty, nutrition and health care. For every childkilled in warfare, it is estimated that three are leftDisability is oneof the least visiblebut most potentfactors ineducationalmarginalization9. In the 1970s, the WorldHealth Organizationestimated that 10% of theglobal population lived witha disability. This roughestimate is still in use today,suggesting that there areabout 650 million people withdisabilities. It is the basis forthe estimate of 150 millionof children with disabilities.181