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Reproduction and dissemination of the document - in electronic and/or printed format - is encouraged, provided acknowledgement is made of the role of the United Nations in making it available. ****************************************************************************** United Nations Decade of Disabled Persons 1983-1992 WORLD PROGRAMME OF ACTION CONCERNING DISABLED PERSONS UNITED NATIONS The World Programme of Action concerning Disabled Persons was adopted by the United Nations General Assembly at its 37th regular session on 3 December 1982, by its resolution 37/52. 1/ Objectives, Background and Concepts ----------------------------------- Objectives Background Definition Prevention Rehabilitation Equalization of opportunities Concepts adopted within the United Nations System Current situation ----------------- General description Disabilities in the developing countries Special groups Prevention Rehabilitation Equalization of opportunities Education Employment Social questions Disability and a new international economic order Consequences of economic and social development Proposals for the implementation of the World Programme of Action concerning Disabled Persons ----------------------------------------------------- Introduction National action Participation of disabled persons in decision-making Prevention of impairment, disability and handicap Rehabilitation Participation of disabled persons in decision-making Equalization of opportunities Legislation Physical environment Income maintenance and social security Education and training Employment Recreation Culture Religion Sports Community action Staff training Information and public education International action General aspects Human rights Technical and economic cooperation Interregional assistance Regional and Bilateral assistance Information and public education Information and evaluation Research Monitoring and evaluation Index 1. Objectives, Background and Concepts -------------------------------------- Objectives The purpose of the World Programme of Action concerning Disabled Persons is to promote effective measures for prevention of disability, rehabilitation and the realization of the goals of ''full participation'' of disabled persons in social life and development, and of ''equality''. This means opportunities equal to those of the whole population and an equal share in the improvement in living conditions resulting from social and economic development. These concepts should apply with the same scope and with the same urgency to all countries, regardless of their level of development. Background More than 500 million people in the world are disabled as a consequence of mental, physical or sensory impairment. They are entitled to the same rights as all other human beings and to equal opportunities. Too often their lives are handicapped by physical and social barriers in society which hamper their full participation. Because of this, millions of children and adults in all parts of the world often face a life that is segregated and debased. 3 An analysis of the situation of disabled persons has to be carved out within the context of different levels of economic and social development and different cultures. Everywhere, however, the ultimate responsibility for remedying the conditions that lead to impairment and for dealing with the consequences of disability rests with Governments. This does not weaken the responsibility of society in general, or of individuals, or of organizations Governments should take the lead in awakening the consciousness of populations regarding the gains to be derived by individuals and society from the inclusion of disabled persons in every area of social, economic and political life. Governments must also ensure that people who are made dependent by severe disability have an opportunity to achieve a standard of living equal to that of their fellow citizens. Non-governmental organizations can, in different ways, assist Governments by formulating needs, suggesting suitable solutions and providing services complementary to those provided by Governments. Sharing of financial and material resources by all sections of the population, not omitting the rural areas of developing countries, could be of major significance to disabled persons by resulting in expanded community services and improved economic opportunities. 4 Much disability could be prevented through measures taken against malnutrition, environmental pollution, poor hygiene, inadequate prenatal and postnatal care, water-borne diseases and accidents of all types . The international community could make a major breakthrough against disabilities caused by poliomyelitis, tetanus, whooping-cough and diphtheria, and to a lesser extent tuberculosis, through a world-wide expansion of programmes of immunization. 5 In many countries, the prerequisites for achieving the purposes of the Programme are economic and social development, extended services provided to the whole population in the humanitarian area, the redistribution of resources and income and an improvement in the living standards of the population. It is necessary to use every effort to prevent wars leading to devastation, catastrophe and poverty, hunger, suffering, diseases and mass disability of people, and therefore to adopt measures at all levels to strengthen international peace and security, to settle all international disputes by peaceful means and to eliminate all forms of racism and racial discrimination in countries where they still exist. It would also be desirable to recommend to all States Members of the United Nations that they maximize the use of their resources for peaceful purposes, including prevention of disability and satisfaction of the needs of disabled persons. All forms of technical assistance that help developing countries to move towards these objectives can support the implementation of the Programme.The realization of these objectives will, however, require extended periods of effort, during which the number of disabled persons is likely to increase. Without effective remedial action, the consequences of disability will add to the obstacles to development. Hence, it is essential that all nations should include in their general development plans immediate measures for the prevention of disability, for the rehabilitation of disabled persons and for the equalization of opportunities. Definition The following distinction is made by the World Health Organization, in the context of health experience, between impairment, disability and handicap: "Impairment: Any loss or abnormality of psychological, physiological, or anatomical structure or function. Disability: Any restriction or lack {resulting from an impairment) of ability to perform an activity in the manner or within the range considered normal for a human being. Handicap: A disadvantage for a given individual, resulting from an impairment or disability, that, limits or prevents the fulfillment of a role that is normal, depending on age, sex, social and cultural factors, for that individual." 2/ 7 Handicap is therefore a function of the relationship between disabled persons and their environment. It occurs when they encounter cultural, physical or social barriers which prevent their access to the various systems of society that are available to other citizens. Thus, handicap is the loss or-limitation of opportunities to take part in the life of the community on an equal level with others. 8 Disabled people do not form a homogeneous group. For example, the mentally ill and the mentally retarded, the visually, hearing and speech impaired and those with restricted mobility or with so-called ''medical disabilities'' all encounter different barriers, of different kinds, which have to be overcome in different ways. 9 The following definitions are developed from that perspective. The relevant terms of action proposed in the World Programme are defined as prevention, rehabilitation and equalization of opportunities. 10 Prevention means measures aimed at preventing the onset of mental, physical and sensory impairments (primary prevention ) or at preventing impairment, when it has occurred, from having negative physical, psychological and social consequences. 11 Rehabilitation means a goal-oriented and time-limited process aimed at enabling an impaired person to reach an optimum mental, physical and/or social functional level, thus providing her or him with the tools to change her or his own life. It can involve measures intended to compensate for a loss of function or a functional limitation (for example by technical aids) and other measures intended to facilitate social adjustment or readjustment. 12 Equalization of opportunities means the process through which the general system of society, such as the physical and cultural environment, housing and transportation, social and health services, educational and work opportunities, cultural and social life, including sports and recreational facilities, are made accessible to all. Prevention A strategy of prevention is essential for reducing the incidence of impairment and disability. The main elements of such a strategy would vary according to a country's state of development, and are as follows: - The most important measures for prevention of impairment are: avoidance of war; improvement of the educational, economic and social status of the least privileged groups; identification of types of impairment and their causes within defined geographical areas; introduction of specific intervention measures through better nutritional practices; improvement of health services, early detection and diagnosis; prenatal and postnatal care; proper health care instruction, including patient and physician education; family planning; legislation and regulations; modification of life-styles; selective placement services; education regarding environmental hazards; and the fostering of better informed and strengthened families and communities; - To the extent that development takes place, old hazards are reduced and new ones arise. These changing circumstances require a shift in strategy, such as nutrition intervention programmes directed at specific population groups most at risk owing to vitamin A deficiency; improved medical care for the aging; training and regulations to reduce accidents in industry, in agriculture, on the roads and in the home; and the control of environmental pollution and of the use and abuse of drugs and alcohol. In this connection, the WH0 strategy for Health for All by the Year 2000 through primary health care should be given proper attention. 14 Measures should be taken for the earliest possible detection of the symptoms and signs of impairment, to be followed immediately by the necessary curative or remedial action, which can prevent disability or at least lead to significant reductions in the severity of disability and can often prevent its becoming a lasting condition. For early detection it is important to ensure adequate education and orientation of families and technical assistance to them by medical social services. Rehabilitation Rehabilitation usually includes the following types of services: þ Early detection, diagnosis and intervention; þ Medical care and treatment; þ Social, psychological and other types of counselling and assistance; þ Training in self-care activities, including mobility, communication and daily living skills, with special provisions as needed, e g., for the hearing impaired, the visually impaired and the mentally retarded; - Provision of technical and mobility aids and other devices; - Specialized education services; - Vocational rehabilitation services (including vocational guidance), vocational training, placement in open or sheltered employment; - Follow-up. 16 In all rehabilitation efforts, emphasis should be placed on the abilities of the individual, whose integrity and dignity must be respected. The normal development and maturation process of disabled children should be given the maximum attention . The capacities of disabled adults to perform work and other activities should be utilized. 17 Important resources for rehabilitation exist in the families of disabled persons and in their communities. In helping disabled persons, every effort should be made to keep their families together, to enable them to live in their own communities and to support family and community groups who are working with this objective. In planning rehabilitation and supportive programmes, it is essential to take into account the customs and structures of the family and community and to promote their abilities to respond to the needs of the disabled individual. 18 Services for disabled persons should be provided, whenever possible, within the existing social, health, education and labour structures of society. These include all levels of health care; primary, secondary and higher- education, general programmes of vocational training and placement in employment; and measures of social security and social services. Rehabilitation services are aimed at facilitating the participation of disabled persons in regular community services and activities. Rehabilitation should take place in the natural environment, supported by community-based services and specialized institutions. Large institutions should be avoided. Specialized institutions, where they are necessary, should be organized so as to ensure an early and lasting integration of disabled persons into society. 19 Rehabilitation programmes should make it possible for disabled persons to take part in designing and organizing the services that they and their families consider necessary. Procedures for the participation of disabled persons in the decision-making relating to their rehabilitation should be provided for within the system. When people such as the severely mentally disabled may not be able to represent themselves adequately in decisions affecting their lives, family members or legally designated agents should take part in planning and decision-making. 20 Efforts should be increased to develop rehabilitation services integrated in other services and make them more readily available. These should not rely on imported costly equipment, raw material and technology. The transfer of technology among nations should be enhanced and should concentrate on methods that are functional and relate to prevailing conditions. Equalization of opportunities To achieve the goals of "full participation and equality", rehabilitation measures aimed at the disabled individual are not sufficient. Experience shows that it is largely the environment which determines the effect of an impairment or a disability on a person's daily life. A person is handicapped when he or she is denied the opportunities generally available in the community that are necessary for the fundamental elements of living, including family life, education, employment, housing, financial and personal security, participation in social and political groups, religious activity, intimate and sexual relationships, access to public facilities, freedom of movement and the general style of daily living. 22 Societies sometimes cater only to people who are in full possession of all their physical and mental faculties. They have to recognize the fact that, despite preventive efforts, there will always be a number of people with impairments and disabilities, and that societies have to identify and remove obstacles to their full participation. Thus, whenever pedagogically possible, education should take place in the ordinary school system, work be provided through open employment and housing be made available as to the population in general. It is the duty of every Government to ensure that the benefits of development programmes also reach disabled citizens. Measures to this effect should be incorporated into the general planning process and the administrative structure of every society. Extra services which disabled persons might need should, as far as possible, be part of the general services of a country. 23 The above does not apply merely to Governments. Anyone in charge of any kind of enterprise should make it accessible to people with disabilities. This applies to public agencies at various levels, to non-governmental organizations, to firms and to private individuals. It also applies to the international level. 24 People with permanent disabilities who are in need of community support services, aids and equipment to enable them to live as normally as possible both at home and in the community should have access to such services. Those who live with such disabled persons and help them in their daily activities should themselves receive support to enable them to have adequate rest and relaxation and an opportunity to take care of their own needs 25 The principle of equal rights for the disabled and non-disabled implies that the needs of each and every individual are of equal importance, that these needs must be made the basis for the planning of societies, and that all resources must be employed in such a way as to ensure, for every individual, equal opportunity for participation. Disability policies should ensure the access of the disabled to all community services. 26 As disabled persons have equal rights, they also have equal obligations. It Is their duty to take part in the building of society. Societies must raise the level of expectation as far as disabled persons are concerned, and in so doing mobilize their full resources for social change. This means, among other things, that young disabled persons should be provided with career and vocational opportunities - not early retirement pensions or public assistance. 27 Persons with disabilities should be expected to fulfil their role in society and meet their obligations as adults. The image of disabled persons depends on social attitudes based on different factors that may be the greatest barrier to participation and equality. We see the disability, shown by the white caner crutches, hearing aids and wheelchairs, but not the person. What is required is to focus on the ability, not on the disability of disabled persons. 28 All over the world, disabled persons have started to unite in organizations as advocates for their own rights to influence decision-makers in Governments and all sectors of society. The role of these organizations includes providing a voice of their own, identifying needs, expressing views on priorities, evaluating services and advocating change and public awareness. As a vehicle of self-development, these organizations provide the opportunity to develop skills in the negotiation process, organizational abilities, mutual support, information-sharing and often vocational skills and opportunities. In view of their vital importance in the process of participation, it is imperative that their development be encouraged. 29 Mentally handicapped people are now beginning to demand a voice of their own and insisting on their right to take part in decision-making and discussion. Even those with limited communication skills have shown themselves able to express their point of view. In this respect, they have much to learn from the self-advocacy movement of persons with other disabilities. This development should be encouraged. 30 Information should be prepared and disseminated to improve the situation of disabled persons. The cooperation of all public media should be sought to bring about presentations that will promote an understanding of the rights of disabled persons aimed at the public and the persons with disabilities themselves, and that will avoid reinforcing traditional stereotypes and prejudices. Concepts adopted within the United Nations system In the Charter of the United Nations, the reaffirmation of the principles of peace, the faith in human rights and fundamental freedoms, the dignity and worth of the human person and the promotion of social justice are given primary importance. 32 The Universal Declaration of Human Rights affirms the right of all people, without distinction of any kind, to marriage; property ownership; equal access to public services; social security; and the realization of economic, social and cultural rights. The International Covenants on Human Rights, 3/ the Declaration on the Rights of Mentally Retarded Persons, 4/ and the Declaration on the Rights of Disabled Persons 5/ give specific expression to the principles contained in the Universal Declaration of Human Rights. 33 The Declaration on Social Progress and Development 6/ proclaims the necessity of protecting the rights of physically and mentally disadvantaged persons and assuring their welfare and rehabilitation. It guarantees everyone the right to and opportunity for useful and productive labour. 34 Within the United Nations Secretariat, a number of offices carry out activities related to the above concepts as well as to the World Programme of Action. They include: the Division of Human Rights; the Department of International Economic and Social Affairs; the Department of Technical Cooperation for Development; the Department of Public Information; the Division of Narcotic Drugs; and the United Nations Conference on Trade and Development. The regional commissions also have an important role: the Economic Commission for Africa in Addis Ababa (Ethiopia), the Economic Commission for Europe in Geneva (Switzerland), the Economic Commission for Latin America in Santiago (Chile), the Economic and Social Commission for Asia and the Pacific in Bangkok (Thailand) and the Economic Commission for Western Asia in Baghdad (Iraq). 35 Other organizations and programmes of the United Nations have adopted approaches related to development that will be significant in implementing the World Programme of Action concerning Disabled Persons. These include: - The mandate contained in General Assembly resolution 3405 (XXX) on new dimensions in technical cooperation, which directs the United Nations Development Programme, interalia, to take into account the importance of reaching the poorest and most vulnerable sections of society when responding to Governments' requests for help in meeting their most urgent and critical needs and which encompasses the concepts of technical cooperation among developing countries; - The concept adopted by the United Nations Children's Fund (UNICEF) of basic services for all children and the strategy adopted by it in 1980 to emphasize strengthening family and community resources to assist disabled children in their natural environments; - The Office of the United Nations High Commissioner for Refugees (UNHCR), with its programme for disabled refugees; - The United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA), which is concerned, among other things, with the prevention of impairments among Palestine refugees and the lowering of social and physical barriers which confront disabled members of the refugee population; - The concepts of specific measures of disaster preparedness and prevention for those already disabled, and of the prevention of permanent disability as a result of injury or treatment received at the time of a disaster, advanced by the Office of the United Nations Disaster Relief Coordinator (UNDRO); - The United Nations Centre for Human Settlements (UNCHS), with its concern about physical barriers and general access to the physical environment; - The United Nations Industrial Development Organization (UNIDO); the activities of UNIDO cover the production of drugs essential for the prevention of disability as well as of technical devices for the disabled. 36 The specialized agencies of the United Nations system, which are involved in promoting, supporting and carrying out field activities, have a long record of work related to disability. Programmes of disability prevention, nutrition, hygiene, education of disabled children and adults, vocational training, job placement and others represent a store of experience and know-how which opens up opportunities for further accomplishments and, at the same time, makes it possible to share these experiences with governmental and non-governmental organizations concerned with disability matters. These agencies and their programmes include: - The basic needs strategy of the International Labour Organisation (ILO) and the principles set forth in ILO recommendation No. 99 concerning vocational rehabilitation of the disabled , 1955; - The Food and Agriculture Organization of the United Nations (FAO), with its emphasis on the relation between nutrition and disability; - The concept of adapted education recommended by an expert group of the United Nations Educational, Scientific and Cultural Organization (UNESCO) on education of disabled persons, which has been reinforced by two guiding principles of the Sundberg Declaration: 7/ 1 Disabled persons shall receive from the community services adapted to their specific personal needs; 2 Through decentralization and sectorization of services, the needs of disabled persons shall be taken into account and satisfied within the framework of the community to which they belong; - The World Health Organization's programme of health for all by the year 2000 and the related primary health care approach, through which the member States of the World Health Organization have already committed themselves to preventing diseases and impairments leading to disabilities. The concept of primary health care, as elaborated by the International Conference on Primary Health Care held at Alma-Ata in 1978, and the application of this concept to the health aspects of disability, are described in the World Health Organization's policy on this subject, approved by the World Health Assembly in 1978; - The International Civil Aviation Organization (ICAO), which has approved recommendations to contracting States concerning facilities of movement and provision of facilities for disabled passengers; - The Executive Committee of the Universal Postal Union (UPU), which has adopted a recommendation inviting all national postal administrations to improve access to their facilities for disabled persons Current situation ------------------ General description There is a large and growing number of persons with disabilities in the world today. The estimated figure of 500 million is confirmed by the results of surveys of segments of population, coupled with the observations of experienced investigators. In most countries, at least one person out of 10 is disabled by physical, mental or sensory impairment, and at least 25 per cent of any population is adversely affected by the presence of disability. 38 The causes of impairments vary throughout the world, as do the prevalence and consequences of disability. These variations are the result of different socio-economic circumstances and of the different provisions that each society makes for the well-being of its members. 39 A survey carried out by experts has produced the estimate of at least 350 million disabled persons living in areas where the services needed to assist them in overcoming their limitations are not available. To a large extent, disabled persons are exposed to physical, cultural and social barriers which handicap their lives even if rehabilitation assistance is available 40 Many factors are responsible for the rising numbers of disabled persons and the relegation of disabled persons to the margin of society. These include: - Wars and the consequences of wars and other forms of violence and destruction, poverty, hunger, epidemics and major shifts in population; - A high proportion of overburdened and impoverished families, and overcrowded and unhealthy housing and living conditions; - Populations with a high proportion of illiteracy and little awareness of basic social services or of health and education measures; - An absence of accurate knowledge about disability, its causes, prevention and treatment; this includes stigma, discrimination and misconceived ideas on disability; - Inadequate programmes of primary health care and services; - Constraints, including a lack of resources, geographical distance and physical and social barriers, that make it impossible for many people to take advantage of available services; - The channelling of resources to highly specialized services that are not relevant to the needs of the majority of people who need help; - The absence or weakness of an infrastructure of related services for social assistance, health, education, vocational training and placement; - Low priority in social and economic development for activities related to equalization of opportunities, disability prevention and rehabilitation; - Industrial, agricultural and transportation-related accidents; - Natural disaster and earthquake; - Pollution of the physical environment; - Stress and other psycho-social problems associated with the transition from a traditional to a modern society; - The imprudent use of medication, the misuse of therapeutic substances and the illicit use of drugs and stimulants; - The faulty treatment of injured persons at the time of a disaster, which can be the cause of avoidable disability; - Urbanization and population growth and other indirect factors. 41 The relationship between disability and poverty has been clearly established. While the risk of impairment is much greater for the poverty-stricken, the converse is also true. The birth of an impaired child, or the occurrence of disability in the family, often places heavy demands on the limited resources of the family and strains on its morale, thus thrusting it deeper into poverty. The combined effect of these factors results in higher proportions of disabled persons among the poorest strata of society. For this reason, the number of affected families living at the poverty level steadily increases in absolute terms. The negative impact of these trends seriously hinders the development process. 42 Existing knowledge and skills could prevent the onset of many impairments and disabilities, could assist affected people in overcoming or minimizing their disabilities, and could enable nations to remove barriers which exclude disabled persons from everyday life. Disabilities in the developing countries 43 The problems of disability in developing countries need to be specially highlighted. As many as 80 per cent of all disabled persons live in isolated rural areas in the developing countries. In some of these countries, the percentage of the disabled population is estimated to be as high as 20 and, thus, if families and relatives are included, 50 per cent of the population could be adversely affected by disability. The problem is made more complex by the fact that, for the most part, disabled persons are also usually extremely poor people. They often live in areas where medical and other related services are scarce, or even totally absent, and where disabilities are not and cannot be detected in time. When they do receive medical attention, if they receive it at all, the impairment may have become irreversible. In many countries, resources are not sufficient to detect and prevent disability and to meet the need for the rehabilitation and supportive services of the disabled population. Trained personnel, research into newer and more effective strategies and approaches to rehabilitation and the manufacturing and provision of aids and equipment for disabled persons are quite inadequate. 44 In such countries, the disability problem is further compounded by the population explosion, which inexorably pushes up the number of disabled persons in both proportional and absolute terms. There is, thus, an urgent need, as the first priority, to help such countries to develop demographic policies to prevent an increase in the disabled population and to rehabilitate and provide services to the already disabled. Special groups 45 The consequences of deficiencies and disablement are particularly serious for women. There are a great many countries where women are subjected to social, cultural and economic disadvantages which impede their access to, for example, health care, education, vocational training and employment. If, in addition, they are physically or mentally disabled, their chances of overcoming their disablement are diminished, which makes it all the more difficult for them to take part in community life. In families, the responsibility for caring for a disabled parent often lies with women, which considerably limits their freedom and their possibilities of taking part in other activities. 46 For many children, the presence of an impairment leads to rejection or isolation from experiences that are part of normal development. This situation may be exacerbated by faulty family and community attitudes and behaviour during the critical years when children's personalities and self-images are developing. 47 In most countries the number of elderly people is increasing, and already in some as many as two thirds of disabled people are also elderly. Most of the conditions which cause their disability (for example, arthritis, strokes, heart disease and deterioration in hearing and vision) are not common among younger disabled people and may require different forms of prevention, treatment, rehabilitation and support services. 48 With the emergence of "victimology" as a branch of criminology, the true extent of injuries inflicted upon the victims of crime, causing permanent or temporary disablement, is only now becoming generally known. 49 Victims of torture who have been disabled physically or mentally, not by accident of birth or normal activity, but by the deliberate infliction of injury, form another group of disabled persons. 50 There are over 10 million refugees and displaced persons in the world today as a result of man-made disasters. Many of them are disabled physically and psychologically as a result of their sufferings from persecution, violence and hazards. Most are in third-world countries, where services and facilities are extremely limited. Being a refugee is in itself a handicap, and a disabled refugee is doubly handicapped. 51 Workers employed abroad often find themselves in a difficult situation associated with a series of handicaps resulting from differences in environment, lack or inadequate knowledge of the language of the country of immigration, prejudice and discrimination, lack or deficiency of vocational training, and inadequate living conditions. The special position of migrant workers in the country of employment exposes them and their families to health hazards and increased risk of occupational accidents which frequently lead to impairment or disability. The situation of disabled migrant workers may be further aggravated by the necessity for them to return to the country of origin, where, in most cases, special services and facilities for the disabled are very limited. Prevention There is a steady growth of activities to prevent impairment, such as the improvement of hygiene, education and nutrition; better access to food and health care through primary health care approaches, with special attention to mother and child care; counselling parents on genetic and prenatal care factors; immunization and control of diseases and infections; accident prevention; and improving the qual- ity of the environment. In some parts of the world, such measures have a significant impact on the incidence of physical and mental impairment. 53 For a majority of the world's population, especially those living in countries in the early stages of economic development, these preventive measures effectively reach only a small proportion of the people in need. Most developing countries have yet to establish a system for the early detection and prevention of impairment through periodic health examinations, particularly for pregnant women, infants and young children. 54 In the Leeds Castle Declaration on the Prevention of Disablement of 12 November 1981, an international group of scientists, doctors, health administrators and politicians called attention to, among others, the following practical measures to prevent disablement: 3 Impairment arising from malnutrition, infection and neglect could be prevented by inexpensive improvement in primary health. 4 ... Many disabilities of later life can be postponed or averted. There are promising lines of research for the control of hereditary and degenerative conditions . . . 5 ... Disability need not give rise to handicap. Failure to apply simple remedies very often increases disability, and the attitudes and institutional arrangements of society increase the chance of disability placing people at a disadvantage. Sustained education of the public and of professionals is urgently needed. 6 Avoidable disability is a prime cause of economic waste and human deprivation in all countries, industrialized and developing. This loss can be reduced rapidly. The technology which will prevent or control most disablement is available and is improving. What is needed is commitment by society to overcome the problems. The priority of existing national and international health programmes must be shifted to ensure the dissemination of knowledge and technology. 7 Although technology for preventive and remedial control of most disabilities exists, the remarkable recent progress in biomedical research promises revolutionary new tools which could greatly strengthen all interventions. Both basic and applied research deserve support over the coming years. 55 It is becoming increasingly recognized that programmes to prevent impairment or to ensure that impairments do not escalate into more limiting disabilities are less costly to society in the long run than having to care later for disabled persons. This applies, for instance, not least to occupational safety programmes, a still neglected field of concern in many countries. Rehabilitation Rehabilitation services are often provided by specialized institutions. However, there exists a growing trend towards placing greater emphasis on the integration of services in general public facilities. 57 There has been an evolution in both the content and the spirit of the activities described as rehabilitation. Traditional practice viewed rehabilitation as a pattern of therapies and services provided to disabled persons in an institutional setting. Often under medical authority. This is gradually being replaced by programmes which, while still providing qualified medical, social and pedagogical services, also involve communities and families and help them to support the efforts of their disabled members to overcome the disabling effects of impairment within a normal social environment. Increasingly it is being recognized that even severely disabled persons can, to a great extent, live independently if the necessary support services are provided. The number requiring care in institutions is much smaller than had previously been assumed and even they can, to a great-extent, live a life that is independent in its essential elements. 58 Many disabled persons require technical aids. In some countries the technology needed to produce such items is well developed, and highly sophisticated devices are manufactured to assist the mobility, communication and daily living of disabled individuals. The costs of such items are high, however, and only a few countries are able to provide such equipment. 59 Many people need simple equipment to facilitate mobility, communication and daily living. Such aids are produced and available in some countries. In many other countries, however, they cannot be obtained because of a lack of their availability and/or of high cost. Increasing attention is being given to the design of simpler, less expensive devices, with local methods of production which are more easily adapted to the country concerned, more appropriate to the needs of most disabled persons and more readily available to them. Equalization of opportunities The rights of persons with disabilities to participate in their societies can be achieved primarily through political and social action. 61 Many countries have taken important steps to eliminate or reduce barriers to full participation. Legislation has in many cases been enacted to guarantee to disabled persons the rights to, and opportunities for, schooling, employment and access to community facilities, to remove cultural and physical barriers and to proscribe discrimination against disabled persons. There has been a movement away from institutions to community-based living. In some developed and developing countries, the emphasis in schooling is increasingly on "open education" with a corresponding decrease in institutions and special schools. Methods of making public transport systems accessible have been devised, as well as methods of making information accessible for sensory-disabled persons. Awareness of the need for such measures has increased. In many cases, public education and awareness campaigns have been launched to educate the public to alter its attitudes and actions towards disabled persons. 62 Often, disabled persons have taken the lead in bringing about an improved understanding of the process of equalization of opportunities. In this context, they have advocated their own integration into the mainstream of society. 63 Despite such efforts, disabled persons are yet far from having achieved equal opportunities and the degree of integration of disabled persons into society is yet far from satisfactory in most countries. Education 64 At least 10 per cent of children are disabled. They have the same right to education as non-disabled persons and they require active intervention and specialized services. But most disabled children in developing countries receive neither specialized services nor compulsory education. 65 There is a great variation from some countries with a high educational level for disabled persons to countries where such facilities are limited or non-existent. 66 There is a lack in existing knowledge of the potential of disabled persons. Furthermore, there is often no legislation which deals with their needs and a shortage of teaching staff and facilities. Disabled persons have in most countries so far not benefitted from a lifelong education. 67 Significant advances in teaching techniques and important innovative developments have taken place in the field of special education and much more can be achieved in the education of disabled persons. But the progress is mostly limited to a few countries or only a few urban centres. 68 The advances concern early detection, assessment and intervention, special education programmes in a variety of settings, with many disabled children able to participate in a regular school setting, while others require very intensive programmes. Employment 69 Many persons with disabilities are denied employment or given only menial and poorly remunerated jobs. This is true even though it can be demonstrated that with proper assessment, training and placement, the great majority of disabled persons can perform a large range of tasks in accordance with prevailing work norms. In times of unemployment and economic distress, disabled persons are usually the first to be discharged and the last to be hired. In some industrialized countries experiencing the effects of economic recession, the rate of unemploy- ment among disabled job-seekers is double that of able-bodied applicants for jobs. In many countries various programmes have been developed and measures taken to create jobs for disabled persons. These include sheltered and production workshops, sheltered enclaves, designated positions, quota schemes, subsidies for employers who train and subsequently engage disabled workers, cooperatives of and for the disabled, etc. The actual number of disabled workers employed in either regular or special establishments is far below the number of employable disabled workers. The wider application of ergonomic principles leads to adaptation of the workplace, tools, machinery and equipment at relatively little cost and helps widen employment opportunities for the disabled. 70 Many disabled persons, particularly In the developing countries, live in rural areas. When the family economy is based on agriculture or other rural occupations and when the traditional extended family exists, it may be possible for most disabled persons to be given some useful tasks to perform. As more families move from rural areas to urban centres, as agriculture becomes more mechanized and commercialized, as money transactions replace barter systems and as the institution of the extended family disintegrates, the vocational plight of disabled persons becomes more severe . For those living in urban slums, competition for employment is heavy, and other economically productive activity is scarce. Many disabled persons in such areas suffer from enforced inactivity and become dependent; others must resort to begging. Social questions 71 Full participation in the basic units of societyþfamily, social groups and communityþis the essence of human experience. The right to equality of opportunity for such participation is set forth in the Universal Declaration of Human Rights and should apply to all people, including those with disabilities. In reality, however, disabled persons are often denied the opportunities of full participation in the activities of the socio-cultural system of which they are a part. This deprivation comes about through physical and social barriers that have evolved from ignorance, indifference and fear. 72 Attitudes and behaviour often lead to the exclusion of disabled persons from social and cultural life. People tend to avoid contact and personal relationships with those who are disabled. The pervasiveness of the prejudice and discrimination affecting disabled persons and the degree to which they are excluded from normal social intercourse produce psychological and social problems for many of them. 73 Too often. the professional and other service personnel with whom disabled persons come into contact fail to appreciate the potential for participation by disabled persons in normal social experiences and thus do not contribute to the integration of disabled individuals and other social groups. 74 Because of these barriers, it is often difficult or impossible for disabled persons to have close and intimate relationships with others. Marriage and parenthood are often unattainable for people who are identified as "disabled", even when there is no functional limitation to preclude them. The needs of mentally handicapped people for personal and social relationships, including sexual partnership, are now increasingly recognized. 75 Many persons with disabilities are not only excluded from the normal social life of their communities but in fact confined in institutions. While the leper colonies of the past have been partly done away with and large institutions are not as numerous as they once were, far too many people are today institutionalized when there is nothing in their condition to justify it. 76 Many disabled persons are excluded from active participation in society because of doorways that are too narrow for wheelchairs; steps that cannot be mounted leading to buildings, buses, trains and aircraft; telephones and light switches that cannot be reached; sanitary facilities that cannot be used . Similarly they can be excluded by other types of barriers, for example oral communication which ignores the needs of the hearing impaired and written information which ignores the needs of the visually impaired. Such barriers are the result of ignorance and lack of concern; they exist despite the fact that most of them could be avoided at no great cost by careful planning. Although some countries have enacted legislation and launched campaigns of public education to eliminate such ob- stacles, the problem remains a crucial one. 77 Generally, existing services, facilities and social actions for the prevention of impairment, the rehabilitation of disabled persons and their integration into society are closely linked to the Governments' and society's willingness and ability to allocate resources. income and services to disadvantaged population groups. Disability and a new international economic order The transfer of resources and technology from developed to developing countries as envisaged within the framework of the new international economic order, as well as other provisions for strengthening the economies of developing nations, would, if implemented, be of benefit to the people of these countries, including the disabled. Improvement of economic conditions in the developing countries, particularly their rural areas, would provide new employment opportunities for disabled persons and needed resources to support measures for prevention, re- habilitation and the equalization of opportunities. The transfer of appropriate technology, if properly managed, could lead to the development of industries specializing in the mass production of devices and aids for dealing with the effects of physical, mental or sensory impairments. 79 The International Development Strategy for the Third United Nations Development Decade 8/ states that particular efforts should be made to integrate the disabled in the development process and that effective measures for prevention, rehabilitation and equalization of opportunities are therefore essential. Positive action to this end would be part of the more general effort to mobilize all human resources for development. Changes in the international economic order will have to go hand in hand with domestic changes aimed at achieving full participation by disadvantaged population groups. Consequences of economic and social development To the extent that development efforts are successful in bringing about better nutrition, education, housing, improved sanitary conditions and adequate primary health care, the prospects of preventing impairment and treating disability greatly improve. Progress along these lines may also be especially facilitated in such areas as: - The training of personnel in general fields such as social assistance, public health, medicine, education and vocational rehabilitation; - Enhanced capacities for the local production of the appliances and equipment needed by disabled persons; - The establishment of social services, social security systems, cooperatives and programmes for mutual assistance at the national and community levels; - Appropriate vocational guidance and work preparation services as well as increased employment opportunities for disabled persons. 81 Since economic development leads to alterations in the size and distribution of the population, to modifications in life styles and to changes in social structures and relationships, the services needed to deal with human problems are generally not being improved and expanded rapidly enough. Such imbalances between economic and social development add to the difficulties of integrating disabled persons into their communities. Proposals for the implementation of the World Programme of Action concerning Disabled Persons ----------------------------------------------------------------- Introduction The objectives of the World Programme of Action concerning Disabled Persons are to promote effective measures for prevention of disability, rehabilitation and the realization of the goals of ''full participation'' of disabled persons in social life and development, and of "equality". In implementing the World Programme due regard has to be paid to the special situation of developing countries and, in particular, of the least developed countries. The immensity of the task of improving living conditions for the whole population and the general scarcity of resources make the attainment of the objectives of the Programme much more difficult in these countries. At the same time, it should be recognized that the implementation of the World Programme of Action in itself will make a contribution to the development process through the mobilization of all human resources and the full participation of the entire population. Though some countries may already have initiated or carried out some of the actions recommended in this Programme, more needs to be done. This applies also to countries with a high general standard of living. 83 Since the situation of the disabled is closely connected with overall development at the national level, the solution of problems in developing countries depends to a very large extent on the creation of adequate international conditions for faster social and economic development. Accordingly, the establishment of a new international economic order is of direct relevance to the implementation of the objectives of the Programme It is particularly essential that the flow of resources to developing countries be substantially increased, as agreed upon in the International Development Strategy for the Third United Nations Development Decade. 84 The realization of these goals will require a multisectoral and multi-disciplinary global strategy for combined and coordinated policies and actions relevant to the equalization of opportunities of disabled persons, effective rehabilitation services and measures for prevention. 85 Disabled persons and their organizations should be consulted in the further development of the World Programme of Action and in its implementation. To this end, every effort should be made to encourage the formation of organizations of disabled persons at the local, national, regional and international levels. Their unique expertise, derived from their experience, can make significant contributions to the planning of programmes and services for disabled persons. Through their discussion of issues they present points of view most widely representative of all concerns of disabled persons. Their impact on public attitudes warrants consultation with them and as a force for change they have significant influence on making disability issues a great priority. The disabled themselves should have a substantive influence in deciding the effectiveness of policies, programmes and services designed for their benefit. Special efforts should be made to involve mentally handicapped persons in this process. National action The World Programme of Action is designed for all nations. The time-span for its implementation and the choice of items to be implemented as a priority will, however, vary from nation to nation depending on the existing situation and their resource constraints, levels of socio-economic development, cultural traditions, and their capacity to formulate and implement the actions envisaged in the Pro- gramme. 87 National Governments bear the ultimate responsibility for the implementation of the measures recommended in this section. Owing, however, to constitutional differences between countries, both local authorities and other bodies within the public and private sectors will be called upon to implement the national measures contained in the World Programme of Action. 88 Member States should urgently initiate national long-term programmes to achieve the objectives of the World Programme of Action; such programmes should be an integral component of the nation's general policy for socio-economic development. 89 Matters concerning disabled persons should be treated within the appropriate general context and not separately. Each ministry or other body within the public or private sector responsible for, or working within, a specific sector should be responsible for those matters related to disabled persons which fall within its area of competence. Governments should establish a focal point (for example, a national commission, committee or similar body) to look into and follow the activities related to the World Programme of Action of various ministries, of other government agencies and of non-governmental organizations. Any mechanism set up should involve all parties concerned, including organizations of disabled persons. The body should have access to decision makers at the highest level. 90 To implement the World Programme of Action, it is necessary for Member States: - To plan, organize and finance activities at each level; - To create, through legislation, the necessary legal bases and authority for measures to achieve the objectives; - To ensure opportunities by eliminating barriers to full participation; - To provide rehabilitation services by giving social, nutritional, medical, educational and vocational assistance and technical aids to disabled persons; - To establish or mobilize relevant public and private organizations; - To support the establishment and growth of organizations of disabled persons; - To prepare and disseminate information relevant to the issues of the World Programme of Action among all elements of the population, including persons with disabilities and their families; - To promote public education to ensure a broad understanding of the key issues of the World Programme of Action and its implementation; - To facilitate research on matters related to the World Programme of Action; - To promote technical assistance and cooperation related to the World Programme of Action; - To facilitate the participation of disabled persons and their organizations in decisions related to the World Programme of Action. Participation of disabled persons in decision-making 91 Member States should increase their assistance to organizations of disabled persons and help them organize and coordinate the representation of the interests and concerns of disabled persons. 92 Member States should actively seek out and encourage in every possible way the development of organizations composed of or representing disabled persons. Such organizations, in whose membership and governing bodies disabled persons, or in some cases relatives, have a decisive influence, exist in many countries. Many of them have not the means to assert themselves and fight for their rights. 93 Member States should establish direct contacts with such organizations and provide channels for them to influence government policies and decisions in all areas that concern them Member States should give the necessary financial support to organizations of disabled persons for this purpose. 94 Organizations and other bodies at all levels should ensure that disabled persons can participate in their activities to the fullest extent possible. Prevention of impairment, disability and handicap 95 The technology to prevent and control most disablement is available and improving but is not always fully utilized. Member States should take appropriate measures for the prevention of impairment and disability and ensure the dissemination of relevant knowledge and technology. 96 Coordinated programmes of prevention at all levels of society are needed. They should include: - Community-based primary health care systems that reach all segments of the population, particularly in rural areas and urban slums; - Effective maternal and child health care and counselling, as well as counselling for family planning and family life; - Education in nutrition and assistance in obtaining a proper diet, especially for mothers and children, including the production and utilization of foods rich in vitamins and other nutrients; - Immunization against communicable diseases, in line with the objectives of the Expanded Programme of Immunization of the World Health Organization; - A system for early detection and early intervention; - Safety regulations and training programmes for the prevention of accidents in the home, in the workplace, on the road and in leisure-related activities; - Adaptation of jobs, equipment and the working environment and the provision of occupational health programmes to prevent the generation of occupational disabilities or diseases and their exacerbation; - Measures to control the imprudent use of medication, drugs, alcohol, tobacco and other stimulants or depressants in order to prevent drug-related disability, particularly among schoolchildren and elderly people. Of particular concern also is the effect upon unborn children of imprudent consumption of these substances by pregnant women; - Educational and public health activities that will assist people in attaining life-styles that will provide the maximum defence against the causes of impairment; - Sustained education of the public and of professionals as well as public information campaigns related to disability prevention programmes; - Adequate training for medical, paramedical and other persons who may be called upon to deal with casualties in emergencies; - Preventive measures incorporated in the training of rural extension workers to assist in reducing incidence of disabilities; - Well-organized vocational training and practical on-the-job training of workers with a view to preventing accidents at work and disabilities of different degrees. Attention should be paid to the fact that outdated technology is often used in developing countries. In many cases, old technology is transferred from industrial countries to developing countries. The old technology, inappropriate for the conditions in developing countries, together with insufficient training and deficient labour protection, contributes to an increased number of accidents at work and to disabilities. Rehabilitation 97 Member States should develop and ensure the provision of rehabilitation services necessary for achieving the objectives of the World Programme of Action. 98 Member States are encouraged to provide for all people the health care and related services needed to eliminate or reduce the disabling effects of impairment. 99 This includes the provision of social, nutritional, health and vocational services needed to enable disabled individuals to reach optimum levels of functioning. Depending on such factors as population distribution, geography and stages of development, services can be delivered through the following channels: - Community-based workers; - General facilities providing health, education, welfare and vocational services; - Other specialized services where the general facilities are unable to provide the necessary services. 100 Member States should ensure the availability of aids and equipment appropriate to the local situation for all those to whose functioning and independence they are essential It is necessary to ensure the provision of technical aids during and after the rehabilitation process. Follow-up repair services and replacement of aids that are obsolete are also needed. 101 It is necessary to make certain that disabled persons who need such equipment have the financial resources as well as the practical opportunities for obtaining them and learning to use them . Import taxes or other procedures that block the ready availability of aids and materials which cannot be manufactured in the country and must be obtained from other countries should be eliminated. It is important to support local production of aids that are suited to the technological, social and economic conditions under which they will be used Development and production of technical aids should follow the overall technological development of a specific country. 102 To stimulate local production and development of technical aids, Member States should consider establishing national centres with a responsibility to support such local developments. In many cases existing special schools, institutes of technology, etc., could serve as a basis for this. Regional cooperation in this connection should be considered. 103 Member States are encouraged to include within the general system of social services personnel competent to provide counselling and other assistance needed to deal with the problems of disabled persons and their families. 104 When the resources of the general social service system are inadequate to meet these needs, special services may be offered until the quality of the general system has been improved. 105 Within the context of available resources, Member States are encouraged to initiate whatever special measures may be necessary to ensure the provision and full use of services needed by disabled persons living in rural areas, urban slums and shanty towns. 106 Disabled persons should not be separated from their families and communities. The system of services must take into account problems of transportation and communication; the need for supporting social, health and education services; the existence of primitive and often hazardous living conditions; and, especially in some urban slums, social barriers that may inhibit people's readiness to seek or accept services. Member States should assure an equitable distribution of these services to all population groups and geographical areas according to need. 107 Health and social services for mentally ill persons have been particularly neglected in many countries. The psychiatric care of persons with mental illness should be supplemented by the provision of social support and guidance to these persons and their families, who are often under particular strain. Where such services are available, the length of stay and the probability of renewed referral to institutions are lessened. In cases where mentally retarded persons are additionally afflicted with problems of mental illness, provisions are necessary to ensure that health care personnel are aware of the distinct needs related to retardation. Equalization of opportunities LEGISLATION 108 Member States should assume responsibility for ensuring that disabled persons are granted equal opportunities with other citizens. 109 Member States should undertake the necessary measures to eliminate any discriminatory practices with respect to disability. 110 In drafting national human rights legislation, and with respect to national committees or similar coordinating national bodies dealing with the problems of disability, particular attention should be given to conditions which may adversely affect the ability of disabled persons to exercise the rights and freedoms guaranteed to their fellow citizens. 111 Member States should give attention to specific rights, such as the rights to education, work, social security and protection from inhuman or degrading treatment, and should examine these rights from the perspective of disabled persons. PHYSICAL ENVIRONMENT 112 Member States should work towards making the physical environment accessible to all, including persons with various types of disability, as specified in paragraph 8 of this document. 113 Member States should adopt a policy of observing accessibility aspects in the planning of human settlements, including programmes in the rural areas of developing countries. 114 Member States are encouraged to adopt a policy ensuring disabled persons access to all new public buildings and facilities, public housing and public transport systems. Furthermore, measures should be adopted that would encourage access to existing public buildings and facilities, housing and transport wherever feasible, especially by taking advantage of renovation. 115 Member States should encourage the provision of support services to enable disabled persons to live as independently as possible in the community. In so doing, they should ensure that persons with a disability have the opportunity to develop and manage these services for themselves, as is now being done in some countries. INCOME MAINTENANCE AND SOCIAL SECURITY 116 Every Member State should work towards the inclusion, within its systems of laws and regulations, of provisions covering the general and supporting objectives of the World Programme of Action referring to social security. 117 Member States should ensure that disabled persons have equal opportunities to obtain all forms of income, maintenance thereof, and social security. Such a process should take place in forms adjusted to the economic system and degree of development of the Member State. 118 Where social security, social insurance and other such systems exist for the general population, they should be reviewed to make certain that adequate benefits and services for prevention, rehabilitation and the equalization of opportunities are provided for disabled persons and their families and that regulations under these systems, whether applicable to services providers or the services recipients, should not exclude or discriminate against such persons. The establishment and the development of a public system of social care and of industrial safety and health protection constitute essential prerequisites for achieving the aims set. 119 Easily accessible arrangements should be made by which disabled persons and their families can appeal, through impartial hearing, against decisions concerning their rights and benefits in this field. EDUCATION AND TRAINING 120 Member States should adopt policies which recognize the rights of disabled persons to equal educational opportunities with others. The education of disabled persons should as far as possible take place in the general school system. Responsibility for their education should be placed upon the educational authorities and laws regarding compulsory education should include children with all ranges of disabilities, including the most severely disabled. 121 Member States should allow for increased flexibility in the application to disabled persons of any regulation concerning admission age, promotion from class to class and, when appropriate, in examination procedures. 122 Basic criteria are to be met when developing educational services for disabled children and adults. These services should be: Individualized, i.e, based on the assessed needs mutually agreed upon by authorities, administrators, parents and disabled students and leading to clearly stated curriculum goals and short term objectives which are regularly reviewed and where necessary revised; Locally accessible, i.e., within reasonable travelling distance of the pupil's home or residence except in special circumstances; Comprehensive, i.e., serving all persons with special needs ir- respective of age or degree of disability, and such that no child of school age is excluded from educational provision on grounds of severity of disability or receives educational services significantly inferior to those enjoyed by any other students; Offering a range of choice commensurate with the range of special needs in any given community. 123 Integration of disabled children into the general educational system requires planning by all parties concerned. 124 If, for some reason, the facilities of the general school system are inadequate for some disabled children, schooling for these children should then be provided for an appropriate period of time in special facilities. The quality of this special schooling should be equal to that of the general school system and closely linked to it. 125 The involvement of parents at all levels of the educational process is vital. Parents should be given the necessary support to provide as normal a family environment for the disabled child as is possible. Personnel should be trained to work with the parents of disabled children. 126 Member States should provide for the participation of disabled persons in adult education programmes, with special attention to rural areas 127 if the facilities of regular adult education courses are in- adequate to meet the needs of some disabled persons, special courses or training centres may be needed until the regular programmes have been modified. Member States should grant disabled persons possibilities for education at the university level. EMPLOYMENT 128 Member States should adopt a policy and supporting structure of services to ensure that disabled persons in both urban and rural areas have equal opportunities for productive and gainful employment in the open labour market. Rural employment and the development of appropriate tools and equipment should be given particular attention. 129 Member States can support the integration of disabled persons into open employment through a variety of measures, such as incentive-oriented quota schemes, reserved or designated employment, loans or grants for small businesses and cooperatives, exclusive contracts or priority production rights, tax concessions, contract compliance or other technical or financial assistance to enterprises employing disabled workers. Member States should support the development of technical aids and facilitate access for disabled persons to aids and assistance, which they need to do their work. 130 The policy and supporting structures, however, should not limit the opportunities for employment and should not hinder the vitality of the private sector of the economy. Member States should remain able to take a variety of measures in response to their domestic situations. 131 There should be mutual cooperation at the central and local level between government and employers' and workers' organizations in order to develop a joint strategy and joint action with a view to ensuring more and better employment opportunities for disabled persons. Such cooperation could concern recruitment policies, measures to improve the work environment in order to prevent handicapping injuries and im- pairments, measures for rehabilitation of employees impaired in the job, e.g ., by adjusting workplaces and work contents to their requirements. 132 These services should include vocational assessment and guidance, vocational training (including that in training workshops), placements and follow-up. Sheltered employment should be made available for those who, because of their special needs or particularly severe disabilities, may not be able to cope with the demands of competitive employment. Such provisions could be in the form of production workshops, home-working, and self-employment schemes, and small groups of severely disabled people employed in sheltered conditions within competitive industry. 133 When acting as employers, central and local governments should promote employment of disabled persons in the public sector. Laws and regulations should not raise obstacles to the employment of disabled persons. RECREATION 134 Member States should ensure that disabled persons have the same opportunities for recreational activities as other citizens. This involves the possibility of using restaurants, cinemas, theatres, libraries, etc., as well as holiday resorts, sports arenas, hotels, beaches and other places for recreation . Member States should take action to remove all obstacles to this effect. Tourist authorities, travel agencies, hotels, voluntary organizations and others involved in organizing recreational activities or travel opportunities should offer their services to all and not discriminate against disabled persons. This involves, for instance, incorporating information on accessibility into their regular information to the public. CULTURE 135 Member States should ensure that disabled persons have the opportunity to utilize their creative, artistic and intellectual potential to the full, not only for their own benefit but also for the enrichment of the community. To this end, access to cultural activities should be ensured. If necessary, special arrangements should be made to meet the needs of individuals with mental or sensory impairments. These could include communication aids for the deaf, literature in Braille and/or cassettes for the visually impaired and reading material adapted to the individual's mental capacity. The domain of cultural activities includes dance, music, literature, theatre and plastic arts. RELIGION 136 Measures should be undertaken to ensure that disabled persons have the opportunity to benefit fully from the religious activities available to the community. In this way, the full participation by disabled persons in these activities will be made possible. SPORTS 137 The importance of sports for disabled persons is becoming increasingly recognized. Member States should therefore encourage all forms of sports activities of disabled persons, inter alia, through the provision of adequate facilities and the proper organization of these activities. Community action 138 Member States should give high priority to the provision of information, training and financial assistance to local communities for the development of programmes that achieve the objectives of the World Programme of Action. 139 Arrangements should be made to encourage and facilitate cooperation among local communities and the exchange of information and experience. A Government benefiting from international technical assistance or technical cooperation in disability-related matters should ensure that the benefits and results of the assistance reach the communities in greatest need. 140 It is important to enlist the active participation of local government bodies, agencies and community organizations, such as citizen's groups, trade unions, women's organizations, consumer organizations, service clubs, religious bodies, political parties and parents'associations. Each community could designate an appropriate body, where organizations of disabled persons could have an influence, to serve as a focal point of communication and coordination to mobilize resources and initiate action. Staff training 141 All authorities responsible for the development and provision of services for disabled persons should give attention to staff matters, particularly to recruitment and training. 142 The training of community-based workers in the early detection of impairment, the provision of primary assistance and referral to appropriate facilities, and follow-up, are vital, as well as the training of medical teams and other personnel at referral centres. Whenever possible, these should be integrated into such related services as primary health care, schools and community development programmes. Member States should develop and intensify training for doctors which emphasizes the disabilities that can be produced by the indiscriminate use of some pharmaceutical products. Sale of proprietary/patent drugs whose unsupervised use could, in the long term, pose personal and public health hazards should be restricted. 143 If services related to mental and physical disabilities are to reach a growing number of disabled persons who receive none at present, it is necessary to provide them through various types of health and social workers in the local communities. Some of their activities are already related to prevention and to services for disabled persons. They will need special guidance and instruction, for instance, on simple rehabilitation measures and techniques to be used by disabled persons and their families. Guidance might be given by rehabilitation professionals at the community or district level, according to the area covered Special training will be necessary for the professionals at the peripheral level who would be responsible for the supervision of local programmes for persons with a disability and for contact with rehabilitation and other services available in the region. 144 Member States should ensure that community workers receive, in addition to specialized knowledge and skills, comprehensive information concerning the social, nutritional, medical, educational and vocational needs of disabled persons. Community workers, with adequate training and supervision, can provide most services needed by disabled persons and can be a valuable asset in overcoming personnel shortages. Their training should include appropriate information on contraceptive technology and planned parenthood. Volunteers can also provide very useful services and other forms of support. Greater emphasis should be placed on expanding the knowledge, capabilities and responsibilities of providers of other services who are already at work in the community in related fields, such as teachers, social workers, professional auxiliary health service personnel, administrators, government planners, community leaders, clergy and family counsellors. Individuals working in service programmes for disabled persons should be trained to understand the reasons for, and importance of, seeking, stimulating and assisting the full participation of disabled persons and their families in decisions concerning care, treatment, rehabilitation and subsequent living and employment arrangements. 145 Special teacher training is a dynamic field, and wherever possible it should take place in the country in which the education is to be used, or at least in a place where the cultural background and level of development are not too different. 146 A prerequisite for successful integration is the provision of appropriate teacher-training programmes, for both ordinary teachers and special teachers. The concept of integrated education should be reflected in teacher-training programmes. 147 When training special teachers, it is important to cover as wide a spectrum as possible, since in many developing countries the special teacher will be a multi-disciplinary team on his own. It should be noted that a high level of training is not always necessary or desirable, and that the vast majority of personnel come from the middle and lower levels of training. Information and public education 148 Member States should encourage a comprehensive public information programme about the rights, contributions and unmet needs of disabled persons that would reach all concerned, including the general public. In this connection, attitude change should be given special importance. 149 Guidelines should be developed in consultation with organizations of disabled persons to encourage the news media to give a sensitive and accurate portrayal of, as well as fair representation of and reporting on, disabilities and disabled persons in radio, television, film, photography and print. An essential element in such guidelines would be that disabled persons should be able to present their problems to the public themselves and to suggest how they might be solved. The inclusion of information on the realities of disabilities in the curricula of journalists' training should be encouraged. 150 Public authorities are responsible for adapting their information so that it reaches everybody, including disabled persons. This does not apply only to the information mentioned above, but also to information concerning civil rights and obligations. 151 A public information programme should be designed to ensure that the most pertinent information reaches all appropriate segments of the population. In addition to the regular media and other normal channels of communication, attention should be given to: þ The preparation of special materials to inform disabled persons and their families of the rights, benefits and services available to them and of the steps to be taken to correct failures and abuses in the system. Such materials should be available in forms that can be used and understood by people with visual, hearing or other communication limitations; þ The preparation of special materials for groups within the population who are not easily reached by the normal channels of communication. Such groups may be separated by language, culture, levels of literacy, geographical distance and other factors; þ The preparation of pictorial material, audio-visual presentations and guidelines for use by community workers in remote areas and other situations where normal forms of communication may be less effective. 152 Member States should ensure that current information is available to disabled persons, their families and professionals regarding programmes and services, legislation, institutions, expertise, aids and devices etc. 153 The authorities responsible for public education should ensure the presentation of systematic information about the realities of disability and its consequences and about prevention, rehabilitation and the equalization of opportunities for disabled persons. 154 Disabled persons and their organizations should be given equal access, employment, adequate resources and professional training with regard to public information, so they may express themselves freely through the media and communicate their points of view and experiences to the general public. International action General aspects 155 The World Programme of Action, as adopted by the General Assembly, constitutes an international long-term plan based on extensive consultations with Governments, organs and bodies within the United Nations system and intergovernmental and non-governmental organizations, including organizations of and for disabled persons. Progress in reaching the goals of the Programme could be achieved more quickly, efficiently and economically if close cooperation were maintained at every level. 156 In view of the role that the Centre for Social Development and Humanitarian Affairs of the Department of International Economic and Social Affairs has been playing within the United Nations in the field of disability prevention, rehabilitation and equalization of opportunities for disabled persons, the Centre should be designated as the focal point for coordinating and monitoring the implementation of the World Programme of Action, including its review and appraisal. 157 The Trust Fund established by the General Assembly for the International Year of Disabled Persons should be used to meet requests for assistance from developing countries and organizations of disabled persons and to further the implementation of the World Programme of Action. 158 In general, there is a need to increase the flow of resources to developing countries to implement the objectives of the World Programme of Action. Therefore, the Secretary General should explore new ways and means of raising funds and take the necessary follow-up measures for mobilizing resources. Voluntary contributions from Governments and from private sources should be encouraged. 159 The Administrative Committee on Coordination should consider the implications of the World Programme of Action for the organizations within the United Nations system and should use the existing mechanisms for continuing liaison and coordination of policy and action, including overall approaches on technical cooperation. 160 International non-governmental organizations should join in the cooperative effort to accomplish the objectives of the World Programme of Action. Existing relationships between such organizations and the United Nations system should be used for this purpose. 161 All international organizations and bodies are urged to cooperate with, and assist, organizations composed of, or representing disabled persons and to ensure that they have opportunities to make their views known when subjects related to the World Programme of Action are discussed. Human rights 162 In order to achieve the theme of the International Year of Disabled Persons, "Full participation and equality", it is strongly urged that the United Nations system make all its facilities totally barrier-free, ensure that communication is fully available to sensorially impaired persons and adopt an affirmative action plan that includes administrative policies and practices to encourage the employment of disabled persons in the entire United Nations system. 163 In considering the status of disabled persons with respect to human rights, priority should be placed on the use of United Nations covenants and other instruments, as well as those of other international organizations within the United Nations system that protect the rights of all persons. This principle is consistent with the theme of the International Year of Disabled Persons, "Full participation and equality". 164 Specifically, organizations and bodies involved in the United Nations system responsible for the preparation and administration of international agreements, covenants and other instruments that might have a direct or indirect impact on disabled people should ensure that such instruments fully take into account the situation of persons who are disabled. 165 The States parties to the International Covenants on Human Rights should pay due attention, in their reports, to the application of the Covenants to the situation of disabled persons. The working group of the Economic and Social Council entrusted with the examination of reports under the International Covenant on Economic, Social and Cultural Rights and the Commission on Human Rights, which has the function of examining reports under the International Covenant on Civil and Political Rights, should pay due attention to this aspect of the reports. 166 Particular conditions may exist which inhibit the ability of disabled persons to exercise the human rights and freedoms recognized as universal to all mankind Consideration should be given by the United Nations Commission on Human Rights to such conditions. 167 National committees or similar coordinating bodies dealing with problems of disability should also pay attention to such conditions. 168 Incidents of gross violation of basic human rights, including torture, can be a cause of mental and physical disability. The Commission on Human Rights should give consideration, interalia, to such violations for the purpose of taking appropriate ameliorative action. 169 The Commission on Human Rights should continue to consider methods of achieving international cooperation for the implementation of internationally recognized basic rights for all, including disabled persons. Technical and economic cooperation International Assistance 170 The developing countries are experiencing increasing difficulties in mobilizing adequate resources for meeting the pressing needs of disabled persons and the millions of disadvantaged persons in these countries in the face of the pressing demands from high priority sectors such as agriculture, rural and industrial development, population control, etc., concerned with basic needs. Their efforts should therefore be supported by the international community, in line with paragraphs 82 and 83 above, and the flow of resources to developing countries should be substantially increased, as stated in the International Development Strategy for the Third United Nations Development Decade. 171 Inasmuch as most international technical cooperation and donor agencies can undertake to collaborate with national endeavours only on the basis of official requests from Governments, increased efforts should be made by all parties concerned with the establishment of programmes related to disabled persons to apprise Governments of the exact nature of the support that can be sought from these agencies. 172 The Vienna Affirmative Action Plan 9/ prepared by the World Symposium of Experts on Technical Cooperation among Developing Countries and Technical Assistance in Disability Prevention and Rehabilitation of Disabled Persons could serve as a guideline for the implementation of technical cooperation activities within the World Programme of Action. 173 Those organizations within the United Nations system that have a mandate, resources and experience in areas related to the World Programme should explore, with the Governments to which they are accredited, ways of adding to existing or planned projects in different sectors components that would respond to the specific needs of disabled persons and the prevention of disability. 174 All international organizations whose activities have a bearing on financial and technical cooperation should be encouraged to ensure that priority is accorded to requests from Member States for assistance in the prevention of disability, rehabilitation and the equalization of opportunities which are in accordance with their natural priorities. Such measures will ensure the allocation of increased resources for both capital investment and recurrent expenditure for services related to prevention, rehabilitation and equalization of opportunities. This action should be reflected in the programmes for economic and social development of all multilateral and bilateral aid agencies, including technical cooperation among developing countries. 175 In seeking to collaborate with Governments to serve better the needs of disabled persons, the various United Nations organizations, as well as bilateral and private institutions, should closely coordinate their inputs in order to contribute more efficiently to the attainment of established goals. 176 As most of the United Nations organizations involved already have the specific responsibility of promoting the establishment of projects or the addition of project components directed towards disabled persons, a clearer division of responsibilities, as set out below, should be established among them in order to improve the response of the United Nations system to the challenge of the International Year of Disabled Persons and the World Programme of Action: þ The United Nations and, in particular, the Department of Technical Cooperation for Development should, together with the specialized agencies and other intergovernmental and non-governmental organizations, carry out technical cooperation activities in support of the implementation of the World Programme of Action; in this connection, the Centre for Social Development and Humanitarian Affairs of the Department of International Economic and Social Affairs should continue to give substantive support, in the implementation of the World Programme of Action, to technical cooperation projects and activities; þ The United Nations Development Programme should continue to use its field establishment to give considerable attention, within its normal programmes and procedures, to project requests from Governments that specially respond to the needs of disabled persons and to prevention of disability. It should particularly encourage technical cooperation in the field of disability prevention, rehabilitation and equalization of opportunities by using its various programmes and services, such as technical cooperation among developing countries, global and interregional projects and the Interim Fund for Science and Technology; þ The main efforts of UNICEF would continue to be directed towards better preventive measures involving greater support for maternal and child health services, health education, disease control and the improvement of nutrition; for those who are already disabled, UNICEF encourages the development of integrated education projects and supports rehabilitation activities at the community level, using inexpensive local resources; þ The specialized agencies, within their mandate and sectoral responsibilities, should give, on the basis of requests from Governments, still greater emphasis to efforts to help meet the needs of disabled persons by using the chances offered to them through the programming processes of individual countries and the establishment of regional, interregional and global projects, as well as through the use of their own resources, when feasible. Their different spheres of responsibility in this respect should be as follows: ILO-vocational rehabilitation and occupational safety and health; UNESCO-education of disabled children and adults; WHO-prevention of disability and medical rehabilitation; FAO-improvement of nutrition; þ In their lending activities, multilateral financial institutions should take into serious consideration the objectives and proposals of the World Programme of Action. REGIONAL AND BILATERAL ASSISTANCE 177 The regional commissions of the United Nations and other regional bodies should encourage regional and sub-regional cooperation in the area of prevention of disability, rehabilitation of disabled persons and equalization of opportunities. They should monitor progress in their regions, identify needs, collect and analyze information, sponsor action-oriented research, supply advisory services and engage in technical cooperation activities. They should include in their action plans research and development, preparation of information materials and the training of personnel; and they should, as an interim measure, facilitate activities in the field of technical cooperation among developing countries which are related to the objectives of the World Programme of Action. They should promote the development of organizations of disabled persons as an essential resource in developing the activities referred to earlier in this paragraph. 178 Member States, in cooperation with regional bodies and commissions, should be encouraged to establish regional (or sub- regional) institutes or offices to promote the interests of persons with a disability, in consultation with organizations of disabled persons and the appropriate international organizations. Other functions should be to promote the activities mentioned above. It is important to understand that the function of the institutes is not to provide direct services but to promote innovative concepts like community-based rehabilitation, coordination, information, training and advice in organizational development of disabled persons. 179 Donor countries should attempt to find the means within their bilateral and multilateral technical assistance programmes to respond to requests for assistance from Member States relating to national or regional measures in the area of prevention, rehabilitation and the equalization of opportunities. These measures should include assistance to appropriate agencies and/or organizations to expand cooperative arrangements within and between regions. Technical cooperation agencies should actively recruit disabled persons at all levels and functions, including field positions. Information and public education 180 The United Nations should carry out and continue activities to increase public awareness of the objectives of the World Programme of Action. To this end the substantive offices should regularly and automatically furnish the Department of Public Information (DPI) with information on their activities so as to enable it to publicize these activities through press releases, features, newsletters, fact sheets, booklets, radio and television interviews and in any other appropriate forms. 181 All agencies involved in projects and programmes that are connected with the World Programme of Action should continue in their endeavours to inform the public. Research should be undertaken by those agencies whose fields of specialization require involvement in such activity. 182 The United Nations, in collaboration with the specialized agencies concerned, should develop innovative approaches using a variety of media for conveying information, including the principles and objectives of the World Programme of Action, to audiences not regularly reached by conventional media or which are unaccustomed to using such media. 183 International organizations should assist national and community bodies in the preparation of public education programmes by suggesting curricula and providing teaching materials and background information about the objectives of the World Programme of Action. Research In view of the little knowledge that is available as to the place of the disabled person within different cultures, which in turn determine attitudes and behaviour patterns, there is a need to undertake studies focusing on the socio-cultural aspects of disability. This will give a more perceptive understanding of the relations between non-disabled and disabled persons in different cultures. The results of such studies will make it possible to propose approaches suited to the realities of the human environment. Furthermore, an effort should be made to develop social indicators relating to the education of disabled persons so as to analyze the problems involved and plan programmes accordingly. 185 Member States should develop a programme of research on the causes, types and incidence of impairment and disability, the economic and social conditions of disabled persons, and the availability and efficacy of existing resources to deal with these matters. 186 Research into the social, economic and participation issues that affect the lives of disabled persons and their families, and the ways these matters are dealt with by society, is of particular importance. Research data may be obtained through national statistical offices and census bureaux; however, it should be noted that a household survey programme designed to collect information about disability issues is more likely to produce useful results than a general census of the population. 187 There is also a need to encourage research with a view to developing better aids and equipment for disabled persons. Particular efforts should be devoted to finding solutions which are suited to the technological and economic conditions in developing countries. 188 The United Nations and its specialized agencies should follow the trends of international research into disability and related research issues to identify existing needs and priorities, while emphasizing innovative approaches to all forms of action recommended in the World Programme of Action. 189 The United Nations should encourage and assist in research projects designed to increase knowledge about the issues covered in the World Programme of Action. It is necessary for the United Nations to be familiar with research findings from various countries and to be aware of research proposals now pending approval. The United Nations also needs to give increased attention to research results and to stress their use and their dissemination. A permanent link with bibliographical retrieval systems is highly recommended. 190 The regional commissions of the United Nations and other regional bodies should include in their action plans research activities to assist Governments in implementing the proposals contained in the World Programme of Action. The key to maximizing the effectiveness of research expenditure for the disabled is the dissemination and sharing of information on the results of research. International governmental and non-governmental agencies should play an active role in establishing collaborative mechanisms between regional and local institutions for joint studies and for the exchange of information. 191 Research at the medical, psychological and social levels offers the promise of reducing physical, mental and social disability. There is a need to develop programmes which include the identification of areas where the probability of progress through research is high. The difference between industrialized countries and developing countries should not prevent the development of fruitful collaboration since many problems are of universal concern. 192 Studies in the following fields are of value to both developing and developed countries: þ Clinical research into the containment of those events which cause disability; evaluation of the individual's functional capacity from the medical, psychological and social aspects; and evaluation of rehabilitation programmes, including information aspects; þ Studies of the prevalence of disability, the functional limitations of the disabled, the conditions under which they live and the problems they face; þ Health and social service research, including research into the gains and costs of different rehabilitation and care policies, ways of making programmes as effective as possible and a search for alternative approaches. Studies of community care of disabled persons would be particularly relevant to developing countries, and the study and evaluation of experiments, as well as comprehensive demonstration programmes, would be of value to all. Much information is available which could be productive for secondary analysis. 193 Health and social science research institutions should be encouraged to undertake research and to collect information on disabled persons. Applied research activities are of particular value in the development of new techniques for the delivery of services, the preparation of information materials appropriate for different language and culture groups, and the training of personnel under conditions relevant to the region. Monitoring and evaluation It is essential that assessment of the situation relating to disabled persons should be carried out periodically and that a baseline should be established to measure developments. The most important criteria for evaluating the World Programme of Action are suggested by the theme of the International Year of Disabled Persons, "Full participation and equality". Monitoring and evaluation should be carried out at periodic intervals at the international and regional levels, as well as at the national level. Evaluation indicators should be selected by the United Nations Department of International Economic and Social Affairs in consultation with Member States and relevant United Nations agencies and other organizations. 195 The United Nations system should carry out a critical periodic evaluation of progress made in implementing the World Programme of Action and to that end should select appropriate indicators for evaluation in consultation with Member States. The Commission for Social Development should play an important role in this respect. The United Nations, together with the specialized agencies, should develop, on a continuing basis, suitable systems for the collection and dissemination of information so as to ensure the improvement of programmes at all levels on the basis of evaluation results. In this connection, the Centre for Social Development and Humanitarian Affairs should have an important role to play. 196 The regional commissions should be requested to carry out monitoring and evaluation functions that would contribute to the global assessments carried out at the international level. Other regional and intergovernmental bodies should be encouraged to take part in this process. 197 At the national level, an evaluation of programmes relating to disabled persons should be carried out periodically. 198 The Statistical Office is urged, together with other units of the Secretariat, the specialized agencies and regional commissions, to cooperate with the developing countries in evolving a realistic and practical system of data collection based either on total enumeration or on representative samples, as may be appropriate, in regard to various disabilities, and, in particular, to prepare technical manuals/documents on how to use household surveys for the collection of such statistics, to be used as essential tools and frames of reference for launching action programmes in the post-lYDP years to ameliorate the condition of disabled persons. 199 In this extensive exercise the United Nations Centre for Social Development and Humanitarian Affairs should play a major role, supported by the United Nations Statistical Office. 200 The Secretary-General should report periodically on efforts by the United Nations and the specialized agencies to hire more disabled persons and to make their facilities and information more accessible to disabled persons. 201 On the basis of the results of the periodic evaluation and of developments in the world economic and social situation, it may be necessary periodically to revise the World Programme of Action. These revisions should take place every five years, the first being in 1987, based upon a report of the Secretary-General to the General Assembly at its forty-second session. The review should also constitute an input to the process of review and appraisal of the International Development Strategy for the Third United Nations Development Decade. Notes 1/ This resolution is contained in United Nations document A/37/51, Official Records of the General Assembly, Thirty-seventh Session Supplement No. 51. 2/ International Classification of Impairments, Disabilities and Handicaps (ICIDH), World Health Organization, Geneva, 1980. 3/ General Assembly resolution 2200 A (XXI) 4/ General Assembly resolution 2856 (XXVI). 5/ General Assembly resolution 3447 (XXX). 6/ General Assembly resolution 2542 (XXIV). 7/ United Nations document A/36/766. 8/ General Assembly resolution 35/56. 9/ United Nations document IYDP/SYMP/L.2/Rev.1 of 16 March 1982. Index Note: Numbers refer to paragraphs Ability/Abilities 6,27,77, 110, 166/16, 17, 28 Able 19, 29, 58, 68, 69, 130, 132, 149 Access 7, 21, 24, 25, 32, 35, 36, 45, 52, 61, 89, 114, 129, 135, 154 Accessible/Accessibility 12, 23, 61, 112, 119, 122, 200/113, 134 Accident/Accidents 49, 52/4, 13, 40, 51, 96 Action plan/Action plans 162, 172/ 177, 190 Activities 15, 16, 18, 24, 34-36, 40, 45, 52, 57, 71, 89 90, 94, 96, 134-137, 143, 172, 174, 176-178 180, 190, 193 Adaptation, Adaptations/Adapted 69, 96/36, 59, 135 Adequate 14, 24, 80, 83, 96, 118, 137, 144, 154, 170 Adjusted/Adjustment 117/11 Administrative Committee on Co-ordination 159 Administrators 54, 122, 144 Adopt Adopted 5, 113, 114, 120, 123, 162/31, 35, 36, 114, 155 Adult/Adults 126, 127/ 2, 16 27, 36, 122, 176 Advisory services 177 Age/Aging 6, 121, 122/13 Agencies 23, 36, 89, 134, 140, 171, 174, 176, 179, 181, 182, 188, 190, 194, 195, 198, 200 Agriculture 13, 36, 70, 170 Aids 11, 15, 24, 27, 43, 58, 59, 78, 90, 100, 101, 102, 129, 135, 152, 187 Aircraft 76 Alcohol 13, 96 Alma-Ata Conference on Primary Health Care 36 Analyze 177, 184 Appliances 80 Applied 54, 193 Appraisal 156, 201 Approaches 35, 43, 52, 159, 182, 184, 188, 192 Arts/Artistic 135 Arthritis 47 Assessment/Assessments 68, 69, 132, 194/196 Assist 3, 35, 39, 42, 58, 96, 161, 183, 189, 190 Assistance 5, 14, 15, 26, 39, 40, 80, 90, 91, 96, 103, 129, 138, 139, 142, 157, 169, 172, 174, 176, 179 Attitude/Attitudes 148/27, 46, 54, 61, 72, 85, 184 Audio-visual 151 Authorities 87, 120, 122, 134, 141, 150, 153 Availability/Available 59, 100, 101, 185/7, 20-22, 39, 40, 54, 59, 95, 105, 107, 132, 136, 143, 151, 152, 162, 184, Avoidable 40, 54 Awareness 28, 40, 61, 180 Barrier/Barriers 27, 162/2, 7, 8, 35, 39, 40, 42, 61, 71, 74, 76, 90, 106 Barter 70 Base-line 194 Behaviour 46, 72, 184 Benefit/Benefits 78, 85, 135, 136/ 22, 118, 119, 139, 151 Bibliographical retrieval systems 189 Bilateral 174-176, 179 Birth 41, 49 Bodies 87, 92, 94, 110, 140, 155, 161, 164, 167, 177, 178 183, 190, 196 Braille 135 Buildings 76, 114 Campaigns 61, 76, 96 Cane 27 Capacity/Capacities 86, 135, 192/16, 80 Capital investment 174 Care 4, 13, 15, 18, 24, 36, 40, 45, 52, 54, 55, 57, 80, 96, 98, 107, 118, 142, 144, 192 Career 26 Cassettes 135 Casualties 96 Catastrophe 5 Cause/Causes 40, 47, 54, 163, 192/13, 38, 40, 96, 185 Census 186 Central 131, 133 Centre for Social Development and Humanitarian Affairs (CSDHA) 156, 176, 195, 199 Chances 45, 176 Change/Changes/Changing 11, 26, 28, 85, 148/79, 81/13 Channels 93, 94, 151 Child/Children 41, 52, 96, 122, 125, 176/2, 16, 35, 36, 46, 53, 64, 68, 96, 120, 122-125, 176 Cinemas 134 Citizen/Citizens 140/3, 7, 22, 108, 110, 134 Class 121 Clergy 144 Clinical 192 Clubs 140 Collaborate/Collaboration 171, 175/182, 191 Commission for Social Development 195 Commission on Human Rights 165, 166, 168, 169 Committee/Committees 36, 89, 159/110, 167 Communicable diseases 96 Communication 15, 29, 58, 59, 76, 106, 135, 140, 151, 162 Community/Communities 3, 4, 7, 17, 18, 21, 24, 25, 35, 36, 45, 46, 61, 71, 80, 96, 99, 115, 122, 135-137, 140, 142, 144, 151, 170, 176, 178, 183, 192/13, 17, 57, 75, 81, 106, 138, 139, 143. Competition/Competitive 70/132 Components 173, 176 Comprehensive 122, 144, 148, 192 Compulsory 64, 120 Concept/Concepts 35, 36, 146/1, 31, 34, 35, 178 Concerns 85,91 Condition/Conditions 14, 75, 198/1, 3, 20, 40, 47, 51, 54, 78, 80, 82, 83, 96, 101, 106, 110, 132, 166, 167, 185, 187, 192, 193 Consequence/Consequences 2/3, 5, 10, 38, 40, 45, 80, 153 Constraints 40, 86 Consultation/Consultations 85, 149, 178, 194, 195/155 Consumer/Consumption 140/96 Contact/Contacts 72, 73, 143/93 Contraceptive 144 Contract, Contracts 129 Contribution/Contributions 82/85, 148, 158 Co-operate /Co-operation 161, 198/30, 34, 35, 90, 102, 131, 139, 155, 159, 169, 171, 172, 174, 176-179 Co-operative/Co-operatives 179/69, 80, 129 Co-ordinate/Co-ordinated/Co-ordinating/Co-ordination 91, 175/84, 96/110, 156, 167/159, 178 Cost/Costs 59, 69, 76/58, 192 Counselling/Counsellors 15, 52, 96, 103/144 Country/Countries 13, 22, 51, 59, 101, 145/1, 3, 5, 35, 37, 43, 45, 47, 50, 53-55, 58, 59, 61, 63-67, 69, 70, 76, 78, 82, 83, 87, 92, 96, 101, 107, 113, 115, 147, 157, 158, 170, 172, 174, 176, 177, 179, 187, 189, 191, 192, 198 Covenants 32, 163-165 Creative potential 135 Crime, Criminology 48 Criteria 122, 194 Crutches 27 Cultural 6, 7, 12, 32, 36, 39, 45, 61, 71, 72, 86, 135, 145, 165, 184 Culture/Cultures 134, 151, 193/3, 184 Curative action 14 Curriculum/Curricula 122 /49, 183 Daily 15, 21, 24, 58, 59 Dance 135 Data 186, 198 Deaf 135 Decentralization 36 Decision/Decisions 19, 28, 29, 89/19, 90, 93, 119, 144 Decision-making 19, 29 Declaration on Social Progress and Development 33 Declaration on the Rights of Disabled Persons 32 Declaration on the Rights of Mentally Retarded Persons 32 Definitions 6, 9 Demand/Demands 29/ 13, 41, 170 Demographic 44 Department of International Economic and Social Affairs (DIESA) 34, 156, 176, 194 Department of Public Information (DPI) 34, 180 Department of Technical Co-operation for Development (DTCD) 34, 176 Depressants 96 Designated 19, 69, 129, 156 Detection 13-15, 53, 68, 96, 142 Developed countries 9, 58, 61, 69, 78, 82, 192 Developing countries 3, 5, 35, 43, 53, 61, 64, 70, 78, 82, 83, 96, 113, 147, 157, 158, 170, 172, 174, 176, 177, 187, 191, 192, 198 Development 1, 3, 5, 13, 16, 22, 28, 29, 33-35, 40, 41, 46, 53, 78-83, 85, 86, 88, 92, 99, 101, 102, 117, 118, 128, 129, 138, 142, 145, 156, 170, 174, 176-178, 191, 193, 195, 199, 201 Development plans/Development programmes 5/22, 142 Devices 15, 35, 58, 59, 78, 152 Diet 96 Diphtheria 4 Disability/Disabilities 1, 3-6, 13, 14, 21, 25, 27, 35-38, 40, 41, 43, 44, 47, 51, 54, 78, 80, 82, 85, 95, 96, 109, 110, 112, 115, 122, 139, 143, 153, 156, 167, 168, 172-174, 176-178, 184, 186, 188, 191, 192/4, 8, 22-24, 27, 29, 30, 36, 37, 42, 43, 54, 55, 60, 69, 71, 75, 90, 96, 120, 132, 142, 143, 149 198 Disability policies 25 Disability prevention 36, 40, 96, 156, 176 Disabled 1-3, 5, 7, 8, 16-19, 21, 22, 24-28, 30, 32, 35-37, 39-45, 47, 49-51, 55, 57-59, 61-74, 76-85, 89-94, 99, 101, 103, 105, 106, 108, 110, 111, 114, 115, 117-129, 131-137, 140, 141, 143, 144, 148-157, 161-166, 169-173, 175-179. 184-187, 190, 192-194, 197, 198, 200 Disabled adults 16, 36 Disabled children 16, 35, 36, 64, 68, 122-125, 176 Disabled citizens 22 Disabled individuals 58, 73, 99 Disabled job-seekers 69 Disabled migrant workers 51 Disabled parent 45 Disabled passengers 36 Disabled people 8, 47, 132, 164 Disabled person/Disabled persons 184/1, 3, 5, 7, 17-19, 22, 24, 26-28, 30, 32, 35, 36, 39-44, 49, 55, 57-59, 61-67, 69-74, 76-78, 80-82, 84, 85, 89-94, 101, 103, 105, 106, 108, 110, 111, 114, 115, 117-121, 126-129, 131, 133-137, 140, 141, 143, 144, 148-157, 161-163, 165, 166, 169-173, 175-179, 184-187, 192-194, 197, 198, 200 Disabled population 51 Disabled refugee/Disabled refugees 50/35 Disabled workers 69, 129 Disablement 45, 48, 54, 95 Disabling 57, 98 Disadvantaged 33, 77, 79, 170 Disaster, disasters 35, 40, 50 Disaster Relief Coordinator 35 Discriminate/Discrimination 118, 134/5, 40, 51, 61, 72 Disease/Diseases 47, 176/4, 5, 36, 52, 96 Displaced persons 50 Disputes 5 Dissemination 54, 95, 189, 190, 195 Distribution 81, 99, 106 District level 143 Division of Human Rights 34 Division of Narcotic Drugs 34 Doctors 54, 142 Domestic 79, 130 Donor 171, 179 Doorways 76 Drug, drugs 13, 34, 35, 40, 96, 142 Early detection 13-15, 53, 68, 96, 142 Earthquake 40 Economic 1, 3, 5, 13, 32, 34, 38, 40, 45, 53, 54, 69, 78-81, 83, 86, 88, 101, 117, 156, 165, 169, 174, 176, 185-187, 194, 201 Economic and Social Commission for Asia and the Pacific (ESCAP) 34 Economic and Social Council 165 Economic and social development 3, 5, 80, 81, 174 Economic Commission for Africa (ECA) 34 Economic Commission for Europe (ECE) 34 Economic Commission for Latin America and the Caribbean (ECLAC) 34 Economic and Social Commission for Western Asia (ESCWA) 34 Economy/Economies 70, 130/ 78 Education/Educational 13-15, 18, 21, 22, 36, 40, 45, 52, 54, 61, 64, 66-48, 76, 80, 90, 96, 99, 106, 111, 119, 120, 126, 127, 145-147, 153, 176, 179, 183, 184/12, 13, 36, 65, 90, 96, 120, 122, 123, 125, 144 Effect/Effects 21, 41, 96/57, 69, 78, 98 Elderly 47, 96 Eliminate 5, 61, 76, 98, 109 Emergencies 96 Employable/Employed 69/25, 51, 69, 132 Employees/Employers 131/69, 131, 133 Employment 15, 18, 21, 22, 45, 51, 61, 68-70, 78, 80, 127-133, 144, 154, 162 Enclaves 69 Enterprise/Enterprises 23/129 Enumeration 198 Environment/Environmental 7, 12, 18, 21, 35, 40, 51, 52, 57 96, 111, 112 125, 131, 184/4, 13 Epidemics 40 Equal/Equality 1-3, 7, 25, 26, 32, 63, 108, 117, 120, 124, 128, 154/1, 21, 27, 71, 82, 162, 163, 194 Equalization of opportunities 5, 9, 12, 21, 40, 60, 62, 78, 79, 84, 107, 118, 153, 156, 174, 176, 177, 179 Equipment 20, 24, 43, 58, 59, 69, 80, 96, 100, 101, 128, 187 Ergonomic 69 Establishments 69 Estimate/Estimated 39/37, 43 Evaluation 192, 194-197, 201 Exclude/Excluded/Exclusion 42, 118/72, 75, 76, 122/72 Exclusive contracts 129 Expanded Programme of Immunization of the World Health Organization 96 Expenditure 174, 190 Experience/Experiences 6, 21, 36, 71, 85, 139, 173/36, 46, 73, 154 Experiments 192 Expertise/Experts 85/39 Extended family 70 Facilities 12, 21, 36, 50, 51, 56, 61, 65, 66, 76, 77, 99, 114, 124, 127, 137, 142, 162, 200 Family/Families 13, 17, 19, 21, 35, 41, 46, 70, 71, 96, 125, 144/13, 14, 17, 19, 40, 41, 43, 45, 51, 57, 70, 90, 103, 106, 107, 118, 119, 143, 144, 151, 152, 186 Faculty 40, 46 Fear 71 Field/Fields 36, 55, 67, 119, 145, 156, 176, 177, 179/80, 144, 181, 192 Film 149 Finance 90 Firms 23 Flexibility 121 Focal point 89, 140, 156 Follow-up 15, 100, 132, 142, 158 Food/Foods 36, 52/96 Food and Agriculture Organization of the United Nations (FAO) 36, 176 Freedom/Freedoms 21, 45/31, 110, 166 Full participation 1, 2, 21, 22, 61, 71, 79, 82, 90, 136, 144, 162, 163, 194 Function/Functions 6, 7, 11, 165, 178/178, 179, 196 Functional/Functioning 11, 20, 74, 192/99, 100 Fund/Funds 35, 157, 176/158 Fundamental 21, 31 Gains 3, 192 General 3, 5, 12, 18, 21, 22, 35, 36, 56, 79, 80, 82, 88, 89, 99, 103, 104, 116, 118, 120, 123, 124, 148, 154, 155, 157, 158, 186, 200, 201 Genetic 52 Geographical 13, 40, 106, 151 Global 84, 176, 196 Goals 1, 21, 82, 84, 122, 155, 175 Government/Governments/Governmental 22, 89, 93, 131, 139, 140, 144/3, 23, 28, 35, 77, 87, 89, 133, 155, 158, 171, 173, 175, 176, 190/3, 23, 36, 89, 155, 160, 176, 190 Grants 129 Groups 13, 17, 21, 45, 71, 73, 77, 79, 106, 132, 140, 151, 193 Guidance 15, 80, 107, 132, 143 Guidelines 149, 151, 172 Handicap/Handicaps 6, 7, 39, 50, 54, 95/51 Handicapped/Handicapping 2, 21, 29, 50, 74, 85/131 Hazards 13, 50, 51, 142 Health 6, 12, 13, 18, 36, 40, 45, 51-54, 80, 96, 98, 99, 106, 107, 118, 142-144, 176, 192, 193 Hearing 6, 15, 27, 47, 76, 119, 151 Help/Helping 5, 24, 35, 40, 44, 57, 91, 176/17 Hereditary 54 Holiday 134 Home 13, 24, 96, 122 Hotels 134 Household 186, 198 Housing 12, 21, 22, 40, 80, 114 Human 2, 6, 31, 32, 34, 35, 54, 71, 79, 81, 82, 110, 113, 161, 163, 165, 166, 168, 169, 184 Human resources 79, 82 Human rights 31, 32, 34, 71, 110, 161, 163, 165, 166, 168, 169 Humanitarian 5, 156, 176, 195, 199 Hunger 5, 40 Hygiene 4, 36, 52 Ignorance 71, 76 Ill/Illness 8, 107/107 Image/Images 27/46 Immigration 51 Immunization 4, 52, 96 Impaired 8, 11, 15, 41, 76, 131, 135, 162 Impairment/Impairments 2, 3, 6, 10, 13, 14, 21, 37, 41, 43, 46, 51-55, 57, 77, 80, 95, 96, 98, 142, 185/ 10, 22, 35, 36, 38, 42, 55, 78, 131, 135 Implement/Implemented/Implementing 86, 87, 90, 158/ 78, 86/ 35, 82, 190, 195 Implementation of the World Programme of Action concerning Disabled Persons 5, 82, 83, 85, 87, 90, 156, 157, 172, 176 Import/Imported 101/20 Improve/Improved/Improvement 30, 36, 80, 131, 176/ 3, 13, 62, 80, 81, 104, /1, 5, 13, 52, 54, 78, 176, 195 Imprudent 40, 96 Inadequate 4, 40, 43, 51, 104, 124, 127 Incentive oriented quota schemes 129 Incidence/Incidences 13, 52, 96, 185/168 Income 5, 77, 115, 117 Independent/Independently 57/57, 115 Indicators 184, 194, 195 Indifference 71 Individual/Individuals/Individualized 6, 16, 17, 21, 25, 135, 176, 192/3, 23, 58, 73, 99, 135, 144/122 Industry/IndustriesIndustrialized 13, 132/78 /54, 69, 191 Inexpensive 54, 176 Infants 53 Infection/Infections 54/52 Influence 28, 85, 92, 93, 140 Inform/Information 151, 181, 28, 30, 34, 61, 76, 90, 96, 134, 138, 139, 144, 147-154, 177-180, 182, 183, 186, 190, 192, 193, 195, 200 Inhibit 106, 166 Inhuman treatment 111 Initiate 88, 105, 140 Injury/Injuries/Injured 35, 49/48, 131/40 Innovative 67, 178, 182, 188 Institutes/Institutions/Institutional 102, 178/18, 56, 57, 61, 75, 107, 152, 175, 176, 190, 193 /54, 57 Integrate/Integrated 79/20, 142, 146, 176 Integration 18, 56, 62, 63, 73, 77, 123, 129, 146 Intercourse 72 Intergovernmental 155, 176, 196 Interim Fund for Science and Technology 176 International 54, 139, 154, 157, 160-165, 169-171, 174, 176, 178, 183, 188, 190, 194, 196 201 International agreements 164 International Civil Aviation Organization (ICAO) 36 International community 4, 170 International Covenant on Civil and Political Rights 165 International Covenant on Economic, Social and Cultural Rights 165 International Covenants on Human Rights 32, 165 International Development Strategy 79, 83, 170, 201 International disputes 5 International Labour Organisation (ILO) 36, 176 International level 23, 85, 196 International organizations 161, 163, 174, 178, 183 International peace and security 5 International Year of Disabled Persons, 1981 157, 162, 163, 176, 194, 198 Interregional 170, 176 Intervention 13, 15, 64, 68, 96 Intimate 21,74 Job/Jobs 36, 131/69, 96 Journalists 149 Know-how 36 Knowledge 40, 42, 51, 54, 66, 95, 144, 184, 189 Labour 18, 33, 36, 96, 128 Lack 6, 40, 51, 59, 66, 76 Language 51, 151, 193 Laws 116, 120, 133 Least developed countries 82 Least privileged groups 13 Leeds Castle Declaration 54 Legal/Legally 90/19 Legislation 13, 61, 66, 76, 90, 107, 110, 152 Leisure 96 Leper colonies 75 Level/Levels 1, 7, 11, 23, 26, 41, 65, 83, 89, 90, 127, 131, 143, 145, 147, 155, 176, 194, 196, 197/3, 5, 18, 23, 80, 85, 86, 94, 96, 99, 125, 147, 151, 179, 191, 194, 195 Libraries 134 Life/Lives 1-3, 7, 11-12, 21, 42, 45, 54, 57, 66, 72, 75, 82/2, 19, 39, 186 Life styles 13, 81, 96 Light switches 76 Limitation/Limitations 7, 11, 74/39, 151, 192 Limited/Limits 1, 29, 41, 50, 51, 65, 67/6, 45 Literacy 151 Literature 135 Living 1, 3, 5, 15, 21, 39-41, 51, 53, 58, 59, 61, 70, 82, 105, 106, 144 Loans 129 Local authorities/Local communities/Local government 87/138, 139, 143/140 Local level/Local situation 85, 131/100 Local production/Local resources 80, 101, 102/ 176 Long-term 88, 142, 155 Loss 6, 7, 11, 54 Maintenance 115, 117 Malnutrition 4, 54 Mandate 35, 173, 176 Manuals 198 Manufactured/Manufacturing 58, 101/43 Market 128 Marriage 32, 74 Mass disability 5 Mass production 78 Material/Materials 3, 20, 135, 151/101, 151, 177, 183, 193 Maternal and child health 96, 176 Measles 4 Measures 1, 4, 5, 10, 11, 13, 14, 18, 21, 22, 35, 40, 52-54, 61, 69, 78, 79, 82, 84, 87, 90, 95, 96, 105, 109, 114, 129-131, 136, 143, 158, 174, 176, 179 Mechanisms 159, 190 Media 30, 149, 151, 154, 182 Medical/Medication/Medicine 8, 13-15, 43, 54, 57, 90, 96, 142, 144, 176, 191, 192/40, 96/80 Member State/Member States 116, 117/36, 88, 90-93, 95, 97, 98, 100, 102, 103, 105, 106, 108, 109, 111-115, 117, 120, 121, 126-130, 134, 135, 137, 138, 142, 144, 148, 152, 174, 178, 179, 185, 194, 195 Members 5, 19, 35, 38, 57 Mental/Mentally 2, 10, 11, 22, 37, 52, 78, 107, 135, 143, 168, 191/8, 15, 19, 29, 32, 33, 45, 49, 74, 85, 107 Methods 20, 59, 61, 169 Migrant workers 51 Million/Millions 2, 37, 39, 50/2, 170 Ministry, Ministries 89 Misuse of therapeutic substances 40 Mobility 8, 15, 58, 59 Modification/Modifications 13/81 Money 70 Monitor/Monitoring 177/156, 194, 196 Mother/Mothers 52/96 Movement 21, 29, 36, 61 Multisectoral 84 Multi-disciplinary 84, 147 Multilateral 174, 176, 179 Music 135 Mutual/Mutually 28, 80, 131/122 Nation/Nations 86, 88/5, 20, 31, 34-36, 42, 78, 79, 83, 86, 155, 156, 159, 160, 162-164, 166, 170, 173, 175-177, 180, 182, 188-190, 194, 195, 199-201 National 36, 54, 80, 83, 85-89, 102, 110, 167, 171, 179, 183, 186, 194, 197 National commission/national committees 89/110, 167 National level 83, 85, 194, 197 Natural 18, 35, 40, 174 Need/Needs 22, 24, 40, 43, 44, 53, 54, 59, 61, 101, 106, 129, 139, 143, 158, 184, 187, 191/3, 5, 17, 24, 25, 23, 35, 36, 40, 59, 66, 74, 76, 82, 104, 107, 122, 127, 132, 135, 144, 148, 170, 173, 175-177, 188, 189 Negotiation 28 New international economic order 78, 79, 83 News media 149 Newsletters 180 Non-disabled 25, 64, 184 Non-governmental 3, 23, 36, 89, 155, 160, 176, 190 Non-governmental organizations 3, 23, 36, 89, 155, 160, 176 Normal 6, 16, 46, 49, 57, 72, 73, 75, 125, 151, 176 Norms 69 Number/Numbers 5, 22, 34, 37, 41, 44, 47, 57, 69, 96, 143/40 Nutrients/Nutrition/Nutritional 96/13, 36, 52, 80, 96, 176/13, 90, 99, 144 Objectives 1,