The majority of disabled persons live in rural isolated areas of Africa, Asia, Latin America and the Caribbean. Despite their obvious presence in the developing world, disabled people have been largely ignored by international development agencies. According to Robert Chambers, the poorest and most isolated people, including disabled persons, are often not taken into account in benefit programs because they live off main thoroughfares, do not speak at town meetings, or hold the land and power in their communities.¹ Disadvantaged by way of disability, isolation, poverty, powerlessness and vulnerability, disabled persons have not had opportunity to speak up and negotiate for help.² This situation is now being reversed as disabled people all over the world are banding together to make their concerns heard. Government policy-makers and development agencies are being approached in hopes of working together on disability-related concerns.

The effect of disability is widespread in the community. It is estimated by the World Health Organization that there are more than 500 million people worldwide who are disabled in some way. This includes people who have physical, mental or sensory impairments and means that one in ten persons is affected. Disability is defined as a functional limitation within the individual caused by physical, mental or sensory impairment, whereas the term handicapped means the loss or limitation of opportunities to take part in the community on an equal level with others.³

Of the total disabled population, 80 percent live in the developing regions of the world -- Africa, Asia, the Caribbean, South and Central America, and the Middle East. In some countries malnutrition and communicable disease contribute to produce disabilities in 20 percent of the population.⁴ Indeed, vitamin A deficiency blinds 500,000 children per year and preventable diseases such as polio and measles continue to disable many simply because vaccines are not available. There are 70 million deaf people in the world, and in developing countries the primary cause is "otitis media," a disease inexpensively preventable at the level of primary health care. Other diseases such as river blindness caused by the simulium fly, guinea worm disease caused by polluted waters, rubella, meningitis and leprosy all result in disabilities that could be prevented with greater sanitation and better primary health care.

Women are often victims of disability. Often receiving less food than their male counterpart, they become weaker and therefore more susceptible to disease. In many parts of Africa and the Middle East, women also experience the disabling effects of female circumcision. For cultural and religious reasons the female genital organs (the clitoris and sometimes the labia) are removed. Performed at an early age without anesthetic and in unsanitary conditions this practice may result in pain that inhibits walking, as well as pelvic and urinary infections and even mental illness due to the trauma associated with the procedure.⁵

It is estimated that when family and friends are considered, disability affects 25 percent of the community. Thus the effects of disability are far-reaching.

In examining the interplay between development and disabled people, this paper will begin with the theological implications of seeking justice. It will then discuss the societal treatment of disabled people and the ensuing response from the disabled community during the 1970s and 1980s. It will look at the formation of groups of disabled persons and the development of self-help projects in the developing world. These projects, as well as MCC's involvement from 1980 to 1988, will be examined.

A.A theology of disability

A well-known characteristic of Jesus's ministry on earth was his acceptance of persons of all kinds. He related intimately with the poor, with women, with prostitutes and adulterers, with the blind and the deaf, with the mobility impaired and the mentally ill. Those persons that society chose to reject and despise, Jesus chose to accept and cherish. He pointed out again and again that we are all made in the image of God and are therefore worthy of respect and fair treatment. A theology of disability calls us to see God's image as it lives in every person.

A theology of disability also calls us to see the imperfection in each one of us who asserts her or his membership in the human race. We are all people who are as yet incomplete, people struggling for wholeness. It is not only those who are blind or deaf or mobility impaired that must acknowledge their disabilities.

A theology of disability must also look at the experience of the disabled person as one of the oppressed peoples of the world. Liberation theology has demanded that Christianity look at the world with new ears and new eyes. Through the oppressed peoples of the world, the words of Jesus are taking on new and powerful meanings. Elsa Tamez, a theologian from Central America, reminds us, "The message of the good news is of the liberation of human beings from everything and everyone that keeps them enslaved. That is why the good news brings joy and hope... The good news that speaks of the liberation of the oppressed cannot be pleasing to the oppressors, who want to go on exploiting the poor. But the good news is indeed good to those who want to change and to see a more just society."⁶

It is time to listen as disabled people speak from the vantage point of oppression, to hear liberation theology born in our own North American context. We need to know that the preaching of the good news to the poor, the release of the captives and the recovery of sight to the blind is for us here and now.

"The love of God, which is the root of our dignity, necessarily becomes loving communion with other human beings and fraternal participation. For us today it must become first and foremost a labor of justice on behalf of the oppressed. The fact is that 'one who has no love for the brother (sister) he (she) has not seen cannot love the God he (she) has seen' (I John 4:20)," writes Gustavo Gutierres in the Puebla Conference Document.⁷

We must live that love in our own churches before we can hope to preach it elsewhere. Active participation of disabled persons is one step toward the wholeness and liberation that a theology based on Christ must include. We are all members of the body and only through acceptance and mutual learning can we be made whole.

B.The church's treatment of disabled people

Throughout the past several hundred years the Christian churches have acted as charity givers to the poor and disabled. Not seen as a legitimate part of the active church, disabled persons were made to feel like lesser persons in the areas of capability, class and faith.

For the most part though, disabled persons were not accepted as peers and equals in the church. Often, even in our churches today, disabled people are viewed as not having enough faith to be healed. Thus, they are disabled as a result of their own sin -- God is punishing them. As Mary Jane Owen, a visually impaired woman recalled: "Someone who knows nothing about me except that I use a white cane as a mobility aid will startle me by approaching unexpectedly and hissing in my direction, 'If you truly believe in the Lord, He could make you see before you get to the end of the block.'"⁸

Such advise reflects a position that needs to be relegated to the regrettable past. It is now time for the church to look again to the scriptures and the example that Jesus gave and learn to accept differences between people as potential for richness and harmony, not discord and fear. For example, the Samaritan woman, an outcast in Jewish society, provided an opportunity for Jesus to talk about the living water of the Gospel. The dishonest tax collector, Zaccheus, becomes an opportunity for a celebration feast within the framework of the kingdom.

Mennonite theology places a strong emphasis on community and the importance of discerning truth in that context. However, even with such an emphasis, Mennonites have not done a good job of including disabled people and other minority groups in their number. Not until recently has attention shifted to a concern for including disabled persons in church communities and Mennonite Central Committee (MCC) projects.

In developing countries churches have been even less likely to address themselves to the concerns of disabled people. There are too many other priorities that seem to demand more immediate attention. The nonstatus of disabled people in society is unfortunately reflected in their place or lack thereof in the church.

It is the wish of all people to be accepted as equals in the community of faith and this wish certainly includes persons who have disabilities. It is important for churches of both developing and nondeveloping nations to take this desire seriously.

C.Society's treatment of disabled persons

Throughout history disabled people have been excluded from participating in the mainstream of society. In medieval times, although not accepted as equals, disabled persons had a place within the family. They contributed to the family income through begging and were seen as a part of the family unit. With the coming of the Industrial Revolution and the accompanying redistribution of work, disabled people lost that place.

In the 1800s and early 1900s institutions were erected and disabled people were locked away, far from the public view. In such settings disabled persons were cared for, but shut off from adult roles such as worker, spouse or parent.

It is out of this atmosphere of rejection that change began to happen and a disabled community began to form.

D.Disabled people organize worldwide

After World War II, the role of people with disabilities began to change. Improved medical rehabilitation techniques and improved technical aids, such as the iron lung and electric wheelchair, meant that more and more disabled people survived and were able to live more mobile lives. At the same time disabled veterans from World War II came home and disabled people from polio epidemics in the 1940s and 1950s survived in ever-increasing numbers. Thus there were many more young disabled people wanting to participate in society.⁹

By the 1960s disabled people began to mobilize for better pensions and employment options in Europe. But it was in the wake of anti-Vietnam War protests, the women's movement and black civil rights movement that North American disabled people began to organize for change. While most European disabled people's groups were concerned with pensions, better wheelchairs and mobility aids, North American people wanted their rights recognized.

Disabled people organized into multidisability (all disability) organizations in Canada and the United States during the mid 1970s. In the late 1970s organizations began to spring up in Asia, Africa Latin America and the Caribbean. These groups wanted technical aids, a decent living and full participation in society for disabled persons.

By 1980 there were organizations of disabled people either local or national, multidisability or uni-disability (one-disability group) in over 50 countries. An international coalition of disabled people's organizations was initiated in Winnipeg, Man., in 1980 at the World Congress of Rehabilitation International (RI). RI is an international organization of disability professionals such as doctors, social workers, physiotherapists and nurses. When the organization defeated a resolution from disabled people asking for an equal say in decisionmaking, the 250 disabled professionals in attendance formed a steering committee to forge their own international organization composed entirely of disabled people. A year and a half later in 1981 Disabled Peoples' International (DPI) was formally founded in Singapore. At this meeting 400 disabled people from 51 countries met to adopt a constitution, a statement of philosophy and to elect a 25-member World Council.

Since then the influence of DPI has been felt in over 100 countries with a formal membership of over 70 countries. The organization now has consultative status with the United Nations and carries out an extensive training program in many of the developing countries.

E.United Nations response

In 1981 the United Nations declared the International Year of Disabled Persons. This was the beginning of a new found interest and concern with the situation of disabled people in the world. This interest was further demonstrated with the proclamation of the Decade of Disabled Persons (1983 to 1992) and the development of the World Program of Action Concerning Disabled Persons. The purpose of the World Program of Action, adopted by the United Nations in 1982, 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."¹⁰ With the consultative help of DPI, the United Nations has done a considerable amount to encourage affirmative action in developing countries. The statement's directives are very clear. "Disabled persons and their organizations should be consulted in the further development of the World Program of Action and its implementation. 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."¹¹

Disabled Peoples' International also has consultative status with the World Health Organization (WHO) and the International Labour Organization (ILO). Both these organizations are part of the United Nations family and have a great effect on programs in the developing nations.

F.Medical model vs self-help

The issue of control has been the major problem between professional service providers and disabled people. Disabled people are demanding the right to make the decisions and take the risks that other adults do in our society. Post World War I saw the number of rehabilitation professionals multiply with both positive and negative results. Positively, disabled people were able to live longer and more physically independent lives, but in the process decision-making power was very often taken away from the person being "rehabilitated" and given to the rehabilitator. The result was a view based on the "medical model" that until recently many disabled people fell victim to. This model views the person with the disability as a "sick patient" who must spend their whole lives becoming well. Jim Derksen, a Canadian disabled activist, defines this role:

The medical model assigns the disabled person a destructive varient of the "sick role." This relieves him or her of all responsibilities but regaining his or her health. The "patient" or "sick" disabled person is allowed and even expected to behave in a childlike manner. Like a child, however, he or she must follow orders; in this case the orders of doctors and the agents or proxies of doctors. Full participation in social, sexual, political, economic and other forms of adult behaviors are denied or at the very least discouraged on the part of the "patient."¹²

As the self image of the disabled community began to change, people realized that they were not patients but citizens with rights. This realization began the movement to create their own groups and increase their participation in the community. This movement has been labeled "self-help." The National Council of Disabled Persons of Zimbabwe illustrates this model:

Our role was to act as a voice of the disabled. We were a "civil rights" organization of the disabled formed to conscientize the disabled about their rights and the fight for the right to access all community services. Our role is not one of concern with the provisions of institutional type rehabilitation schemes, but the integration of disabled people in the mainstream of society is our cardinal fight point.¹³

In the last 15 years these organizations have lobbied governmental and non-governmental organizations for greater accessibility to all aspects of society.

This analysis follows the process in most Western nations but is also relevant to what is happening in the developing world. At present the medical model is still seen as ideal in many countries and it is important to recognize the dangers inherent in this mentality. As mentioned earlier, three phases have been identified in the historical treatment of disability. Phase one sees disabled persons as cripples, beggars and objects of sympathy. Phase two views the disabled person as an unproductive, "useless" member of society who must be institutionalized and managed by professionals.¹⁴ Finally, the third stage is characterized by consumer involvement. (In the early 1970s, disabled people defined themselves as consumers of services. The term consumer thus became defined as the participation of disabled people in activities affecting their lives.) Many development agencies believe that developing countries have to go through stage one and two before real consumer involvement can take place. Disabled people do not believe that this is the case and some of the changes that are happening on the international front with organizations such as the ILO, the United Nations and DPI prove that such stages are not evolutionary. If development agencies continue to follow the traditional line of thought, full participation by disabled persons is indeed a long way off.¹⁵

The following section will discuss the status of disabled people, contrasting the situation as it is found in North America with that of the developing world (Africa, Asia, Latin America, the Caribbean and the Middle East).