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Disability-inclusive healthcare in humanitarian camps: Pushing the boundaries of disability studies and global health

MIRZA, Mansha
2015

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A significant proportion of forced migrants live in humanitarian camps located in remote regions of the global South. Disabled persons have been historically neglected within camp programs across all service sectors, especially healthcare. This paper describes an exploratory research study on healthcare access for forced migrants with disabilities in the context of humanitarian camps. Based on the methodological framework of rapid ethnography, the research involved guided tours, community mapping exercises, ethnographic observations, and semi-structured interviews in a refugee camp in southern Africa. Additional key informants from other sites were interviewed remotely using a convenience sampling strategy. Several important insights emerged from the research including: misperceptions about the health-related needs of disabled persons, their specialized health needs falling outside the ‘social minimum’ of humanitarian healthcare, and concerns about distributional ethics in relation to disability-inclusive healthcare. The research also highlighted barriers and strategies for addressing disability-specific health needs given significant resource constraints in humanitarian camps. These findings are discussed in light of practical and theoretical challenges in the fields of disability studies and global health.

 

Disability and the Global South (DGS), 2015, Vol. 2 No. 1

Beneath the rhetoric: Policy to reduce the mental health treatment gap in Africa

COOPER, Sara
2015

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In this paper I problematize knowledge on reducing the ‘gap’ in treatment produced by 14 national mental health policies in Africa. To contextualize this analysis, I begin with a historic-political account of the emergence of the notion of primary health care and its entanglement within decolonization forces of the 1960s. I unpack how and why this concept was subsequently atrophied, being stripped of its more revolutionary sentiments from the 1980s. Against this backdrop, I show how, although the 14 national mental health policies are saturated with the rhetoric of primary health care and associated concepts of community participation and ownership, in practice they tend to marginalize local meaning-systems and endorse a top-down framework heavily informed by colonial medicine. The policies thus end up reproducing many of the very Eurocentric assumptions that the original primary health care notion sought to transcend. More specifically, the paradigms of evidence-based research/practice and individualised human rights become the gatekeepers of knowledge. These two paradigms, which are deeply embedded within contemporary global mental health discourse, are legislating what are legitimate forms of knowing, and by extension, valid forms of care. I argue that a greater appreciation of the primary health care concept, in its earliest formulation, offers a potentially fruitful terrain of engagement for developing more contextually-embedded and epistemologically appropriate mental health policies in Africa. This in turn might help reduce the current ‘gap’ in mental health care treatment so many countries on the continent face.

 

Disability and the Global South (DGS), 2015, Vol. 2 No. 3

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