On some recent occasions, the prime minister has suggested use of the word divyanga, instead of vikalanga, for individuals with disabilities. Any change in nomenclature is for disability division (social justice & empowerment ministry) to work out, after consultations. However, underlying that nomenclature change, there is a definition and mind-set issue. Globally, 15% of the population faces some form of disability and there is a United Nations Convention on the Rights of Persons with Disabilities (CRPD). (India signed this in 2007.) Since 1995, we also have a piece of legislation called Persons with Disabilities (Equal Opportunities, Protection of Rights and Full Participation) Act. What’s the percentage of disabled population in India? Census 2011 tells us percentage of disabled population is 2.21%, 2.41% of male population and 2.01% of female population. There are higher (more than 2.5%) levels of disability in states like Jammu & Kashmir, Sikkim, Maharashtra, Andhra Pradesh, Odisha and Sikkim. But even in those states, percentage is less than 3%. Logically, India can’t be that much of an outlier. This means we are under-estimating disability. We aren’t defining and capturing it adequately. On Censuses, part of the story is the following. From 1872 to 1931, all Censuses asked a question on disability. No such question was asked between 1941 and 1971. A question was asked in 1981, dropped again in 1991. Questions were again asked in 2001 and 2011.
Comparability across 2001 and 2011 becomes difficult because definition of disability wasn’t identical. While 2001 asked a question about five types of disability, 2011 extended it to eight, to capture “disability” better. Under Disability Act, disability is defined as (a) blindness; (b) low vision; (c) leprosy-cured; (d) hearing impairment; (e) loco-motor disability; (f) mental retardation; and (g) mental illness. Let me give a few examples to illustrate definitional changes. What happens if you have problems with only one eye or only one ear? You were disabled in 2001, not in 2011. What happens if you have a hearing aid? You weren’t disabled in 2001, but are in 2011. More specifically, the eight types of disability in 2011 are in (1) seeing, (2) hearing, (3) speech, (4) movement, (5) mental retardation (new category in 2011), (6) mental illness (new category in 2011), (7) any other, and (8) multiple disability (new category in 2011). The numbers I cited earlier are based on this—26.8 million disabled people, 18.6 million in rural India and 8.2 million in urban India. Within that, most people are disabled under heads of seeing, hearing, movement and “any other”. Not surprisingly, disability is a function of age, with a sharp increase after 60 years.
We are undoubtedly measuring it better, but we are still not measuring it properly. One reason is obvious, discussed in literature. We still approach disability from a medical or pathological angle, focusing on a condition regarded as “abnormal”. In contrast, in most developed countries, focus has shifted to a social approach, highlighting institutional and social arrangements preventing those with impairments from leading normal lives. Consider the Disability Act. To be classified as “disabled”, you need a medical certificate, specifying the extent of disability. To become “disabled”, your functioning must be 40% or less than whatever is regarded as “normal”. Take a look at the Railway Concession Rules for disabled passengers to see how complicated we have made it. NSSO (National Sample Survey Organization) has also occasionally done surveys on disability. Since those are surveys, not Censuses, let us ignore those, though one should mention that NSS figures on disability are much higher, three to four times more. In the course of the 11th Plan (2007-12), the former Planning Commission suggested the disability figure was 5-6% of total population. As life expectancy increases, because of correlation with age, disability will also increase.
On Censuses, no matter how good the training and irrespective of how many kinds of disability are covered, do you seriously expect enumerators to be able to measure or capture disability? That’s unlikely. That’s precisely the reason I used the expression “question was asked”. Census essentially functions on the basis of self-reporting of disability and sometimes, the question isn’t even asked. In all probability, gap between true disability and measured disability is more for mental disability than for physical disability. We shouldn’t wait for Census 2021 to improve matters.
That’s the reason I wished to flag Kerala’s Disability Census of 2014-15, started under the Social Security Mission, the first state to have such a Census. This covers 22 kinds of disability—in movement, muscular dystrophy, chronic neurological disorders, multiple-sclerosis, hunched backs, dwarfism, blindness, seriously impeded vision, in learning, in speech, mental retardation, mental illness, autism, deafness, leprosy free persons, haemophilia, thalassemia, sickle-cell anaemia, cerebral palsy, epilepsy, deafness and blindness and multiple-disabilities. Sure, this covers many more kinds of disability, but I am still sceptical. As far as I know, the Census Report is still in draft form. However, broadly, this is the Kerala story—2.2% of the population is disabled, 11% of households have disabled individuals. Above 60, 12% of the population is disabled. These numbers may well be right and my only reason for scepticism is the low overall figure of 2.2%. For Kerala, Census 2011 gave us a disabled population of 761,843. Kerala Census 2014-15 gives us a figure of 791,998. Since the years are different, I am not convinced that the Kerala Census, laudable though the effort is, has corrected under-estimation sufficiently.
The author is member NITI Aayog. Views are personal