Abstract
BackgroundWhile it is widely assumed that disability, poverty and health are closely linked, research falls short of fully understanding the link. One approach to analysing the links between disability and poverty is through the concept of structural violence, referring to social structures that contribute to the impoverishment of individuals or communities. These structures can be political, ecological, legal and economic, among others.ObjectiveTo explore structural violence and how it affects families of children with cerebral palsy among the Tonga ethnic group living in poor rural communities of Binga in Zimbabwe.MethodThis is a longitudinal, qualitative and ethnographic study. Data were collected over a period of eight years from 2005 to 2013. Data collection techniques were in-depth interviews, participant observation and focus group discussions. Purposive sampling was used to recruit 53 informants.ResultsStructural violence was noted through four themes: internal displacement and development, food and politics, water and sanitation, and social services. Poverty was noted in the form of unemployment, lack of education, healthcare, food and shelter. The concept of structural violence inflicted social suffering on the informants. Politics played a major role in activities such as food withdrawal, lack of water, development and allocation of local resources to ‘the people of the city’, leaving the informants struggling with care.ConclusionPolitical and economic forces have structured risks and created a situation of extreme human suffering. The capabilities approach brings out the challenges associated with cerebral palsy in the context of development challenges.
Highlights
The concomitant relationship between poverty and disability is well established in the literature (Ansell 2005; Emmett & Alant 2006; Palmer 2011; Rousso 2003), and we are beginning to understand the complexities of the relationship
What people can positively achieve is influenced by economic opportunities, political liberties, social powers, and the enabling conditions of good health, basic education, and the encouragement and cultivation of initiatives
Displacement resulted in loss of cultural identity when materials of cultural values and shrines were left behind, loss of livelihoods as well as unprotected settlements that exposed them to wild animal attacks
Summary
The concomitant relationship between poverty and disability is well established in the literature (Ansell 2005; Emmett & Alant 2006; Palmer 2011; Rousso 2003), and we are beginning to understand the complexities of the relationship. Ensuring access to appropriate support, such as early childhood intervention and education, can fulfil the rights of children with disabilities, promoting rich and fulfilling childhoods and preparing them for full and meaningful participation in adulthood (Simeonsson 2000). Barriers such as inadequate services and lack of accessible environments create more problems for children with disabilities and their parents. If children with developmental delays or disabilities and their families are not provided with timely and appropriate early intervention, support and protection, their difficulties can become more severe – often leading to lifetime consequences, increased poverty and profound exclusion (United Nations Fund, World Health Organization & The World Bank 2012)
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