Is Mild Episodic Chronic Illness a Disability? A Reflexive Exploration in a Middle Income Country

Abstract

International policies differ on how milder and episodic phases of chronic illnesses such as multiple sclerosis are managed as a disability in employment contexts. We contend that the answer to the title questions depends on how the starting point of a disability is conceptualized, and how the subsequent trajectory of illness experiences and outcomes are managed in the lived structural context. Situating discussions at the interface of management and global health scholarship, we use policy analysis, personal reflections and narratives from ten working individuals with MS in Malaysia to deliberate on the ‘disabling’ work effects of mild and episodic chronic illness. The participants narrate affecting work experiences- ‘participation restrictions and barriers to autonomy and choice’ that commence at diagnosis- prior to a ‘permanent impairment. Themes from their discussions illustrate a trajectory of accumulated constraints, which include the negotiation of limiting and non-limiting symptoms on work compete...