A conversation with...
Dr. Armando J. Vásquez Barrios
Regional Advisor on Rehabilitation
Pan American Health Organization (PAHO)
(Based in Santiago, Chile)
Mental Health, Rehabilitation and Disabilities:
"We have the capacity to include, respect, and coexist with our differences, which is where the best part of our humanity lies"
Dr. Armando J. Vásquez Barrios
Dr. Armando J. Vásquez Barrios is the Pan American Regional Advisor on Rehabilitation. He is a member of the core team behind the institution's Mental Health, Substance Abuse, and Rehabilitation Unit. In his view, inadequate prevention measures, gaps and serious limitations in the quality of treatment coverage, and centralized responses are determinants of a troubling regional epidemiology on disability that exacerbate the situation. He notes that efforts are needed to keep this situation from worsening.
"In the first two decades of the new millennium, cardiovascular diseases in South America and the Caribbean will cause three times as many deaths and disabilities as infectious diseases will," warned Dr. Vásquez Barrios, PAHO Regional Advisor on Rehabilitation. "Health systems in the Region are not prepared."
Dr. Vásquez said that for people with disabilities, health and well-being will be a reality only through policies, programs and efforts that advocate that right and that ensure its recognition in all social, economic, and cultural initiatives. Paraphrasing a senior United Nations official, Dr. Vásquez said: "We have the capacity to include, respect, and coexist with our differences, which is where the best part of our humanity lies."
Based in Santiago, Chile, Dr. Vásquez explained some of the principal reasons for attitudes towards disabilities that hinder the necessary programmatic actions. He mentioned, for example, that in the view of still too many, disabilities are still considered a minor problem, one that indeed continues to be approached from a charity perspective.
Searching for long-term solutions
Dr. Vásquez explained that PAHO is working closely with Member States governments in the Region and with other partners to find long-term solutions to our people's health problems, especially those of the most neglected and vulnerable sectors.
"Cardiovascular diseases in South America and the Caribbean will cause three times as many deaths and disabilities as infectious diseases will."
"Addressing disabilities and providing integrated responses to the needs of people with disabilities are based on respecting and promoting human rights and are part of the Organization's strategic lines of action," he said.
"PAHO/WHO recognizes and promotes the health and well-being of all people as a fundamental human right, irrespective of their functional status. PAHO/WHO also recognizes that people with disabilities are entitled to enjoy the same privileges and rights as other citizens and to have equal access to economic and social resources and to the legal protection to exercise these rights. Steps to promote equal opportunity, along with the principle of nondiscrimination, would allow for the integration of people with disabilities into society so that they can fully enjoy the rights and privileges available to all other citizens."
PAHO, he said, has helped consolidate the rehabilitation component into the health care model. "The community-based rehabilitation (CBR) strategy is an effort to tackle the new challenges and changes resulting from the gap between the needs of people with disabilities and their access to health care."
The Regional Advisor listed some of the actions covered by these efforts:
- formulating and developing rehabilitation policies and programs
- promoting technical cooperation among countries
- describing and analyzing the situation of people with disabilities
- implementing the CBR
- implementing special projects (assistance to Central American landmine victims)
- developing the CBR in indigenous and areas surrounding major urban centers
- promoting socioeconomic inclusion and integration
- promoting school integration and inclusive education
- promoting and creating national rehabilitation councils
- developing protocols and standards in disability prevention and rehabilitation
- strengthening rehabilitation services
- engaging in joint efforts with local authorities to establish access programs and eliminate architectural barriers
- strengthening human resources education
- strengthening orthotic and prosthetic services
- supporting the monitoring of the United Nations Standard Rules for the Equalization of Opportunities for Persons with Disabilities
For people with disabilities, health and well-being will be a reality only through policies, programs and efforts that advocate that right and that ensure its recognition in all social, economic, and cultural initiatives.
"These PAHO efforts have crystallized with the adoption of Resolution CD47.R1, Disability: Prevention and Rehabilitation in the Context of the Right to the Enjoyment of the Highest Attainable Standard of Health and Other Related Rights."
How to bridge the gaps?
A fundamental requirement for formulating suitable policies and programs is an awareness of the true magnitude of the problem, Vásquez said. Every country, he explained, must know the epidemiological behavior of disabilities and their prevalence. Countries must record data continuously to allow for adequate surveillance and decision-making. This will make possible to promote actions that truly address the problem.
"Undoubtedly, efforts already under way or projected to improve the quality of life of persons with disabilities and promote equal opportunity for them go beyond the role of the health sector. Inter-sectoral actions and interventions must be coordinated. And above all, the participation of people with disabilities, their families, and communities must be ensured: rehabilitation is a shared social responsibility."