About the Author

Bupinder Zutshi, Ph. D., Center for the Study of Regional Development, Jawaharlal Nehru University, New Delhi, India. Email: bzutshi@vsnl.com, Phone: 011-31067803 Currently teaching at Centre for the Study of Regional Development, Jawaharlal. Nehru University, New Delhi, has more than 25 years of teaching experience at post-graduate and research level. Has taught at Utkal University, Kashmir University and Jawaharlal Nehru University. His fields of interest include population studies, child labour, child education, gender studies and regional development. Has published four books and several research articles in journals of repute. Has completed several research and field action oriented projects on child education, child labour, Non-formal education, gender studies and disabled population. These projects were sponsored by the UNESCO (New Delhi), UNESCO:IBE (Geneva), United Nations High Commissioner for Human Rights (Geneva), International Labour Organization (New Delhi), the National Human Rights Commission of India, the Policy Science Center, Inc., funded by the Learning and Research Program on Culture and Poverty of the World Bank, the Ford Foundation and the Indian Council of Social Science Research.

Research Associate:
P.K.Prasad
Aruna Rai

Research Assistants:
P.P. Tripathi,
A.K. Kapoor

Computer Assistance:
Satyendra Kumar
Anish Kapoor

Cartographic Assistance:
Puspahas Panigrahi

Abbreviations and Acronyms

Acknowledgements

I wish to put on record my gratitude to the Ford Foundation of India, New Delhi for having given me an opportunity to conduct the research study on the DISABILITY STATUS IN INDIA- A CASE STUDY OF DELHI METROPLOLITAN REGION

My deeep appreciation and sincere acknowledgements go to Professor K. Warikoo and Dr. Sharad. K. Soni from Himalayan Research and Cultural Foundation, New Delhi and Dr. Deepa Nag Haksar, Secretary, DIVA-India for providing all possible academic and administrative support and guidance in solving many financial and administrative problems from time to time.

I am deeply indebted to the Project Coordinators of Project - Applied Ethics Institute of India, Governing Body members of the Himalayan Research and Cultural Foundation and DIVA- India for making the necessary arrangements to carry out the research work. All members have been extremely cooperative, accommodative, and non-interfering throughout the period of study.

I am also grateful to members of Initiative for Social Change and Action, particularly to Professor C.J. Daswani, Professor Z. M. Shahid Siddiqui, Professor Tillottama Daswani, and Ms. Mariam Karim for their stimulating academic thoughts on disability sector in India. Dr. Mondira Dutta deserves a special thanks for being supportive at all stages including the organizing of the seminar and particularly drafting the proceedings of the seminar on Services for differently Abled Persons in India.

I am grateful to Justice Rajinder Sachhar (Ex-Chief Justice of Delhi High Court), Mr. Javed Abidi, Director, National Centre for Promotion of Employment for Disabled People (NCPEDP), staff and officials from Institute for Physically Handicapped and Vocational Rehabilitation Centre for Disabilities in Delhi and representatives from Civil Society Organizations like National Association for the Blind (New Delhi), Amar Jyoti, Hemophilia Federation, Institute of Public Opinion, Institute of Research and Action Planning, Awaaz Special School, DLDAV, Association of Kashmiri Samiti, Indian Social Institute, Manzil Welfare Society, SAI Pragya Institute, ADDI (Spastic Society of India), Delhi Brotherhood Society, Sadhu Vaswani School, Family of Disabled, SPANDAN, Blue Bell School, Delhi Association of Deaf, TWMR Special Institute, DOON Research and Rehabilitation Centre for Handicapped, Child Guidance Centre, ADHAAR, VIDYA, Spastic Society (Delhi) and Mass media, All India Radio and other print media for attending one day seminar organised by the AEII at India International Centre, New Delhi on 21st June 2003. .

I am grateful for the unrestrained support and cooperation showered upon my research team by the office staff of Rehabilitation Council of India, New Delhi, Ministry of Social Justice and Empowerment, Government of India, Department of Social Welfare, Government of NCT of Delhi, Office of the Chief Commissioner for persons with disability and NGOs associated with the services for disability sector in Delhi. I am thankful to the differently abled and challenged persons seeking services and support from different NGOs for enriching our knowledge about disability challenges and prospects during the course of our interviews with them. Their support and cooperation was valuable to prepare the report.

I am thankful to my entire team who has tried hard to help me complete this study. Special mention needs to be made about Mr. P.K.Prasad, Aruna Rai, Sumit Arora, Ashok Kapoor, Praveen Kumar Choudhari, Anish Kapoor, Puspahas, P.P. Tripathi and other office staff of AEII, who spent months together in the field supervising the survey work.

Last but not the least my sincere thanks go to my children Aneesh and Ipshita for constant help, support and inspiration and helping me in designing the lay out of the presentation of this report.

Dr. Bupinder Zutshi

List of Contents

List of Tables

List of Figures and Diagrams

List of Maps

Preface

The present study examines the conceptual and theoretical aspects of disability sector in India with a special focus on magnitude, prevalence rates, incidence rates, characteristics and composition of disabled person in India. Special focus has been given to identify available services and facilities for disabled persons through government and non-government organizations with special reference to Delhi Metropolitan region. The report has been divided into six parts excluding the executive summary, which presents main conclusions of the report for each part and also presents major recommendation of the report. The lay out of the report is substantiated with the help of tables, maps, figures and diagrams for easy visual understanding.

Part-I examines the definitional and conceptual aspects of disability. It identifies various disability type groups based on specific physical, sensory and learning characteristics. It also attempts to trace and analyses international initiatives undertaken for the welfare of disability sector during last 50 years. The last section of this part examines national initiatives through legislation and other affirmative actions and initiatives to focus disability agenda for pro-active measures.

Part-II has been divided into seven sections. Each section examines magnitude, composition and characteristics of different types of disability / impairments. The disabilities/ impairments covered are all disabled, locomotor impaired, hearing impaired, vision impaired, speech impaired and mentally impaired. It examines the NSSO data collected for the disabled person through a sample surveys during 47th and 58th round in 1991 and 2002 respectively. The analysis includes state wise, gender wise and rural/ urban distribution of disabled persons depicting their magnitude, prevalence rates, incidence rate, degree of impairment, causes for impairment and a in depth analysis of demographic, social and economic characteristics of the disabled persons

Part-III has been divided into three sections. It examines government services for the disabled persons in terms of developing national and regional institutes to support and create conducive environment for equal opportunities for disabled persons. Part-III also examines services and facilities provided by these national and regional institutes to disabled persons in India. The budget allocations for the disability sector welfare have also been presented in this section. Last section examines the concessions and other benefits provided to disabled persons for creating equal opportunities for their integration. It also analyses the status of implementation of the PWD-Act 1995 provisions in the states in India and by the central government.

Part-IV examines services and other facilities available for disabled person in the Delhi Metropolitan region. The analysis has been attempted both though primary and secondary sources of information. A details field survey was conducted in Delhi selecting 83 NGOs and voluntary organizations and 63 beneficiaries. The respondents included NGOs, Government organization personnel as well as disabled/-impaired persons seeking support from these organizations. Detailed analysis of the existing services as well as required services has been attempted on the basis of the field survey. Last section of the part documents the 'Good Practice- Initiatives' of NGOs and government organizations providing support to disabled persons in Delhi region.

Part-V of the report presents the broad conclusions and recommendations of the report. The recommendations are suggested based on the field survey data analysis, discussions with target groups and stakeholders and from the deliberations of the seminar organised in Delhi, where a large number of NGOs, government officials, target groups and other stakeholders were present.

A detailed list of references, literature reviewed and bibliography scanned for the study purpose is given in Part-VI of the report. These references, disability data and bibliography has been identified in libraries visited in Delhi, web search engines through internet and material collected from government departments and NGOs offices located in Delhi.

Last Part of the report documents annexes detailing NGOs working for Disability welfare in Delhi, NGOs and beneficiaries selected for a detailed field survey, field questionnaires used for the survey and a report on the seminar entitled " Services for Differently Abled Persons in India". The seminar was organised as a part of the research report to provide insights about disability sector in India through wider participation from stakeholders and target groups.

Defining Disability:

Defining disability is difficult to accommodate the expectations of all disabled groups. There are hundreds of different disabilities and there are, as many causes for these disabilities. Some people are born with disabilities; others become disabled later on in their lives. Some disabilities exhibit themselves only periodically like fits and seizures; others are constant conditions and are life-long. The severity of some stays the same, while others get progressively worse like muscular dystrophy and cystic fibrosis. Some are hidden and not obvious like epilepsy or haemophilia (impairment of blood clotting mechanism). Some disabilities can be controlled and cured while others still baffle the experts. Thus, finding a consensus on the different and frequently varying definitions of disabilities, whether sophisticated or practical, has never been easy. Some include total or partial impairment of senses and physical and intellectual capacities while defining disability. Others refer to a handicap or deviation of a social nature, injury or illness or incapacities to accomplish physiological functions or to obtain or keep employment. These definitions also reflect the consequences for the individual - cultural, social, economic and environmental- that stem from the disability.

Helander¹: Helander gave the simplest and may be the initial definition of a disabled person. "A person who in his/her society is regarded as disabled, because of a difference in appearances and/or behaviour." In most instances, a disabled person has functional limitations and/or activity restrictions. A 'functional limitation' disability may be defined as 'specific reductions in bodily functions that are described at the level of the person'. While 'Activity restriction' disability may be defined as 'specific reductions in daily activities that are described at the level of the person'.

American Disability Act 1990 (ADA)

ADA defines individuals with a physical or mental impairment that substantially limits at least one major life activity, individuals with a history of such impairment, and people who are regarded by others or perceived as having such impairment. This definition protect people with epilepsy, diabetes, mental health conditions, amputees, and others who are able to mitigate the effects of their impairments but nonetheless encounter discrimination in the workplace and other settings because of fears, myths and stereotypes of individual employers and other covered entities. ADA has categorised disability physical and mental disability groups:

Physical disability: It includes . . . "Having any physiological disease, disorder, condition, cosmetic disfigurement, or anatomical loss that . . . affects one or more of the following body systems: neurological, immunological, musculo-skeletal, special sense organs, respiratory, including speech organs, cardiovascular, reproductive, digestive, genitourinary, hemic and lymphatic, skin, and endocrine [and] limits a major life activity . . .. Having a record or history of a disease, disorder, condition, cosmetic disfigurement, anatomical loss, or health impairment . . . which the employer knows . . .. Being regarded or treated . . . as having, or having had, any physical condition that makes achievement of a major life activity difficult. Being regarded or treated . . . as having, or having had, a disease, disorder, condition, cosmetic disfigurement, anatomical loss, or health impairment that has no present disabling effect but may become a physical disability"³.

Mental disability: It includes . . . "Having any mental or psychological disorder or condition, such as mental retardation, organic brain syndrome, emotional or mental illness, or specific learning disabilities, that limits a major life activity . . . . Having a record or history of a mental or psychological disorder or condition . . . which is known to the employer . . .. Being regarded or treated by the employer or other entity covered by this part as having, or having had, any mental condition that makes achievement of a major life activity difficult. Being regarded or treated . . . as having, or having had, a mental or psychological disorder or condition that has no present disabling effect, but that may become a mental disability . . ."⁴

Australia Disability Discrimination Act, (ADDA) 1972

Disability in relation to a person, means

1. Total or partial loss of the person's bodily or mental functions; or
2. Total or partial loss of a part of the body; or
3. The presence in the body of organisms capable of causing disease or illness; or
4. The presence in the body of organisms causing disease or illness; or
5. The malfunction, malformation or disfigurement of a part of the person's body; or
6. A disorder or malfunction that results in the person learning differently from a person without the disorder or malfunction; or
7. A disorder, illness or disease that affects a person's thought processes, perception of reality, emotions or judgment or that results in disturbed behaviour and includes a disability that:
   1. Presently exists; or
   2. Previously existed but no longer exists; or
   3. May exist in the future; or
   4. Is imputed to a to a person.

British Disability Discrimination Act (BDDA), 1995

Disability is a physical or mental impairment, which has a substantial and long-term adverse effect on his ability to carry out normal day-to-day activities. In order to apply durability test, the British Act uses three different terms: loss of faculty, disability and disablement. These are meant to be separate concepts.

Loss of Faculty-

Loss of faculty is any pathological condition or any loss or reduction of normal physical or mental functions of an organ or part of the body. A loss of faculty in itself may not be a disability but is an actual cause of one or more disabilities, e.g., the loss of one kidney.

Disability-

A 'disability' means an inability to perform a normal bodily or mental process. It could either be complete inability to do something (such as walking) or it can be partial inability to do something (such as one can lift weights but not heavy ones).

Disablement-

It is the sum total of all the separate disabilities an individual may suffer from. It means an overall inability to perform the normal activities of life and the loss of health, strength and power to enjoy a normal life. While assessing an individual his/her physical and mental condition, inconvenience, genuine embarrassment or anxieties are taken into account.

India: Persons with Disabilities Act 1995 (PWD-Equal opportunities, Protection of Rights and Full Participation)

Disability is defined a person suffering from not less than forty per cent of any disability as certified by a medical authority. The disabilities identified are; blindness, low vision, cerebral palsy, leprosy, leprosy cured, hearing impairment, locomotor disability, mental illness and mental retardation as well as multiple disabilities.

The National Sample Survey Organization (NSSO), India:

The NSSO that conducted survey of persons with disabilities in 1981, 1991 and 2002 in India, considered disability as " Any restriction or lack of abilities to perform an activity in the manner or within the range considered normal for human being". It excludes illness /injury of recent origin (morbidity) resulting into temporary loss of ability to see, hears, speak or move.

International Labour Organization (ILO):

The ILO in its Vocational Rehabilitation and Employment (Disabled Persons) Convention defines a disabled person as an individual whose prospects of securing, retaining and advancing a suitable employment are substantially reduced as a result of duly recognised physical or mental impairment. The Declaration on the Rights of Disabled Persons, the term " Disabled Person" means, " Any person unable to ensure by himself or herself, wholly or partly, the necessities of a normal individual and / or social life as a result of deficiency, either congenital or not, in his or her physical or mental capabilities".

United Nations: Standard rules on the Equalisation of Opportunities for Persons with Disabilities, 1994

'Disability' summarizes a great number of different functional limitations occurring in any population in any country of the world. People may be disabled by physical, intellectual or sensory impairment, medical conditions or mental illness.

The term 'handicap' means the loss or limitation of opportunities to take part in the life of the community on an equal level with others. It describes the encounter between the persons with a disability and the environment. The purpose of this term is to emphasize the focus on the shortcomings in the environment and in many organised activities in society, e.g., information, communication and education, which prevent persons with disabilities from participating on equal terms.

World Health Organization (WHO): International Classification of Impairments, Disabilities and Handicaps (ICIDH) in 1980.

The ICIDH provides a conceptual framework for disability with three parts:

Impairment is "any loss or abnormality of psychological, physiological, or anatomical structure or function". Impairments are disturbances at the level of the organ, which includes defects in or loss of a limb, organ or other body structure, as well as defects in or loss of a mental function. Examples of impairments include blindness, deafness, loss of sight in an eye, paralysis of a limb, amputation of a limb; mental retardation, partial sight, loss of speech, mutism, cerebral palsy and learning difficulties.

Disability is a "restriction or lack (resulting from an impairment) of ability to perform an activity in the manner or within the range considered normal for a human being". It describes a functional limitation or activity restriction caused by impairment. Disabilities are descriptions of disturbances in function at the level of the person. Examples of disabilities include difficulty in seeing, speaking or hearing; learning, difficulty in moving or climbing stairs; difficulty in grasping, reaching, bathing, eating, and toileting etc;

Handicap is a "disadvantage for a given individual, resulting from an impairment or disability, that limits or prevents the fulfillment of a role that is normal (depending on age, sex and social and cultural factors) for that individual". The term is also a classification of "circumstances in which disabled people are likely to find themselves". Handicap describes the social and economic roles of impaired or disabled persons that place them at a disadvantage compared to other persons. These disadvantages are brought about through the interaction of the person with specific environments and cultures. Examples of handicaps include being bedridden or confined to home; being unable to use public transport; being socially isolated, being forced to remain illiterate.

World Health Organization: International Classification of Impairments, Disabilities and Handicaps (ICIDH) in 2001.

The document, referred to as the ICIDH-2, is officially titled the "International Classification of Functioning and Disability," or ICF . Under this new system, the three concepts of impairment, disability and handicap have been replaced by two concepts -

"Body functions and structures" (replacing "impairment"); and "Activities and participation" (replacing "handicap") - which are thoughts to extend the prior categories to permit the description of positive as well as negative experiences. The prior concept of "disability," or "functional" abilities or inabilities, is now conceived of as an umbrella concept applicable to either the body perspective, or to the individual and society perspective. The new system explicitly contemplates an assessment of "environmental factors," including the physical environment, the social environment and the impact of attitudes, and of "personal factors," which correspond to the personality and characteristic attributes of an individual.

Disability types:

Disabled people do not form a homogenous group. They may be, the physically disabled, mentally retarded, the visually, hearing and speech impaired, those with restricted mobility or with so-called "medical disabilities" and learning disabilities. They can broadly be classified as Physical and Communication, Mental, Learning and Medical disabilities.

1. Physical and Communication Disabilities:

   Physical and Communication disabilities involve either loss of vision, physical movement, communication skills or a weakness or change in normal motor control. Some physical disabilities are present at birth (congenital) or are acquired due to illness, accident, or unknown causes. Loss of vision leads to complete blindness or low vision, loss of movement is often caused by spinal cord injury (damage to the nervous system) or by physical trauma such as severe fracture, burns or the amputation of a limb. One of the most common physical disabilities in young people is, cerebral palsy (CP). It produces disturbances of voluntary motor control ranging from clumsy and awkward movements to little or no coordinated movement. Individuals with CP can have related speech problems, as well as impaired hearing or vision. Other conditions such as muscular dystrophy, multiple sclerosis and amyotrophic lateral sclerosis, produce similar types of changes in physical functioning.

   1. Visual impairment (VI):
      Blindness: 'Blindness' refers to a condition where a person suffers from any of the following conditions, namely -total absence of sight; or visual acuity not exceeding 6/60 or 20/200 (snellen) in the better eye with correcting lenses; or limitation of the field of vision subtending an angle of 20 degrees or worse.

      Person with low vision - A person with impairment of visual functioning even after treatment or standard refractive correction but who uses or is potentially capable of using vision for the planning or execution of a task with appropriate assistive device.

   2. Hearing Impairment (HI)
      Whose sense of hearing is non-functional for ordinary purposes in life? They do not hear/understand sound at all, even with amplified speech. The cases included in this category will be those having hearing loss of more than 60 decibels in the better ear (profound impairment) in the conversational range of frequency or total loss of hearing in both ears.

   3. Locomotor Impairment (LC).
      Locomotor impairment is disability of the bones, joint or muscles leading to substantial restriction of the movement of the limbs or a usual form of cerebral palsy and autism. Some common conditions giving raise to locomotor disability could be poliomyelitis, cerebral palsy, autism, amputation, injuries of spine, head, soft tissues, fractures, muscular dystrophies etc.
      
      
      • Orthopedic disability: A person inability to execute distinctive activities associated with moving both himself and objects, from place to place, and such inability resulting from affliction of either bones, joints, muscles or nerves. It could be poliomyelitis, amputation, injuries of spine, head, soft tissues, fractures, muscular dystrophies etc.
      • Cerebral Palsy: A condition of Motor dysfunction of a person resulting from brain insult or injuries occurring in the pre-natal, peri- natal or infant period of development that affect movement control. The injury may be a brain infection (bacterial meningitis, viral encephalitis) or head injury before birth or following an accident.
      • Erb's palsy, Brachial Plexus Palsy, or Shoulder Dystocia: A condition when excessive lateral traction is applied to the fetal neck region during delivery. This can cause the Childs nerves to be torn, resulting in a limp arm. Tearing of these nerves can cause permanent paralysis of the arm.
      • Autism: Autism is a complex developmental disability that typically appears during the first three years of life. It is the result of a neurological disorder that affects the functioning of the brain. It is a developmental disability typically affecting the processing, integrating, and organizing of information that significantly impacts communication, social interaction, functional skills, and educational performance.

   4. Leprosy or 'Leprosy cured person' means any person who has been cured of leprosy but is suffering from -
      • Loss of sensation in hands or feet as well as loss of sensation and paresis in the eye and eye-lid but with no manifest deformity;
      • Manifest deformity and paresis but having sufficient mobility in their hands and feet to enable them to engage in normal economic activity;
      • Extreme physical deformity as well as advanced age that prevent him from undertaking any gainful occupation, and the expression 'leprosy cured' shall be construed accordingly.

2. Mental, psychological illness and Mental Retardation:
   
   
   1. Mental, psychological Illnesses: These encompass Schizophrenia, anxiety disorders and depressive disorders. Schizophrenia is a highly complex disorder, which is caused due to a series of chemical changes in the brain. It usually occurs between the age groups of 15-25 years and is characterized by fragmented thoughts followed by an inability to process information. The condition affects the individual's family, professional and social life making him incapable of functioning normally. Surprisingly their intelligence is not affected and many of them are capable of leading partially normal life if they follow their regular pattern of medication and rehabilitation programmes such as those offered by half-way-homes.
   2. Mental Retardation: The definition includes 'any person who is unable to ensure himself/herself, wholly or partly, the necessities of a normal individual or social life including work, as a result of deficiency in his/her physical or mental capability'. A condition characterized by abnormal brain development in the womb not corresponding with normal physical growth. Their learning ability, reasoning power and judgment all develop at a slower pace. Accidents, poisoning, or illness after birth can be a cause for mental retardation. Many of the mentally retarded people are able to participate in activities with non-disabled people given an appropriate adaptation and support. Others may require a long-term structured programme. With adequate training and education such persons can be more self-reliant citizens. They can be found holding non-skilled or semi skilled jobs and can be made to effectively integrated into the social structure. Mental retardation is divisible into the following four categories.
      
      1. Mild retardation IQ - 50 - 70
      2. Moderate retardation IQ - 35 - 49
      3. Severe retardation IQ - 20 - 34
      4. Profound retardation IQ under 20
         
3. Learning Disabilities:

   It is a disorder, which affects the basic psychological processes of understanding or using written or spoken language. This disorder affects development of language, speech, reading and associated communication skills needed for social interaction. These children have deviant activity level, average or above average intelligence with perceptual disorders, problems in reading, writing, spelling & arithmetic, delayed or slow development of speech articulation, short attention span, frequent changes in mood, low self esteem, low or below average social competence, impulsive, problems in motor activities and spatial organization, poor temporal concepts, passive, lacking strategies for tackling academic problems, having inadequate grasp of what strategies are available for problem solving and do not believe in their abilities.

   Conditions such as brain injury, minimal brain dysfunction, dyslexia, and developmental aphasia are examples of learning disabilities.

   • Dyslexia: Affect persons ability to acquire, process, and/or use either, spoken, read, written or nonverbal information (organization/planning, functional literacy skills, memory, reasoning, problem solving, perceptual skills) or in other words in short- difficulty with language in its various uses (not always reading).
   • Dysgraphia: Difficulty with the act of writing both in the technical as well as the expressive sense. There may also be difficulty with spelling.
   • Dyscalculia: Difficulty with calculations
   • Attention Deficit and Hyperactivity Disorder (ADHD)
     
4. Multiple Disabilities:

   A combination of two or more disabilities as defined in clause (i) of section 2 of the Person with disabilities (Equal Opportunities, Protection of Rights and Full Participation) Act 1995 namely Blindness/low vision Speech and Hearing impairment Locomotor disability including leprosy cured Mental retardation and Mental illness.
   
   

5. Medical Disaisabilities (MD):

   A medical disability can be defined as a condition that requires intervention such as medical treatment, prescription drugs, and/or accommodation to help a person participate in life's activities. Medical disabilities may be acute or chronic, visible or invisible, and the type of support needed is diverse. The chronic health problems include fibromyalgia, chronic fatigue syndrome, arthritis, kidney disease, allergies, cardiovascular problems, cancer, diabetes, and HIV infections, as well as respiratory and gastro-intestinal disorders. Recognizing medical conditions may be difficult because many are "hidden". The primary diagnosis may be accompanied by secondary impairments in mobility, vision, hearing, speech, or coordination depending on the nature and/or progression of the condition. Medical disabilities can be classified into:

   Autoimmune Illness: It includes fibromyalgia, chronic fatigue syndrome, rheumatoid arthritis, asthma and lupus. A lowered immunity can result in frequent illnesses. Patients can experience flare-ups, side effects of medication, or hospitalisation.

   Blood serum disorders: It includes haemophilia, thalassemia, sickle cell anaemia, HIV/AIDS, and other disorders. Blood serum disorders can be characterized by severe crisis periods with extreme pain and other complications, which may necessitate hospitalisation.

   Epilepsy: It is a disorder of the central nervous system, which results in a seizure. For many adults, epileptic seizures are largely controlled by anti-convulsion medication. There are four major kinds of seizures, distinguished by the degree of convulsion and the extent to which the person is conscious. Grand mal epilepsy involves sudden and violent convulsions and loss of consciousness, whereas Petit mal epilepsy is milder and involves little or no loss of consciousness. The person may stop what he/she is doing and stare momentarily.

   Cancers: It can occur in almost any organ system of the body, the systems and particular disabling effects will vary greatly from one person to another. People may experience visual problems, lack of balance and coordination, joint pain, backaches, headaches, abdominal pain, drowsiness, lethargy, difficulty in breathing and swallowing, weakness, bleeding, or anaemia. The primary treatments for cancer can cause additional effects such as violent nausea, drowsiness, and fatigue. Medical treatment can result in amputation, paralysis, sensory deficits, and language and memory problems.

   Cystic Fibrosis (CF): It is a disease affecting the cells lining the pancreas, small intestines, sweat glands, and lungs. CF's respiratory symptoms are chronic and eventually lead to fatal lung infections.

   Muscular Dystrophy: It refers to a group of hereditary, progressive disorders that most often occur with young people, producing degeneration of voluntary muscles of the trunk and extremities. Atrophying of muscles results in chronic weakness and fatigue and may cause respiratory or cardiac problems. Walking, if possible, is slow.

   Multiple Sclerosis: is a progressive disease of the central nervous system, characterized by a decline of muscle control. Symptoms range from mild to severe and may include blurred vision, legal blindness, tremors, weakness or numbness in limbs, unsteady gait, paralysis, slurred speech, mood swings, or attention deficits. Periodic remissions are common and may last from