The Human Immunodeficiency Virus (HIV) is a virus that makes the immune system collapse, making a person totally defenceless to infections. A person living with HIV may experience episodic and/or chronic impairments. These may result from illness and/or from treatment side effects, in particular: general fatigue and weight loss; neurological disorders; mental and cognitive disorders such as dementia; and joint and muscle problems. Different examples of rehabilitation across the care cycle are given. A case study in India is provided.
Cardiovascular disease (CVD) refers to conditions that affect the heart and blood vessels. Most commonly this includes coronary heart disease (heart attacks), cerebrovascular disease (stroke) or raised blood pressure (hypertension). A stroke occurs when a blood clot (ischaemia) or a bleed (haemorrhage) disrupts the blood supply to part of the brain, starving that area of oxygen. Stroke is a leading cause of serious long-term disability.
Diabetes is the 9th most common cause of years lived with disability. Diabetes is a chronic disease that occurs either when the pancreas does not produce enough insulin or when the body cannot effectively use the insulin it produces. This causes an increased concentration of glucose in the blood (hyper glycaemia). There are three types - Type 1, Type 2 and gestational. Common impairments and activity limitations are reported including: neuropathy; peripheral vascular disease; retinopathy; kidney complications; stroke and depression.
Child health encompasses physical, mental and social well-being of children under the age of five. The leading causes of under-five deaths are pre-term birth complications, pneumonia, birth asphyxia, diarrhoea and malaria. Malnutrition contributes to nearly half of all under-five deaths. All these conditions contribute hugely to child impairments too.
Maternal health concerns the health and wellbeing of mothers from before pregnancy (pre-conception), during pregnancy (ante-natal), during and after childbirth (peri- and post-natal). Common impairments and activity limitations from obstetric fistulae, pelvic floor dysfunction, maternal depression and musculoskeletal disorders are outlined and examples of rehabilitation strategies are given. A case study of fistula in Burundi is reported.
This drawing illustrates an inclusive (modern and well equipped) classroom environment. Here are some of the recommendations illustrated:
• Group seating arrangement to promote group working, peer to peer support and buddy systems.
• Use visual supports eg, timetable in pictures.
• Accessible and child friend classroom: ramps, low reach blackboards, large window to let in light, easy maneuverability, accessible teaching and learning materials.
• Interactive teaching methods, supported by a specialist itinerant teacher (eg sign language or braille experts).