Is childhood disability preventable?

In Bangladesh, too many people receive ineffective therapies, too many individuals and their families lack access to basic information and support, too little money is being spent on research, and far too many societies keep people with cerebral palsy out of sight, out of mind and out of options.

Cerebral palsy (CP), the most common physical disability in childhood, is caused by an injury to the developing brain which occurs before, during or soon after birth. For most cases, the cause is unknown. CP is a lifelong disability that affects movement and is often accompanied by speech, swallowing, cognitive, vision and hearing impairments. While there is no treatment for the condition, therapy and medication can help those with CP live a fulfilling life.

According to doctors, CP can affect different parts of the body; both arms and legs can be affected, the muscles of the trunk, face and mouth are often also affected. Children with CP may also have a range of physical and cognitive impairments. Its impact can range from a weakness in one hand, to almost a complete lack of voluntary movement. It is a complex disability: 1 in 4 children with CP cannot talk, 1 in 3 cannot walk, 1 in 2 have an intellectual disability, 1 in 4 have epilepsy.
CP is more often caused by preventable risk factors such as intra-partum related neonatal respiratory depression, neonatal encephalopathy, and infections.
In 2015, the first population-based CP register, was piloted in Bangladesh (the Bangladesh CP Register) with technical support from the Australian Cerebral Palsy Alliance/ACPR Team, in collaboration with the University of Sydney, Australia and CSF Global.

The findings from the Bangladesh Cerebral Palsy Register (BCPR) project have resulted in an estimated prevalence of 4 children out of every 1,000 having CP. This means that there are a total of 260,000 children with CP throughout Bangladesh.

The most striking finding is that over half of the children (58.9%) had confirmed prenatal and perinatal causes of CP (e.g. birth asphyxia, neonatal encephalopathy, neonatal sepsis)—causes which were largely preventable.

“In our studies, we have found that 61.8% of the children with CP had birth asphyxia and 47.4% faced complications during birth. We have also found that among the children with CP in Bangladesh, 75% do not have access to education, 96% have never received any assistive devices, and 66% never received rehabilitative services”, said CSF Global.
Dr. Mohammad Muhit, disability expert and president of  CSF Global, said, “These findings from Bangladesh indicate that a major portion of CP can potentially be prevented by simple public health interventions (e.g. institutionalized deliveries, training local health care workers on neonatal resuscitation and preventing childhood infections)”.

Our vision should be a rights-based inclusive society for children with disability. We need to eliminate preventable causes of childhood impairment and ensure that children with disability have access to high quality health, rehabilitation, education, and social inclusion programmes to enable their equal and valued participation in society.        

Only by working together can we hope to achieve the desirable outcome of disability-inclusive society. We need a world where persons with disabilities are not left behind, said Dr. Muhit.

The writer can be reached at: [email protected]