HUMAN RIGHTS. YES!

PART 4:
LEARNING ABOUT HUMAN RIGHTS


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PART 4:
LEARNING ABOUT HUMAN RIGHTS

 


Section 3:
Learning Exercises for Part 2

The Convention on the Rights of Persons with Disabilities

 


EXERCISES FOR CHAPTER 8:
THE RIGHT TO HEALTH

 

 

 

EXERCISE 8.1:
Understanding the Right to Health

Objective: To understand rights and responsibilities associated with the right to the “highest attainable standard of health”

Time: 30 minutes

Materials: Paper and pen/pencil or chalkboard and chalk

 

1. Brainstorm:

Ask participants to brainstorm definitions of health or “a healthy person.” Record suggestions on chart paper. Assist the group in arriving at a definition that combines their main ideas and write it at the top of the chart paper. Follow up with questions like these:

· Can someone with a disability be considered “a healthy person”?

· What are the essential requirements for a person to attain health? Consider material, informational, environmental, and behavioural factors.

· What happens when one of these necessities is missing? When two or more are missing?

· Who has the responsibility to see that all people are able to attain good health?

2. Introduce:

Emphasize that achieving human health involves both rights and responsibilities, as well as both governmental and individual efforts. Divide participants into small groups and ask each group to choose one health topic to explore.

Suggested Topics for Discussion

· Contagious diseases

· Nutrition

· Respiratory health

· HIV/AIDS or other infectious diseases

· Sanitary Conditions and hygiene

· Immunization

· Other health issues in your community

 

2. Discuss:

Explain that each group should:

a. Decide what the government’s responsibilities are regarding this health issue.

b. Decide what individuals must do for themselves.

Demonstrate how to structure and record the discussion using a chart like that below.

Example: Safe drinking water

 


HEALTH ISSUE: SAFE DRINKING WATER
Government Responsibilities
Individual Responsibilities

· Making sure that public sources of water are safe

· Making sure that clean water is available to all people equally

· Providing information about the importance of avoiding unsafe water and how to counteract its effects

· Supplying clean water in emergency situations

· Refraining from activities that may contaminate drinking water

· Taking recommended actions when water might be unsafe (for example, boiling water, going to another source to obtain water)

· Reporting illnesses believed to be the result of unclean water from a public source

· Reporting sources of water pollution

 

 

2. Report:

Ask a spokesperson from each group to present their findings.

3. Discuss:

· What measures must a government take to meet its responsibility to implement the right to health? Is your government succeeding in implementing this right?

· Do you think your government is providing the “highest attainable standard of health”? Why or why not?

· What must individuals do to meet their responsibility to implement this human right? Do you think most people understand their responsibilities?

· What are some barriers that persons with disabilities face in attaining the right to health?

· What special measures should governments take to ensure that persons with disabilities enjoy this human right?

 

EXERCISE 8.2:
Identifying Barriers to Health for Persons with Disabilities

Objective: To identify the social, legal, and practical challenges to persons with disabilities claiming the right to health

Time: 45 minutes

Materials: Copies of Article 25 of the CRPD

 

1. Brainstorm:

Ask participants to give examples of barriers that prevent persons with disabilities from claiming the right to health. List these.

2. Discuss:

Divide participants into three groups.

Ask each group to list the specific barriers that persons with diverse types of disabilities may experience. Ensure coverage of at least:

· Physical disabilities;

· Sensory disabilities;

· Intellectual disabilities; and

· Psychosocial disabilities.

Ask each group to explain why these barriers exist. Ask the groups to consider if persons with certain types of disabilities experience higher levels of discrimination and why this is the case.

3. Report/Discuss:

Have each group read the list of barriers it identified. List these and discuss:

· Do persons with certain types of disabilities experience higher levels of discrimination? Why?

Distribute copies of CRPD Article 25, Health, and/or read it out loud and discuss:

· How are the barriers identified by the groups addressed in Article 25?

· What actions does the CRPD require States to take to remove these barriers?

· How can persons with disabilities assist governments in implementing these changes?

· How would these changes contribute to the improved health of persons with disabilities?

 

EXERCISE 8.3:
Designing Accessible Health Services

Objective: To identify the resources and solutions needed to remove practical barriers to health care services

Time: 45 minutes

Materials: Handout of scenarios

 

1. Introduce:

Observe that even when health care services are available to the general population, persons with disabilities often face barriers in accessing them. Divide the participants into three groups and give each one of the scenarios in which a person with a disability seeks medical care.

 

Handout 8.3

SCENARIOS

 

Scenario 1:

José is a wheelchair user who is paralyzed from the waist down. He has come with his friends to the community centre to participate in an HIV/AIDS education session. The session is to be held on the second floor and there is no elevator.

 

Scenario 2:

Alika is deaf and has come to an HIV/AIDS testing centre alone. She is literate and can communicate in writing.

 

Scenario 3:

Karen has an intellectual disability. She is 28 and lives with her family. She has an independent social life, a boyfriend, and a job selling fruit in the market. Karen’s mother has accompanied her to the counselling centre.

Give these instructions:

(a) Read the scenarios aloud and discuss:

· What are the potential accessibility barriers the patient might encounter in the health care setting? What is likely to happen next when each character enters the medical system (for example, emergency room, doctor’s office, examining room)?

· What factors might prevent each person from receiving the best possible care?

· What solutions are needed to accommodate the disability? What resources do these solutions require?

· What kind of training would health professionals require to make sure they can provide the best care (for example, accessibility training, education on the rights of persons with disabilities)?

(b) Based on your discussion, plan two brief role-plays showing the best and worst outcomes.

2. Discuss/Plan:

Give participants plenty of time to plan their role-plays.

3. Present:

Ask each group to present its role-play. Ask for comments after each:

· Are there other possible worst-case outcomes?

· Are there additions to the best-case outcomes to suggest?

 

4. Discuss:

· Are these role-plays realistic?

· What can be done to ensure that persons with disabilities receive the best possible care when they enter the medical system?

· What kind of training would doctors and health care professionals need to make sure they can provide the best care to persons with disabilities?

Note to Facilitator: Adapt these scenarios to the needs and context of your participants (for example, use other settings, other disabilities, other illnesses, including those related to sexuality and reproduction, and other barriers).

Optional Exercise: Design an accessible examination room. Either draw what the room would look like or simply list the features it should have to be accessible to persons with all types of disabilities.

 

EXERCISE 8.4:
Scenarios in Medical Decision Making

Objective: To examine ways in which disability may influence medical decisions.

Time: 45 minutes

Materials: Copies of Handout 8.4

 

1. Discuss:

Explain that this exercise examines the ways in which disability may influence medical decisions. Divide participants into three groups and give each a scenario from the list on the handout below. Ask the groups to discuss their scenarios and make a decision.

2. Report:

Ask a spokesperson from each group to describe their scenario and the decision they reached. After each report, ask for questions and comments from the other groups and ask questions like these:

· How did you make your decision? What factors influenced your decision?

· Is this disability discrimination?

· How should decisions like these be made in real life?

3. Discuss:

· What are the human rights principles that apply in these situations?

· Who should be responsible for making these decisions? Doctors? The government? Ethics committees?

· In fact, how are decisions like these usually made?

· How can persons with disabilities be protected from discrimination based on disability?

Handout 8.4

SCENARIOS

 

Scenario 1:

Two children of similar age require heart transplants. One is a child with Down Syndrome and the other is a child with no disability. Neither child has any other known medical condition besides the heart-related illness. The likelihood of success of the transplant is equal for both children. The life expectancy of a person with Down Syndrome is generally estimated to be twenty years less than a person without Down Syndrome (if neither is affected by poverty, neglect or other factors that reduce life-expectancy). Based on this information, which child should receive the heart transplant?

Scenario 2:

Two women who are HIV-positive apply to receive expensive retroviral drugs from a public health clinic with limited resources. One woman has a chronic psychosocial disability; the other has no disability. The clinic can only support one new client. Based on this information, which woman should receive the drugs?

Scenario 3:

Two members of the same community step on landmines and lose a leg below the knee. One is a seven-year-old schoolboy and the other a farmer aged forty. Both wish to have an artificial leg, but there are resources for only one to receive a prosthesis. The adult will probably be able to wear his artificial limb for many years, but the boy will out-grow his several times before he reaches adulthood. The boy’s rehabilitation will therefore be much more expensive than the man’s. Based on this information, who should receive the artificial leg?

 

 

 

EXERCISE 8.5:
Designing Accessible HIV/AIDS Services

Objective: To identify the resources and solutions needed to remove practical barriers to health care services, and HIV/AIDS services in particular

Time: 45 minutes

Materials: Handout 8.3 (see exercise 8.3 for copy of handout)


1. Introduce:

Observe that even when health care services, including HIV/AIDS services, are available to the general population, persons with disabilities often face barriers in accessing them. Divide the participants into three groups and give each group one of the scenarios in which a person with a disability seeks medical care.

2. Discuss/Plan:

Give these instructions:

Step 1: Read the scenarios aloud and discuss:

· What are the potential accessibility barriers the patient might encounter in the health care setting?

· What is likely to happen next in each scenario?

· What factors might prevent each person from receiving the best possible access and accommodation?

· What solutions are needed to accommodate the disability? What resources do these solutions require?

· What kind of training would HIV/AIDS educators and health professionals need to make sure they can provide the best care (for example, accessibility training and/or education on the rights of persons with disabilities)?

Step 2: Based on your discussion, plan two brief role-plays showing the best and worst outcomes.

3. Present:

Ask each group to present its role-plays. Ask for comments after each:

· Are there other possible worst-case outcomes?

· Are there additions to the best-case outcomes to suggest?

4. Discuss:

· Are these role-plays realistic?

· What can be done to ensure that persons with disabilities receive the best possible care when they enter the medical system?

· What kind of training would doctors and health care professionals need to make sure they can provide the best care to persons with disabilities?

Note to Facilitator: Adapt these scenarios to the needs and context of your participants (for example, use other settings, other disabilities, other issues relating to HIV/AIDS, including those related to sexuality and reproduction, and other barriers).

Optional Exercise: Design an accessible medical treatment centre. Either draw what the room would look like or list the features it should have to be accessible to persons with all types of disabilities.

 

EXERCISES FOR CHAPTER 9:

THE RIGHT TO HABILITATION AND REHABILITATION

 

EXERCISE 9.1:
Habilitation or Rehabilitation?

Objective: To understand what it means to enjoy the right to habilitation and rehabilitation

Time: 45 minutes

Materials: Slips of paper and pencils; chart paper and markers or blackboard and chalk

1. Introduce:

Remind participants of the distinctions between habilitation and rehabilitation.

2. Create Examples:

Divide participants into small groups; give each group 10 slips of paper and pens and these instructions:

(a) Working together as a group, make up two examples for each of these terms: habilitation, rehabilitation, and reasonable accommodation.

(b) Write each example on a separate slip of paper along with a label indicating which term you are illustrating.

(c) Try to use a variety of disabilities (for example, psychosocial and physical) and motivations (for example, health, employment, education, social service).

Sample:

 

You lost the ability to write after a stroke. Now you are learning to write again.

Rehabilitation


Note to Facilitator: Adapt Step 2 to accommodate participants who have visual disabilities and/or cannot write.

3. Test your knowledge:

Collect the slips, fold them, and place them in a container. Divide the participants into two teams and explain the competition:

(a) A player from Team A will draw a slip from the container and read it aloud.

(b) The first player from Team B must identify the situation as habilitation, rehabilitation or reasonable accommodation. If the answer is correct, Team B wins a point.

(c) Continue in this way, alternating teams until all the slips have been used. Tally a score and declare a winner.

 

4. Define:

Define some basic objectives of the following areas of habilitation and rehabilitation:

· Health;

· Employment;

· Education; and

· Social services.

 

5. Discuss:

· Are any of the above areas more important than others, in your opinion?

· Do you think that most persons with disabilities in your community have access to adequate habilitation and rehabilitation services? Do you think that they know about their right to habilitation and rehabilitation? If not, why?

· What can be done to ensure that all persons with disabilities have access to habilitation and rehabilitation?

 

EXERCISE 9.2:
Participating in the Design of Habilitation and Rehabilitation Programmes

Objective: To practice developing an action plan for habilitation or rehabilitation

Time: 1 hour

Materials: None

 

1. Introduce:

Ask participants questions like these about the importance of the participation of persons with disabilities:

· Why is it important for habilitation and rehabilitation programmes to be “individualized”?

· Why should persons with disabilities play a role in developing programmes for which they are the beneficiaries?

· How are habilitation and rehabilitation programmes usually planned in your community?

 

2. Discuss:

Divide participants into small groups. Give these instructions:

(a) Invent a fictional but typical situation of a person who requires habilitation or rehabilitation services in one of the following areas: health, employment, education, or social services.

(b) Choose somebody to play the role of the “client” (the person for whom the habilitation or rehabilitation is being provided).

(c) Other group members can designate themselves as other actors, such as service providers, counsellors, doctors, family members, disability advocates, other persons with disabilities, or others who should be involved in the design and implementation of a habilitation or rehabilitation plan.

(d) Use the following questions as a basic guide for developing an outline for the plan. Stress to participants that they are not being asked to create a complicated, detailed plan, but rather an outline that defines the goals, approach, and basic structure. Some questions should be answered solely or primarily by the client, while others will involve other actors.

· What goals are you attempting to reach that require assistance in the form of habilitation or rehabilitation?

· What is the definition of success for your habilitation or rehabilitation scheme?

· Why are you entitled to these services?

· What human rights are affected by your need for habilitation or rehabilitation in this context?

· Who should participate in the design of your programme?

· What is each person’s responsibility (including the client)?

· What resources are required for the client to successfully reach his or her goals (for example, training, assistive technologies)?

· What qualifications, training, or education should instructors, counsellors, health care practitioners, or other team members have in order to provide the habilitation or rehabilitation services required.

 

3. Report:

Ask each group to introduce its “client,” and explain the collaborative process they used to design the habilitation or rehabilitation plan. Allow both the client and the spokesperson to describe their roles in planning. Briefly describe the plan.

4. Analyze/Discuss:

· What was the most difficult part of this process? What problems were encountered?

· What types of decisions were easy?

· What other questions or subjects, in addition to those listed above, did the groups identify as critical to address?

· What can persons with disabilities do if they feel like they are not being included in decisions regarding their own habilitation and rehabilitation programmes?

 

EXERCISES FOR CHAPTER 10:

THE RIGHT TO WORK

 

EXERCISE 10.1:

What Does it Mean to Enjoy the Right to Work?

Objective: To understand what it means to enjoy the right to work

Time: 30 minutes

Materials: Chart paper and markers or blackboard and chalk

 

1. Define:

Divide participants into small groups and ask each group to come up with their own definition of “the right to work.”

2. Report:

Ask a spokesperson from each group to give their definition. Record these and discuss the differences and similarities of these definitions. Help the group recognize where their definitions may differ from that used in this chapter.

3. Discuss:

· Do you know persons with disabilities in your community who work? Where do they work and what kinds of jobs do they do?

· Do the persons with disabilities in your community who work seem to enjoy the right to work according to your definition?

· Do you think that most persons with disabilities in your community enjoy the right to work? Who in particular do you think does enjoy the right to work? Who does not?

· What can be done to ensure that all persons with disabilities in the community can fully enjoy the right to work?

 

EXERCISE 10.2:

Understanding Barriers to Enjoyment of the Right to Work

Objective: To explore barriers to the right to work

Time: 45 minutes

Materials: Copies of Handout 10.2

 

1. Introduction:

Ask for participants to give examples of barriers that prevent some persons with disabilities in the community from enjoying the right to work. List these barriers. Ask if some particular groups of persons with disabilities are especially prevented from enjoying the right to work.

2. Discuss:

Divide participants into small groups of two or three. Ask each group to review the three scenarios, describing which aspects of the right to work were denied in each case and how they were denied.

3. Report:

Following the small group discussions, reconvene and ask participants to share their thoughts about the scenarios they discussed. Ask questions like these:

· What barriers to employment were evident in the scenarios?

· Did you find disability discrimination? Where?

· What aspect(s) of Article 27 were violated in each of the scenarios?

4. Analyze/Discuss:

Discuss with the group what it would take for each of the individuals in the three scenarios to achieve the right to work.

· Consider the various supports and accommodations referenced in CRPD Article 27.

· What could be done to obtain these supports and accommodations?

 

 

 

Handout 10.2

DENIAL OF THE RIGHT TO WORK SCENARIOS

Scenario 1:

Adnan has just graduated from university with a degree in business. He was the first person who is blind to receive a degree from his university. He is eager to obtain employment and identifies three good prospects. The first is with a bank that requires an online application. Unfortunately, the online application is not accessible to him because his screen-reading technology will not work with the application. The second opportunity is with a software company and Adnan arrives at the office for the interview. He is told by the interviewer that the company has never before hired a person who is blind and he is not sure how comfortable he would be working there. The third opportunity is with a large coffee roasting company. Adnan gets through to the third interview and is then told that he cannot be hired because there is concern that it might be unsafe for him as the business offices are inside the factory and some parts of the factory have elevated hallways with no railings and other hazards.

Scenario 2:

Fiona is a teacher who was in a car accident. She is looking forward to returning to work. She now uses a wheelchair as a result of a spinal cord injury. The principal at her school has told her that she really ought to retire. He explains that it will not work out for her because the front entrance of the school has stairs, though the back entrance is accessible; her desk is not high enough for her wheelchair and if the school gives her a new desk, all the other teachers will want new desks, which is expensive; some of the students might make fun of her and he does not want her treated badly; and, since she is in a wheelchair, she will likely be too tired to get her job done.

Scenario 3:

Robert is a man with an intellectual disability. He has been employed at the corner grocery shop in his community for the past ten years, stocking shelves, cleaning, and assisting the store manager. He shows up for work on time, and does his tasks independently and very thoroughly. The grocery shop is sold to another owner who is dismayed to find a person with an intellectual disability in his store. He tells the store manager that Robert should be fired because he is “too slow,” will make the customers in the store uncomfortable, and having him on the staff will make people think that the owner “cannot hire normal people.”


 

EXERCISE 10.3:

Understanding the Right to Work

Objective: To review and understand the right to work affirmed by the CRPD

Time: 45 minutes

Materials: Chart paper and markers or blackboard and chalk; copies of CRPD Article 27

 

1. Review:

Divide the participants into small groups. Ask each group to work together to paraphrase Article 27, Work and employment, in common language and give some examples of how that right could be enjoyed and make a difference for persons with disabilities in their community.

Note to Facilitator: Given the length of Article 27, you may want to ask different groups to address different sections.

2. Paraphrase:

Read Article 27 aloud. Pause at each comma or natural section to ask different groups for their paraphrase. Discuss the meaning of the section until everyone can agree on a paraphrase.

Write the final paraphrase of Article 27 on chart paper and read it aloud.

3. Give examples:

Ask for examples of how the right to work could be enjoyed and make a difference for persons with disabilities.

4. Discuss:

How can Article 27 of the CRPD be used to set national disability rights agendas and formulate platforms of action for submission to political parties or government decision makers? What does it mean to persons with disabilities in your country?

 

EXERCISE 10.4:

Sheltered versus Supported Employment?

Objective: To discuss the benefits of different types of work environments

Time: 30 minutes

Materials: Chart paper and markers or blackboard and chalk

 

1. Explain:

Briefly discuss definitions of sheltered and supported types of work environments:

· Sheltered employment is designed specifically for the employment of persons with disabilities. It usually does not include any non-disabled workers other than those in supervisory roles.

· Integrated or Supported employment, which originated in the United States, is an alternative to sheltered and other segregated forms of employment. It takes place in an integrated workplace with ongoing support for persons with disabilities.

 

2. Brainstorm:

Display two flipchart sheets with “Sheltered” and “Supported” employment options. Ask participants to give advantages and disadvantages of the two types of work environments, as you name different aspects of employment:

· Employment contract

· Working conditions

· Pay

· Applicability of health and safety rules

· Benefits

· Job security

· Training/learning opportunities

· Promotion

 

3. Discuss and Report:

Divide participants into small groups. Ask the small groups to discuss the advantages and disadvantages of “sheltered” versus “supported” employment and list them out. Ask a spokesperson from each group to present the highlights of their discussion to the larger group.

 

4. Conclude

Invite participants to discuss possible actions to support persons with disabilities at the workplace and in other settings.

 

 

 

 


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