Unmet health need of the physically handicapped, aged

disabled and the aged: Janashakthi Insurance Ltd. has come forward to sponsor our Health Quest programme which is a special one calling upon the building industry - Architects and Engineers on the need and the urgency when designing buildings to provide facilities for all in society, (including the disabled and the aged) to use them with ease, which is lacking in almost all the public and private buildings today.

This is a denial of a basic human right for this sector of the community, who deserves to be treated and get the utmost attention and care of the society.

Janashakthi Insurance which is sponsoring this programme for Dr. Ajith C. S. Perera's DIRIYA enabling the disabled society, will be held on Sunday July 30, 2006 at Lower Crystal Room Hotel Taj Samudra, Colombo from 5 p.m. to 7 p.m.

Those who are interested to attend this programme, where cash prizes too are being offered for the best three questions sent on the topic -'Unmet health need of the physically handicapped, aged', please register your name at Janashakthi, as accommodation will be limited to 80 persons only. Call Erandha or Thilini on Tel. 2309728 and register your name.

Here's Dr. Ajith C. S. Perera on social inclusion vital for better health writing on this unmet need:

'Social exclusion' describes a way of life trapped in a vicious cycle of marginalisation, where opportunities are few, services are difficult to access, people lose hope, self-esteem is shattered, innate potential is wasted, unwanted dependencies and serious hardship are increased.

It is caused and perpetuated by different reasons, such as low income, poor health, low educational attainment, living in a poor physical environment. But, social exclusion created by man to his own kind through poor design of public buildings, forgetting the diversity of people using their finished product, is increasing here at an alarming rate and is greatly adding to the other causes.

There is a growing understanding of the remarkable sensitivity of our health to the social environment. People's lifestyles, and their mental conditions, strongly influence their overall well-being.

Societies that equally enable all citizens to play a full and useful role in the social, economic and spiritual life of their society, and thereby pave the way to give people a sense of belonging, participating and being respected and valued, will be healthier than those where people face social exclusion, deprivation and insecurity.

Risk factor for mental disorders

The World Health Organisation (1999) defines mental health as a state of well-being in which the individual realizes his own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a productive contribution to his community.

Mental health is affected by a number of factors. These factors do not necessarily cause the disorder, however, and their influence varies depending on the person, whether they occur alone or along with other risk factors, etc.

Various Centres around the world for mental heath, now list social exclusion as a key risk factor for mental disorders. It is the design man makes in constructing, working and living environments at public buildings and places, that eventually makes or breaks life!

You may be amazed to know what wonders can happen to the 'Quality of Human Life' and also the well-being of a wide range of people, with judicious adjustments to the 'Designs and Plans' of our physical environments. Of course what must be remembered is: invariably it is more expensive and tedious to make post-construction adjustments to reduce 'created barriers' for social inclusion than to get 'right things right' from the start.

Social exclusion affects health

Social exclusion resulting from barriers at man-made constructions promotes physical inactivity. The health burden created by physical inactivity, latest medical research confirms, is second only to that created by smoking. 'All inclusive barrier-free design', on the other hand, promotes vital physical movements of all parts of our body through common activities of daily living.

Social integration and connectedness bring a sense of belonging in the community. Modern community mental healthcare considers this as vital for improving mental health and also protective against mental disorder. In fact, everyone requires a social network to satisfy the human need to be cared for, loved, accepted and emotionally supported, as often as possible.

Prolonged social exclusion precipitates a feeling of intense sadness, boredom, loneliness, lack of supportive friendships and worthlessness along with mood disorders (mania),changes in behaviour, loss of hope, insecurity, very low self esteem, anxiety, frustration, and anger persisting beyond an appropriate length of time.

It has powerful and damaging effects on health. It can even lead to suicidal thoughts and attempts. Such states of depression also suppress the immune system, making a lonely and isolated person more susceptible to certain infections, such as those by the viruses that cause the common cold.

Mind and body are inter-dependent and hence underlying psychological problems often lead to distressing or dis-abling physical symptoms, even though no physical disease may be present. Emotions can affect certain body functions, such as heart rate, sleep patterns and bowel movements.

When combined these could trigger a psychiatric disorder where the person begins to feel these symptoms represent a serious illness or disease. Or it could even lead to 'Social phobia' where they avoid social situations even when opportunity comes their way.

Dreams of comfortable life

Today, many a business organisation offers investment schemes bringing in financial solutions at all stages of life, even on retirement. Eye catching advertisements make them appear lucrative.

However, the fact they don't reveal is that financial solutions alone, even guaranteed for one's entire lifetime, cannot bring comfort, mental and physical well being, productivity, self reliance, dignity, safety and protection to human life or minimise unwanted dependencies and thereby fulfil aspirations and realise sweet dreams for the future.

Life is a challenge and, to meet that successfully, people need to be educated and made aware of other crucial necessities to acquire these vital needs.

Aphasia:

Language disabilities and the brain

Nimisha Muttiah (Speech and Language Pathologist)

LANGUAGE DISORDER: Aphasia is a language disorder that results from damage to the language areas in the brain. The most common causes of Aphasia are, Stroke (that results in paralysis of the right side of the body usually), Traumatic Brain Injury, Blow to the head, Brain Tumours.

Different areas of the brain have different language functions. Therefore aphasia can be classified according to which particular area / language function is affected.

Major types of Aphasia Broca's Aphasia

Patients with this type of Aphasia exhibit extremely effortful and non-fluent speech, slow rate, limited word output, unable to articulate sounds correctly, impaired repetition of words.

They may also have writing problems - laborious writing having spelling errors and letter omissions. Broca's Aphasic patients usually have good comprehension skills, therefore even though they can understand what is being spoken to them, they are unable to express themselves.

Wernicke's Aphasia

Effortless and fluent speech output, although the speech they produce maybe irrelevant, sometimes even meaningless as they may not be speaking real words at all!

Their comprehension of speech is affected, often not being able to comprehend questions directed to them, or answering totally irrelevantly.

Unable to point to objects named in the room, as a result of not understanding what was spoken.

Some patients may speak incessantly, and although they talk much, they do not communicate much at all.

Global Aphasia

In patients with Global Aphasia usually all language skills are profoundly impaired.

Therefore these patients have difficulty in producing speech or expression, as well as in understanding the speech around them or comprehension.

They may keep repeating short utterances again and again.

Reading and writing is usually affected.

Conduction Aphasia

The most significant characteristic in these patients is that repetition of words, phrases, and sentences are affected. Although words that they usually find difficult to repeat they maybe able to say spontaneously.

Comprehension and expression of language is usually more or less intact, although it maybe variable.

Anomic Aphasia

Anomia refers to a difficulty in naming. They have difficulty in naming an object pointed to in a room even something as simple as a table!

They would also substitute words while naming e.g. chair for table, sometimes substituting even meaningless words.

Also because of lack of the precise word they talk around the word e.g. if the word is table instead of just naming it, they would describe it saying it has four legs, made of wood etc.

Reading, writing and repetition is usually unaffected.

Role of a Speech Language Pathologist

A Speech Language Pathologist works in collaboration with other rehabilitation professionals in the treatment of an aphasic patient.

Depending on the type of Aphasia acquired the Speech Language Pathologist would provide the patient with a suitable communication method, advise the family on how to improve his/her communication.

This is extremely essential as communication is vital for any human being and it would decrease the person's frustration if he/she is able to express how they feel, their needs and wants etc.

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