Pan American Health Organization

Pan American Health Organization

Topic A: Special Needs Awareness and Education

HACIA Democracy XXIV Summit of the Americas

Committee Chairs: Cora Neudeck and Sara Surani

Director of English Committees: Benjamin Schafer

Introduction

There are currently over 50 million individuals with learning, physical, and developmental disabilities throughout Latin America and the Caribbean, a number which constitutes over 10% of the population.[1]In the crucial period of development under the age of five, mortality for children with disabilities can often be four times as high as it is for those without disabilities, with higher rates of birth complications and other difficulties such as malnutrition, lack of care, and physical and sexual abuse.[2]Even if children with special needs and disabilities make it through childhood, with education rates as low as 20-30% and literacy rates hardly reaching 50%, it is evident that individuals with special needs or disabilities start out in the world with many disadvantages.[3]After overcoming these initial challenges of birth and education, the likelihood of a child with special needs having a long, healthy, happy, and successful life is significantly reduced. As a Lancet article found that without adequate support and treatment of disabilities and special needs, individuals can drop out of school and face discrimination, poverty, malnutrition, abuse, and other challenges, leading to an estimated 200 million children under age five unable to reach their full potential.[4] These problems have significant long-term impacts, with the World Bank even speculating that up to 82% of individuals with disabilities spend their lives in poverty.[5]

With unique learning and career needs and specializations, individuals with special needs (including Autism Spectrum, Down’s Syndrome, cerebral palsy, and other disorders) may require slightly more help or assistance in order to achieve their goals. With talents in areas which might not be as easily identifiable or hirable, individuals with special needs and disabilities often struggle to find their stride in the education system or job market, with unemployment estimates from the World Bank as high as 80-90% for individuals with special needs.[6]While many regions of the world provide specialized plans for education, with student to teacher ratios often over 35:1 in schools throughout Latin America, it can be almost impossible for teachers to provide specialized plans for children without conventional learning goals.[7] With many students only attending school for eight hours per week throughout Latin America and the Caribbean, the education, development, and care of children is often left solely up to families and communities. However, with expensive treatment costs and high poverty rates, local support sources often lack the resources and the ability to properly care for the special needs of their children.[8]

If adequate support does not exist from an early age, individuals with special needs or disabilities may not ever learn how to fully read, speak languages of the region, or develop employable stills, hindering their hiring capabilities and often restricting them solely to routine hard-labor or low-paying jobs with low salaries and benefits.[9] These low salaries often are not enough to allow individuals to care for themselves, with less than 20% of individuals with special needs in Latin America receiving basic health or insurance benefits.[10]Those with physical disabilities face even further challenges, with wheelchair-accessible areas and infrastructure rare or virtually non-existent in many areas. Individuals with disabilities that lead to inadequate social and developmental skills are often unable to advocate for themselves at work and may only gain entry-level positions and baseline salaries without utilization of their own individual and unique skills. In the long-term, this system leads to poverty, destitute living conditions, and lack of access to proper medical facilities – all incredibly serious costs for many individuals with special needs.[11]

As the Pan-American Health Organization, our mission is to ensure access to care and improve the health of all residents of the Americas. Bearing in mind this organizational commitment, coupled with the idea that healthcare is a fundamental human right, we seek to tackle these problems.[12]Although these statistics begin to highlight how significant of a problem this situation is, it is entirely different to begin to solve these issues. Special needs are not one-size-fits-all, and thus treatment, awareness, and education necessarily come in a variety of ways. As PAHO, it will be our responsibility to ensure the fair treatment and success of these children and adults in their communities, schools, and careers, to mitigate poverty, increase literacy and career opportunities, reduce abuse and discrimination, ensure access to basic human rights, and, most importantly, increase the awareness about and understanding of different types of disabilities.

Through governmental collaboration on the international level, as well as establishment of specialized individual level education and advocacy programs, there is potential to have a real impact on the physical, mental, and social development of hundreds of thousands of people across Latin America and the Caribbean who face extenuating circumstances that they themselves did not create.[13]Throughout the rest of the bulletin, we will further explore these issues as well as begin to understand the complex history of special needs and disabilities in Latin America and the Caribbean before finally highlighting the crux of the debate on the issue and potential solutions for position papers and resolutions to address the problem.

History and Powers of the Committee

The Pan-American Health Organization (PAHO) was founded in 1902 with the mission of strengthening regional and national health systems and improving the health of all residents of the Americas.[14]PAHO holds the distinction of being the oldest international public health organization, and throughout this history it has contributed to huge strides in healthcare and international cooperation. The organization has a staff of scientific and medical experts as well as over 100 partners in PAHO/WHO (World Health Organization) Collaborating Centers, and it works with government agencies, professional associations, academic institutions, and other civil society organizations to achieve its outcomes.[15] PAHO is a member of the United Nations system as the Regional Office for the Americas of the WHO and further is the dedicated health branch of the Inter-American system.[16]

In its constitution, adopted in 1947, the stated purpose of PAHO is “to promote and coordinate efforts of the countries of the Western Hemisphere to combat disease, lengthen life, and promote the physical and mental health of the people.”[17]Originally founded as the International Sanitary Bureau, the organization concentrated at first on dealing with information regarding the health status of the Americas and creating a framework of sanitary regulations and procedures to prevent a variety of communicable diseases such as cholera, yellow fever, and smallpox while avoiding excessive quarantines.[18] The International Sanitary Bureau became the Pan American Sanitary Bureau in 1923 and the Pan American Sanitary Organization in 1947. To reflect the shift in focus from only the sanitary aspects of global health to a broader perspective on inter-American health cooperation, the name was changed to PAHO in 1958.[19]

PAHO is currently composed of 35 Member States from across the Western Hemisphere, as well as four Associate Members, three Participating States, and two Observer States. Each Member State is entitled to one vote. Associate Members may vote in technical commissions, but not in the governing bodies of PAHO. Participating States are granted votes only in PAHO budgetary matters; this status is typically given to states that are responsible for territories in the Western Hemisphere, despite having their seat of government in another part of the world. Observer States may engage in discussions with the governing bodies but cannot vote or make substantive proposals, procedural motions, or requests.[20]PAHO is governed by three bodies: the Pan American Sanitary Conference, which meets every five years and serves as the supreme governing body of PAHO; the Directing Council, which meets annually in years that the Sanitary Conference does not convene; and the Executive Committee, which is composed of nine Member States elected for three year terms that meets semiannually.[21]At the 2018 HACIA Summit of the Americas, the PAHO Committee will simulate the Directing Council, in which the 35 Member States are present.

Under the direction of Chile’s Dr. Abraham Horowitz, the first Latin American director of PAHO in 1958, the organization grew rapidly from its previous role in occasionally exchanging information between regional health offices. Instead of relying solely on research produced in the United States, PAHO established several regional health centers that would work at a more local level. This new outreach also served to increase local research capability and enabled each center to tailor health technologies and innovations to the needs of the community in which it served.[22]

The 1961 Punta del Este Charter recognized primary care as the most effective tool to provide health services to both rural citizens of member countries and rapidly-growing urban populations. The Charter further adopted the promotion of health as an integral part of development.[23]Significant disparities in health outcomes throughout the Americas despite recent gains in poverty reduction, however, have indicated that simply promoting growth does not necessarily equate with promoting desired health outcomes.

The huge inequality prevalent throughout many parts of the region remains one of the greatest inhibitors of major progress on health objectives for much of the population. Former PAHO director Dr. George A. O. Alleyne argued that the primary cause of major health problems in the Americas is massive income inequality and other forms of inequality throughout the region. In an effort to provide what it calls “social medicine,” PAHO thus examines the social and economic roots of health concerns.[24] A major challenge for the organization is the pursuit of greater equality in areas of physical, social, and ecological contributors to health impacts.[25]

Aims of the Committee

In this committee, we will seek the best methods to help increase understanding of special needs and provide solutions to the lack of care, treatment, and education for individuals with special needs or disabilities. While this is a very widespread and long-standing issue, it still is entirely possible to find innovative, collaborative, inclusive solutions to help increase the educational, social, and physical support of individuals with special needs. Delegates are encouraged to come up with ambitious ideas, but also to bear in mind the real-world financial, temporal, social, and political barriers that exist in order to fully address the relevant problems in the best way possible. Delegates should read the bulletin and any relevant materials in full to be able to understand the topic and be fully prepared for committee discussion and collaboration. Through understanding, we will be able to work to create solutions to further our mission of health equity and access across the Americas.

The issue of special needs and disabilities treatment, awareness, and education holds incredible potential for the future of Latin America and the Caribbean, not only in the individual economic and human rights benefits achieved, but also for the overall international growth and power of Latin America. Without basic health, educational, and developmental frameworks for many of its most susceptible residents, it will be difficult for Latin America and the Caribbean to ensure health equality for all its citizens on a global level.

The primary goal of this committee will be to address these inequities in care, treatment, and education, while also raising awareness and advocacy on a national level. Resolutions should be tailored to provide multilateral solutions while also realizing country-specific problems in Latin America and the Caribbean. Through addressing gaps in health, education, poverty, and career support, while also focusing on the physical and social needs of those with disabilities, delegates will be able to construct an overarching set of solutions to re-imagine life with special needs in Latin America and the Caribbean.

As delegates further research into this material, they should consider pre-existing structured support organizations through NGOs in the region while also focusing on successful programs in other similar tropical and rural regions. Delegates are encouraged to use relevant, timely, scholarly sources when forming solutions for the issue. Additionally, delegates should look to find ways to ensure these solutions are able to move beyond our committee walls and to potentially have the ability to make a real impact with special needs individuals throughout Latin America and the Caribbean. Delegates should also note the difficulty and complexity of this situation and work to address nuances within it in a clear and respectful manner, as would be expected of a delegate of their position in the real-world PAHO.

With these factors in mind, we are confident that the solutions that delegates can imagine on this situation can be incredibly innovative and impactful, helping to solve these complex issues of health care inequality in access throughout these regions in Latin America and the Caribbean and seeking to improve the quality of life of hundreds of thousands of individuals suffering from special needs and disabilities.

The Topic in Context

The history of the issue of disabilities within the UN began in 1948 with the The Universal Declaration of Human Rights (UDHR), setting out to ensure that all individuals had access to basic and essential human rights, even those with special needs.[26] This was greatly expanded in 1982 with the creation of the United Nations World Program of Action Concerning Disabled Persons (WPA), the first large international step toward ensuring adequate and equitable standards of treatment and care for all individuals with intellectual and physical disabilities.[27] Strides to safeguard equality for those with special needs continued with the adoption in 1994 of a universal standard, the Standard Rules for Equalization of Opportunities for Persons with Disabilities, representing governmental commitments to further expand equality of access of opportunities for those with special needs.[28] In 2000, the Organization of American States (OAS) took specific action itself with the Inter-American Convention on the Elimination of All Forms of Discrimination Against Persons with Disabilities in order “to promote full integration of persons with disabilities into society.”[29] However, despite the creation of over 180 disability-related UN human rights documents, necessary health and accessibility resources, for individuals with disabilities remain inadequate.[30]

Although there are many large scale governmental organizations like PAHO working to help find solutions to the many complex health and equality challenges for those with intellectual and physical disabilities, inequalities still exist in communities, schools, and workplaces in terms of abuse, discrimination, and lack of access to essential health services. Outside of the government, there are also many private entities and non-governmental organizations (NGOs) that have identified this problem and are hoping to make an impact as well. Over the past 30 years, many NGOs and governmental organizations throughout the world have made large strides toward increasing access to resources for those living with disabilities, resulting in an increase in awareness, equity, and educational, health, and job resources for thousands of individuals with disabilities. The UNHCR lists several organizations, including Christian Blind Mission International (CBM), Inclusion International, International Committee of the Red Cross (ICRC), and Handicap International. There are hundreds more involved on the global level, and even more in individual regions, with organizations specializing in different fields such as basic medical services, education and job support, or mental health development.[31] With focusing on these key issues, raising necessary funds, and lobbying for equal opportunities, these and other NGOs in the region have continuously made strides in disability education, awareness, and treatment through collaboration with governments and local development organizations.

However, before further analyzing this problem from a non-governmental and governmental perspective, it will be helpful to define what special needs and disabilities are in order for delegates to understand the inequalities and spectrum that exist, from developmental to learning to physical impairments, all of which can have incredibly large impacts on day to day life for children and individuals with special needs.

Developmental disabilities, which originate in birth or childhood, are one of the largest categories and can include Autism Spectrum Disorder, Fetal Alcohol Syndrome, Down Syndrome, or neurological brain injuries. These can have significant impacts on social and educational life, and are “expected to continue indefinitely.”[32] Learning disabilities are another category, one that includes neurological difficulties that cause children or adults to have difficulty solving problems, writing, or focusing in school or work environments. These most commonly include Dyslexia (trouble understanding written words), Auditory and Visual Processing Disorders (“difficulty understanding language despite normal hearing and vision”), or Attention-Deficit Hyperactivity Disorder (ADHD)(challenges with maintaining focus on specific topics or ideas).[33] These special needs can have impacts on school and work performance, leading to educational delays and long-term difficulties in communication and learning. One final category we will analyze is that of physical or sensory impairments, including blindness, deafness, Cerebral Palsy (impairment of motor function), Muscular Dystrophy (progressive loss of muscle mass and ability), Ataxia (loss of bodily control of movements), or Spina Bifida (gaps in the spine). These can all result from bone, muscle, or sensory system failures, and can be represent one of the most expensive categories of special needs - requiring specialized medical care or necessary equipment that can cost hundreds or thousands of dollars such as wheelchairs, braces, surgery or prosthetic limbs.[34]