Yet what is disability? What would be the approach to disabilities? What are the current issues in the management of disabilities in the present time? All these remain as daunting problems to be addressed with utmost care.

There are various types of disabilities that have an impact on normal living and functioning , causing dependability and handicaps of different nature. Disabilities are global problems that affects all ages, sexes and at any stage and on all spheres life. The causes of disabilities are innumerable. Anything and everything under the sun including the sun itself may be a cause for disability, which can berserks’ normal life at any moment. In fact, it is just a luck and grace of god that you are crossing the line of time without a mishap.

The disabilities may be developmental like Autism, mental subnormality, learning disability, deaf mute, blindness, cerebral palsy, neuro-genetic syndromes, multiple congenital anomalies, birth injuries or later developed due to various infections affecting the nervous system, stroke, dementia, tumor or trauma or what else! The lists are unlimited and causes are innumerable.

Disabilities of any kind are not merely a state or condition alone. It should be viewed as a disease or disorder that requires systematic and scientific approach to analyze the nature and cause of it .The inter-national classification of impairment, disabilities and handicap (ICIDH) under recommendation of WHO have paved a systematic approach to disabilities. This emphasis on early detection, identification and diagnosis with utmost accuracy using all modern technique, administration of appropriate medication and timely intervention to minimize the disability and choose the suitable rehabilitation program, including education, vocational training and job placement.

To the third world countries that basically depend on the manpower for its developments, disabilities will have a different type of impact. Most of these countries especially in the context of India and specifically to Kerala, are undergoing a rapid demographic transition and transformation. These include a reduction in family strength to 1.7 through effective family planning programs and an increase in life expectancy. The health indices in the state of Kerala –reduction in infant mortality rate, reduction in maternal mortality, control of infectious and contagious diseases through effective immunization programs are laudable and comparable to that of the most developed countries. Nevertheless, the undercurrents of these developments and its impact on non-communicable morbid diseases and disorders are overlooked. The demographic transition has a great impact in the prevalence of these disorders in the effect that family burden and risks to the family has increased. That is, any disability irrespective of its prevalence in the community will have an impact on the family to 50 –100%.

The meaning of having progeny is propagation of the family to next generation and also the social responsibility of the children to look after their parents. If so, disabilities like gross mental retardation, motor disabilities of severe nature, multiple congenital anomalies, autism, genetic and metabolic disorders may not accomplish such expectations. Disabilities occurring in the young adults and middle aged have other grave consequences like reduction in the productive man power in the general community while loss of the earning members to the family. The impact can be imaginable, when it occurs to non-protected manual manual labors, those who are employed in high-risk jobs, or when he or she is the sole bread winner of the family. Therefore it is imperative that the perspectives to disabilities to be changed in terms of early detection, prevention, steps to ameliorate the severity of the problem and the dream of treating them successfully.

Alternatively we need to look into what a disabled can provide to us by tapping their hidden talents and abilities which may be even unlimited and rare genius like that of Albert Einstein, Edison, Helen Keller, Christopher Reeve, Beethoven, Leonardo Da Vinci, Isaac Newton, Winston Churchill, Bill Clinton or Stephen Hawkins mention a few among them. Disabled needs opportunity to have independent life and to prove their ability and individuality.

Nevertheless, the approaches to disabilities in the developing nations are merely confined to social rehabilitation, evolving out of sympathy or religious consciousness or even political gains. Rarely a precise scientific diagnosis is made, yet dump them together in broad categories. Prenatal diagnosis and attempts for prevention are negligible. Facilities for understanding the genetic and metabolic basis of these disorders, which are the keystones in prevention and treatment are lacking. Neuro-imaging, tissue diagnosis for identification of structural abnormalities and patho-physiology are often considered as waste of money and manpower. The dearth of trained professionals for clinical diagnosis, evaluation, education and rehabilitation are major handicaps. Rehabilitation to be scientific requires dedicated doctors, paramedical professionals, special educators and social workers.

A systematic approach to disabilities should include scientific diagnosis of the problem with incorporation of technological advances, treatment, amelioration or reduction in the severity of the problem by identifying the correctable factors, education, vocational training and job placement. Facilities for research into the etiology and pathology including molecular genetics, metabolic abnormalities, hormonal and micronutrient abnormalities are essential for the prevention and treatment of the disorders. Prenatal diagnosis, marital counseling, anticipation of the problem and social awareness are essential keystones in the prevention of the disorders. Advances in computer technologies, mechanical and space research technologies should incorporate for augmented communication, mobility and education and recreation. Above all empathy towards the disabled and regard for him as a fellow being is of utmost importance for the cultural development of any nation or community.