Thomas Mathew, nearly 75, is the quintessential Malayali who toils abroad and returns post-retirement to Kerala, with the childhood memories preserved with utmost fondness. Thomas had left his village near Thiruvalla, a prosperous town in Central Travancore, in his early 20s. He spent the better part of his life in mofussil Munich in Germany. His wife worked there as a Nurse. He doubled up as the homemaker while working as a retail assistant in a department store. They brought up their three daughters there, all of whom settled down in the West - two in Germany and one in the United Kingdom; they work as nurses too. His wife is no more. He lives in a three-bedroom flat on a busy road in Kakkanad, a suburb of Kochi. He fights loneliness and the heckle of urban chaos, mumbling at the lack of discipline, concern for the old and the mad rush all around. No one seems to have time for people like Thomas whose only longing is for someone to talk to.
He gets up early in the morning; even if he tries, further sleep evades him. His mind is filled with an eerie feeling of loneliness. He has taken to the internet - he browses using his smartphone, a gift by one of his daughters, for news, music and biblical talks; he chats with his social media friends too, a dwindling number as days pass. After breakfast he walks to the town centre to meet a few acquaintances. They sit at the benches in the foyer of the local church and talk about their nostalgic past. His eyesight has been failing of late and he is frightful of early signs of Parkinson’s which his doctor has mildly indicated. At the crossings, no one stops the vehicles to give way to pedestrians and traffic lights generally don’t function. There is a foot over bridge, but climbing is too cumbersome; there is no ramp or escalator. Along his path he has to walk over the tarmac of the road too often because hawkers have usurped the pavements. Worn out by tension, bored by loneliness and uneasy at not having anything particularly to do, Thomas returns home by noon. He takes a nap and talks to his children in the evening, if lucky to get them over WhatsApp. He has an early dinner, watches TV for some time and goes to bed with a vacant mind. As he moves his shivering hand to draw a cross close to his chest before retiring for another night of disturbed sleep, he is unsure whether to thank God for yet another day!
There are nearly 110 million people over the age of 60 in India as of 2019. By 2050 the percentage of old would cross 20% of the population according to UN and World Bank estimates. In states like Kerala and Punjab with high emigration rates, the problems of loneliness, disability and sickness among the aged are set to become more acute.
The number of people with disabilities affecting mobility, cognition, speech, hearing and vision who need care and a support is significant and is growing by the day. According to Government estimates, there were 2.7 crores citizens with some form of disability according to 2011 census. The figure now could be over 3.5 Crores. That is nearly 50% of the entire population of the UK and close to that of Canada! Yet how insensitive and casual are we to the feelings and sufferings of the senior citizens, physically and mentally challenged and others with deficiencies affecting their day to day life!
What do we need in order to build an inclusive society that supports ease of living for all sections? Three contributory factors are critical, namely physical infrastructure, governance framework and supportive values and attitudes. Unlike in the developed world, India's disabled are rendered socially vulnerable by a variety of factors - lack of quality education, deficient social security and a low level of social sensitization.
We seem to have developed an inverted system of social equity exemplified by structural deficiencies in the ease of living in general. Some accentuating factors are:
To talk about global benchmarks in citizen care and ease of living in this milieu is more of a joke.
There are basically four types of disability hampering the ease of living. These relate to mobility, speech and hearing, cognition and visual ability.
Physical accessibility is a critical support that the disabled citizens need. According to National Centre for Promotion of Employment for Disabled People (NCPEDP), just one in 250 hotel rooms in India are accessible for the disabled. Globally the ratio is 1:50. Availability of ramps for wheelchair users at public places is the bare minimum expectation from a civilized society. According to section 44 of Rights of Persons with Disabilities Act, 2016, creation of ramps in public buildings, modification of toilets for wheelchair users and installation of Braille control buttons and indicators in elevators are accorded top priority. But progress so far is dismal. As part of the Accessible India Campaign, access to 50% of public places were to be made fully disabled-friendly by July 2018. But only 3% of buildings have become accessible so far. The target of making at least 25% of public transport disabled-friendly has also not been met. Unlike the Metro rail, which has better accessibility features, our passenger trains and public buses are infamously inaccessible for the disabled.
In developed societies, digital technology products, applications and solutions enable persons with special needs to go through daily routines with ease. With IoT enabled infrastructure, the disabled can lead better quality of life than was possible just a decade above. Think of a blind pedestrian using a sensor-enabled walking stick to move hassle free over pavements. Deaf and dumb persons are able to communicate through sign language, the assistive device picking up the gestures and converting into audio message.
The implications of the advances in mHealth (Mobile Enabled Health Services) are far-reaching. Elderly people with limited mobility can go through the entire medical services value chain such as appointment with doctor, video consultation and diagnosis, medicine delivery and payment without stepping out of their homes. In future, we would see the convergence of physical and digital delivery models in health services. This is made possible by leveraging infrastructure and intellectual capability of the hospitals as well as use of digital technology for delivery.
Internet access and social networking have large implications for the health and well-being of the old and the disabled. Feeling of wellness and social belonging enhance the longevity, health and happiness of people, especially those who need care and support.
As humans, we learn until we die. A Pew survey in the US found that 53% of old people above 65 years browse the web to educate themselves on a variety of domains of knowledge and skill. In India too, many senior citizens have taken to the web, social media and online video/music for entertainment, reaching out to those with similar interests and to update knowledge.
Many easily accessible and fairly inexpensive electronic devices, such as iPads and Kindles, have integrated features that help those with vision impairment, such as font enlargement, a huge help also for people with age-related deterioration of vision. Dictation technology for smartphones is improving too. Voice recognition applications like Alexa and Siri respond to verbal instructions to perform routine tasks, making life of old and disabled persons easier. Combination of voice recognition with robotics opens up immense possibilities for assistive devices and applications for those with special needs.
There are many apps and devices to support ease of living for the visually challenged. Dot is a wearable that is the world’s first Braille smartwatch. It can connect via Bluetooth to any smartphone to retrieve and translate the text from an email or messaging app into Braille.
UNI is a communication tool for the deaf using gesture and speech technology. It detects hand and finger gestures with the help of specialized camera algorithm and generates text messages to convey meaning of the sign language. By My Eyes is an application that helps blind people to connect with volunteers from around the world. assist-Mi is a similar application that helps disabled people to get assistance in real-time from caregivers.
Many parents of children with autism are turning to iPads and other tablets to enable their kids to communicate, practice eye contact and learn new vocabulary. Children enjoy the repetitiveness of the computer’s speech functions and appear to be less distracted when using tablets. iPhone and iPad’s Assistive Touch technology lets people with motor control problems use the device: instead of having to pinch the screen to zoom or adjust volume using side buttons, an on-screen guide allows users to perform these functions just through tapping. The digital innovations on assistive devices are set to gather momentum in the coming years.
No amount of technology can compensate for the apathy of Governments to make and enforce supportive policies and the failure of the community to demonstrate care and concern for those who need support. Inclusiveness and diversity management should be inculcated from an early age.