Examine the causes of impairments in Zimbabwe and suggest ways of minimising

Impairment is a matter of perception. If you can do just one thing well, you're needed by
someone. Section 22(1) of the Constitution of Zimbabwe states that the Zimbabwean
government and its agencies must recognise the rights of persons with physical or mental
disabilities, in particular their right to be treated with respect and dignity. Furthermore,
Section 22(2) of the Constitution of Zimbabwe mandates the state and all its institutions to
assist persons with physical or mental disabilities to achieve their full potential and to
minimise the disadvantages suffered by them.

Impairment is any loss or abnormality of psychological, physiological or anatomical structure

or function. Impairment prevents someone from doing something, for example, how
blindness is impairment to seeing. The inability to move the legs easily at the joints and
inability to bear weight on the feet is an impairment.
There are some main types of impairments which include; Physical, Sensory, Speech and
language, Specific difficulties, cognitive impairments and e.t.c. A physical impairment affects
the ability to move or to coordinate and control movement when performing tasks. A physical
impairment may also affect the ability to use or feel certain parts of the body.
There is a wide range of conditions that may result in a physical impairment. These include
cerebral palsy, spina bifida, muscular dystrophy, arthritis, osteogenesis imperfecta, congenital
malformation of the limbs, some acquired brain injury, some orthopaedic conditions. There is
also some chronic health and/or medical problems such as burns or cancer may also affect a
persons physical development, resulting in impairment.A physical impairment may be
present from birth (congenital) or acquired later for example through an accident or illness;
and progressive or non-progressive which means whether or not the condition increases in
extent or severity.
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Under sensory impairments is were Visual impairment fall and it represents a continuum,
from people with very poor vision, people who can see light but no shapes and people who
have no perception of light at all. A person is termed legally blind when their visual acuity
sharpness of vision is 20/200 or worse after correction, or when their field of vision is less
than 20 degrees in the best eye after correction. Low vision includes problems after
correction such as dimness of vision, haziness, film over the eye, foggy vision, extreme nearor farsightedness, distortion of vision, spots before the eyes, color distortions, visual field
defects, tunnel vision, no peripheral vision, abnormal sensitivity to light or glare, and night
blindness.
Many diseases causing severe visual impairments are common in those who are aging for
example, glaucoma, cataracts, macular degeneration, and diabetic retinopathy. With current
demographic trends toward a larger proportion of elderly, the incidence of visual impairments
will certainly increase. Common causes that lead to vision loss or visual impairment include
injury to the eye, inherited conditions, infections etc. Injury to the eyes while playing or at
work or due to accidents may result in vision loss and impairment. Particularly injuries to the
cornea are the commonest cause of vision loss. Retinitis pigmentosa is the most common
cause of inherited blindness. Infections of the eyes can sometimes happen for example, if the
mother has had a viral infection like measles that is transmitted from the mother to the
developing foetus during pregnancy the baby may be born with blindness or visual
impairment. Trachoma of the eyes caused by contagious microorganism called Chlamydia
trachomatis may also damage eye sight. This is seen in the developing and underdeveloped
countries with poor water and sanitation facilities.
Amblyopia is basically impaired vision in one eye due to lack of its use in early childhood.
This is seen in squint or lazy eye since both the eyes project differently and send in

different messages to the brain, the brain may then turn off or suppress images from the
weaker eye. This stops development of the weaker eye leading to amblyopia in that eye.
Cataract which is clouding of part or the entire lens of the eye. Normally, the lens is clear to
let in the light that focuses on the retina. Cataracts prevent light from easily passing through
the lens, and this causes loss of vision. Diabetic retinopathy affects the small blood vessels in
the retina. When damaged this leads to impairment of vision. Glaucoma, this condition results
due to raised pressure within the eyes. The increased pressure impairs vision by damaging the
optic nerve. This may be seen in older adults and in some babies as well who are born with
the condition.
Hearing impairment is a hearing loss that prevents a person from totally receiving sounds
through the ear. If the loss is mild, the person has difficulty hearing faint or distant speech. A
person with this degree of hearing impairment may use a hearing aid to amplify sounds.
Hearing Impairments make it difficult or impossible to hear lecturers, access multimedia
materials, and participate in discussions. Examples of accommodations for students who are
deaf or hard of hearing include; Interpreter, real-time captioning, FM system, notetaker, open
or closed-captioned films, use of visual aids, written assignments, lab instructions,
demonstration summaries, visual warning system for lab emergencies, use of electronic mail
for class and private discussions etc.
Hard hearing people who are hard of hearing have varying amounts of hearing loss but
usually not enough to be considered deaf. Many people who are deaf consider spoken
language their primary language and consider themselves "hard of hearing". How one
classifies themselves relative to hearing loss or deafness is a very personal decision and
reflects much more than just their ability to hear.

Loss of Sensorineural hearing loss occurs when there is damage to the inner ear cochlea or to
the nerve pathways from the inner ear retrocochlear to the brain. Sensorineural hearing loss
cannot be medically or surgically corrected. It is a permanent loss. Sensorineural hearing loss
not only involves a reduction in sound level, or ability to hear faint sounds, but also affects
speech understanding, or ability to hear clearly. Sensorineural hearing loss can be caused by
diseases, birth injury, drugs that are toxic to the auditory system, and genetic syndromes.
Sensorineural hearing loss may also occur as a result of noise exposure, viruses, head trauma,
aging, and tumors.
Loss of Conductive hearing loss occurs when sound is not conducted efficiently through the
outer ear canal to the eardrum and the tiny bones, or ossicles, of the middle ear. Conductive
hearing loss usually involves a reduction in sound level, or the ability to hear faint sounds.
This type of hearing loss can often be medically or surgically corrected. Examples of
conditions that may cause a conductive hearing loss include; Conditions associated with
middle ear pathology such as fluid in the middle ear from colds, allergies serous otitis media,
poor Eustachian tube function, ear infection (otitis media), perforated eardrum, benign
tumours, Impacted earwax (cerumen), Infection in the ear canal (external otitis), Presence of
a foreign body, Absence or malformation of the outer ear, ear canal, or middle ear e.t.c
Deafness or hearing impairment is decreased or absent ability to perceive auditory
information. While some cases of hearing loss are reversible with medical treatment, many
lead to a permanent disability. Of vital importance is the age at which the hearing loss
occurred, as this may interfere with the acquisition of spoken language. Hearing loss is when
you are unable to partially or completely hear sound in one or both of your ears. In most
people, hearing loss begins after age 20 (MedlinePlus). Hearing loss typically occurs
gradually over time, but by the time a person reaches 65, hearing loss can be quite significant.

The National Institute on Deafness and Other Communication Disorders (NICDC) reported
that, in 2010, 30 percent of those between the ages of 65 and 74 said they had hearing loss
Conductive Hearing Loss occurs when sounds is not able to travel from the outer ear to the
eardrum and the bones of the middle ear. When this type of hearing loss occurs, you may find
it difficult to hear soft or muffled sounds. Conductive hearing loss can be treated through
medical interventions and is not always permanent. Treatment may include antibiotics or
surgical interventions, such as a cochlear implant. A cochlear implant is a small electrical
machine (placed under your skin behind the ear) that translates sound vibrations into
electrical signals that your brain can then interpret as meaningful sound. Conductive hearing
loss can be caused by; ear infections (otitis media), allergies (serous otitis media), swimmers
ear (otitis externa), a build-up of wax in the ear, a foreign object that has become stuck in the
ear scarring of the ear canal due to recurrent infections e.t.c.
Sensorineural Hearing Loss happens when there is damage to inner ear structures or in the
nerve pathways to the brain. This type of hearing loss is usually permanent. Sensorineural
Hearing Loss makes even distinct, normal-to-loud sounds seem muffled or unclear. Mixed
hearing loss may also occur. This happens when both conductive hearing loss and
Sensorineural Hearing Loss occur at the same time. In such cases listed below a doctor
should be called, hearing loss that interferes with daily activities, hearing loss that becomes
worse or that does not go away, hearing loss that is worse in one ear, sudden hearing loss,
having ear pain along with hearing problems. The symptoms of hearing Loss can be treated
for example, if you develop hearing loss that is due to a build-up of wax in the ear canal, you
can remove the wax at home. Over-the-counter solutions, including wax softeners, can be
used to remove wax from the ear. Syringes can also be used to push warm water through the
ear canal to remove the wax. If a foreign object is stuck in the ear canal, it may (depending on
the object) be able to remove the object at home. However, in this case, it would be wise to
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consult a doctor before attempting to remove the object rather than unintentionally damage
the ear. If hearing loss is caused by an infection, doctors may need to prescribe antibiotics. If
hearing loss is caused by other conductive hearing problems, doctors may refer you to a
specialist to receive a hearing aid or a cochlear implant.
Complications of hearing loss have shown negative impact to a persons quality of life and
mental state. An individual with hearing loss may have difficulty understanding others. This
can increase anxiety level or cause depression. Treatment for hearing loss may improve life
significantly. It may restore self-confidence while also improving the ability to communicate
with friends and family members.
Not all cases of hearing loss can be prevented. However, there are several steps that can be
taken to protect hearing. Use safety equipment if working in areas with loud noises, and wear
earplugs when swimming. An individual should have regular hearing tests when working
around loud noises, swim often, or go to concerts on a regular basis. Avoid prolonged
exposure to loud noises and music. Seek help for ear infections, as they may cause permanent
damage to the ear if left untreated.
Speech-language impairment involves the neurological, cognitive and/or physical structures
and functions specific to speech-language processing. The impairment relates to an individual
capacity in speech/language comprehension and/or production that significantly impacts on
the persons educational progress compared with their age cohort. Speech disorders
developmental or acquired, these include articulation disorders, voice disorders or fluency
disorders Speech and language disorders refer to problems in communication and related
areas such as oral motor function. These delays and disorders range from simple sound
substitutions to the inability to understand or use language or use the oral-motor mechanism
for functional speech and feeding. Some causes of speech and language disorders include
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hearing loss, neurological disorders, brain injury, mental retardation, drug abuse, physical
impairments such as cleft lip or palate, and vocal abuse or misuse. Frequently, however, the
cause is unknown.
Expressive language disorder means a child has difficulty with verbal and written expression.
The disorder can either be delayed or disordered or a combination of the two. For example,
the child generally has difficulties with spoken language. Their vocabulary (the number of
words they know and say) tends to be smaller compared with other children of the same age.
They are usually also below the average level for their age in producing sentences, putting
words together to formulate thoughts, recalling of words, using language.
Receptive language disorder means the child has difficulties with understanding what is said
to them. The symptoms vary between individuals but, generally, problems with language
comprehension usually begin before the age of four years. Children need to understand
language before they can use language effectively. In most cases, the child with a receptive
language problem also has an expressive language disorder, which means they have trouble
using spoken language. It is estimated that between three and five per cent of children have a
receptive or expressive language disorder, or a mixture of both. Other names for receptive
language disorder include central auditory processing disorder and comprehension deficit.
Treatment options include speechlanguage therapy.
Mixed receptive-expressive language disorder is a communication disorder in which both the
receptive and expressive areas of communication may be affected in any degree, from mild to
severe. Speech and language disorders refer to problems in communication and related areas
such as oral motor function. These delays and disorders range from simple sound
substitutions to the inability to understand or use language or use the oral-motor mechanism
for functional speech and feeding. Some causes of speech and language disorders include
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hearing loss, neurological disorders, brain injury, mental retardation, drug abuse, physical
impairments such as cleft lip or palate, and vocal abuse or misuse. Frequently, however, the
cause is unknown.
Adult speech impairment includes any symptom that causes an adult to have difficulty with
vocal communication. Such problems may include slurred, slowed, hoarse, stuttered, or rapid
speech. Other symptoms may include stiff facial muscles, drooling, poor accessibility of
words, and sudden contraction of vocal muscles. This can be minimised is such a way that
when you experience a sudden onset of speech impairment, seek medical care right away.
This may indicate a serious underlying condition. Common types of speech Impairment may
be present in different forms. Adult-impaired speech is a symptom of several different speech
disorders. They include; pasmodic dysphonia, identified by involuntary movements of the
vocal cords when speaking. Your voice may be hoarse, airy, and tight, aphasia, the inability
to express and comprehend language. Individuals with aphasia may find it difficult to think of
words. They may also mispronounce words, dysarthria: weak vocal muscles. These weak
muscles causes slurred and slow speech. The larynx (voice box) and vocal cords have
difficulty coordinating to make a fluent sound, vocal disturbances: any factor that changes
the function or shape of your vocal cords can cause changes in the sound and ease of speech.
Causes of speech impairment can occur suddenly or can gradually progress. Each speech
impairment type has a different cause, which is what sets it apart. Spasmodic Dysphonia is
abnormal brain functioning. Though scientists are not sure, it is believed this condition
originates in the basal ganglia (part of the brain that controls muscle movement in the body).
Aphasia Brain damage from a stroke or blood clot is a common cause of aphasia. Other
causes include, head trauma, brain tumour, cognitive degenerative conditions, such as
Alzheimers disease or dementia, Dysarthria-Degenerative muscle and motor conditions, such

as multiple sclerosis, muscular dystrophy, cerebral palsy, and Parkinsons disease may cause
this condition.
The minimisation and treatment of speech impairment will depend on the cause. Usually, it
will involve medical and home care treatment. Home Care Options for Speech impairment
can be very trying. It is paramount for family members and loved ones to be patient. Family
members should help with communication when possible. Home care options may differ
depending on the type of speech impairment. Home treatments must be discussed with the
doctor before beginning them.
Spasmodic Dysphonia - using electronic devices that translate typed messages into verbal
communication may ease some frustration associated with spasmodic dysphonia. Individuals
with aphasia often have confusion. Family members can orient the individual several times
daily with time and place to help decrease confusion. Limit the amount of external stimuli
an overload of stimuli can potentially worsen confusion. Speak in short, simple sentences for
easy comprehension. An individual with aphasia should carry an identification card with the
name of his or her disorder. The person should also have emergency contact information in
his or her pocket at all times. Dysarthria -Family members should speak slowly and use
nonverbal cues because individuals with dysarthria may process verbal language at a slow
rate. Allow enough time for the speech-impaired individual to respond to questions or
comments. Provide tools to aid in communication. A pen and paper is a common means of
communication. This will provide time for voice to heal or prevent further damage. In such
cases avoiding caffeine and other drugs that may irritate the vocal cords may be of great
importance. Unless the impairment is caused by overuse or a virus, it is not likely to remedy
itself. If speech impairment is left untreated, the speech and underlying condition are likely to
worsen. This is why quick diagnosis is important to allow prompt treatment.

Preventing Speech Impairment - A few methods can reduce risk of developing impaired
speech, as many impairments result from trauma. Some lifestyle habits one can adopt to help
prevent the onset of impaired speech include; not overusing voice by screaming or placing
stress on vocal cords, quitting smoking, as smoking is linked with throat cancers decreasing
your risk of a stroke by exercising frequently, regulating diabetes, maintaining a healthy
blood pressure, and reducing bad cholesterol levels, seeking prompt medical help for unusual
symptoms, limiting alcohol use and avoiding vocal-impairing drugs, such as caffeine,
amphetamines, and antidepressants.
Cognitive impairments which include mental retardation comprises of memory, perception,
problem-solving, conceptualisation and attention deficits. This may result from a range of
conditions such as mental retardation, autism, brain injury, Parkinson's disease, Alzheimer's
disease and old age. A person is considered mentally retarded if they have difficulty
functioning independently. For most, the cause is unknown, although infections, Down
Syndrome, premature birth, birth trauma, or lack of oxygen may all cause retardation.
Cognitive impairment may be present at birth or can occur at any point in a persons lifespan.
Some early causes of cognitive impairment include chromosome abnormalities and genetic
syndromes, malnutrition, prenatal drug exposure, poisoning due to lead or other heavy
metals, hypoglycemia (low blood sugar), neonatal jaundice (high bilirubin levels developing
after birth), hypothyroidism (underactive thyroid), complications of prematurity, trauma or
child abuse such as Cognitive impairment occurs when problems with thought processes
occur. It can include loss of higher reasoning, forgetfulness, learning disabilities,
concentration difficulties, decreased intelligence shaken baby syndrome, or oxygen
deprivation in the womb or during or after birth.
Cognitive impairment that develops in childhood or adolescence can result from many
conditions. Examples include side effects of cancer therapy, malnutrition, heavy metal
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poisoning, autism (abnormal development of communication and social skills), metabolic

conditions, and systemic lupus erythematosus (disorder in which the body attacks its own
healthy cells and tissues).
With age, other conditions such as stroke, dementia, delirium, brain tumors, chronic alcohol
use or abuse, substance abuse, some vitamin deficiencies, and some chronic diseases may
cause cognitive impairment. Head injury and infection of the brain or of the covering of the
brain and spinal cord (meninges) can cause cognitive impairment at any age. Cognitive
impairment can also be caused by conditions that occur after birth or during childhood and
adolescence including; Autism (abnormal development of communication and social skills),
Head injury, Heavy metal poisoning such as lead poisoning, Infection, Kidney disease (which
includes any type of kidney problem such as kidney stones, kidney failure, and kidney
anomalies)
People with impairments have trouble doing something. If you have a hearing impairment,
you cant hear very well. If you have taste impairment, you cant enjoy flavours. If you bump
your head and cant remember your name, youre suffering a mental impairment. Some
impairment is temporary. If you sprain your ankle, it will heal, but you'll have to live with the
impairment for a while. Losing your job is impairment to your career and finances.
Impairments make things more difficult. Because cognitive impairment can be due to serious
diseases, failure to seek treatment can result in serious complications and permanent damage.
Once the underlying cause is diagnosed, it is important to follow the treatment plan for health
care professional designed specifically for that to reduce the risk of potential complications
including; Developmental delays and failure to thrive, Learning disability, Paralysis or
inability to move a body part, Permanent cognitive impairment etc.

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Barriers relating to past Impairment where a person has had an impairment in the past and
recovered, barriers can still apply. For example, a person who has had mental health problems
and recovered can still be disabled if an organisation refuses to employ her or him simply
because she or he has spent some time in the mental health system.
Zimbabwe as a State should begin now to address this important public health challenge, and
State public health professionals need to join in the cause. Like every other public health
issue, the State can conduct surveillance that will help determine the best strategies,
programs, and policies to address the needs of community-dwelling impaired individuals with
physical, Sensory, Speech and language, Specific difficulties, cognitive impairments and to
improve the health and well-being of people impacted by it. Public health efforts are critical
to promote healthy behaviour and extend independent life in the community.

With the growing number of persons affected by physical, Sensory, Speech and language,
Specific difficulties, cognitive impairments it is more important than ever to implement an
effective public health solution to avert a potential crisis. Public health leaders and their
networks must address the needs of community-dwelling persons with impairments a
vulnerable population with a comprehensive and coordinated public health approach. Taking
steps to address the challenges of impairments today will ultimately have a positive impact on
individuals and communities across the great state of Zimbabwe tomorrow.

Here are some facts public health professionals might consider when developing public
health strategies, programs and policies, Continue to assess and monitor the impact of
impairments in Zimbabwe by supporting organisation for people living with Disability. The
country can also develop collaborative work groups to address physical, Sensory, Speech and
language, Specific difficulties, cognitive impairments. For example, several states have
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developed Alzheimers state action plans countries like America. Convene collaborative work
groups to address the needs of community-dwelling individuals with impairment challenges
and their families. Create and disseminate educational resources for the individuals newly
diagnosed with different impairment, the families affected by those impairment, and the
champions who can educate others in the community about the importance of maintaining
these impairments mentioned above.

These days the technology can solve our problems and then some. Solutions may not only
erase physical or mental deficits but leave patients better off than 'able-bodied' folks. The
person

who

has

disability

today

may

have

superability

tomorrow.

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