Life to Live

The history of people with disabilities in Australia - 100 years

A resource guide prepared by: Disability Services Australia Ltd

Medical Advances, Health & Safety

Understanding and preventing disability have been the major medical focuses for the past 100 years.

This includes:
* development of vaccines to prevent serious illnesses which can cause disability
* improvements in the care of accident victims
* education about safety on the roads and in the workplace
* education to reduce the risks of birth defects caused during pregnancy
* recognising the importance of care and understanding for people with disabilities

Australia has played a leading role in medical research, in the development of treatments and in the creation of models of care.


Preventing Disability

The Rubella Link: In 1941, an Australian by the name of N. M. Gregg was the first person to notice a link between babies born with cataracts - a clouding of the lens of the eye which reduces vision, and mothers who had been infected with Rubella during early pregnancy. Infection with Rubella, also known as German Measles, is also known to cause damage to the heart, brain and hearing of unborn children. A Rubella vaccine has been available since 1969.

Premature Babies: In the 1950s, international research made a link between blindness in babies who were born prematurely, and the levels of oxygen which were given to them in intensive care units, such as humidicribs. The condition is known as Retinopathy of Prematurity (ROP). Contributing factors included receiving too much oxygen or too little oxygen, often combined with sickness in the infant. New technology which allowed monitoring of blood oxygen levels in premature babies in intensive care units has reduced the incidence of this particular condition.

Vaccines: Immunisation against infectious diseases was a major health milestone in Australia during the 20th Century. In 1916, Commonwealth Serum Laboratories (CSL) were established in Victoria to develop and supply vaccines for Australia. Vaccines, which were mostly the result of international research, were progressively produced by CSL for diseases such as diphtheria, smallpox, typhoid fever, cholera, whooping cough, tetanus, poliomyelitis, measles, rubella, mumps and hepatitis. National immunisation programs for children in Australia have been successful in reducing the incidence of infectious childhood diseases and associated disabilities which can result from them.

Accident Care for Spinal Injuries: Since the 1980s, better knowledge about spinal cord injuries has led to revised procedures for handling of victims, particularly at an accident site. The injured person is immobilised and handled gently by ambulance officers and medical staff in order to reduce the risk of further injury to the spinal cord.

New Treatment for MS: Multiple Sclerosis (MS) is a disease which affects the central nervous system and may cause temporary or permanent disabilities in varying degrees, such as decreased mobility, speech impairment, loss of bladder control, reduced vision and fatigue. A major breakthrough occurred in the treatment of this disease in 1993, with the development of new medication. This treatment has been available in Australia since 1995 and evidence shows that it may reduce the frequency or severity of symptoms for some people with MS.

Alcohol and Smoking During Pregnancy: International research, particularly since the 1980s has indicated that smoking or the consumption of excess alcohol during pregnancy can lead to a higher risk of brain damage in a child, which could result in such things as learning and/or intellectual disabilities. Education about the risks may reduce the incidence of these kinds of disability.

Folate: In the 1990s, international research showed a link between Folate, a B Group Vitamin, and serious birth defects, known as neural tube defects, which affect the brain and spinal cord. A common neural tube defect is spina bifida. Studies have shown that a suitable intake of folate, which is available from fruits and dark leafy vegetables for example, or as a vitamin supplement (folic acid) can dramatically reduce the risk of these defects in developing babies.

Local Innovation

History of the Bionic Ear: The bionic ear is a relatively new technology which may benefit people with hearing impairments by improving their ability to hear.

It is a device which is placed in the ear during an operation, which can convert sound into electrical impulses, which in turn directly stimulates the hearing nerves. The brain then interprets this as sound.

Australia leads the world with its technology in this field.
* In 1967, Professor Graeme Clark, from the University of Melbourne, began research on hearing devices which could be surgically implanted in the ear.
* From 1970 to 1979 the Department of Otolaryngology at the University of Melbourne set about researching and developing the "bionic ear" as it came to be known.
* In 1978, as a result of this work, the world's first multi-channel cochlear implant was carried out by Professor Clark's medical team at the Royal Victorian Eye and Ear Hospital.
* In 1979, Nucleus, a group of companies in Australia which manufactures and develops medical equipment, expressed an interest in the development and manufacture of the bionic ear.
* From 1981 onwards, in association with the University of Melbourne and the support of the Australian Government, Nucleus began to develop a cochlear implant and to carry out worldwide clinical trials.
* Cochlear, a division of Nucleus, was established in 1983 and developed a 22 channel implant with a wearable speech processor.
* In 1984, the Bionic Ear and Hearing Research Institute (now known as the Bionic Ear Institute) was established in Melbourne to provide funding and continue the research pioneered by the University of Melbourne.
* Cochlear is not the only developer and manufacturer of coclear implants, however, it is a world leader. Since the early 1980s, more than 30,000 people worldwide have received Australian developed Nucleus implants manufactured by Cochlear. People of many different ages have received cochlear implants, including people who have lost their sense of hearing. Young children with cochlear implants learn to recognise various sounds, such as speech, and also learn speaking skills.
* In 2000, Professor Graeme Clark published a book about the development of the bionic ear, called "Sounds from Silence".

Fred Hollows:

New Zealand born Professor Hollows came to Australia in 1965 as Associate Professor of Ophthalmology at the University of NSW.
During the 1970s Professor Hollows began working with Aboriginal communities throughout Australia, pioneering the treatment of trachoma and other eye diseases.
It was while working as a consultant to the World Health Organisation that Professor Hollows became aware of the high incidence of cataract blindness in developing countries and set about resolving the problem by finding ways to reduce the cost of eye health care and treatment.
Professor Hollows died in 1993, however, The Fred Hollows Foundation continues to carry out this important work.

Safety

Road Safety Awareness: Studies have shown that suitable vehicle restraints for drivers and passengers help reduce the risk of injury in car accidents. In Australia, laws exist which enforce the use of appropriate restraints and car seats for children, the wearing of seat belts for all adults, and the wearing of helmets for motorcycle riders. The wearing of seat belts has been compulsory in Australia since the 1970s. Additionally, the wearing of safety helmets for push bicycle riders has been compulsory since the early 1990s. Other measures aimed at reducing the risk of road and pedestrian accidents have included programs aimed at reducing drink driving and speeding, improvements in road design and motor vehicle safety testing. Road accidents are one of the major causes of spinal cord and brain injuries in Australia. Educational programs about road safety can reduce this risk.

Health and Safety Awareness at Work: In 1985, the National Occupational Health and Safety Commission Act was passed in order to improve and enforce health and safety standards in Australian workplaces. The National Occupational Health and Safety Commission publishes national guidelines for work practices which foster health and safety in the workplace. It aims to reduce the incidence of disability caused by work-related injuries.
Care and Support

Physical Disabilities: Motor Neuron Disease (MND) is one of the lessor known and rarer causes of disability among Australians. There is no known cause or cure for the disease, however, the provision of health care and related services for people suffering from MND and other diseases causing severe physical disability show how far Australia has come in terms of the management of physical disability and care of people with debilitating conditions.

MND is a group of diseases which attacks the nerve cells in our bodies which enable us to move, speak, breathe and swallow.

Organisations which were established to assist specific disability groups, such as the Motor Neuron Disease Association of Australia, provide a vital link between someone with a disease like MND and the health and community services which are available to support them. Associations can provide information and assistance when required to both the person with the disease and to their families and carers. In the case of MND, the team of support may include the association, carers, doctors, dieticians, occupational therapists, physiotherapists, speech pathologists, psychologists, home care nurses and social workers. They are able to provide a range of services including assistance with mobility, eating, speaking/communicating, breathing, personal hygiene and counselling.

Mental Illness Awareness: The treatment of mental illness underwent significant changes during the 1900s. Mental illnesses affect a person's ability to cope with living - one's thoughts, feelings, ability to communicate, to work and to carry out normal daily activities can be affected. In the past, people with mental illnesses, and indeed intellectual disabilities, tended to be physically isolated from society due to a lack of understanding or acceptance by society. Today, however, that has changed considerably, with appreciation for an individual's worth and rights, despite disability. Greater knowledge of the nature of mental illnesses, together with more effective medication and improved counselling services, means that most mental illnesses today can be treated. It is believed that one in five Australians could experience some form of mental illness during their lives.

Acquired Brain Injury: There is a significant difference between someone with a brain injury and someone with an intellectual disability or mental illness. Brain injury, or acquired brain injury as it is sometimes known, has only recently been recognised as a separate disability group. In NSW alone, it is estimated that some 10,000 people each year receive a brain injury, many requiring ongoing support. Brain injury is a loss of brain function and can be caused by such things as road, sport or work related accidents, excessive drinking of alcohol or use of drugs, stroke, brain tumours and lack of oxygen from near drowning or a severe asthma attack. No two people are affected in the same way and often the disabilities which result from a brain injury are not immediately noticeable as it does not affect previously stored memories. However, a brain injury can affect a person's ongoing ability to remember things and to concentrate. It can also affect a person's motivation, energy levels and their ability to relate to other people. Recognition of the disabilities associated with a brain injury has been a major step in the development of appropriate treatment. Modern approaches to treatment stress counselling by trained psychologists and social workers, as well as encouraging the support of family and friends.

Case Study:
Second Chance Gail

In 1990 Gail Dolman sustained a near-fatal brain injury as a result of a hit-and-run accident. The accident occurred while Gail was opening her car door. Propelled 20 metres down the road as she was hit by another vehicle, she sustained fractures to her femur, tibia, fibula and scapular, as well as a fractured pelvis and skull. As a result of severe brain injuries, Gail lay in hospital in a coma for six weeks.

The road to recovery was slow, involving physiotherapy, speech therapy and occupational therapy. Gail had also acquired short term memory loss as a result of the accident and attended a workshop which offered some strategies for dealing with this.

The Commonwealth Rehabilitation Service was able to assist Gail to get back to work. She had been an enrolled nurse prior to the accident and did a pathology course to enable her to collect blood. She found a job as a blood collector, however, this only lasted two weeks after discovering that she now had epilepsy, also a result of the accident. Gail then turned to voluntary work while searching for employment. Finally in 1997, she obtained a nursing position doing eye surgery two days a week at Westmead Hospital in Sydney, which greatly increased her self-confidence and self-esteem.

At present, Gail works as a casual attendant carer for people with a brain injury, and with her own personal experiences and knowledge, is able to assist them on their road to recovery. Gail is also actively involved in community education programs, particularly for school children, discussing the issues surrounding acquired brain injuries and emphasising road safety. She has won a number of community service awards for her voluntary work.


Links

Explore the following websites to find out more:

Fred Hollows Foundation http://www.hollows.org
Cochlear http://www.cochlear.com
The Bionic Ear Institute http://www.medoto.unimelb.edu.au
Australian Department of Health and Aged Care http://www.health.gov.au/
Kidsafe: The Child Accident Prevention Foundation of Australia http://www.greenweb.com.au/kidsafe
Motor Neuron Disease Association of NSW http://www.netspace.net.au/~mndansw/
MS Society of NSW http://www.msnsw.org.au

Discussion and Further Reading

Questions to Explore in Class
1. What are some of the causes of disability?

2. How has medical research improved our understanding of the causes of disability? How has it helped to prevent disability?

3. What are some of the ways we can improve safety and help prevent injury?



Creative Ideas

* Make a collage or a painting with the theme of "safety."

* In small groups, create a short play about "road safety" and share it with the rest of the class.


Further Reading
Sounds from Silence: Graeme Clark and the Bionic Ear Story - by Professor Graeme Clark