People Who Are Blind
In relation to health care, the major issues confronting people who are blind are access to information and access to premises and services. There is considerable overlap between these issues as they manifest themselves in people’s daily lives, but insofar as it is possible we will endeavour to discuss each separately here. In addition to outlining the problems, wherever possible we will discuss possible solutions. We are not aware of specific research on either the interactions of blind Australians with the health care system or on the mortality and morbidity of blind people compared with the general population. We rely in this paper on our organisation’s extensive experience, as the national peak body representing blind people in this country, of the experiences of the people we represent in their interactions with the health care system.
Access to Information
In relation to the general population, increasing amounts of emphasis have been placed on the importance of people being informed consumers of health services. The concept of informed consumption relies on free and open access to relevant information, and yet this is something which is routinely denied to blind people. This is manifest on many levels and in a variety of contexts, the following being merely indicative:
▪ Much information of an ephemeral kind, regarding community resources, specific campaigns, etc, is disseminated via bulletins and brochures in doctors’ surgeries, clinics and community health centres. The existence of this information, much less its contents, remains unknown to blind people unless it is specifically brought to their attention. Only a small fraction of this information is ever made available in alternative formats accessible to people with print disabilities.
▪ Medical and related reference materials are seldom available in alternative formats, either for purchase or in library collections. Thus, for example, a blind person who is pregnant, caring for young children,. or diagnosed with a life-threatening illness, has access to a severely limited range of information, usually not of their own choosing, and is especially likely to be deprived of access to information from non-mainstream sources (such as home birthing, naturopathy, traditional Chinese medicine).
▪ Major health care institutions such as hospitals generate a great deal of information on in-patient, out-patient, and community and preventive health programmes. Little attention has been paid to making this information accessible to people with print disabilities, although it could be argued that the lack of access to such information can jeopardise an individual’s health and even their life.
▪ Very little attention has been paid to the provision of information regarding pharmaceuticals in accessible formats. Packaging of most propriety pharmaceuticals is generally labelled in a manner which is inaccessible to all but those with good visual acuity. Not only is information about pharmaceuticals inaccessible; equipment for measurement and monitoring is also either inaccessible or prohibitively expensive. For example, it is extremely difficult to find medical measuring devices with tactile markings; talking glucometers exist but are too expensive for many people. These are serious issues considering the consequences of even minor variations in the dosage of many pharmaceuticals.
Access to Premises and Services
In addition to access to information, blind people are continually faced with issues relating to access to the physical and social environment. Very few health care settings seem to pay attention to the access needs of blind people when designing the physical environment. Many health care services are located in old and/or converted buildings, however even these settings can be made more accessible by means of better lighting,