Hesperian Health Guides

Causes of disability

In this chapter:

Some women have been disabled since birth. Some women become more disabled over time. Some women become disabled suddenly, because of an accident or disease.

It is not possible to prevent all impairments. Some babies form differently inside the womb and no one knows why.

But many disabilities in babies are caused by harmful conditions of women's lives. If women can get enough nutritious food to eat, can protect themselves from work with toxic chemicals, and can get good health care, including care at the time of childbirth, then many disabilities could be prevented.

a thin, sick baby who does not get enough food.

Poverty and malnutrition

Poverty is one of the biggest causes of disability. Poor people are most vulnerable to disability because they are forced to live and work in unsafe environments with poor sanitation, crowded living conditions, and with little access to education, clean water, or enough good food. This makes diseases such as tuberculosis and polio--and the severe disabilities they cause-- much more common because diseases get passed from one person to another more easily.

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While she was pregnant, the mother of this girl with cleft lip and palate did not get enough food to eat containing folic acid and calcium (such as dark green leafy vegetables, beans, and eggs).

Many babies who are born in poor families may be born with disabilities or may die in infancy. This may be because the mother did not get enough to eat when she was pregnant. Or it may be because she did not get enough to eat when she was a girl. Starting in childhood, a girl is often given less food to eat than a boy. As a result, she may grow more slowly and her bones may not develop properly, which can later cause difficulty during childbirth-- especially if she does not receive good health care.

If a baby or young child does not get enough good food to eat, she or he may become blind or have trouble learning or understanding.


In today's wars, more civilians than soldiers are killed or disabled, and most of them are women and children. Explosions cause people to become deaf, blind, and lose their limbs, as well as causing other injuries. Their mental health is also badly affected by the violence. The destruction of homes, schools, health centers, and means of livelihood that results from conflicts and wars leads to increased disability, poverty, and disease.

Nuclear accidents

Many people have suffered after being exposed to massive amounts of radiation. This happened after accidents in nuclear power plants at Three Mile Island in the USA in 1979, and at Chernobyl in the Ukraine in 1986. And it also happened when the USA dropped nuclear bombs on Japan in 1945. These incidents caused widespread destruction and death from exposure to radiation.

The people who survived these accidents and bombing attacks have suffered mainly from cancers--either tumors in various parts of the body, especially in the thyroid gland—or leukemia (cancer of the blood), all of which bring an early death. In communities where these nuclear incidents happened, there has also been an increase in the number of children born with learning difficulties, such as Down syndrome.

Poor access to health care

Good health care can prevent many disabilities. Difficult labor and birth can cause a baby to be born with a disability such as cerebral palsy. Trained birth attendants who can identify risks and handle emergencies can prevent babies from being born with many disabilities. Immunization can also prevent many disabilities. But many times vaccines are not available, or people who are poor or live far from cities cannot afford them, or there are not enough for everyone.


a child cupping a hand behind her ear.
If a woman gets German measles (rubella) during the first 3 months of pregnancy, her child may be born deaf.

Some illnesses a pregnant woman may get can cause physical or learning problems when her baby is born. Illnesses that can cause birth defects include German measles (rubella), which is a common cause of deafness in newborn babies. There is a vaccine that gives protection against rubella, but a woman who gets an immunization of the rubella vaccine should not get pregnant for one month afterward.

Syphilis, herpes, and HIV can also be passed from a mother to her baby and can cause birth defects. So women need to be tested and treated for sexually transmitted infections to protect the baby developing in the womb.

Some illnesses a baby or small child may get can also cause disability, such as meningitis, polio, and measles. It is important for newborn babies to get immunizations for protection. Children who live in places where leprosy (Hansen's disease) is common need to be tested as early as possible.

Medicines and injections

When used correctly, certain injected medicines, like some vaccinations, are important to protect health and prevent disability. However, there is a worldwide epidemic of unnecessary injections. Each year these unnecessary injections sicken, kill, or disable millions of persons, especially children.

a syringe with a large X drawn through it.
Avoid unnecessary injections.

Giving injections with an unclean needle or syringe is a common cause of infection and can pass the germs that cause serious diseases such as HIV/AIDS or hepatitis. Unclean injections are also a common cause of infection that can lead to paralysis or spinal cord injury or death. Also, some injected medicines can cause dangerous
allergic reactions, poisoning, and deafness to a baby in the mother's womb.

A needle or syringe must never be used to inject more than one person without disinfecting
it each time.

Some medicines and drugs taken during pregnancy can cause disability in the baby. The overuse of injectable medicines, such as oxytocin, to speed up childbirth and 'give force' to the mother's labor, deprives the baby of oxygen during birth. It is a major cause of brain damage. Alcohol and tobacco used during pregnancy can also damage a developing baby.

Everyone must consider the possible risks and benefits of using any medication. Doctors, nurses, other health workers, pharmacists, and everyone else must stop the misuse and overuse of medicines—especially of injections. For ideas on teaching about the danger of unnecessary injections, see Helping Health Workers Learn, Chapters 18, 19, and 27.

Dangerous work conditions

Women who work long hours without enough rest are likely to have accidents. Women who work in factories, mines or on agricultural plantations can be exposed to dangerous machinery, tools, or chemicals. Accidents, overwork and exposure to chemicals can all cause disability.

A growing number of women have also been permanently injured due to violence at work. Supervisors sometimes use violence and threats to try and make women work harder and faster. Sometimes the authorities bring in the military or police to stop women from striking or protesting unsafe working conditions.


Many women and children get disabling injuries at home by burns from cooking fires, falls, road accidents, and breathing or drinking toxic chemicals. Workplace accidents, especially in less regulated sectors such as construction, agriculture, mining, and smaller businesses, are a common source of disability.

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This woman was a farm worker and was exposed to dangerous chemicals when she was pregnant. This affected her baby while he was in the womb, and he was born with a disability.

Poisons and pesticides

Poisons such as lead found in paints, pesticides such as rat poison, and other chemicals can cause disabilities in people and cause birth defects in babies growing in the womb. Smoking or chewing tobacco, breathing smoke, and drinking alcohol during pregnancy can also harm a child before she is born.

Workers often use chemicals on the job or in the fields without being taught how to use them safely, or without even knowing if they are dangerous. Accidents in factories can release poisons into the air, water, or ground, causing terrible health problems, including permanent disabilities.

Inherited disabilities

Some disabilities are known to be inherited, such as spinal muscular atrophy and muscular dystrophy (diseases of the muscles and nerves). Women who already have one or more children with an inherited disability are more likely to give birth to another child with the same problem. Other disabilities can result when close blood relatives (such as brothers and sisters, first cousins, or parents and children) have children together. Children born to mothers 40 years of age or older are more likely to have Down syndrome. However, most disabilities are not inherited. In most cases, the parents of a baby born with a disability did nothing to cause the disability. They should never be blamed.

This page was updated:30 Nov 2023