The World Health Organization has defined health as "a complete physical, mental and social well-being and not merely the absence of disease or infirmity." The concept has more recently been extended to include healthrelated quality of life (1,2). According to the international classification of impairments, disabilities, and handicap, impairment is concerned with physical aspects of health, disability has to do with the loss of functional capacity resulting from impaired organ, and handicap is a measure of the social and cultural consequences of an impairment or disability (1). Disability affects physical health, social relationship of people, life in the realms of family, friends, and neighbours, psychological state, and level of independence (3). The consequences of disability can have an impact at personal, interpersonal, family and social levels.
Although disability is as old as the human race, the issue of disability and the experiences of disabled people have received little consideration in general academic circle (4). These issues have been marginalized, and only in the disciplines of medicine and psychology, has disability been given an important place. People with disabilities remain at the margins of society as one of the impoverished groups (5). The International Year of Disabled Persons in 1981 stimulated much interest worldwide in disability. UNICEF has estimated that fourfifths of the disabled people of the world live in developing countries (1). The overall low levels of development and inadequate health and social welfare services have all contributed to the persistence of poor quality of life among the disabled people in these countries, particularly in Bangladesh. It is generally agreed that more information on the extent of the impact of disabilities is required to formulate future policies aiming at improving the quality of life of disabled people (6,7).
The quality of life of disabled people has been studied in developed countries. As the various health indicators of population are improving in developing countries, attention should now shift to improve the quality of life of the marginalized and under-privileged groups. In Bangladesh, where life is difficult for many able-bodied people, disabled people are more likely to face much greater problems in the absence of a disabled-friendly environment. They are less likely to be educated, employed, or rehabilitated. Social segregation of disabled persons is extremely widespread (8). Moreover, social welfare services do not still provide special privileges for the disabled. As a result, most disabled people usually face insensitivity, cruelty, and often pity. The dominance of a medical model of disability has tended to 'blame the victim' which, as Imrie states, shows people with disabilities as 'inferior, dependent and of little or no value' (5). This discrimination prevents or confuses thinking about solutions. Although some changes in approach have taken place, there is still a need for major changes if disabled people are to be integrated comfortably within mainstream society.
Attempts have been made to publish a series of papers on disability in Bangladesh. One paper on the prevalence and pattern of disability and another on the use of healthcare by disabled people have already been published (6,9). The present paper reports the results on impact of disability. Disability affects the different facets of life of a person, and this life is often complicated by negative forces, such as ignorance, prejudice, negativism, and insensitivity. The study attempted to explore and understand disability, particularly in the light of its psychological and social impacts. The results of this study are expected to help us understand in detail the impact of disability on the quality of life of disabled people in rural Bangladesh. This, in turn, will guide policy-makers in framing laws and prioritization and allocation of resources to create a disabled-friendly environment in Bangladesh. …