China won nearly twice as many medals as the closest countries in the 2008 Paralympics, winning over 200 medals. Their take in 2004 was only 1.5 times their nearest competitors. We know that China starts training their athletes from the age of 4. China's out sized success at the paralympics makes me suspect that those who can't quite make the cut are incentivized to injure themselves in such a way as to make themselves viable competitors in the paralympics. Think of it as a more glamorous version of Indian beggars who are forcibly amputated in an attempt to increase their donation rate. Another possibility is that the training routines in China are so rough or general safety conditions are so much worse in a large developing country that when this is combined with a government program focused on winning medals then many more athletes end up being qualified compared to developed countries. Diminished mental capacity qualifies athletes for certain events at the paralympics, so those who decide to fake it at least don't have to inflict permanent bodily harm on themselves.