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Posted July 1997

Special: Empowering the rural disabled in Asia and the Pacific
Disabled women in rural areas of the region
Fahmeeda Wahab
Development Adviser, Canadian High Commission
Bangladesh
E-mail: fahmeeda.wahab@dhaka01.x400.gc.ca

Introduction | Women | Cambodia 1 | Cambodia 2 | Lao PDR | Sri Lanka | Thailand 1 | Thailand 2 | Vietnam 1 | Vietnam 2 | Agroindustry | Horticulture | Strategies

Introduction

Development practitioners are often in unison in recognising and proclaiming that women comprise one of the various sub-groups within the genre of the overall disadvantaged population in the developing countries. A myriad of factors contributing to their 'most disadvantaged' position - a situation of doubtful distinction- are identified. There are abandoned women, distressed women, widows, separated and divorced women, assetless women, women heads of households, illiterate women- the list is seemingly unending. It is revealing that in this enormous list of sub-groups of the disadvantaged population, seldom is any mention made of disabled women. Disabled women, therefore, comprise one of the most neglected, if not almost totally ignored segment of the population. The blindness, deafness and muteness regarding the existence of, and problems encountered by disabled women, among those of us working supposedly for the benefit of disadvantaged women at the grassroots, national, regional or global levels, may be understood by reviewing data on the disabled.

It is necessary to understand clearly why and how disabled women are at a greater disadvantage compared to disabled men. For both men as well as women, disability becomes more of a disadvantage when compounded by low socio-economic and educational status. Women in developing countries are generally in a worse situation compared to men by these counts. Disabled women, therefore, who are poor and illiterate are worse off than men under same conditions. In the case of women the one factor where men are distinctively better- off is in the area of socio-cultural set-up. In the context of majority of Asian countries, women are assigned a low status culturally. Cultural biases against women manifest themselves in preference for male children, incidents of female infanticides and/ or foetal murders, higher malnutrition among female children due to differential allocation of food among male and female children, preferential treatment of male children in terms of greater health care and access to education, dowry deaths and so on. Given this biased cultural set-up, and given limited resources at the national, community and household level in a developing country, it is considered a bad investment to spend on educating a disabled girl child, adolescent or woman and to rehabilitate them so that they can be integrated into the community as productive and equal members.

Thus a disabled woman is left aside, isolated, marginalised, socially unaccepted and neglected- an object of pity, and considered to be a burden barely borne out of sheer humanistic obligations. The vulnerability of a disabled women is multiplied manifold as she is mentally and/or physically unable to fend for herself in the face of sexual harassment, rape or other forms of physical violence.

Statistics: Where are the disabled?

There is hardly any data on the extent of the disabled population in recognised sources of international data. The World Development Report, the Human Development Report, the Asian Outlook- three major authorities on world level data published annually by the World Bank, the UNDP and the Asian Development Bank respectively, do not have data on the number of disabled persons in different countries. The much proclaimed Human Development Index (HDI) has failed to include this aspect of very real human misery. National level statistics are also not collected or collated on a regular basis on the disabled. Apart from a few sporadic and infrequently undertaken studies and surveys, data on the nature and extent of disabilities is not available in most of the countries of the Asia-Pacific region.The exclusion of data on the disabled amongst a melee of other socio-economic and health indicators in itself brings to the fore the marginalisation of the issue within the broad spectrum of concerns relating to human resources development.

In this scenario of overall data gaps on the nature and extent of disability, sex disaggregated data is even more difficult to obtain. So much so, that disabled women remain invisible in the arena of planning and formulating policies and programmes of poverty alleviation and development.

Data on the number of disabled, obtained through national surveys conducted in several countries in the region is presented in Table 1. This data pertains to different years and is being used in the absence of more recent data. It is indicative of the magnitude of the disabled segment of the national population.

The data shows that the percentage of disabled adult population ranges from 1- 3 percent. This is consistent with estimates by ILO which state that `4 percent of any working population are likely to have significant mental or physical impairment'. Whereas according to WHO figures, 300 million or 10 percent of the population in developing countries are disabled and 3.5 percent are physically handicapped. The figures may be considered to be consistent, considering that a significant percentage of the disabled comprise children and youth.

Despite the constant cry for gender disaggregated data on all aspects of human life, data on disabled men and women separately is not easy to find. Nor is data available in readily usable form on the segments of the population with specific disabilities. In order to ensure inclusion of gender concerns into the issue of rehabilitating and integrating the disabled into the mainstream of productive society, data on disabled women and their specific problems and needs have to be collected and analysed through adequate and focussed research.

Table 1. Number and Percentage of Disabled in the Population of the Asian Region
Country Year Number/Percentage of Disabled Population
Bangladesh 1985 10% of the population
India198112 million
Indonesia1990 (est.)300,000 handicapped children
China198550 million are disabled. Among them, 8.7 million are children between 0-14 years, i.e. 41.3 million are disabled adults
Republic of Korea19852.5% of the population or 915,000
Nepal-3% of the population
Pakistan-10 million handicapped (4.6 million adults)
The Philippines-3.4 million disabled children
Sri Lanka198712% of all primary school going children suffer from visual, speech, hearing and motor problems
Vietnam1989 There are 1.5 million handicapped children and youth
Source: Report on the Tenth APEID Regional Seminar on Special Education, Japanese National Commission for UNESCO and NISE

It is important to differentiate between different types of disability and their sources of origin. Some broad categorisations of disabilities are based on whether they are physical or mental; congenital or acquired, preventable or not, curable or non-curable and finally, according to the degree to which the disabled can be effectively rehabilitated/ integrated into productive society. If education and training/ rehabilitation and employment programmes for the disabled are to be meaningful and sustainable , it is imperative that these distinctions be considered consciously and data be collected on a regular basis on the different types of the disabled.

Initiatives, albeit extremely inadequate, have been taken at the global, regional, national and community levels to address the needs of disabled men and women. Although some of these initiatives have recognised the need for viewing the problem of disabled women separately, projects specifically for disabled women are extremely limited and far between.

Initiatives for the disabled revisited

In recognition of the importance of focussing on the needs of the disabled, the United Nations had declared 1981 as the International Year of the Disabled Persons and 1983-1992 as the International Decade of Disabled Persons. Accordingly, the World Programme of Action Concerning Disabled Persons was adopted by the UN General Assembly in its 37th Regular Session in December 1982. The Programme of action called for promotion of disability prevention and rehabilitation and equality of opportunities for disabled persons. The Programme of Action defined rehabilitation as 'a goal-oriented and time limited process aimed at enabling an impaired person to reach an optimum mental, physical and/or social functional level, thus providing her or him with the tools to change her or his own life. It can involve measures intended to compensate for a loss of function or a functional limitation (e.g. technical aids) and other measures intended to facilitate social adjustment or readjustment.' Among other things, the measures referred to above were considered to include the following:
Social, psychological and other types of counselling and assistance training in self-care, including mobility provision of technical and mobility aids and devices specialised educational services vocational rehabilitation services (including vocational guidance) training placement in open/sheltered employment.
In 1987, the Economic and Social Council of the Asia-Pacific (ESCAP) of the UN, in collaboration with the Asia-Pacific Council of Disabled People's International had convened a Regional Expert Seminar to Review Achievements at the Mid-Point of the UN Decade of Disabled Persons. The Seminar identified negative societal attitudes as a major impediment to the World Programme of Action in the Asia-Pacific region. As a follow-up to this finding, ESCAP has proclaimed 1993-2000 as the Asia Pacific Decade of Disabled Persons. One aim of this initiative is to prevent disabilities and rehabilitate the disabled within the community by creating a facilitating environment for them so that they can be integrated and participate as equals with the able bodied.

Educating the disabled : Some pertinent issues

In the context of designing programmes for educating, training and employing the disabled, it is necessary to understand the fine distinctions between an impairment, a disability and a handicap. These distinctions were voiced in the UN World Programme of Action Concerning Disabled Persons as follows: In developing countries, where the rate of unemployment and under-employment is high, and resources are scarce, the scope of preventing or curing, either partially or fully, and educating, training and rehabilitating the disabled is limited. In the case of rural areas, with extremely limited levels of awareness and physical facilities, this is more true. In the case of women, the situation is most deplorable. For a rural or a rural based woman, therefore an impairment almost invariably translates into a disability and a handicap. There are other ways in which an impairment may become a handicap. A physical impairment may lead to emotional distress which, in turn results in impairment in mental abilities. Unacceptance by the mainstream society and marginalisation may also lead to the disabled himself or herself, their family as well as the community to view the disability to be synonymous with a handicap.

Responses to the needs of the disabled have been undertaken in almost all countries in the world at the national as well as private and non-governmental levels. Curricula and training modules for the disabled have been designed and used in special institutions as well as in normal schools as integrative programmes.

Five types of disabilities have been generally identified for purposes of designing education and training programmes for the disabled, viz., mental retardation, motor impairment, speech and hearing disability, visual impairment and autism. The efforts of selected countries in Asia are mentioned below as illustrations.

Bangladesh

The Department of Social Welfare under the Ministry of Social Welfare, Government of Bangladesh, along with NGOs and voluntary associations provide services for the disabled in the country. The Bangladesh Protibondhi Kalyan Samity (the Bangladesh Association for the Welfare of the Disabled) is the only association for all types of the disabled in the country. Besides, there are associations for people with specific types of disabilities such as the Bangladesh National Association for the Deaf,a Rehabilitation Institute and Hospital for the Orthopoedically Disabled (RIHOD), run under the government initiative. Some NGO efforts include provision of residential facilities for poor children under treatment at the RIHOD.The Bangladesh Institute for the Mentally Retarded (BIMR) is involved in rehabilitation of the mentally retarded. There are also institutions for the paralysed. Schools for the hearing and speech impaired and training and rehabilitation of the visually impaired including sheltered workshops are run under both public as well as private initiatives. For the visually impaired, there are 51 integrated schools, out of which 47 are government-run and four are run privately. Out of these 57, the integrated programme is operational in 42 schools. The percentage of female students in these schools is very low. A survey in these schools revealed that out of all 42 schools, only in one was there 50 percent participation of female visually impaired students. Out of 229 visually impaired students who have passed the Secondary School Certificate examination, only 17 are females. Apart from a few NGOs addressing the needs of the visually impaired, the needs of women in these special circumstances are addressed inadequately.

It is ironic that although 87 percent of the disabled population live in rural areas almost all the education and training institutions for the disabled are located in the urban areas and almost exclusively address the needs of urban and relatively well off people. In the rural areas of Bangladesh girls without any impairments are not normally sent to school due to socio-cultural taboos like 'purdah'. Even if such taboos are overcome, the physical constraint in the form of inadequate transport facilities would render it almost unthinkable for disabled girls and women to avail opportunities of education and training, even if they were available in the rural areas.

India

There are four national institutes for the visually handicapped, speech and hearing impaired, mentally handicapped and orthopaedic handicapped. The problem of providing education and training to the population with speech impairment, the mentally handicapped and those suffering from cerebral palsy are acute due to resource constraint, both in terms of physical resources as well as in terms of trained and motivated manpower.

Indonesia

Special education programmes are run for the blind, deaf and speech impaired, mentally retarded, emotionally disturbed and socially maladjusted.

China

China has a hundred year history of Special Education (education of the handicapped). The first national survey of the handicapped was conducted in 1987. On the basis of the survey six categories of handicapped were identified: the visually impaired, mentally handicapped, physically handicapped, emotionally disordered and multiply handicapped. However, detailed data on the various types of disabled population is not readily available. Moreover, combining the categories of hearing and speech impaired renders it difficult to identify the extent of the hearing and speech impaired separately. As a result, there are no special schools for the speech impaired. Despite limited resources, China aims to provide education for all handicapped persons by the year 2000 and integrate them with the mainstream population.

Malaysia

In the integrated schools which are run for the disabled, an additional four years is allocated for the disabled. Vocational education is also imparted.

Nepal

Special schools for the visually and hearing impaired and the mentally retarded are run. However, these are extremely inadequate considering the population. It has been estimated that 1.25 percent of the hearing impaired children below 14 years are attending school.

Pakistan

It has been estimated that among the 10 million handicapped people in Pakistan, the distribution between urban and rural areas is in the ratio 3:1. Out of this figure, there are 1.1 million young people upto 20 years who need education and training as well as employment opportunities. A survey conducted in 1986 in Islamabad showed the breakdown of population with various types of disabilities. According to the survey, the breakdown was as follows: mentally handicapped 21%; visually impaired 15%; hearing impaired 9%; physically handicapped 33%; multiply disabled 19% and other types of disabled 3%.

The Directorate General of Special Education has provided legislative support to the disabled through the passing of an Ordinance in 1981. The Ordinance has fixed a quota of 1 percent of employment for the disabled in all employment agencies employing more than 100 persons. Other measures include exemption of duty on import of motor vehicles and other equipment used by the disabled.

The Philippines

Various Acts and Codes have been formulated for the disabled. Special education is provided to the visually and hearing impaired children. In the school year 1990-91, 80,529 children were enrolled in public and private special schools. Forty seven of them had autism.

The Republic of Korea

There are special schools separately for five types of disabilities: the mentally retarded, visually impaired, hearing impaired, physically and health impaired and for the emotionally disturbed. The ministry of education is in charge of these schools where education is provided free of cost.

Sri Lanka

At present there are 26 special schools and 600 integrated special units to cater to the needs of 10,000 disabled children although the population of disabled children in Sri Lanka has been estimated to be 400,000. Most of the disabled children are mentally retarded (75%) and therefore academic under-achievers. There are 824 hearing impaired and 1202 mentally retarded children in 89 special and 135 regular schools respectively. The number of children with speech disorders, autism and multiple disabilities is negligible. In addition to the special schools, special homes and institutions cater to the needs of 300 mentally retarded and multiply handicapped children. Teachers training courses are also provided. All the special schools operate under the jurisdiction of the Special Education Unit (SEU) under the Chief Education Officer. The SEU is also involved in policy formulation and coordination with other government ministries. The National Institute of Special Education (NISE) is responsible for training of the education personnel, research, curriculum development and provision of consultancy services. The NISE faces shortage of funds from local sources. This is a reflection of the low priority accorded to the education of the disabled.

Thailand

Educational institutions for the disabled in Thailand operate under both public as well as private initiatives. There is only one institution for the education of autistic children, the Child's Psychiatric Hospital. This hospital accepts day and board children. It has been estimated that 4.5 children per 10,000 are autistic. The male: female ratio is 4.5:1. This may be due to low incidence of autism among female children, but it could also be due to reportage or low rate of help-seeking by female autistic children. Data on other types of disabilities, e.g., cleft lip/palate, multiply disabled are not available. There are no special institutions for children with multiple disabilities. Some private institutions are coming up to meet the needs of disabled children, albeit in a limited number, e.g., the Foundation for the Mentally Retarded under the patronage of the Queen. The major problem faced by both public as well private institutions is lack of funds.

Resource constraint and the extra cost involved in educating and training as well as rehabilitating prevent NGOs and other similar organisations to take up programmes for the disabled in rural areas. This is a myopic view like all other programming exercises which are undertaken without considering the felt needs of the people. Disabled women ( and men) who are not productively employed and even those who are not able to perform their day to day activities without the help of others impose a cost to their families and to society. This cost should be weighed against the costs of providing training and education to them.

Although resource constraints impede the provision of education to the disabled, the major problem goes beyond this. It has its roots in attitudes and perceptions of the mainstream society. There is widespread ignorance regarding the causes of disability and the potential of disabled people to become productive and self-reliant members of society. Acceptability of disabled children , especially visually, speech and hearing impaired, motor disabled and mentally retarded in general schools is extremely limited. Often, in fact, the difference between mentally retarded and mentally disturbed or mad people is not made. Thus, it is the attitudinal 'barrier' prevailing in the mind set of the families of the disabled and the community which is the major impediment towards making education and training for disabled accessible to rural women.

Employment

A legal provision for ensuring employment opportunities for the disabled was given in the form of the Convention Concerning Vocational Rehabilitation and Employment (Disabled Persons) (No. 159) passed by the International Labour Organisation (ILO) in 1983. The convention provides for vocational rehabilitation measures for all categories of disabled persons. It also provides for equal opportunities for the disabled and general workers. Apart from the fact that social justice calls for equalisation of opportunities for disabled persons, from the economic policy of view, it is imperative that the disabled are provided an enabling environment so that they can participate in economic activities. It is also imperative that the disabled person be integrated into the day to day activities of the household and community.

Attempts are being undertaken through Community Based Rehabilitation to integrate the disabled with the mainstream of the society. Employment opportunities for disabled rural women must be contextual to their socio-cultural set-up in order not to further jeopardise their integration within the community. At the same time there is need for community education to counter discrimination and isolation of the disabled. Disabled persons should be the ultimate decision makers in matters affecting rehabilitation. Therefore careful needs assessment should be made taking into account gender differentials, custom, age, marital status etc. In view of the paucity of data on employment of rural disabled women, three institutions in Bangladesh were identified and their activities in this field reviewed. These may safely be taken to provide a representative picture of the situation prevailing in Bangladesh regarding the employment of disabled rural women in the country.

Bangladesh Protibandhi Kalyan Somity (BPKS)

This is a non-profit, voluntary organisation the members of which are all 'persons with disabilities (PWDs).It was established in 1985 and subsequently registered with the Ministry of Social Welfare and the NGO Affairs Bureau. As of October, 1994 there were 1550 full members (both male as well as female) spread across ten district branches. The organisation has used these branches to form a network among PWDs in most parts of Bangladesh. BPKS has a general body and an 11 member Executive Committee comprised of representatives from each district branch. The Executive Committee, which runs the overall activities of the organisation, is elected to office and thus ensures the participation of grassroots level PWDs in decision-making and implementation of programmes. BPKS is the only self-help organisation of the disabled in the country which caters to the needs of all types of disabled. The staff comprise both disabled as well as non-disabled persons in the ratio 51:49. Among the rehabilitation and employment programmes for disabled women run by BPKS, there are two tailoring training centres in Mymensingh and Chandpur. Every year thirty female and male PWDs receive training on tailoring from each of these centres. The trainers are also disabled women. During the training period, a stipend is provided to the trainees.

As part of its Community Based Rehabilitation (CBR) Programme, BPKS runs two projects in Norshingdi and Jamalpur. Among other components, formation of groups (cooperatives) with disabled and non-disabled members, savings and credit activities for income generation are the main features of these projects.

The branches are provided with technical and logistic support as well as limited financial resources to undertake need-based programmes. The branches also mobilise their own resources to undertake programmes for the local PWDs.

Recently a Women's Group has been formed at the organisation comprising 12 members. This group is mandated to undertake programmes specifically for disabled women. The group is headed by a physically handicapped woman.

BPKS also has a Job Placement Programme under which it motivates employers in the government, private sector and NGOs to employ PWDs, provided they have the qualifications. Since November 1988, 84 PWDs (male and female) have been assisted in having a full-time job. Follow-up is also done to help PWDs and their employers resolve problems during the service period.

Helen Keller International

This is an international NGO . It is an urban based NGO, but it provides technical assistance for the education and rehabilitation of the blind. It provides counselling services for blind children and their parents. It also has Job Placement programmes. It provides training to NGOs for employing visually impaired people. An attempt was made by HKI to route credit to rural blind women through a local NGO so that they may undertake income-generating activities. But the programme has been abandoned once it was found out that the benefits of the programme did not accrue to the visually impaired rural woman in a sustained manner. It was found that once the credit was repaid, the capital equipment (for instance rickshaws) would be taken over by the non-disabled male family members, without giving any returns to the disabled female. HKI itself employs three visually impaired persons,out of whom two are female.

Fellowship for the Advancement of the Visually Handicapped (FAVH)

This is a local NGO for the visually impaired. It runs a programme in Faridpur under which blind men and women are trained in tailoring skills and in making cane furniture. They are provided with funds at the end of the training programme with which they may start up their own trades.

Bangladesh Deaf Women's Welfare Association

This is a relatively new association. It is also a voluntary, non-profit organisation. It has emerged as a corollary to the Bangladesh Deaf welfare association and is yet to be registered. However, the Bangladesh Deaf Welfare Association is the largest national association for the deaf. This association along with the association for deaf women is located in Dhaka. There are four regional offices which provide a networking facility with the deaf all over the country.The Deaf Women's Welfare Association provides training in tailoring to deaf women. It has seven sewing machines and one embroidery machine. A six-month course is run by two teachers. The women are given transport and daily allowances. The Association has an executive body, the member-secretary of which is a hearing impaired woman.

Agenda for future action

Although 70-80 percent of the disabled in developing countries, including those of Asia live in rural areas, most of the programmes for the disabled cater to the urban population. It is also evident that most of the programme beneficiaries are men, inspite of the fact that many of them are 'gender neutral' and may even have a female bias in traditional terms. Most of the activities are related to self-employment or to employment in small and cottage industries (eg., tailoring, cane furniture). For rural disabled women, there seems to be a considerable potential for small industrial activities.

A necessary precondition to appropriate policy formulation and programme strategy is availability of data. It is evident that there are considerable data gaps. National census data should include data on disabled women at sufficient levels of aggregation, (eg., rural-urban, male-female, age and socio-economic groups). Data should also be disaggregated in terms of specific types of disabilities. These data should be readily available to the relevant policy-making bodies.

Policies should consciously take into account the needs of the disabled. There are examples of legislations passed at the international and national levels for ensuring equal rights for the disabled to participate in formal employment. Quotas can be set aside and enforced for employing disabled persons. In countries like Bangladesh, the infrastructure for integrating disabled women into economic activities exist in the form of a large number of NGOs as well as public sector programmes spread throughout the rural areas. These organisations and programmes have the manpower and the receiving mechanism which can be used to provide training and credit services to the rural disabled women.

Policies which can be formulated and implemented with relative ease are those pertaining to creating an enabling environment for the disabled to participate more fully in economic and social activities. Modifications and provisions in building designs, in roads and modes of transport which take into consideration the needs of the disabled can easily be ensured. In Bangladesh, as a result of lobbying by the BPKS, the Building and Housing research Institute under the Public Works Department has passed a resolution to the effect that in future all government buildings will have provisions so that the disabled may easily access them. Similar initiatives may be undertaken for roads in terms of having audio traffic signals, among other measures. Similarly, in the rural areas, special schools for the disabled women may be located at convenient localities or the timings may be set in accordance to the convenience of the women.

Equipment used by the disabled should be designed in such a way as to suit the social and cultural setup within which the disabled person lives. For instance, in designing artificial limbs, a woman's need for cradling a an infant and feeding her and stooping to collect water or fuelwood must be taken into consideration.

The most important issue for integration of the disabled in any society is for the mainstream to act and live in conjunction with and not separately from the disabled. For this, awareness regarding the nature of disabilities, their causes and the potential ability of the disabled must be raised. Communication skills of the non-disabled with the disabled could be enhanced by teaching the basics of sign language in schools and through the media.

The disabled people have immense potentials which reman untapped. These can be put to productive and profitable use to benefit the family, the society and the country. It is said that a nation's development is also measured by the ease with which it integrates the disabled into the mainstream society. As a criteria of development, the issue of considering the disabled as a neglected but extremely important sub-group of the population merits immediate and continuous attention.


Empowering the rural disabled: Introduction | Women | Cambodia 1 | Cambodia 2 | Lao PDR | Sri Lanka | Thailand 1 | Thailand 2 | Vietnam 1 | Vietnam 2 | Agroindustry | Horticulture | Strategies



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