Disabilities: Indispensable part for Social Development

Abhilasha Bhatta Karakheti

Introduction

A disability is a condition or function judged to be significantly impaired relative to the usual standard of an individual or group. The term is used to refer to individual functioning, including physical impairment, sensory impairment, cognitive impairment, intellectual impairment, mental illness, and various types of chronic disease. The Disability Discrimination Act (DDA) defines a disabled person as someone who has a physical or mental impairment that has a substantial and long-term adverse effect on his or her ability to carry out normal day-to-day activities. A normal day-to-day activity must affect one of the ‘capacities’ listed in the Act which include mobility, manual dexterity, speech, hearing, seeing and memory.

Types of disabilities

Types of disabilities include various physical and mental impairments that can hamper or reduce a person’s ability to carry out his day to day activities. These impairments can be termed as disability of the person to do his or her day to day activities.

These impairments can be termed as disability of the person to do his day to day activities as previously. Disability is categorized in seven types (Physical, Hearing, Visual, Deaf-blind, Speech, Mental and Multiple) by its nature and four types (Complete, Sever, Moderate and Milled) by its degree of severity.

Statistic of persons with disability in Nepal

 In Nepal no exclusive disability survey has been carried out so far by the government so that the government has no any comprehensive data regarding disability. Based on the WHO’s sample survey report it is estimated that around 10% of the total population are living with some kind of disability in Nepal.  Carry out disability survey throughout the nation at a time is too costly for the country like Nepal. Considering this reality the Ministry of Women Children and Social Welfare has identified an alternative way to bring the statistic in cost effective way.

Since 2009 the Ministry of Women Children and Social Welfare has started initiation to establish a system for collecting and updating data of people with disabilities in each district with the close financial and technical cooperation of local government agencies, disability related NGOs, disability resource center, CBR implementing NGOs and INGOs. The ministry has developed a uniform format and guidelines for data collection including special data entry software and provided to the local focal agencies. The local focal agencies of Ministry and CBR implementing NGOs were also given essential trainings and orientations about data collection and data entry. The Ministry also provided some small amount of budget to each district and coordinated the other local government agencies to contribute on that. This method has shown some encouraging results. According to the latest update nearly 55 out of 75 district have finished collecting data. This data are kept basically in the related district and used for making program and strategies to increase the access of Persons with Disabilities in health, education, livelihood, empowerment and social participation.

Beside this disability issues has also been incorporated in the population census held on 2011. This is believed that the census data will be helpful for the government to make statistics based national plan and strategies in the favor of persons with disabilities.

Common Conditions that Cause Disability

 

• Arthritis and other musculoskeletal problems. These are the most common causes of long-term disability. They make up as much as a third of all disability cases. Arthritis is probably the biggest single cause. About one in three people say that arthritis affects their ability to do their jobs in some way, according to the CDC. Other muscle and joint problems — bad backs, bones that never mend, bad hips — are common causes of disability too.
• Accidents. Although surveys show that people assume accidents are the most likely cause of disability, they are actually the cause of less than 10% of disability cases. This category includes not only accidents at home or on the road, but accidental poisoning too.
• Mental health problems. You might think of disability as physical, but mental health problems can make work difficult or impossible. Depression, bipolar disorder, and other conditions can be as disabling as any physical illness. Mental health problems are the most common reason that people file for Social Security disability,
• Nervous system disorders. This category includes a number of conditions — Multiple Sclerosis (MS), Parkinson’s disease, epilepsy, Alzheimer’s disease, and other conditions that affect the brain or nerves. MS is a leading cause of disability in young adults. It most often appears between ages 20 and 40.

Besides these, Heredity, Conflict and Poverty also plays major contribution to increase the number of disabilities in a society.

Important Legal Provisions and policies for persons with disabilities in Nepal

 Nepal promulgated Disable Welfare and Protection Act in 1982 which is probably the first exclusively disability related law in South Asia. This law has ensured various rights for people with disabilities such as free education, free vocational training, free health check up, reservation for employment in private sectors, travel fare discount, tax discount on assistive devices and accessories etc. Besides this the rights of persons with disabilities have also been incorporated in other national laws such as Education Act, Local Self Governance Act, Civil Service Act, Child Act, Transport related Act, Financial Act etc.

5% seats are reserved for persons with disabilities in civil service according to the Civil Service Act. 50% fare discount is given to disabled in domestic flight and other public transport. Every person with disability can enjoy free education in government school and campuses. In government hospital free health check up is available for disabled and each government hospital having more than 50 beds are entitled to reserve two beds for disabled persons at free of cost according to the disable welfare and protection bylaw.  Government revised the definition and classification of disability in 2006. People with complete disability are provided monthly social security allowance of Rs. 1000/-

Ministry of Women Children and Social Welfare have implemented a comprehensive disability related policy, named National Policy and Plan of Action on disability, in 2006. This policy has outlined 17 priorities including special issues of disabled children and women.  Nepal ratified the UNCRPD -2006 on 27 December 2009 by the legislative parliament and now the focal Ministry has forwarded the process of amending the domestic laws to make them compatible with UNCRPD.

 Governmental Body for Disability/National Structure

• Disabled Service National Coordination Committee (Chaired by Minister; represents from Go’s, DPOs, NGOs and Experts)
• CBR Directive &Coordination National Committee/IMC (Chaired by Secretary; represents from Cross Cutting GO’s, DPOs, SHOs, Experts)
• CBR Coordination and Monitoring District Committee(Chaired by Chief District Officer)
• CBR Village/Municipality (ward) Management Committee(Chaired by Mayor/VDC Secretary)
• Focal Ministry: MoWCS, Department and District level Office in all 75 District.

About NPPAD
National Policy and Plan of Action on Disability (NPPAD)

• NPPAD was formulated in 2006
• It is Ten Years Plan of Action
• It has remaining Five Years (Half of the Life)
• We’re revising CBR Guidelines (based on the guidelines of WHO)
• We have ratified UNCRPWDs

That’s why:

• As a state party there are obligations to effectively implement  the international  convention
•  Need for combined efforts from all stakeholders for the  effective  implementation of  the UNCRPWDs
•  Need a strategic plan for enhancing inter ministerial coordination for its effective implementation.

Main Points of National Policy and Plan of Action on Disability (NPPAD), 2006

• Training and Employment: Free Training and reservation on Agencies (Public and Private)
• Awareness and Advocacy:  Leadership Development and Capacity Building In Community Level Training
• Disable Friendly Physical structure
• Communication and Information
• Education: Free, Barrier less Environment, Inclusive/Special education and Teacher Training
• Prevention of Disability
• Health: Free, Bed Reservation
• Rehabilitation, Empowerment and Poverty Alleviation: National Disable Fund
• Assistive Devices: Free and To Develop Manpower
• DPOs, Self help Organization: To promote, to Protect, to assist and to include
• Women and Disability: Leadership, Inclusion, Entrepreneurship
• Spots, Culture and entertainment:  Representation on National Sports Council, Para Olympic Committee

 CBR Program

Rehabilitation program based on communities will be expanded for the people with disability. In this regard, a policy will be adopted to expand and develop human resources. A policy related to rehabilitation of people with disability will be provided and effectively implemented by amending the Disabled Protection and Welfare Act, 2039, and Regulation, 2051. For the empowerment of the people with disability, provisions will be made for technical and vocational training by providing loans in concessional rates for machine, equipment, and infrastructure development. Appropriate programs for empowerment of people with disability (social, economic and political) will be determined and effectively implemented. A fund will be established at the national level for social security and economic upliftment of people with disability.

Assistive Devices Production and Distribution

 Assistive devices are a tools, to help the person with disabilities to perform tasks and daily life activities. Assistive devices for mobility/ambulation can also be referred to as ambulatory aids. Ambulatory aids (eg, canes, walkers) are used to provide an extension of the upper extremities to help transmit body weight and provide support for the user.

Assistive devices can help to improve the PWDs quality of life and maintain to sense of independence. Well designed high quality assistive devices, or daily living aids, that support independent living for the handicapped and disabled people or those with a medical condition or injury should make life easier and safer for the aged and disabled.

The government of Nepal has to the launched the program to make ensure of the disable people by assistive devices on the basis of disabilities people. Now government has established five regions assistive devices centers.

Social Security of Person with Disabilities

 Family structures are still very strong in Nepal. In many ways this provides a structure of support for disabled people within the family which can at times be lacking in the West. However, there are also instances where extreme poverty combined with lack of awareness about the potential of disabled people can lead both to over protection and at times to abusive and discriminating treatment. Western commentators are often quick to blame such behavior on traditional and unenlightened beliefs. However, it is important to continually bear in mind the effects which extreme poverty has in creating a negative environment for disabled people. For example, a recent article in a Nepali newspaper described a village family who had resorted to physically restraining their adult son who had mental health difficulties. The family said that he had, for a period of time, received appropriate medication which had greatly improved his situation. However, when the medication ended they were unable to afford to repeat the subscription hence his behavior had greatly deteriorated.  Examples such as these show the urgent need for action at the levels of policy, of public awareness and of implementation. Certain actions have tried to address this situation. For instance the DHRC weekly radio program Disability Voice on disability has done much to raise awareness. However it is very clear that far more needs to be done on a national level if disabled people throughout Nepal are to be allowed and supported to play an equal role in society.

 Social Welfare

 The Act allows for disability allowance to be paid to disabled people, but this is a empower rather than a duty and is qualified by statement that this is subject to available resources. People with mental health difficulties: The Act states that people with a mental disorder should have arrangements made for them to be treated either at a hospital or at home. Although this is then qualified by the next phrase except for treatment or security arrangements.

Empowerment Program for Person with Disability

• Vocational Training Centers
• Sheltered Workshops
• Special Schools for the Persons with Disabilities
• Project for Cerebral Palsied Children
• Project for Pre-School and Early Intervention and Training
• Home based Rehabilitation Program / Home Management Program
• Project for Rehabilitation of Leprosy Cured Persons (LCPs)
• Project relating to Survey, Identification, Awareness and Sensitization
• Project for Community Based Rehabilitation
• Project for Human Resource Development
• Seminars / Workshops / Rural Camps
• Project for Legal Literacy, Including Legal Counseling, Legal Aid and Analysis and Evaluation of Existing Laws
• Environment Friendly and Eco-Promotive Projects for the Handicapped
• Grant for Purchase of Vehicle
• Grant for Computer
• Project for Low Vision Centers
• Community Based Rehabilitation Centers (CBRCs)

Conclusion

There is still very much work to be done in the area of policy development and policy implementation in Nepal. However, it has also shown how much potential there is for this development to take place. The current political situation, both internal and external, is supportive of changes which need to occur. Moreover Nepal has in recent years developed both individual examples of very good practice and also has seen the rise of committed disability organizations who are keen to work together to take advantage of the current political context. In the situation where every citizen, morally and ethically realizes the circumstances of a disabled and gets devoted towards the disabilities, there is a no long day when disabilities live like a proud citizen of this nation. For this, all the government and non-governmental organizations should work as a helping hand from urban to remote villages without any discrimination. With this, we will be able to achieve our millennium goals and build a prosperous nation

Abhilasha Bhatta Karakheti is working in Ministry of Women, Children and Social Welfare of Nepal

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