Acute lack of professionals to support the disabled community in Nepal

International Day of People with disabilities (PWDs), an international observance promoted by the United Nations since 1992, is celebrated every year on 3 December which aims to promote the rights and well-being of PWDs in all spheres of society and development, to increase awareness of, in the situation of PWDs in every aspect of political, social, economic, and cultural life.

The history of the day turns down to 1976, when the United Nations General Assembly proclaimed 1981 as the International Year of PWDs.

The theme for this year’s International Day of PWDs is “Transformation towards sustainable and resilient society for all”.

PWDs, on average as a group, are more likely to experience adverse socioeconomic outcomes than persons without disabilities, such as lower education, poorer health outcomes, lower levels of employment, and higher poverty rates. Barriers such as inaccessible buildings, lack of accessible transport, lower access to information and communication technology (ICT), inadequate standards, lower level of services and funding for those services, as well as too little data and analysis for evidence-based, efficient, and effective policies.

Global Scenario:

Fifteen percent of the world’s population experience some form of disability while the disability prevalence is higher in developing countries.

On a current scenario, around 10 per cent of the world’s population or a roughly 650 million people live with disability. Females with disabilities stand higher than that of males in most OECD (Organization for Economic Co-operation and Development) countries. Developing countries contribute to 80 percent of PWDs, according to UNDP. The World Bank estimates that 20 per cent of the world's poorest people have some kind of disability, and tend to be regarded in their own communities as the most disadvantaged. Poor people are more at risk of acquiring a disability because of lack of access to good nutrition, health care, sanitation, as well as safe living and working conditions. Once this occurs, people face barriers to the education, employment, and public services that can help them escape poverty.

A 2004 British study shows that PWDs are more likely to be victims of violence or rape and are less likely to obtain police intervention, legal protection or preventive care while women and girls with disabilities are particularly vulnerable to abuse. Research shows that at an annual rate, violence against children with disabilities occurs at least 1.7 times greater than for their peers without disabilities.

Statistics in Nepal

As per the 2011 census, Nepal’s figure shows that among the total population of two million there are 513,301 PWDs that counts for, around two percent. Among them, highest number are physically disabled (36%) followed by 18 percent having visionary problem, 15 percent having hearing disability, around 12 percent having speech related disability, and 6 percent being mentally retarded.

There are five districts with highest number of people with physical disability based on the 2011 census which are Kathmandu (6,030 people), Morang (6,029 people), Kailali (5,631 people), Jhapa (5,524 people) and Surkhet (4,627 people).

The number of PWDs have been estimated to increase after the 2015 earthquake where thousands of Nepalese were temporarily or permanently disabled through crush or other injuries. Another key factor that has left many families with disability in Nepal, is the armed conflict leading children suffering from devastating physical injuries due to explosives, often losing limbs, being left blind or deaf.

The situation

In Nepal, PWDs s often feel excluded from many areas of daily life. Accessing government services is one area in which they feel limited and their rights overlooked. An acute lack of trained and skilled professionals in the field of habilitation and rehabilitation is severely impacting medical, psychological, social, and vocational support for the disabled community in Nepal. There are currently only about 400 physiotherapists and eight speech pathologists to serve the entire country. Instead, personal care workers with limited or no formal training are left to care for PWDs. In addition to that, PWDs are not well integrated into the labor market where most are either unemployed or discouraged from actively seeking work. While of those working, many are either underemployed or paid below minimum wage, or do work that is below their potential.

Efforts made

In 2006, Government of Nepal announced its most comprehensive policy document dealing with the affirmative decisions including positive discrimination of PWDs in Nepal. The Government announced quotas for PWDs in training programs conducted by the government organizations, employment within government agencies, and also for the private organizations that hire more than 25 persons. Inclusive education was proposed for free pre- primary and higher level education for PWDs and also for the construction of disabled friendly school infrastructures. In the area of health, the policy was proposed to provide free basic health services at the government hospitals and health centers for PWDs. It was also mentioned that the production of assistive devices and products would be expanded including those programs that pre- detect disability, early screening, distribution of iodized salt, iron tablets, vaccines, and Vitamin A.

PWDs voiced their opinions on a recently tabled Disability Bill during a meeting held between PWDs and lawmakers organized by the Women, Children, Senior Citizen, and Social Welfare Committee of the Legislature Parliament and UNDP's Parliament Support Project with over 45 participants from eight districts actively raising their concerns with the parliamentarians. The Bill proposed a comprehensive definition of disability, different categories of disability, provision of identity card, record management, and rights of PWDs, including access to education, health, employment, social security, and rehabilitation of PWDs. It introduced the provision to allow special privileges and facilities on access to credit facilities for entrepreneurship, discount on public transportation, exemption from taxes, and excise duty on the material that are useful for health, employment, and education for PWDs. The Bill has been tabled at the parliament in order to consolidate the existing legal provision and introduce new ones to better protect and promote human rights of PWDs.

The legislative parliament has passed the Disability Rights Bill on 6th August 2017 in Kathmandu. The purpose behind the formulation of this act was amendment of Disabled Protection and Welfare act 1982, stepping ahead for the domestication of United Nations Convention on the Rights of people with Disability (UNCRPD) and incorporating the disability related provision ensured by the constitution of Nepal 2072. This act has also aims to contribute to the implementation of UNCRPD and disability related constitutional provisions to uplift life of Nepalese PWDs. The access of person with disabilities to basic services, human rights, opportunities including health, education, and employment are expected to increase in an equal basis significantly with the effective implementation of this act. This act has the following key features: guided by the rights based approach, formulated in line with the UNCRPD and the disability related provisions endured in the constitution of Nepal, the classification of disability has been amended, prohibits all kinds of discriminations on the basis of disability with the provision of actions and punishment against it, provision of equal access to education, health, employment, public physical infrastructure, transportation and information and communication service, and developed in accordance to the federation system.

Stakeholders

For promoting the rights of PWDs throughout the country, National Federation of Disabled Nepal (NFDN) and Nepal Society of the Disabled (NSD) have been working on the forefront. Nepal Disabled Rights Center (DHRC Nepal) has been working to encourage organized development by training PWDs for playing role in good governance and securing rights. Physical Rehabilitation Services for Conflict Affected PWDs in Nepal, a project financially supported by MoPR/NPTF provides physical rehabilitation services to PWDs affected directly or indirectly by the conflict.

In co-ordination with NGOs, Government and local bodies, Nepal Disabled Association and Action on Disability Rights and Development-Nepal has been working to spread awareness. Conflict Victim and Disable Society Nepal (CVDS-Nepal), promotes skill development and livelihood opportunity of PWDs and conflict victims. In partnership with the Nepalese government, Handicap International builds the capacity of rehabilitation centers so that PWDs can receive assistance devices and quality physical therapy.

What needs to be comprehended:

With many policies and organizations, governmental or non-governmental, working for PWDs, most of their issues still seem to remain unheard and unaddressed. While Nepal is a signatory of several international human rights instrument including the Convention on Rights of People with Disabilities (CRPD), the national implementation process is still very slow. Being disabled not only places the people on a vulnerable edge but the lack of access to all services and lack of availability of disable friendly services pushes them more towards deprivation. The services being provided needs to cater the needs of PWDs. Providing them employment opportunities and creating an environment for vocational rehabilitation is a must today. There requires conscious effort for advocacy in understanding their needs along with expertise and physical presence of the representatives of such people at the policy and decision making level. With SDGs’ pledge to leave no one behind, inclusive development is what today’s generation needs. PWDs, as both beneficiaries and agents of change, can fast track the process towards inclusive and sustainable development and promote resilient society for all, including in the context of disaster risk reduction and humanitarian action, and urban development. Governments, PWDs, and their representative organizations, academic institutions and the private sector need to work as a “team” to achieve the Sustainable Development Goals (SDGs).

Contributors: Pankaj Joshi, Aanchal Parajuli and Cherry Shrestha

References:

https://www.un.org/development/desa/disabilities/international-day-of-persons-with-disabilities-3-december/idpd2017.html#Background

http://www.worldbank.org/en/topic/disability

https://www.disabled-world.com/disability/statistics/

https://www.google.com.np/url?sa=t&rct=j&q=&esrc=s&source=web&cd=5&cad=rja&uact=8&ved=0ahUKEwixwPPLr73XAhXMqI8KHdxBDZgQFghAMAQ&url=http%3A%2F%2Fku.edu.np%2Farts%2Fdrc%2Fpolicy_review.pdf&usg=AOvVaw0GdOjrVdOIGQFETYxgPnZM

http://codefornepal.org/en/2016/07/disability/

http://www.un.org.np/oneun/undaf/disabilities

http://www.np.undp.org/content/nepal/en/home/presscenter/articles/2016/09/13/people-with-disabilities-express-their-needs-to-nepal-s-decision-makers.html