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In 2005 and
2006 Handicap International conducted a national survey on disability (NDSA,
National Disability Survey in Afghanistan)
by the
agreement and support of Ministry of Labor, social affairs Martyrs and
Disabled, Ministry of Public Health, Ministry of Education and Central
statistic organization. Its main objective was to collect appropriate
information about the statistic and other relevant issues (education of
PwDs, access to various services, livelihood, economics…) to People with
Disabilities in Afghanistan. NDSA estimates the number of PwDs in
Afghanistan between 747,500 and 867,100. An average of 1 out of 5 households
has at least one person with disability. More than half of persons with
disabilities in Afghanistan are living in Central, Western and Southern
regions of Afghanistan. 69.7% of Afghan with disabilities living in rural
areas and 30.3% in cities, while most of the activities have been focusing
in the urban areas. The prevalence rate of Afghans with Disabilities is
2.7%.
The National
Disability Survey in Afghanistan (NDSA) is providing scientific and accurate
insight about all aspects of disability in Afghanistan. Reports have been
disseminated throughout the disability community, are being translated in
Dari and Pashto and are used as a tool to raise awareness on the situation
of disabled people in the country.
As mentioned
one of the aspects the NDSA did was about the challenges ahead PwDs . Here
is the summary of the book provided in an article .
Understanding the Challenges ahead
Inclusion is a major factor to look at when formulating recommendations for
stakeholders active in the disability field. Today, Afghanistan does not yet
have disability public policies that express commitments to equalize
opportunities for persons with disability. Furthermore, while in the process
of being established, these policies must be defined by the persons with
disability themselves. The NDSA project in general and this document
particularly, is a tool for organizations of persons with disability, to
help them find their way against social and environmental barriers and their
place in Afghan society. The project adopts a capability approach towards
disability by focusing on what individual’s value doing or being in a given
environment. It also highlights the social, economic and environmental
barriers to equality that persons with disability undergo in the Afghan
society.
Remove Barriers
The economic environment has a major impact on opportunities in terms of
employment and autonomy of persons with disability. Generally barriers are
related directly to the type of disability the individual has. Working,
whether in an administration, a company, in the fields or outside the
compound, is a significant issue for persons with disability. This can
ultimately affect their ability to gain an income, or to produce food and
engage in income generating activities. Inaccessibility is due to several
constraints: impairment as well as poverty and physical inaccessibility.
Other types of barriers are linked to attitudes and prejudice.
Changing Social Attitudes and Beliefs Regarding Disability
In Afghanistan, a problem arises from the fact that disability is not
perceived in the same way everywhere, and varies according to gender
differences, traditional or ethnic attitudes and religious motives.
Therefore, persons with disability may be more or less vulnerable in daily
life and may not be subjected in the same way to poverty. In fact, they do
not constitute a homogeneous group, but various sub-groups facing different
needs and opportunities.
Gender Concerns
The fact that in many areas of social and economic life, women are
systematically in a worse situation than men is of great concern. The NDSA
analysis clearly shows that women with disability are poorer, cannot access
school, are in worse health conditions, do not participate to the labour
market and, as a result of stigmatization, are excluded from social
participation. Better access for women and girls with disability to health
services and to schools can be ensured by increasing the number of women
staff.
Access to Employment and Income: Changing Perception
When asked, the first thing persons with disability seek is a job to earn
their living. While progress is being made towards employment for persons
with disability, many barriers remain, especially for women with
disabilities and persons living in remote rural areas. The labour market,
dominated by the agricultural sector, provides few opportunities for the
most impaired and especially for women if they are disabled. Yet, the
practice of a paid activity is a clincher for social recognition, thus
self-esteem and independence. Nevertheless, average income of persons with
disability is lower and the level of unemployment is higher than that for
non-disabled. Even if the level of employment for persons with physical or
sensorial disability (mainly men) and for war survivors is as high as for
non-disabled persons, the level of income remains lower for the former. An
active employment policy based, among other measures, on a general
obligation of employment of a certain percentage of persons with disability,
both in public and private sectors, is a fi rst step towards inclusion in
the labour market.
Access to Public Services: Health and Education
Many of the causes of impairments and injuries are preventable by increasing
the level and quality of antenatal care, improving women’s health education,
improving immunization, eliminating malnutrition and promoting awareness
regarding a balanced diet and other daily practices to improve health. In
brief, priority focus should be placed on prevention rather than cure, using
a multidisciplinary approach that includes local leaders and other
communication tools such as radio broadcast.
Persons with disability are currently spending more for their health and
using the health facilities more than non-disabled. Nevertheless, they face
more constraints and difficulties in benefit ting from a better health.
Ensuring access to health services is a priority. A major issue is to
address barriers to access public health services such as distance to health
facilities and cost. For people with reduced mobility, assistive devices –
standardized, well-made, well-fitting, using local materials whenever
possible and repairable locally – should be made available countrywide.
Availability of generic drugs at the lowest possible price is also a
challenge.
The development of vaccination programs is another challenge. In order to
follow-up with the inclusion of persons with disability in the health
system, and particularly at the level of the BPHS, they should be tracked
through the MoPH information management systems.
The current efforts of different decision makers to send children to school
are not reaching persons with disability equally. The proportion of
non-disabled children accessing public schools is almost two times higher
than the proportion of children with disability. Another major challenge is
access to school for girls, and especially girls with disability. The
current deterioration of the security situation might become a step backward
in the access to school for girls in parts of the country. An important way
to strongly support inclusive education is to make schools accessible to
children with disability and change legislation in order to include children
with all types of disability, including the most severely disabled, in
schools for the compulsory education period. Responsibility for the
education of children with disability will be placed upon the MoE along with
a coordinating body to be created. A major issue is awareness – to convince
teachers and both families of children with disability and parents of other
children of the relevance of inclusive education.
Because integration of children with disability into the general educational
system requires planning by all parties concerned, the coordinating body
will ensure effective coordination work of all stakeholders, from conception
of the law to training of teachers, awareness of community and designing of
buildings.
Empowerment: Decisions Taken by Persons with Disability
Persons with disability have not yet succeeded in having their voices heard,
except for war survivors who are the only persons with disability enjoying
real prestige in Afghan society due to their status as former Mujahidin. The
capability approach applied to disability offers a perspective of empowering
all persons with disability by providing a framework aiming at equal
entitlements for persons with disability and non-disabled persons. The
well-being and subsequent freedom of persons with disability depends on
their capacity to express their needs and benefit from opportunities offered
by a welcoming and inclusive environment. Public policies must ensure their
capacity to fully participate in social life.
Mainstreaming: Inclusion and Accountability?
Gathering of knowledge on livelihood, beliefs, needs and expectations of
persons with disability is a way of fuelling a national disability strategy
based on such principles as empowerment and mainstreaming. This view, which
has been put forward by a number of disabled persons’ organizations, tends
to look at the barriers that exist within the social context and that
prevent a person from achieving the same level of functioning as that of a
non-disabled person. In this perspective it is society that needs to be
redesigned in order to take into account the disabled persons’ needs.
Mainstreaming persons with Disability is a progressive way of reshaping
society in order to better include them.
Coordination of Action and Actors: Towards the Institution of a
Coordinating Body?
The participants in the First National Landmine Victim Assistance Workshop
held in Kabul between 6th and 8th August 2006 at the Ministry of Foreign
Affairs enthusiastically advocate the creation of an independent
coordinating body in charge of disability issues in Afghanistan with a
strong representation of organizations of persons with disability. This body
could take up the task of programming, managing and coordinating the
disability policy in a field where actions are currently planned by
different ministries and carried out in isolation by various local
governmental bodies or implementing agencies, especially INGOs.
This coordinating body could be in charge of promoting and protecting the
full range of the rights of persons with disability, including their right
to accessibility, education, employment, rehabilitation and health, and
welfare support. Persons with disability should be fully represented in this
body as they have a central role to play in the formulation of the national
disability strategy in different issues that affect their lives directly. |
