REHABILITATION OF THE HANDICAPPED
All along, society has tended to treat the handicapped as a class apart—objects of sympathy and charity. The fact that persons with handicaps, too, are human beings and that they cannot be denied their basic rights to love and care, education and training, gainful employment and ultimate social integration is being realized all over the world including India. Few may know that several years ago, the UN framed the rights of disabled persons; similarly, a Convention held in Belgium several years ago formulated the rights of the mentally challenged.
Today both the government and the community have recognized that the welfare of the disabled is an integral part of the human resource development and accordingly efforts are being made by both official and non-official agencies to make the handicapped self-reliant and self-confident through a series of measures like education and training, provision of employment and their social integration into the national mainstream.
According to a survey conducted by the National Sample Survey Organization (NSSO) in 1991, there were 16.15 million people suffering from physical disability and they constituted 1.9 percent of the total population of the country then. According to another sample survey conducted by the NSSO the same year in respect of children in the age group of 1-14 years with delayed mental development, the incidence rate was 29 per thousand in urban areas and 30 percent in rural areas. If we take the visually-handicapped (blind), according to the National Sample Survey conducted from July to December in 1991 by the Department of Statistics, Government of India, the estimated population of the visually impaired was 0.44 percent of the general population. More than eighty percent of the visually handicapped live in villages, while most of the rehabilitation centres and educational opportunities cater only to the blind in the urban areas. Even here the residential schools cover only six percent of the visually impaired children. The remaining 94 percent children are denied access to any kind of education.
Prevention is better than cure and this applies to the handicapped as well. The sad truth is that over 70 percent of disabilities are preventable. Take the case of blindness in children. In the dim light or at night the poor children have a blurred vision. And as the darkness is blotted out by the radiance of the sun the next morning, the vision returns to these children what is commonly known as night blindness. The troubles start with the conjunctive becoming dry and flaky and the membrane lose its luster leading to the condition known as exophthalmia or ‘dry eye’. Grey spots appear on the white portion of the eye, but these lesions by themselves do not affect vision, but slow and steady neglect of timely treatment affects the cornea first, ultimately leading to keratomalacia, resulting in total and permanent blindness. Around 12,000 children of the toddler age group thus lose sight every year because of Vitamin A deficiency. Lack of vitamin A triggers night blindness that afflicts about ten to fifteen percent of all children.
There are several sources of Vitamin A in India which are abundant in supply and easily available; such common items like green leafy vegetables as drumstick leaves, amaranth, palak and fruits like mango and papaya provide lots of Vitamin A. Studies conducted have shown that if 40 gms of green leafy vegetables are included in the existing diet without any other changes, the child would get the necessary Vitamin A.
Preventable blindness apart, there are several childhood disabilities that can be prevented by timely immunization. Polio vaccine has thus come as a godsend to prevent the crippling disability among children
It is a tragic truth that only two percent of the rural and five percent of the urban handicapped population have any access to some kind of rehabilitation services.
Till 1970, ‘rehabilitation’ generally meant either institutionalization of the disabled in special institutions or the physical management of their disability. From the 1970’s we have switched over to a community-based approach, with the concept of rehabilitation becoming more holistic. The shift in emphasis was brought about by the WHO that emphasized the need for the involvement of the communities in the entire rehabilitation process. For rehabilitation to be successful, communities must recognize and accept that people with handicaps like blindness, deafness, orthopaedic and mental disabilities have the same rights as other human beings. It is essential that the community must realize that all human beings are of equal worth and are entitled to equal rights, privileges and responsibilities. Thus community is duty-bound to play a signal role in main streaming the disabled. Gone are the days when disabled population could be segregated and confined to special institutions.
The disabled have to be empowered by timely and suitable interventions by the family and the community providing the appropriate means like education, training, mobility training, and access to modem technology and financial help in order to make them self-reliant, self-confident and responsible citizens of the country. It should be borne in mind that disability does not mean forfeiture of the fundamental human rights every human being is entitled to. One becomes disabled by birth or due to extraneous factors over which one has no control. It could be caused by disease or an accident or problems during pregnancy. Has the society or the authority any right to penalize the handicapped by depriving them of the basic rights that are enjoyed by other citizens? This forms the basic philosophy of the community-based rehabilitation of CBR.
CBR helps persons with disabilities to stay within the loving care and security of the family and contribute their share towards the family income. Properly trained, every person with disability can earn honest bread. Unlike institutional rehabilitation, CBR helps to prepare the community for the long term acceptance of the handicapped person.
A comprehensive law, namely, the Persons with Disabilities (Equal Opportunities, Protection of Rights and Full Participation) Act, 1995 was enacted and enforced in February 1996. The law deals with both prevention and promotional aspects of the rehabilitation such as education, employment and vocational training, creation of barrier-free environment provision of rehabilitation services for persons with disabilities, institutional services and supportive social security measures like unemployment allowance and a grievance red ressal machinery both at the Central and State levels. An Expert Committee was Constituted on July 2,1999 to identify/review the posts in Groups ‘A’, ‘B’, ‘C and ‘D’ to be reserved for persons with disabilities in the Ministréis/Departments and PSUs.
This is indeed a landmark legislation that provides the much needed protection and status to every handicapped person. Under the new law the governments and local authorities have to undertake various measures for the prevention and early detection of disabilities, creation of barrier-free environment, protection of rights, provision of Medicare and rehabilitation services. The Act also provides for education, training, employment and vocational training, reservation in identified posts, research and manpower development, establishment of homes for persons with severe disabilities etc. The Act eliminates any kind of discrimination against disabled in the sharing of development benefits. The Act also provides for facilitating the mobility of the disabled, as provided in Chapter Vin of the Act. It says that rail compartments, buses, vessels and aircrafts shall be designed to permit easy access to the disabled. In all public places and in waiting rooms, the toilets have to be designed in such away as to permit wheelchair users to use them. The building rules of local bodies may have to be amended to provide for ramps in public buildings, toilets for wheelchair users, Braille symbols and auditory signals in elevators or lifts, etc.
Unlike so many other laws, this Act is comprehensive and the best the disabled in our country can dream of. But its success depends upon implementation. It has yet to be ascertained as to whether we have made a modest beginning in implementing at least some of the salient provisions of this laudable Act.
What the community and the government can do is to create the congenial conditions where every disabled person feels that he is not disabled and he has got enough faculty and ability to contribute his mite to the national well being and leave his footprints on the sands of time. Despite their handicaps—great souls like Tulsidas, Homer, Beethoven, Edison, Ravindra Jain and hundreds of those who participate in the Olympics for the Paralyzed show that they are more able than the able-bodied. In fact, some of the able-bodied, because of lack of dedication to duty, appear “handicapped” and there is no dearth of such “incurable handicapped” in our country.