*Laws and policies are not very supportive, whatever is there, is not being properly implemented

*Social barriers and a lack of awareness

*A lack of adequate coordination amongst different stakeholders

Ignorance and wrong beliefs surrounding disability, compounded with negative and derogatory attitude of community, including family members, have contributed to the marginality of development that has occurred in the Disability sector in Bangladesh. This section discusses some of the problems that exist in the country today.

Rules of business

One major policy that has prevented disability from being mainstreamed as a cross cutting development issue is the Rules of Business of the Government of Bangladesh. According to the Rules of Business, the Ministry of Social Welfare, since its inception in the mid 1960's has been the lead ministry to cater to all the issues of people with disabilities in Bangladesh, including education, employment, rehabilitation etc. But the Ministry, along with the Department of Social Services is not capable enough to deal with all the issues.

Over the years, the relevant ministries, in our neighbouring countries have changed their respective names, for example, Ministry of Social Rights in Sri Lanka, Ministry of Social Justice in Pakistan, Ministry of Social Justice and Empowerment in India. In Bangladesh however, it has continued as the Ministry of Social Welfare, which is why disability issue is still looked upon as a charity or welfare issue and not a rights issue.

Disability related law and policy

Existing Laws are inadequate and mostly welfare oriented. The stakeholders who are enshrined with the responsibility to uphold the laws and policies are often ignorant and/or not adequately aware or sensitized on disability issues. As such, disability is not prioritized as a rights issue and the national documents are rarely disseminated. At the same time, there are conflicting laws and policies (e.g. Rules of Business) resulting in a lack of inter-ministerial coordination, and also improper and contradictory interpretation of law and policies.

National and local committees constituted under the laws and policies are rarely active and aware of their roles and responsibilities. International charters/declarations/treaties etc. are often signed/ratified without in-depth understanding and so there remains a lack of commitment to fulfil these. Frequent transfer/turnover of policy makers and implementers is yet another problem. The process of review/amendment of these laws and policies are also very lengthy and complicated. As a result, whatever development initiative takes place is centralized.

In a country where the mere recognition of their existence is at stake, the GOB had adopted a National Policy on Disability in 1995. A draft legislation, to uphold the Policy, was prepared by NFOWD in association with other NGOs, disability activists, journalists, lawyers and people with disabilities themselves. It required 6 years of campaigning and influencing, and finally the legislation came about in April 2001. But this too has been renamed as the 'Disability Welfare Act 2001', deleting the 'Development' component and keeping it merely as a 'welfare' issue. Under the purview of the Inter-Ministerial Taskforce of Disability, a National Action Plan had been drafted by a team with the key support from NFOWD. The Taskforce has finalized the plan, but it awaits approval in a Cabinet meeting.

The Disability Welfare Act was passed in the National Parliament in 2001 as a Finance Bill. But no funding has been allocated against the Bill in the four annual national budgets to date.

Education

Access of children with disabilities to education is extremely limited. An in-equal educational system, a rigid and unfriendly education curriculum, the ignorance and a lack of awareness of parents, compounded with the inadequate knowledge of teachers and the unfriendly environment existing in most of the institutions, has done very little to promote education of children with disabilities in Bangladesh.

With regard to special education, the government is operating 13 primary schools for people with disabilities -- seven schools for those with hearing impairment, five for visually impaired people, and one school for those with intellectual disabilities. Private voluntary organisations are also involved in institutional based educational rehabilitation through five schools for people with hearing impairment, one for those with visual impairment, and three schools for those with intellectual disabilities, along with their branches in different districts.

At the high school level, the government is running 64 integrated programs attached to regular schools, while private voluntary development organisations are operating a number of schools each for those with visual and hearing impairments.

The total number of children enrolled in special and integrated education programmes is estimated to be far below 5,000. In terms of manpower in special education, 15 postgraduate teachers are trained each year through the Department of Special Education, under Dhaka University. Several other teachers' training programmes are also being offered by other private voluntary NGOs. The government has also developed a National Centre for Special Education, and it is likely that there will be a significant increase in the numbers of teachers trained in special education.

With all these efforts combined, only 4 per cent of children with disabilities within the primary school-going age have so far been enrolled in education.

Bangladesh has two independent ministries catering to education -- the Ministry of Education and the Ministry of Primary and Mass Education -- which are striving to meet the goal of "Education for all by 2015". Yet the education of the children with disabilities is under the purview of the Ministry of Social Welfare, which plays no part to achieve the universal goal. Among the staggering 96 per cent children who are still out of education, a major (70%) portion could have been enrolled in the regular national education program with very little effort. This could be brought under a planned Inclusive Education Program. The remaining 30 per cent could be enrolled under Integrated and Special Education Programs. Yet this has not happened as yet. The second phase of the national Primary Education Development Program (PEDP-II) has just included the issue upon insistence of NFOWD and under the pressure from its donors. But how effectively this will come about remains to be seen.

Rehabilitation infrastructure and medical services

According to Einer Helander's (UNDP) estimate, an average of 8.5 million severely or moderately disabled people are added each year to the total global figure, which approximately amount to 23,200 people a day. Such figures point to the urgency of finding answers as to how best to provide services and to promote integration, equal opportunities and human rights for people with disabilities.

While rehabilitation has been gaining increased prominence over the last few years (especially with the formation of a National Coordination Committee for people with disabilities, initiating and promoting the SAARC Disability Fund, the National Disability Foundation, initiating micro-credit for people with disabilities etc), the state of the present rehabilitation infrastructure remains weak, especially at the community level. Of the limited opportunities for rehabilitation, almost all are institutional based programs located in urban centers. This implies that the current rehabilitation infrastructure is ill equipped to meet the needs of majority of people with disabilities in the country, most of whom not only live in rural areas, but who are also unlikely to have sufficient resources to gain access to even basic rehabilitation services.

Inadequate skilled medical personnel and inadequate medical rehabilitation services by the government hampers people with disabilities from acquiring adequate medical rehabilitation services. The government operates only one orthopedic hospital in Dhaka and one orthopedic unit at each of the medical college hospitals, as well as three leprosy hospitals. The government is also running two vocational rehabilitation centres for those with orthopedic disabilities. Several private voluntary development organistions are running orthotics and prosthetics workshops, as well as two training centers each for people with visual and intellectual disabilities. The lone currently functional hydrotherapy unit in the country is also run by an NGO.

After two decades, the government has recognised a couple of training courses on physiotherapy and occupational therapy, and thus there is now a scope to add to the number of the very few professional therapists that Bangladesh ever had. But the courses are not offered by the government. At the non-government sector, another center is developing a plethora of rehabilitations aides, and so far close to 500 such trained personnel are working across the country. But that course too is yet to receive affiliation from the government.

Prevention

As Bangladesh makes progress, through its health policies on its infant mortality rate, immunisation coverage and general health care, we are likely to experience lower incidence of impairments. However, the gains due to improved health care is likely to be outweighed by the triple effects of increased numbers of impaired children surviving: increased numbers of people incurring impairments due to old age (e.g cataracts & arthritis) and widespread malnutrition. This compounded with the natural calamities and a constant occurrence of traffic accidents implies that the prevalence of impairments in Bangladesh is likely to continually rise over-time although the nature and distribution of impairments are also likely to change considerably.

The national health policies have rarely incorporated Disability issues, and so the main actors in this field are the non-government organisations. The Jibon Tori (Life Boat) floating hospital, run by one of the Members of NFOWD, is the only fully equipped such facility catering to the rural areas across the country.

Employment

Employment and/or self-income generation activities are essential towards economic self-reliance of people with disabilities. While the National Constitution categorically prohibits discrimination in employment in any form, employment of people with disabilities has been a farfetched dream. The government had declared a 10 per cent quota for people with disabilities along with orphans about two decades back. But due to in-sensitisation of employers about potentialities of disabled people, contradictory employment policies, loopholes in the system and a lack of proper monitoring, the declared quota for the disabled people had never been implemented properly. In a recent development however, the Prime Minister had declared a 1 per cent quota in all cadre service jobs. The Ministry of Establishment, with the support of the Ministry of Social Welfare, is currently in the process of developing a policy for establishing and implementing this new quota.

Communication and

accessibility

Bangladesh has a building code, which clearly demarcates accessibility options for all including people with disabilities. Yet again loopholes in the system, a lack of proper monitoring and a lack of penalisation systems could not establish accessibility for the people with disabilities. Public and private offices, educational institutions, public transportation, utility infrastructure, recreation and tourist spots, market places -- almost all are inaccessible to people with disabilities. The government has adopted decisions to create separate ticket counters and reserved seats for people with disabilities in public transports. However, with the transports themselves lacking accessibility options, these decisions did not come of much use.

Coordination and cross learning and sharing

NFOWD is the only recognised national level coordination body of NGOs working in the field of Disability in Bangladesh. The last five years have seen a proliferation of other local and regional level networks and coordinating bodies in the same field. While most of these are formed principally to enhance the program outputs, they are also playing some role in local level advocacy initiatives. Despite that, there still remains a lack of effective mechanisms for coordination and cross learning and sharing.

Historically research initiatives in the field of disability have been scarce in this country. With only a handful of organisations involved in this field, utilisation of available research findings has also not been as optimal as expected. NFOWD has strived to use the information from a few of these initiatives, namely in the areas of education and employment, but otherwise the use has been limited. There is only one network disseminating information using the electronic media, but it is mostly one-way communication, and also since the disseminated material is principally in English, its usage could not match its potentialities. A handful of organistions publish newsletters regularly, but most of them contain information regarding their own programme activities. As such, cross learning of programmes, information on national and international research initiatives and events had not been facilitated adequately. With very few exceptions, all of the organisations in the disability sector are totally dependent on donor funding. Due to a scarcity of funds, and with very little human resources, most of these organisations are stretched beyond their capacities to cater to the unending needs in their respective fields. As a result learning through exchange visits has also been very limited.

In the backdrop of all these problems the silver lining is that the government is showing a keen interest to work hand in hand with the non-government sector. Being a coordinating body, NFOWD will never have its own field-based programmes, but could learn immensely from the experience of its member organisations working across the country. Based on these learnings, on the developments that are in progress at the international scenario, on our vast experience of always working with the government in the past, and also on the knowledge that we are gathering from the different studies that are being conducted recently, NFOWD is ideally placed to facilitate the government and advocate for and influence many positive changes, that could definitely bring about positive changes in the lives and livelihoods of people with disabilities in this country.

Dr. Nafeesur Rahman is Director, National Forum of Organizations Working with the Disabled (NFOWD).