Workshop on Community-Based Rehabilitation (CBR) and Poverty Alleviation of Persons with Disabilities
Bangkok, 5 July 2005

SELF-HELP GROUPS AS A TOOL FOR ECONOMIC EMPOWERMENT OF PERSONS WITH DISABILITY

Maya Thomas*, MJ Thomas **

INTRODUCTION

Over the last two decades, community based rehabilitation programmes for persons with disability have increased the coverage of services in different countries. Along with service coverage has come the realisation that functional independence alone is not enough. Issues of ‘participation’, ‘ownership’ and ‘mutual support’ are gaining increasing emphasis. The field of disability rehabilitation has thus moved from a medical and impairment orientated activity, to one focusing on rights and group organisation.

Another issue that has attracted international attention, along with efforts to address it, is poverty and its relation to disability. Arguments in literature debate about poverty causing disability and vice versa. What emerges clearly is the fact that a majority of persons with disability from developing countries tend to be excluded from the development process and remain in poverty. Of late there is increasing emphasis on issues related to rights of persons with disability and on organising them into self-advocacy groups so that they can demand and gain their rights at different levels and on different platforms. Many field level programmes have started organising self-help groups of persons with disability and their families, to enable them to access the benefits of developmental processes.

WHY DO PERSONS WITH DISABILITY GET EXCLUDED FROM THE DEVELOPMENT PROCESS?

At a NOVIB conference in Bangladesh in 1998, people with disabilities were identified as the ‘hard-core poor’ who are rarely included in development programmes including micro-finance activities (1). They are often the poorest of the poor in many communities, and therefore the most needy group to be considered in any development process. However, they are also a difficult group to carry out interventions for, because of their special needs and various attitudinal barriers. As a result, most community development programmes tend to exclude them from their activities. A study conducted in Bangladesh in 1999 identified some reasons for the exclusion of people with disabilities from micro credit programmes (1). These included

• negative attitudes and prejudices about credit-worthiness of persons with disability;
• lack of policies, knowledge and skills on the part of development organisations to include persons with disability into credit programmes;
• mobility problems of persons with disability that prevent them from attending meetings;
• low level of education and skills in persons with disability due to their lack of access to these services;
• lack of flexibility in existing credit operations to facilitate inclusion of persons with disability; and
• expectations of charity and lack of motivation on the part of persons with disability and their families.

The study suggested that context specific strategies would need to be considered by each organisation to include people with disabilities into micro-credit programmes, as multiple factors can influence their exclusion.

SELF-HELP GROUPS

A self-help group is a voluntary association of people that functions democratically and accountably, to achieve the collective goals of the group (2). Self-help groups are viewed as a means to achieve the newly emerging goals of inclusion and ownership in programmes by persons with disability, and to enhance their participation in the development process. Organising persons with disability or their families into self-help groups can serve different purposes depending on the situation and the need. Such a group of can help improve their members` visibility in the community. The members can also support each other through discussions about common problems, share their resources and find solutions together. The availability of an empathetic, supportive group helps persons with disability and their families to enhance their confidence and self esteem (3). In addition, these groups can work towards their own economic upliftment.

SOME CHARACTERISTICS OF DEMOCRATIC SELF HELP GROUPS

• In such groups, members come together to fulfil a commonly perceived need. The goals of the group need to be clear, known to and shared by all members, and should originate from the needs of the members. An external facilitator can help facilitate formation of a group, but the governance should be the responsibility of its members.
• Every member in a democratic group has a role to perform and makes decisions in a participatory way to achieve a set of shared goals. This is a difficult phase in the process of group formation and usually takes a long time for completion. In many developing countries people are not familiar with democratic styles of functioning and as a result, power struggles could occur between members of the group and sometimes lead to their fragmentation into sub-groups. In some instances a group is formed after deliberately excluding some stakeholders in an attempt to limit membership and thus reduce perceived threats or competition from others.
• Another important element in the formation of a group is the value addition that each member brings to the group in order to achieve the shared goals. This can be estimated by the willingness of members to contribute their share of resources to the group. During this process, those who are not ready to contribute get excluded and it is assumed that their commitment to the goals of the group do not match those of others who contribute.
• The size of the group can vary depending on the need, although homogeneous groups tend to be more sustainable.
• Self-help groups are dynamic and their composition can change over time. They usually last as long as the members continue to have commonly perceived needs.
• Group characteristics differ in rural and urban areas (3). In urban areas, people usually come together on different occasions to create awareness, improve service provision and support each other. These groups tend to be well informed, have adequate resources, and are able to effectively advocate their causes. In rural areas however, lack of information, awareness and resources are major problems.
• It is important to spend time and effort in the process of group formation before formalisation of self-help groups in order to prevent future disintegration or loss of interest. The presence of an external facilitator is important, to prevent hijacking of benefits, keep the group motivated, and train them on different aspects of group functioning, especially micro-credit and economic development.

CHALLENGES IN ORGANISING GROUPS OF PEOPLE WITH DISABILITIES

Many difficulties are faced in the process of forming cohesive groups of persons with disability. In urban settings, particularly in the lower income sections, group formation can be particularly difficult (4). People who live in poorer sections of urban areas that exhibit many forms of social discomforts, do not easily trust each other. They often do not have a permanent address, do not easily form human bonding and show less concern for collective causes. The initial time taken for group formation in this context can be quite long.

In rural areas, there are other problems such as distances between clients, and difficult terrain, that can make group formation less practical.

Another problem is the fear that a powerful few in the group will hijack the benefits from others (5). persons with disability are usually a minority group in the community, hence their needs are often viewed as a low priority by the rest and they may tend to get marginalised in a group. In order to prevent a few from hijacking the benefits of the group, especially micro-credit activity, time needs to be given for the process of cohesive group formation before initiating credit activities. Groups would also need considerable training and capacity building before they can function effectively and democratically. In such situations, an external facilitator helps to facilitate cohesive and democratic group formation and to carry out capacity building.

Lack of motivation on the part of persons with disability is another major barrier. Many persons with disability are not motivated to form groups to undertake their own development programmes. They expect grants rather than self generated economic development (6). Service providers also prefer to give grants because they are easier to administer than economic development schemes, such as credit programmes. As a strategy to enhance motivation, economic development policies of the programme should be explained clearly to all staff and clients in a programme prior to initiation of activities. Counselling and motivating clients, their families and members of the community, either individually or in groups, will change attitudes that favour charity, towards self-reliance and development.

Lack of trust between members and inadequate knowledge of benefits from co-operative enterprises can also be a barrier. Many believe that individual enterprises are better than group enterprises because of lack of trust between individuals. Much time will be needed during the initial stages of group formation to build mutual trust and confidence, and to imbibe the values and benefits of working together in groups for a common enterprise.

ORGANISING SELF-HELP GROUPS OF PEOPLE WITH DISABILITIES

Despite the challenges, self-help groups of persons with disability have been successfully organised in many countries. There are a few pre-conditions that can be of help in organising persons with disability.

• Meetings need to be arranged in places that are accessible and not too distant from members’ dwellings.
• Mobility needs of members will need to be addressed where feasible.
• The members should clearly articulate and agree on a common goal.
• Groups should set the dates for meetings and intimate the agenda earlier, and should discuss matters that concern them directly, such as commonly perceived needs, creation of opportunities, availability of resources and so on.
• A facilitator may be needed in the initial stages to ensure that chosen leaders do not dominate the group.
• Assigning tasks and responsibilities to group members acts as a motivator to keep them involved.

Group meetings can also be used for education and training of members in micro-credit management, administration and leadership skills. Often, groups that start micro-credit tend to focus only on that activity, ignoring all other subjects on the agenda. Facilitators and group leaders need to guard against this practice by assigning separate time for different subjects on the agenda, and including micro-credit as one part of the meeting.

It is easier to organise people who live in permanent dwellings in urban areas, because they do not migrate. In rural areas it is easier to organise those who come from a traditional background with low migration and high affective bonding. Women’s groups are generally easier to initiate than those of men. In some areas, it may be possible to organise integrated groups of persons with disability along with others, while in other areas, it may be easier to have groups solely of persons with disability.

CONCLUSION

If it is feasible in the given context, group organisation has several advantages. It could be used to initiate micro-credit finance and group pressure could effectively be used to motivate clients to improve their economic development. As a result of group formation, motivation to succeed could also become greater. In some instances, groups could take on the responsibility of monitoring some aspects of the programme. Participation from members of the community could improve, as group members and their activities become more visible. Groups could also function as a platform to create awareness on different issues and for purposes of advocacy. Working together as a group can ensure better access to existing schemes and programmes. Group organisation for different purposes thus becomes a tool for overall empowerment of persons with disability.

REFERENCES

1. Thomas M. Feasibility of integrating people with disabilities in savings and credit programmes in Bangladesh. Asia Pacific Disability Rehabilitation Journal 2000; 11(1):27-31.
2. Ramachandran R. Organising self-help groups of people with disabilities. Friday Meeting Transactions 2000; 2(1): 3-4.
3. Ramachandran R. A forum for disabled people. Saudi Journal of Disability and Rehabilitation 2000; 6(1): 22-24.
4. Thomas M, Thomas MJ. Implications of urbanisation of India on CBR planning. Asia Pacific Disability Rehabilitation Journal 2001; 12(1): 73-78.
5. Thomas M, Thomas MJ. Planning for ‘community participation’ in CBR. Asia Pacific Disability Rehabilitation Journal 2001; 12(1): 44-51.
6. Thomas M, Thomas MJ. Evaluation of TLM India CBR Programme. The Leprosy Mission India, Delhi, 2002.

*Editor, Asia Pacific Disability Rehabilitation Journal
**Co-ordinator and Consultant, Dept of Psychiatry, Sagar Apollo Hospital, Bangalore
J-124 Ushas apts, 16th Main., 4th Block Jayanagar, Bangalore – 560 011, India
Tel: +91-80-26633762, email: m_thomas@rediffmail.com

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