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

Bangladesh Country Paper
Community Based Rehabilitation Practices and alleviation of Poverty of people with disabilities in Bangladesh

Presented by
Khandakar Jahurul Alam
President NFOWD and Executive Director
Centre for Services and Information on Disability (CSID)
Nazmul Bari
Deputy Director, and
Masudul Abedin Khan
Projects Coordinator
Centre for Disability in Development (CDD)

Slide 1

Bangladesh Country Paper
Community Based Rehabilitation Practices and alleviation of Poverty of people with disabilities in Bangladesh

Khandakar Jahurul Alam
President NFOWD and Executive Director
Centre for Services and Information on Disability (CSID)
Nazmul Bari
Deputy Director, and
Masudul Abedin Khan
Projects Coordinator
Centre for Disability in Development (CDD)

Slides 2-5

Disability situation in Bangladesh: A problem analysis

1. Debatable statistics on the prevalence of disability in Bangladesh.
2. Government findings of 1982, 1986 and 1998 estimated prevalence rate of 0.64%, 0.5% and 1.60%.
3. Sample surveys by NGOs indicate 7.8%, 8.8% and 5.6%.
4. 7 million to 14 million people with disabilities in Bangladesh.
5. People with disabilities are amongst the most vulnerable of the disadvantaged groups of people.
6. They receive little or no development assistance.
7. Therapeutic services and availability of assistive devices are extremely limited.
8. Professionals like physiotherapist, occupational therapists are few.
9. Many People with disabilities lack skills to be involved in economic activities.
10. Lack of knowledge, skills & experience of development organisations to include people with disabilities in skill development training and initiatives.
11. Insufficient specialist services on Braille, sign, speech therapy.
12. Many employers are reluctant in employing people with disabilities into their work force, mostly due to their ignorance about the potentialities of people with disabilities, negative attitude, the work environment not being accessible and their lack of interest to renovate or adapt the working environment befitting to people with disabilities.
13. Limited opportunities to study at educational institutes.
14. Lack of self-organization amongst people with disabilities.
15. Majority of people with disabilities are unaware of their fundamental rights.
16. People with disabilities are out of development mainly due to lack of awareness of people who design and implement development programs, negative attitude among general population prevalent towards people with disabilities, scarcity of resources and lack of knowledge and skills on how to address needs of people with disabilities inside development programs.
17. Poverty has a strong influence on disability situation in the country.
18. 80% living in the rural areas.
19. Poor nutrition, dangerous working and living conditions, limited access to health care, poor hygiene, bad sanitation, inadequate information about causes of impairment, and natural disasters contribute to the creation of disabilities.
20. For every person who has an impairment and/or disability, 4 to 5 other family members are also affected.
21. 68.9% of people with disability cannot seek medical or rehabilitation assistance due to economic hardships.

Slides 6-7

Undertaken efforts: GO~NGO Initiatives

1. Government and NGO communities are working in partnerships and collaborations.
2. NFOWD was formed in 1991 to raise voices to establish and promote rights of people with disabilities in the country.
3. National policy & legislation on disability exist.
4. The National Coordination Committee was reformed and strengthened.
5. Inter Ministerial Taskforce has been formed.
6. District Coordination Committees are in its process of formation.
7. National Foundation for Development of the Disabled People, provides funding support to grassroots level NGOs.
8. Disability highlighted in the PRSP.
9. National Action Plan on Disability is in its finalization stages.
10. 10% quota for the employment of people with disabilities.
11. 1% quota in all government cadre service jobs.
12. Micro-finance scheme for acid survivor women and persons with disabilities.
13. Credit facilities for people with disabilities.
14. Monthly allowance to 50,000 very poor and severely disabled persons.
15. 300 organizations are currently working on disability issues.
16. Movement of Disabled People’s Organisations and Self Help groups intensified.

Slides 8-11

Community Based Rehabilitation in Bangladesh: The past and now

1. CBR practices started at a very small scale from late 80’s. Till mid 90’s CBR programs did not expand much.
2. Main activities that encompassed CBR were sensitization, treatment, primary rehabilitation therapy, education, vocational training and income generating activities.
3. Most organizations were disability focused organizations and disabled people’s organization.
4. Most activities were urban based, addressed mainly one specific disability groups, focused more on an individual people with disability, and saw disability more from medical rehabilitation perspective rather than the social development model.
5. Limited understanding of CBR as an approach.
6. Participation of people with disabilities in the planning, implementation and monitoring of CBR programs were also limited.
7. Efforts had been undertaken in the country to popularize CBR as an approach, create a uniformed understanding of CBR and expand its implementation and coverage.
8. Dhaka Declaration 1997 in its clause 3(c) urges “Community Based Rehabilitation interventions to be incorporated in social development programs at all level”.
9. Regional Symposium on Disability 2003 in its declaration calls in clause (n) for “A more effective use of Community Based Rehabilitation (CBR) using a holistic, community specific and rights-based approach to promote awareness, disseminate information on disability issues and provide services amongst society”.
10. CBR activities in the country got momentum since 1997 after the successful staging of the 2nd South Asian CBR Conference.
11. Range of activities under CBR also increased with physiotherapy, assistive devices being available, referral networks strengthened, and early detection and interventions programs being undertaken.
12. Increase on the number of studies and researches conducted on disability and CBR concerned issues.
13. Concept of Community Approaches to Handicap in Development (CAHD) evolved in the country to implement Community Based Rehabilitation programs mainly through already established development organizations with multi-sectoral development programs.
14. Dhaka Declaration 2003 states in clause (o) “Community Approaches to Handicap in Development (CAHD) should be considered as one of the components for implementation for inclusion of disability issues into mainstream development”.
15. Increased involvement of the development organizations, disabled people’s organizations and government initiatives.
16. CBR programs of development and other organizations are allowing people with disabilities and their family members to have access to development programs of these organizations, including their poverty alleviation programs.
17. Directory published in 2002 shows that 177 NGOs in Bangladesh were implementing some form of CBR programs.
18. Government has not yet started any CBR programs but there is a plan.

Slides 12-17

Critical issues and further needs for CBR and Poverty alleviation

• There is great prospect of CBR in Bangladesh.
• To strengthen the existing CBR programs and initiate new ones it is imperative to address and recognize certain concerned issues, like: -

1. CBR should be promoted by the Government of Bangladesh and NGOs as an effective approach for the prevention of disability, early detection and intervention for children with disabilities, reaching out to people with disabilities in rural areas, raising awareness and advocacy for the inclusion of people with disabilities in the community, including social, cultural and religious activities.
2. CBR programs should be comprehensive including components of (a) creation of positive attitudes towards people with disabilities, (b) provision of rehabilitation services, (c) provision of education and training opportunities, (d) creation of micro-credit and macro income-generation opportunities, (v) provision of care facilities, (e) prevention of the causes of disabilities and (vii) monitoring and evaluation.
3. It should be realized that poverty alleviation of people with disabilities will not be attained only by undertaking vocational skill training and income generation activities for people with disabilities but by implementing all the components of CBR.
4. The Government should start planning, allocating resources and implementing CBR programs through its own structures. Financial resources currently allocated should be increased to support the CBR work of more but qualified NGOs.
5. Where ever applicable, policy papers, legislations and action plans on development issues of the Government and Non-government agencies should consider disability as a crosscutting issue and address it accordingly.
6. National poverty reduction strategy paper, the PRSP should include disability issues. The programs of PRSP must be implemented accordingly to alleviate the poverty of people with disabilities.
7. More employment (self-employment and job market) opportunities for people with disabilities should be created from community level to tertiary level.
8. Effective linkages and partnerships should be created and strengthened among public sector, private sector and civil society and their roles strengthened in comprehensive CBR programs and in poverty alleviation activities for people with disabilities.
9. Physical, information and communication environment should be made accessible for people with disabilities.
10. CBR programs should be community centered and community driven ensuring community involvement and ownership.
11. Involvement of people with disabilities, their organizations and their family members at all levels of CBR programs from planning, implementing to evaluation should be ensured.
12. Strengthen education programs of people with disabilities with in CBR programs with the understanding that educated people with disabilities will in the future have more opportunities for better employment thus contributing in reducing poverty.
13. Capacity development of organizations and agencies implementing CBR should be ensured through training, follow-up, information, materials and other capacity development means.
14. Organizations that build capacities of CBR organizations should be supported and sustained.
15. Credit policies and schemes of lead micro credit agencies should be pro-disability and accessible enough for people with disabilities to benefit.
16. In cases where people with profound disabilities are unable to be involved in poverty alleviation programs under CBR, their family members should be involved to increase income level of the family resulting in benefits to the people with disability as a family member.
17. Local governments and District Disability Welfare Committee should be extensively involved to support CBR implementation and poverty alleviation programs for disable persons at local level.
18. National policy papers on CBR and Poverty Alleviation of people with disabilities should be drafted in conformity to nationally and internationally acknowledged documents on disability issues. These policy papers should preferably lead to the development of a nation wide action plan with resources allocated for implementation of activities.
19. Appropriate, accurate and acceptable data and statistics on disability issues should be collected for designing effective plans and undertaking programs on CBR and poverty alleviation initiatives of people with disabilities.
20. CBR and poverty alleviation initiatives of people with disabilities should be strengthened in the hill tract areas and in other geographical locations where least initiatives have been taken thus far.
21. Organizations that build capacities of CBR organizations should be supported and sustained.
22. Credit policies and schemes of lead micro credit agencies should be pro-disability and accessible enough for people with disabilities to benefit.
23. In cases where people with profound disabilities are unable to be involved in poverty alleviation programs under CBR, their family members should be involved to increase income level of the family resulting in benefits to the people with disability as a family member.
24. Local governments and District Disability Welfare Committee should be extensively involved to support CBR implementation and poverty alleviation programs for disable persons at local level.

18

Conclusion

1. The paradigm shift from a charity-based approach to a developmental and rights-based approach towards empowerment of persons with disabilities has started in Bangladesh.
2. Whatever the attainments and achievements are, it is not enough by any means for a country of 140 million people. There are so much that needs to be done in the coming future on CBR and poverty alleviation. However, we definitely are on the right track of progress.

Thank you!

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