'Integrate the disabled into the mainstream of society'

by Ranga Chandrarathne
 

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[The Article is based on an interview with Vidyajyothi Professor Lalitha Mendis, President, of the Sri Lanka Medical Association (SLMA).]

The late Prime Minister of Sweden Olof Palme, speaking at the Stanford University Law School in the 1970s explained the Swedish perception of the disabled. He said, all babies are helpless, cared for by their parents; sick people are cared for by those who are well; elderly people are cared for by those younger and healthier, etc.

Able bodied people are able to help those who need it without pity, because they know their turn at being not able bodied will come. An important, enlightened and liberal perception 'We all pass through various phases, swinging between different shades and grades of disability.

The Swedish concept was that of the disabled belonging to one group of people' abled and disabled - a huge spectrum of differently abled persons.

In Sri Lanka, we treat the disabled as a separate group and many of them with justification feel they are marginalised. What we need to do is to take all possible measures to integrate them fully into society so that they feel one with the rest, and belong to it on an equal footing.

Legislation plays a vital role in safeguarding the position of the disabled in society . However, close examination reveals that there are some gaps in Sri Lanka's legislation on the disabled.

The Protection of the Rights of Persons with Disabilities Act No. 28 of 1996, enables persons with disabilities to seek legal redress against discrimination, but doe not provide specific penalties or criminal or civil liability for non compliance with the provisions of the Act.

The Disabled persons? accessibility regulations, gazetted in October 2006 under this Act, has provided detailed regulations with diagrams on how public buildings and service buildings should be made accessible within three years, but we rarely see the implementation of those regulations. Furthermore the Act does not specify that Regulations which flow from it become law.

With respect to employment, it would be interesting to find out how many Ministries, Departments and Corporation have implemented the circular (The Public Administration Circular No 27/88 of August 1988) that instructed them to allocate 3 per cent of employment opportunities for disabled persons.

It is important to address existing gaps in legislation, work towards speedy implementation, and to create awareness among the disabled, their care givers and well wishers of what redress is available for them through the law.

Exact data is not available on the number of disabled persons in Sri Lanka, but according to global estimates, 10 per cent of the world's population are disabled. So at a given time, Sri Lanka has about 2 million disabled persons.

Among the common causes of disability in Sri Lanka, are malnutrition, poverty, road traffic accident, war injuries, disabilities in sight, in hearing, developmental disabilities, disability following stroke neurological disorders and spinal injuries, and other causes such as multiple sclerosis and ageing.

Critical issues

The most critical issues facing the disabled are:- access to education, lack of employment, discrimination, lack of awareness and negative attitude by non disabled people, poor compliance with existing legislation and lack of access to health provision.

As in the case of legislation, opportunities in education for disabled children are inadequate.

The first special school for children with sight disability and hearing disability was set up in Ratmalana in 1912 by the missionaries. As at 2006 there were 25 government assisted Special Schools for disabled in Sri Lanka and others run by NGOs. In 1968 the Government moved towards introducing Inclusive Education whereby disabled students are integrated into the mainstream education system.

Special schools

The schools for the blind and those with hearing defects at Ratmalana are model special schools. The school for the blind has a Principal with state of the art training, and has equipped itself with foreign funding with voice synthesised computers, large screen TVs, and 2 Braille printers, music room and other equipment for vocational training. Students study here up to O-levels and those who are fit for A-levels are admitted to mainstream schools.

Other children are given 2 years of vocational training in 12 fields. As in the school for the blind, in the school for children with hearing defects, vocational training is given high priority.

Success of the education provided by these special schools is amply manifested by their excellent performance. For instance, 80 students who recently completed education at school for the blind, and about 85 per cent of students from the school for those with hearing defects have obtained employment.

The success of these schools illustrate the importance of expert leadership by the Principal, Board of Management and teachers and the importance of vocational training. However, the importance of vocational training in the integration of children into society has not been understood, or acted upon by the Department of Education.

In all assisted special schools including the two schools at Ratmalana, Government pays the salaries only of teachers of routine subjects and not of those providing vocational training.

As at 2005 there were 877 such schools catering to just over 25,000 students in all provinces. About 1383 Special Education Teachers trained at the Maharagama teacher training institute are employed in these schools.

It is commendable that every province has schools which provide Inclusive Education. However, for a programme that began almost 40 years back and considering that these 25,000 or so children represent children with several types of disabilities, physical, sight, hearing and intellectual, this enrolment is low.

So far no proper research or study has been conducted on how successful the Inclusive Education programme has been or the competence and effectiveness of specially trained teachers and the assistance they receive from authorities.

It is advisable to have a model Inclusive Education School in each province. Enrolment in the universities of disabled students also remains low an average of 42 students per year has been enroled on university courses in the last 5 years. Universities need funds to provide a learning and living environment for disabled students. Learning disorders and Developmental disorders.

Children with Learning disorders (e.g dyslexia) and developmental disorders such as Autism are the most neglected group of disabled persons in Sri Lanka.

These disorders can be detected at a very early age. An early detection system is of paramount importance because early introduction of special therapeutic interventions could enable about 47 per cent of these children to enter the normal education system.

However, currently, Sri Lanka does not have a good structured detection system, although one is being developed by the Ministry of Health. In the government sector, only the lady Ridgeway Hospital has a centre to assess these children.

Professionals such as Community Paediatricians, Speech Therapists and Psychologists who are needed to provide special therapeutic interventions are very few in Sri Lanka and urgently needed.

Community based Rehabilitation (CBR)

This programme was begun in 1992 with the objective of supporting each and every child who has a disability and also to provide support to parents and other family members to enable them to fulfil their responsibilities.

Although the CBR programme was begun with enthusiasm and many personnel were trained, it is not seen by persons working in the field as being successful. By and large the programme confines itself to providing assistance devices.

Some NGOs provide the kind of CBR programmes that Sri Lanka needs by providing services such as mobility training, training in daily activities, developmental stimulation, communication training, providing rehabilitation equipment, referral for education, home based education, behaviour training, vocational training and income generation activity Every year many patients are admitted to hospitals with stroke, spinal injuries and head injuries. Patients have paralysis of limbs.

Though these patients are provided with good institutional care at great cost, they are returned many of them still disabled or handicapped to their homes or to local hospitals without adequate rehabilitation. Often families are not educated on how to cope with paralysed patients. Lives are saved at great cost, but what of the quality of the rest of their lives?

There are only three rehabilitation hospitals in Sri Lanka; The Ragama Rehabilitation Hospital, The Ranavirusevana for the Forces and The Digana Rehabilitation Hospital. However, Sri Lanka does not have a single Spinal Injuries unit.

Rehabilitation services at the provincial level are much needed and an urgent expansion of cadre, and training of health care personnel and others needed to care for the disabled such as physiotherapists, occupational therapists and speech therapists.

At present in the government sector there are only 1.48 physiotherapists per 100,000 population, 0.3 Occupational therapists per 100,000 population and 0.1 speech therapists per 100,000 population.

Stigma, prejudice and attitudes

Social stigma is another factor that hinders the disabled persons integrating into mainstream society and enjoying their citizen's rights.

A considerable amount of groundwork is still to be done in this area in order to stamp out negative attitudes, social stigma and prejudice.

Here, the media, and producers of teledramas and films can play an enormous role. There is much to be done integrating the disabled of Sri Lanka into society that they can live with self-respect and on an equal basis with the rest of their countrymen.

The SLMA has formed a Disability committee and welcomes comments from the public