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Breaking the vicious cycle

  • Published at 11:57 pm February 6th, 2020
Disability
Photo: BIGSTOCK

Disability and poverty feed into each other

O the evening of February 3 this year, the phone rang and the caller, an old friend, said: “Happy birthday.” 

I replied: “Thank you so much, but it is not until April,” whereupon he reminded me that it was the anniversary of the founding, in 1991, of NFOWD (National Forum of Organizations Working with the Disabled). 

I had forgotten, because NFOWD today, sadly, is a shadow of its former self. It grew out of the desire of Bangladeshis, with different disabilities, to join together and speak strongly with one voice, and I am very glad that the Canadian organization, CUSO, for which I worked at the time, was able to support this initiative with Canadian government (CIDA) funds. 

NFOWD spoke to and campaigned with the government, the donors, the media, and the public alike. NFOWD shouted loudly that disability should be seen as a development issue and that disability is strongly connected to poverty. 

For instance, it is clear that malnutrition, poor sanitation, and inadequate child-rearing practices all stem from poverty. They are factors in disability along with accidents, and also visual and hearing impairments. 

And it is a vicious circle, because disability then causes further poverty by preventing the disabled individual from earning a living. It can further affect the extended family’s economic well-being by removing the female care-giver from the labour market. 

Over the years, NFOWD played a vital role in establishing the “National Policy on Disability 1995,” the “Bangladesh Persons with Disability Welfare Act, 2001,” the “National Action Plan on Disability, 2006” and the “Rights and Protection of Persons with Disabilities Act, 2013.” 

However, as we all know, having acts of parliament is one thing, and implementing them is quite another, as the rules of business have to be understood all the way down to the union parishads or the municipal wards. 

It may be that district, upazilla, and town committees on the rights and protection of persons with disabilities do indeed exist, but in practice, very little is happening. 

Through the course of the 7th Five Year Plan, there were supposed to have been designated disability focal points in ministries and departments with responsibility for implementation of disability-related activities, but there has been little action. 

For the 8th Five Year Plan, the government, it is understood, is determined that disability should be as important a cross-cutting issue as anything else. 

However, for serious planning and budgeting, it is imperative that the government ensures that its Ministries of Social Welfare, Health, and Finance are working with the correct numbers of persons with disabilities. 

Recent government figures have suggested an incidence of less than 2% of the population having a disability in Bangladesh. Figures such as this are quite ridiculous, and are largely a result of employing badly trained enumerators. 

The World Health Organization (WHO) uses 15% as a general guide, which takes into account that populations around the world are living to greater ages, so the number of persons with disabilities due to ageing are increasing. For planning and budgeting purposes, the government must use the correct and realistic figures.

It is also important to note that, after many years of resistance, bilateral and multilateral donors now make it mandatory that all development work that they support are inclusive of persons with disabilities. 

The United Nation’s Convention of the Rights of Persons’ with Disability (UNCRPD) defines persons with disabilities as “those with long term physical, mental, intellectual, or sensory impairment which, in interaction with various barriers, may hinder their full and effective participation in society as equals.”

Bearing this definition in mind, one wonders why people with mental illness or depression are usually overlooked. However, recent surveys suggest that a large number of children and adults suffer from depression.

The “National Mental Health Survey, Bangladesh 2019” found that 16.8% of people aged above 18 suffer from some kind of mental health condition ranging from depression and anxiety to neurodevelopmental disorders and sexual dysfunction. 

It also found that the rate of mental health conditions is 13.6% among children aged between seven to 17 years. The study, conducted in 64 districts involving 8,928 adults and 2,270 children, found a massive treatment gap. Only 8% of adults take treatment while less than 6% of children adhere to treatment among all those diagnosed with mental disorders. People with mental illness and depression are often regarded as mad, and it is not understood by many that mental illness and depression can be cured. 

We read too often of students taking their own lives due to depression related to exams, the pressure to achieve being too much. 

Parents and teachers should work hard together to ensure these sorts of tragedies cannot occur. The Ministry of Education should also take a much more active role in this regard.

(Julian Francis’ interest in and commitment to disability has been inspired by his elder brother, James, who had Down Syndrome, and his elder son, Neil, who has a severe learning disability).

Julian Francis has been associated with relief and development activities of Bangladesh since the War of Liberation. In 2012, the government of Bangladesh awarded him the ‘Friends of Liberation War Honour’ in recognition of his work among the refugees in India in 1971, and in 2018 honoured him with full Bangladesh citizenship.