15745_Insight Plus Issue 3 FINAL

InsightPlusPerspectives on social inclusion

Issue 3 June 2011

www.sightsavers.org

©Pe

ter

Di C

ampo

/Sig

htsa

vers

www.sightsavers.org

Front cover photo:Musu Konneh selling items from her stall, Sierra Leone

ContentsForeword 2 Diane Mulligan

Social inclusion: a way forward 4 Praveen Kumar and Prasannakumar PN

Making elections accessible to disabled people in Cameroon 8 Cyrille Evini

Working with partners in Bangladesh: social inclusion and inclusive education 11 Zakia Haque and Nusrat Zerin

Inclusive community development for community-based rehabilitation 15 Niaz Ullah Khan and Munazza Gillani

First ever careers fair for people with disabilities in Ghana 18 Joyce Ashun

A study of the role of networking in promoting social inclusion in Bangladesh 21 Gertrude Fefoame, Zakia Haque, Diane Mulligan and Susie Miles

Empowering disabled people through employment opportunities in Ampara, Sri Lanka 25 Dr Sunil Fernando and Padmasiri Bandara

Inside Sightsavers Uganda since the launch of the CBR Guidelines 29 Julie Nabukeera

Project Access: an advocacy initiative in India 31 Dr Rajesh Kapse

Promoting social inclusion through accessible water and sanitation services 34 Munazza Gillani, Muhammad Bilal and Niaz Ullah Khan

Learning summary 37 Taitos Matafeni

Page 1

From the editorClaire Stevens, Learning Support Officer

Welcome to the third issue of Insight Plus, Sightsavers’ bi-annual learning review.

Working with partners across Africa, Asia and the Caribbean, Sightsavers’ aim is to eliminate avoidable blindness and promote equality of opportunity for disabled people. This series collates learning and best practice from across our programmes, with each issue focusing on a different thematic area.

In this issue, we look at social inclusion and how working together with disabled people, their families and local communities can break down barriers and ensure that disabled people are able to participate fully in society, receive an education, gain employment and be part of local decision-making processes.

Featured case studies include joint efforts towards an accessible electoral process in Cameroon, new ways of working towards social inclusion in Uganda, and campaigning for accessible banking systems in India. We also learn more about a recent research study into the role of networking in promoting social inclusion in Bangladesh.

I hope you find Insight Plus useful, and welcome your comments and suggestions. Please send your feedback to [email protected]

SightsaversGrosvenor HallBolnore RoadHaywards HeathWest SussexRH16 4BXUKTel: +44 (0) 1444 446600Fax: +44 (0) 1444 446688www.sightsavers.org

CopyrightAny Insight Plus material may befreely reproduced, provided thatacknowledgement is given to Sightsavers as the author.

ISSN 2044-4338

www.sightsavers.orgPage 2

When I joined Sightsavers four years ago, most of our social inclusion work was delivered with partner organisations through limited community-based rehabilitation and education for blind and low vision children.

Since then, the organisation has embraced a new strategic plan that places inclusive education, empowerment of disabled people and community development as three out of four ‘change themes’ to guide our programme work.

In addition, the UN disability convention has been ratified by over 100 countries, the WHO/ILO/UNESCO/IDDC community-based rehabilitation guidelines were finally launched in 2010, the MDG outcome document from the 2010 review recommended the collection and disaggregation of data along disability lines, and the WHO World Disability Report was released in June 2011.

Each of these milestones has provided an ever expanding international framework that contextualises Sightsavers’ social inclusion work and allows our ‘change themes’ to be linked to the wider global inclusive development agenda. This agenda promotes a ‘twin track approach’ to disability that seeks to both deliver disability-specific projects and programmes, as well as to ‘mainstream’ disability among general development stakeholders.

But enough of the macro-level, big picture stuff; here is a micro-level view of a recent visit to Malawi where I met an inspiring woman who shows us what can be achieved in one of the poorest countries we work in.

ForewordDiane Mulligan, Programme Development Advisor

Diane Mulligan meets Denisia

©/S

ight

save

rs

Page 3

Denisia’s storyDenisia is 41 and lives in the Deza district of Malawi. When she was a year old, she contracted measles and became blind. Denisia attended her local mainstream primary school, accessing Braille books at a local resource centre. She was an excellent student and received a scholarship to a prestigious secondary school, but became pregnant and could not continue with her education.

In 1993, Denisia lost her parents. She got married the following year, aged 24 and had three further children, two of whom died. I met her eldest boy, who had returned from Lilongwe, the capital, where he had been working in a house for three months, but did not like the work so had come back to the village. I also met her other son, who is at primary school.

Denisia’s husband was a traditional healer. He travelled widely and Denisia explained that she could not always keep track of his whereabouts. In 2007, both Denisia and her husband tested positive for HIV. Denisia’s husband left her and his children because of her positive result. In 2009, Denisia started free anti-retroviral treatment at the nearby hospital

and also received counselling. Currently, she is accompanied on visits to the hospital by her sister, so that she is clear about the administration regime of her drugs. Her advice to other blind people to prevent becoming HIV positive is to try and abstain from sexual relations or, if this is not possible, to use condoms, which are free at hospitals or can be bought at local shops.

Denisia belongs to a support group for people living positively called ‘Unity’. It is an anonymous group that meets locally. There are about 200 members, both men and women, but she is the only blind person. Denisia also belongs to another support group; the Malawi Union of the Blind (MUB), which she joined in 2003 when they began to establish branches outside of the capital city. MUB is one of Sightsavers’ partners in Malawi and has helped Denisia to live more independently and to gain daily living skills, although she does not use a white cane. In 2006, Denisia became a peer educator for MUB, assisting other blind people to become more independent and teaching them how to avoid contracting HIV.

A typical day for Denisia involves housework, getting her child ready for school, selling goods and shopping in the market. Denisia’s income comes from a home-based small business where she sells sugar, paraffin and salt. She attended a training workshop with MUB and instead of using the daily allowance provided for an evening meal, she saved it to use as capital to start her business. Denisia has a savings account, which she acquired from a previous joint account with her husband.

When I visited Denisia, she was helping to settle her baby niece who was crying. Denisia lives in a very poor rural area, she is blind and she is HIV positive. But despite her challenging situation, Denisia is a very dynamic, enthusiastic and motivated individual.

©/S

ight

save

rs

Denisia with her family


IntroductionEveryone has the right to health, education, a livelihood and a life lived with dignity. However, the needs of disabled people have traditionally been treated as special and separate and this has kept them outside mainstream society. People with disabilities, especially those who are blind or have low vision, can easily become isolated from their communities. They often find it harder to attend school, to find employment, to be part of day-to-day community activities and to exercise their social, economic, cultural, civil and political rights. Community-based rehabilitation (CBR) was initiated in 1978 by the World Health Organization (WHO) as a strategy to address some of these issues through general community development for the rehabilitation, equalisation and social inclusion of all people with disabilities. Over the last 30 years, CBR has evolved into a multi-sectoral strategy to address the broader needs of disabled people, ensuring their participation and inclusion in society and enhancing the quality of their lives. Sightsavers was one of the first organisations to adopt CBR as an organisational strategy and programmes in India have been developed using this approach since 1983. Initially, projects focused on service delivery, aiming to equip blind people with skills to help them to lead more fulfilling and independent lives,

thereby reducing marginalisation. There was also a strong preventive element to these programmes. Over the last 25 years, Sightsavers’ approach to CBR has evolved from services delivered to the individual to one that is participative and inclusive. One of the key components of Sightsavers’ current strategy is the social inclusion of disabled people. During the last decade the external environment has also seen some changes, such as the Millennium Development Goals (MDGs), the United Nations Convention on Rights of Persons with Disabilities (UNCRPD) and the WHO CBR Guidelines and Matrix. Within this framework, this article aims to describe the transition plan of Sightsavers’ social inclusion programmes in North East India, especially in the State of Orissa, and how they are being aligned with organisational strategy and other international commitments.

Programme designSightsavers CBR projects in North East India were previously designed as stand alone interventions for an individual’s rehabilitation, with a bias towards the provision of eye care as a preventive and curative measure. Based on the changing scenario internationally, as well as within Sightsavers, all projects are being redesigned considering the WHO CBR Guidelines and Matrix and the PRSP (Poverty

Social inclusion: a way forwardPraveen Kumar, Senior Programme Officer, North East IndiaPrasannakumar PN, Area Director, North East India

Inclusivehealth

Inclusiveeducation

Inclusivelivelihood

Inclusivedevelopment

Inclusivesociety

Societyfor all

Page 5

Reduction Strategy Papers) approach, with scalability in mind. In the new approach, CBR has been identified as primarily a community- based process for the individual development of disabled people and is therefore an essential part of poverty reduction strategies to act as a vehicle for mainstreaming disability. Inclusive development is integral to the promotion and protection of human rights of disabled people. Aligning the programme with the CBR Matrix, the overall strategy is to ensure provision of inclusive health, education and livelihood opportunities for disabled people, leading to inclusive development and an inclusive society, as depicted in the diagram below left. To ensure inclusive development for disabled people, a three tier strategy has been adopted in the programme, especially in its CBR approach.

Community LevelIn addition to working with individual visually impaired people, and other disabled people, at the community level, the projects sensitise and train Panchayati Raj Institutions (local administrative bodies), community-based organisations and other local groups such as village development committees, self-help groups and disabled people’s organisations (DPOs), adopting a twin-track approach. This enhances their awareness levels, which leads to acceptance and inclusion of disabled people at the community level.

NGO/district level At the district level, the projects are working closely with the government-run district

disability resource centre (where available) and district social welfare department to ensure appropriate rehabilitation facilities and assistive devices are available to disabled people, wherever appropriate. The implementing organisation and its project team sensitise other non-governmental organisations (NGOs) in the district on inclusive programme planning and including disabled people in their programmes at all levels. In addition to this, the projects also include disabled people as team members wherever appropriate. The implementing organisation also promotes a district level DPO which works closely with the CBR project.

State level At the state level, it is planned to work closely with state level disability fora and other international NGOs working in the disability sector, whenever and wherever appropriate. Sightsavers and its partners will also work closely with various government departments such as the disability commissioner, the vocational rehabilitation centre and the state education department. In addition to the above, Sightsavers will develop appropriate information, education and communication (IEC) materials in the local language for each state. Empowerment processes at all levels will be key to the strategy, which includes training and exposure for project staff, identified DPO members and other stakeholders, information generation and flow, and facilitating legal assistance to disabled people through the project.

3 tier strategy

Community level NGO/district level State level

PRI CBO DPO VDC

SHG SHAG C Club

Model village

DDRC IPP Staff

NGOs DPOs DSW

Projects

SDF INGO VRC

WCD OPEPA

IEC

Strategies


Changes in processBased on the above transition plan, the following changes are currently being undertaken at various levels of implementation.

From project to programmesAs part of Sightsavers’ new strategic direction, all programme portfolios were reviewed. In North East India, standalone CBR projects in Orissa and Jharkhand are being brought under two state level social inclusion programmes. As part of this move, all aspects of the projects will be based at the district level except the rehabilitation aspect which will be in one block (sub-district) of the district. The rehabilitation and education aspects will be the entry points, after which other components will be introduced at appropriate levels, with scale up in mind. Currently some of the notable changes that have been incorporated in the projects are the adoption of a twin-track approach at all appropriate levels and a gradual shift towards promoting CBR as a poverty reduction strategy.

Adoption of a twin-track approachA twin-track approach encompasses a) disability specific programmes and b) the mainstreaming of disability in all activities. This approach means that Sightsavers will work to ensure that a disability perspective is included in all its projects across the area. At the same time, Sightsavers will support, where appropriate, initiatives aimed directly at the empowerment of people with disabilities. Adopting a twin-track approach is being encouraged in the projects in order to reduce stigma and combat exclusion.

Ensuring UNCRPD at the grassroots levelThe CBR projects are focusing on familiarising communities with the concept of the rights of disabled people and with the United Nations Convention on the Rights of Persons with Disabilities. Various approaches are being used to promote collaboration among local groups and establish a common voice. This has resulted in the inclusion of several disabled people in existing self-help groups and also in the formation of new self-help groups of disabled people.

Aligning with the CBR MatrixMoving from the older approach and aligning with the CBR Matrix was initially considered a challenge. However, as the projects started interlinking the components and referring beneficiaries needing support to other stakeholders who were stronger in those areas, the projects slowly became aligned with the matrix. Moreover, adoption of a twin-track approach, thereby strengthening the opportunities for better health, education and livelihoods, has been empowering for disabled people. While maintaining our existing focus on rehabilitation and livelihoods, the new approach has increased focus on the education and empowerment components of the matrix.

Poverty reduction Disability is both a cause and consequence of poverty (DFID, 20001) and poor people themselves describe people with disabilities as among the most excluded or ‘poorest of the poor’ (Narayan and Petesch, 20022). Because of this well established link between disability and poverty, the Millennium Development Goals cannot be achieved without including people with disabilities. The link between poverty and disability is an example of discrimination, social exclusion and denial of rights, together with a lack of access to basic services. It is not confined to a person’s impairment itself and hence Sightsavers North East India has been adopting a broader disability perspective in almost all its initiatives. The projects ensure that disabled people benefit through the national flagship programme of NREGS (National Rural

1 DFID (2000) Disability, Poverty and Development. Department for International Development: London.2 Narayan, D. and Petesch, P. (2002), Voices of the Poor: From Many Lands: World Bank.3 Jan Shikshan Sansthan (JSS) http://www.nlm.nic.in/jss.htm

Health

Livelihood

Education

Social

Empowerment

Page 7

Employment Guarantee Scheme) and NRHM (National Rural Health Mission), ensuring they are part of wider development programmes. A skills development programme is also being provided in collaboration with Jan Shikshan Sansthan3. A Government of India scheme, this offers vocational skills and technical knowledge to poor people at a very low cost, ensuring that beneficiaries receive training in their preferred trade.

Disabled people’s organisations (DPOs)Being poor means being voiceless! Working with DPOs is our approach to enabling disabled people to have a voice of their own, an important step in reducing their poverty. All CBR projects in Orissa have promoted district level DPOs and are in the process of strengthening them at the project level. In addition, Sightsavers is planning a DPO strengthening project with specific focus on building DPO capacity for advocacy and leadership.

AccessibilityAn accessibility study of Sightsavers office in Kolkata and four hospital partners is planned during 2011, with the aim of enhancing disabled people’s access to better eye health. In a period of two years, it is planned to enhance the accessibility at all Sightsavers-supported hospitals in the area. Based on this experience, Sightsavers will advocate with the state governments for enhancing the accessibility of public hospitals in the state.

Advocacy agendaFor the smooth realisation of the above plans, it is necessary to have appropriate systems and policies. Advocacy plays a key role in ensuring that these elements are in place. The following are key advocacy issues that Sightsavers North East India plans to take up during the next five years, from 2011 to 2014:

v State governments to revisit State Disability Policy based on new laws on disability.

v Accessible health care for disabled people at government hospitals.

v Smoothing the process of disability certification and other entitlements for disabled people in Orissa and Jharkhand.

v Scale up of CBR initiatives by other stakeholders.

Challenges and learning

v The process of changing the direction of our social inclusion was challenging and we met several hurdles, such as feeling lost and the fear of not being able to align our programmes with the organisational vision and strategy. Clearer guidelines on this would have been helpful.

v It was also challenging for the team to synchronise the timeline of several projects, the strategy plan period and commitments made to partners. The team is still working on smoother ways to move from projects to programmes.

v Within the team and across our partner organisations, we saw varied levels of understanding in relation to the new direction and approaches. Appropriate interventions were required to improve people’s understanding and ensure that we were all on the same page.

CBO: Community-based OrganisationC Club: Children’s ClubDDRC: District Disability Resource CentreDPO: Disabled People’s OrganisationDSW: Department of Social WelfareIEC: Information Education Communication INGO: International Non Governmental OrganisationIPP: Inclusive Project PlanningJSS: Jan Shikshan Sansthan (http://www.nlm.nic.in/jss.htm) NGO: Non Governmental OrganisationOPEPA: Orissa Primary Education Programme Authority (www.opepa.in,) PRI: Panchayati Raj Institution (local administrative body)SDF: State Disability ForumSHAG: Self Help Advocacy GroupSHG: Self Help GroupSSA: Sarva Shiksha Abhiyan (Education For All) www.ssa.nic.inVDC: Village Development CommitteeVRC: Vocational Rehabilitation Centre, a Government of India initiative (www.dget.gov.in/vrc) WCD: Women and Child Development Department (the Stage Government disability programme is managed under this department in many states)

Background Cameroon has been independent since the 1st of January 1960 and the constitution and laws of the country have always endorsed the rights of all citizens to participate in electoral processes. However, no specific steps have been taken to ensure that disabled people are able to participate in the electoral process on an equal basis and, as a result, their participation has been at best marginal and often lacking in dignity. In effect, no reasonable adjustments have ever been made to ensure that disabled people take part in elections equally and in significant numbers. In a bid to address this, and in collaboration with other stakeholders, Sightsavers Cameroon engaged the national electoral body, Elections Cameroon (ELECAM), to pilot accessible

elections in the 2011 presidential elections.

How did it all start?Sightsavers Cameroon country office was inspired by experiences in Sierra Leone, Liberia and Ghana, where Sightsavers had previously supported the introduction of accessible elections. In mid-2010, Sightsavers Cameroon carried out informal consultations with local stakeholders including disabled people’s organisations (DPOs) and blind people’s organisations (BPOs), United Nations regional agencies and the National Commission on Human Rights and Freedoms. The initiative was unanimously backed and a letter was written to ELECAM to request discussions about this issue. On 22 October


Making elections accessible to disabled people in CameroonCyrille Evini, Programme Manager, Cameroon

©S

ight

save

rs

ELECAM display board

2010, Sightsavers led a group of stakeholders including the United Nations’ Centre for Human Rights and Democracy in Central Africa, the United Nations Development Programme Special Programme for Elections, the National Commission for Human Rights and Freedoms, the Executive Director of the national umbrella disabled people’s organisation (UNAPHAC) and the national president of the national blind union (ANAC). This group met with the national president of ELECAM to explore the possibility of establishing a partnership between ELECAM and the Sightsavers-led group, with the aim of making the electoral process more inclusive. Following this meeting, ELECAM appointed a focal person to work with Sightsavers and other stakeholders to explore strategies aimed at facilitating the inclusion of disabled people in the electoral process.

What does the project entail?The project has four objectives:1. Mobilisation to ensure mass registration of disabled people in voting listsTo achieve this objective, a number of communication/sensitisation activities will take place, targeting decision makers, political leaders, DPOs, people with disabilities and the general public. Also included are training workshops to equip stakeholders with the skills and knowledge to understand the different ways of making elections accessible to disabled people. 2. Making 15 pilot polling stations accessible to disabled peopleThis objective focuses on making polling stations physically accessible to disabled people and also producing tactile ballot papers for visually impaired people.3. Ensuring effective participation of disabled people in the election, both as voters and observersThis includes supporting disabled people to participate effectively in elections. The project will also train disabled people as election observers and ensure that existing observers receive training on assessing disabled people’s participation in the electoral process. 4. Ensuring that the whole process is documented Regular meetings will be held to document the process, address challenges and capture

key learning. At the end of the entire process, it is expected that all stakeholders will attend a workshop to document best practices, so as to trigger scaling up of the project during the next elections.

How far have we gone?Since the first meeting with ELECAM on 22 October 2010 a lot has been achieved. A sub-regional training and advocacy workshop was held to sensitise decision makers on the United Nations Convention on the Rights of Persons with Disabilities and the need for inclusion in all aspects of life. Sensitisation workshops and training on the rights of disabled people were also held for Members of Parliament and for journalists. A planning workshop was held on the effective participation of people with disabilities in the Cameroon electoral process and, from this, a plan of action was developed. In implementing the activities included in the action plan, the following achievements have been seen to date:

v ELECAM has included a disability field in the computer programme used to register voters. This allows for the disaggregation of data by disability status and impairment type.

v ELECAM has developed a display board featuring disabled people participating in the electoral process alongside non disabled people

v Regional and sub-regional representatives of ELECAM have been instructed to actively engage DPOs and their members in all aspects of the electoral process.

v Sensitisation and awareness raising campaigns through TV, radio and written media by DPOs and ELECAM, calling for disabled people’s participation in the electoral process and increasing their understanding of their basic rights as citizens.

v Many disabled people have registered and are hoping to vote for the first time in their lives. They are excited to be included in the electoral process.

v Disabled people are making their voices heard through the media, including radio and TV programmes. They are also promoting their message during occasions such as Women’s Day and

Page 9

National Youth Day, during which a group of disabled people marched with a banner calling for the electoral process to be made inclusive.

v Commitment and engagement from ELECAM and the state, as evidenced by their New Year speeches.

v Advocacy/sensitisation meeting with political party and other national opinion leaders to encourage them to add disability to their agenda.

v Capacity building of DPOs, BPOs and other stakeholders on the legal framework around elections in Cameroon.

What have been the challenges and learning so far?Firstly, there is an absence of local data on the number of disabled people and their geographic distribution within the country. This had an impact on the planning and monitoring of the project. Having reliable data on disability is crucial, both for planning and for advocacy purposes. A key learning from this project is that actors engaging in advocacy for the rights of disabled people should pro-actively seek

the best available evidence to back up their advocacy efforts, and that it is important to share information and best practice with other interested parties. Another challenge was the absence of National ID Cards for over eighty percent of disabled people and, consequently, their inability to register in voting lists. There is also limited understanding of the electoral process by civil society actors and political apathy by some disabled people themselves. To address this, the project engaged partners in a number of activities related to accessible elections and the social inclusion of disabled people, with the aim of building their understanding and involvement. Networking and partnering was also a key learning from this project. Having a wide range of partners has been very beneficial as each partner brings different strengths and experience; authority, legitimacy, credibility, technical expertise, funding etc. As a country office, and given that Sightsavers is relatively new to the area of rights for disabled people, networking with well established partners helped to fast track the project’s impact in this area.

What are our next steps?Working towards the project objectives and action plan, the project now intends to build on the above achievements through the following activities:

v Developing and implementing a media plan to rally more stakeholders around the project.

v Identifying the 15 pilot polling stations and upgrading them so they are accessible to disabled people.

v Capacity building initiatives with DPOs and BPOs, covering advocacy techniques, organisational development, resource mobilisation and leadership.

v Training disabled people on accessible elections, and training disabled people and other stakeholders as election observers.

v Supporting the production of tactile voting materials.

We hope to continue the momentum of this project to achieve all our objectives and also to build on the broader partnerships and networks that we have joined or established as part of the process.


©S

ight

save

rs

Stakeholders in discussion

IntroductionSightsavers Bangladesh is working with partners and local communities to raise awareness about the rights of people with disabilities. By involving people with disabilities and their communities in the planning and delivery of appropriate services, we are enhancing the development and inclusion of people with disabilities within their own communities. We are working in areas such as community-based rehabilitation, inclusive education of children with disabilities and the inclusive planning and delivery of eye health and other services at community level. Assistance for Blind Children (ABC) is one of our successful implementing partners in

Narshingdi district. ABC works in the field of social inclusion and inclusive education and the success of the programme depends on their participatory approach to working with communities and beneficiaries, as described below and in the featured case studies.

Assistance for Blind ChildrenAssistance for Blind Children (ABC) is a non-profit organisation in Bangladesh, established in April 1978. Their areas of focus include treating and preventing eye conditions and blindness, education services for visually impaired children, socio-economic rehabilitation of blind children and adults and generally raising awareness of these issues.

Page 11

Working with partners in Bangladesh: social inclusion and inclusive educationZakia Haque, Project Manager, BangladeshNusrat Zerin, Project Manager, Bangladesh

Tactile teaching materials

© R

ifat K

han/

Sig

htsa

vers


ABC provides eye care services through its two eye clinics in Gazipur and Bogra districts. They contribute to the field of education for visually impaired children through establishing seven boarding schools across different districts. There are six schools for boys and one for girls, covering different grades/classes. These schools fall under the Integrated Government Education Programme run by the Department of Social Services within the Government of Bangladesh. ABC has also established a Braille production unit to supply Braille textbooks to their schools. With the help of Sightsavers, this unit is also supporting the Government’s special education programme and contributing to their requirement for Braille textbooks. The unit produces a range of Braille materials, including magazines, a calendar and recreational reading materials, which are distributed to Braille readers throughout the country. From 1987, with support from Sightsavers, ABC started to implement community-based rehabilitation activities in two sub-districts of Tangail district. Through this project, visually impaired people were identified by a survey and were provided with initial rehabilitation services, such as orientation, mobility and daily living skills.

Expanding their workFrom 2009, following Sightsavers’ new strategic framework, ABC and Sightsavers made some changes to the design of their social inclusion and inclusive education programmes in Narshingdi district. These programmes were expanded to look at disability issues more broadly and consider how they could promote equal opportunities and full participation of people with disabilities in mainstream national development initiatives. Areas of focus included the formation of self-help groups for people with disabilities, leadership and skills-based training for income generating activities and creating links with different government safety net programmes such as disability allowance and microcredit from banks etc. They also focused on implementing mainstream education programmes and raising awareness of disability amongst local communities. ABC launched a mainstream education programme for visually impaired children on a pilot basis from July 2006 to December 2007. The pilot was conducted with 10 government

primary schools and during this period ABC conducted door-to-door surveys to identify visually impaired children and sent teachers from the 10 schools for foundation training on inclusive education and Braille at the national Centre for Disability in Development. Work was also carried out to ensure that the classrooms and wider school environments were accessible for visually impaired children, with adaptations such as improved safety railings and colour contrasting for doors, windows and stairs. With the support of Sightsavers, the programme was extended in 2008 to focus more on the capacity building of school teachers. Working in one upazila1 in Narshingdi district, the project also aimed to increase awareness and involvement of the local community and school authorities in planning for visually impaired children to attend mainstream primary schools. ABC’s experiences in rehabilitation and education for visually impaired people, combined with financial, technical and professional support from Sightsavers, has enabled them to move towards promoting the wider social inclusion of visually impaired people. In implementing social inclusion and inclusive education programmes in Narshingdi district, Sightsavers Bangladesh and ABC have made significant progress in scaling up these activities at the district level. 28 primary schools are included in the mainstream education programme in Raypura and Shivpur, two upazilas in Narshingdi district. A total of 58 disabled children are covered by this programme, among them 37 who are visually impaired. This programme is linked to ABC’s wider social inclusion initiatives in several ways, including community referral pathways, awareness raising activities and involving self-help group members in providing Braille and inclusive education training, creating a sustainable community resource pool. The programme is also working to build the capacity of Government education officials, mainstream teachers and teacher trainers, increasing their understanding of inclusive education. The programme is advocating that responsibility for the education of disabled children should sit within the Ministry of Education, and not separately within the Ministry of Social Welfare as it does currently. Overall, the programme is emerging as a demonstration model for social inclusion and inclusive education at the community level.

1 An upazila is a sub-district

Page 13

Jahanara Akter: a renewed leaf“I always had a desire that I won’t remain idle at home... I will work hard to become empowered” says Jahanara Akter as she tells us the story of her journey to triumph over a world that had shut its eyes to her. When Jahanara was two, she had a diarrheal disease. She recovered within two weeks, but started losing her sight. By the time she was five, her vision was lost completely. With shattered confidence and dependency on others, Jahanara could not participate fully in community life and was often made to feel unwelcome, if not shunned. She was unable to complete her daily chores without help and had no opportunities for a proper education and no employment prospects. Her life in Thanahati village in Raipura, Narshingdi, became a burden for her family. In 2005, at the age of 26, Jahanara was identified through a door-to-door survey conducted by a community-based rehabilitation (CBR) project run by ABC and Sightsavers. Jahanara received basic rehabilitation training, including orientation, mobility and daily living skills. She started learning to be independent again; doing her daily chores by herself, using her white cane to move around and slowly reintegrating into her community. She gradually left her isolation behind, tackling her challenges with a fresh perspective and the power of her new knowledge. In later months, she became a keen learner of

Braille and also received training in leadership and advocacy skills. With the support of CBR field workers from ABC, Jahanara formed Raipura Protibondhi Kallyan Shomobay Shomity, a self-help group for people with disabilities. Jahanara remarks “as a disabled person, I’m not staying at home, rather I can encourage other disabled people to get involved in income generating activities.” She is chairperson of the group, which has around 20 members and which spearheads entrepreneurial activities such as making candles for the local market. Jahanara also teaches Braille to visually impaired students in her local community and is soon to be recruited as a resource teacher by a local school authority in her village.With her confidence and good communication skills, Jahanara participates in and delivers speeches at various CBR workshops and discussion meetings. She emphasises the neglect of education rights; “parents keep their disabled child at home. They don’t know that disabled children have equal rights for education.” Sharing her experiences, she encourages other people like her and other leaders in the community to take a stand. Jahanara is well known among local political leaders, government officials and local NGOs. She strives to bring neglected issues regarding disability into the mainstream and has visited the local Member of Parliament to present the concerns of local people with disabilities. A local philanthropist has also responded to Jahanara’s efforts with financial support for a candle factory for the Shomity. Jahanara is well respected by the members of her self-help group and beyond. A dynamic personality, she is also a great singer, writes poetry and plays many different musical instruments. She has recently got married to another member of her group, taking the plunge to yet another happy adventure.

©S

hafiq

ul A

lam

Kiro

n/S

ight

save

rs

Jahanara reading Braille

Jahanara facilitating a community awareness meeting

©S

hafiq

ul A

lam

Kiro

n/S

ight

save

rs


Shakil Mia: a new hope for lifeMd. Shakil Mia is eight years old and lives with his parents and two brothers in Mirzanagar village in Narshingdi district. His father, Md. Jahangir Mia, is a day labourer and his mother, Nilufa Akhter, is a housewife.

Shakil became blind at the age of four as a result of an accident while playing ‘danguli’, a local game involving a bat and a small piece of wood. He received an injury to his eyes and gradually lost his sight. Initially, he received traditional treatment within the village, but was later taken to the Dhaka Progressive Lions Eye Hospital in Narshingdi, Islamia Eye Hospital in Dhaka city and the National Institute of Ophthalmology. No improvement was seen and Shakil became blind. He found it difficult to perform day to day activities at home and was very dependant on his mother. His parents were not aware that he needed education for his development. In 2010, at the age of seven, Shakil was identified by a door to door survey in Narshingdi district, run by ABC and Sightsavers, as part of their community-based rehabilitation project. Mr. Mominul Haque, an ABC rehabilitation assistant, informed Shakil’s parents that visually impaired children could study at the nearest primary school. Initially, Shakil’s parents were sceptical, but they received guidance and counselling from Md. Sazzadul Islam, the community educator from ABC’s mainstream education project, and from Mr Tariqul Islam, ABC’s CBR project officer. They discussed the need for Shakil to receive an education and encouraged his parents to enrol him in the nearby government primary school, where teachers had received training in inclusive education and had the skills to support Shakil’s development. Shakil was enrolled at Uttar

Mirzanagar Government primary school in 2010. After starting to study with other children, his family and other community members saw that blind children can learn alongside their peers. At school, Shakil attends class regularly and takes part in activities such as assemblies and physical exercise. Teachers trained in inclusive education support him and help him to learn Braille. They produce different types of tactile education materials using items such as lentils, rice, string and sticks. These materials allow Shakil to practise pre-Braille techniques at school and at home, following the shapes with his fingers to read Braille alphabets. His mother, Nilufa, is educated and is very interested in supporting her son with his studies. She has started to learn Braille from the community educator and says ”to make my son educated and independent, I want to learn Braille and help him in studies at home, so whenever he faces difficulties in reading, writing in Braille I may help him.” Shakil is making good progress at school; he is learning the alphabet in both Bangla and English and can now read and write around five words in both languages. Alongside his schooling, Shakil is also receiving basic rehabilitation training covering orientation, mobility and daily living skills. He can now perform tasks on his own, get around using his white cane and play with neighbouring children. He has recently joined the blind cricket team in Narshingdi, organised by ABC, and is keen to complete his education and prepare himself to get a good job in the future.

©N

usra

t Zer

in/S

ight

save

rs

Shakil practicing pre-Braille tactile techniques

Shakil and his mother with his teacher and staff from ABC

©N

usra

t Zer

in/S

ight

save

rs

Page 15

IntroductionSightsavers supports a twin-track approach to community-based rehabilitation (CBR), which promotes the mainstreaming of disability across all development initiatives, as well as the implementation of disability-specific programmes. Sightsavers strives for an inclusive community development approach, with a focus on helping community-based organisations (CBOs) to include disability in their interventions and activities. We also support disabled people’s organisations (DPOs) to advocate for the rights of disabled people and for the ratification and effective implementation of international and national commitments to integrating disability into development.

A CBR project based on the principles of ‘community approaches to handicapped in development’ (CAHD), was initiated with the Civil and Human Institutional Development Programme (CHIP) in Swabi District, Pakistan, from 2005 to 2009. Taking our learning from this project, a new initiative was then designed; Inclusive Community Development through Mainstreaming People with Disability. Focusing on two tehsils (sub-districts) of Jehlum District, Punjab Province, this pilot project is being implemented through a partnership between Sightsavers, CHIP and the Special Talent Exchange Program (STEP). The project is supported through the Civil Society Challenge Fund of the UK Department for International Development and will run for four years from 2008 to 2012. The project assists civil society

Inclusive community development for community-based rehabilitationNiaz Ullah Khan, Country Director, PakistanMunazza Gillani, Programme Manager, Pakistan

Yasmin Ahktar received a wheelchair through the project

©M

uham

mad

Bila

l/Sig

htsa

vers


organisations (CSOs) and local government in working together to establish, promote and strengthen Citizens Community Boards (CCBs) and women’s organisations in Jehlum District. Using a rights-based approach to social mobilisation, there groups are supported to include disabled people and enable them to realise their right to participate in decision-making processes which affect their lives. The lessons and recommendations from the pilot project will be used to advocate for the implementation of legislation and pro-disability poverty alleviation strategies within the mainstream development agenda.

Programme approach The project is being implemented in 30 villages within the two tehsils of Jehlum District; Tehsil Sohawa and Tehsil Jehlum. The population of the project area is 30,000, with an estimated 3,000 people targeted by the project, including people with disabilities, communities, local

government representatives and other service providers. A network of linkages and partnerships are being established between citizens, CSOs, DPOs, local government, elected representatives and the private sector. Local Government departments, CSOs and other stakeholders are contacted at district and sub-district levels to ensure relationships and linkages exist between the two Tehsils of Jehlum District.Through a baseline study1 337 people with disabilities were identified by CSO survey teams working with communities, representing a prevalence rate of less than 1.1 percent. The national 1981 census rate was 0.45 to 0.53 percent, and the Directorate General, Special Education, established a later rate of 2.6 percent in a 1986 survey. In the sixth national five year plan of 1984, a figure of between four to six percent was estimated2. This diversity in prevalence rates reflects both the wide range of criteria used in studies to identify disability and impairment levels, and the attitudes of local communities and those undertaking studies. The baseline study figure for the current project in Jhelum has already increased and, with greater awareness across the targeted population, is likely to be shown to rise further if the study is repeated in the later stages of the project.

Contribution to the Millennium Development GoalsThe project is contributing directly or indirectly to the achievement of four of the Millennium Development Goals (MDGs):

v Goal one: Eradicate extreme poverty and hungerIn line with this MDG, the project contributes to reducing poverty among disabled people living in rural areas. Frequently excluded from microfinance, skills training and other livelihood and employment support projects, they make up a particularly poor and marginalised group. By promoting formal registration of people with disabilities, those who are able to compete for employment can do so in line with the Government

1 Baseline Survey Report under Project on Inclusive Development through Mainstreaming People with Disabilities in Social Mobilization in District Jehlum. December 20082 See for example: Disability prevalence and correlates in Pakistan: a demographic analysis Pakistan Development Review, Autumn, 1992 by Mohammad Afzal. http://findarticles.com/p/articles/mi_6788/is_3_31/ai_n28620593/?tag=content;col1.

Making local housing more accessible

©M

uham

mad

Bila

l/Sig

htsa

vers

Page 17

requirement that employers include a percentage of registered disabled people in their workforce.

v Goal two: Achieve universal primary educationThe project has improved the enrolment of children with disabilities into public and community-managed primary schools. 33 children, 17 boys and 16 girls have been enrolled into mainstream schools.

v Goal three: Promote gender equality and empower womenThe project works to strengthen women’s organisations and empower women to participate in local development plans. Disabled women are a particularly marginalised and vulnerable social group and the project has therefore placed special emphasis on making them more visible and involved in local decision making.

v Goal six: Combat HIV/AIDS, malaria and other diseasesWorking with the national HIV/AIDS programme, the project has highlighted the results of a study undertaken with disabled people and their families: Understanding the status of knowledge and risk perceptions about HIV vulnerabilities of people with disability in District Jehlum. The project aims to enhance disabled people’s awareness around the prevention of HIV/AIDS.

Through promoting disabled people’s general participation in community life and decision-making, they are then able to benefit from wider services and programmes that aim to achieve these, and other, MDGs.

Lessons and challengesOne of the challenges faced by this project is finding ways to meet the expectations of disabled people and their families that their basic medical assessment and assistive device needs will be met. The project aimed to stimulate demand from communities for these needs to be addressed by service providers (Government and others), with minimal draw on project resources. However, we found that prioritising to meet at least some of these expectations was important in achieving credibility for our community inclusion work. This has been achieved through significant effort by the project partners in setting up an assessment programme and seeking non-project funding support for assistive devices.

Meeting this challenge requires further analysis to assess the minimum levels of support needed for inclusive community structures to take off. This is important so that a clear model approach can be developed and made available for replication in other districts, as the project intends.Relations with the Government have been difficult to coordinate because, although individual key players have demonstrated enthusiasm, the relevant political and institutional structures lack clarity and direction. This is in part due to a history of addressing disability from a special needs or segregated perspective with little attention to mainstreaming through inclusion and integration. A further factor has been the uncertainty created politically and administratively through the decision to decentralise services formerly managed nationally to the provinces (the 18th Constitutional Amendment). Following consultations at national and provincial level, key disability actors have made recommendations for the effective implementation of a National Action Plan on Disability. The National Planning Commission and other key government ministries and departments have used these recommendations to update the existing 2006 plan, but the revised version has not yet been released due to uncertainties about the decentralisation of responsibilities for its implementation.Internally, the complementary roles of the three partners have been critical to understanding, developing and implementing the project. CHIP, experienced in community development, has undertaken or coordinated the main survey and facilitation work at community, tehsil and district levels. STEP, as an accomplished DPO, has provided advice and assessments on accessibility options, plus awareness and capacity building on disability. Sightsavers has used its expertise and experience of working with government service providers to focus the project on linking community level initiatives to the Government at practical, policy and strategic levels. This has been achieved through stakeholder workshops in four provinces of Pakistan and a national consultation workshop. STEP and Sightsavers have planned and led these consultations with CHIP providing evidence from the programme.

BackgroundIn 2007, Sightsavers entered into a partnership with Standard Chartered Bank (SCB) as part of ‘Seeing is Believing’, the bank’s corporate social responsibility initiative. This focuses on eye care with the long term goal of contributing to the elimination of avoidable blindness by the year 2020. The project in Ghana was centred on setting up district structures, strengthening management, planning and reporting processes, and integrating the project into the mainstream health care delivery system. It looked at the provision of appropriate technology, improving cataract surgery numbers and providing a refraction and low vision service. The project was implemented in 21 districts in the eastern region of Ghana, ending in December 2010. To further build on this partnership, and as part of SCB’s diversity and inclusion policy, SCB Ghana decided to focus on broader disability issues. They invited a few non-governmental

organisations (NGOs), including Sightsavers, to a breakfast meeting to seek their input on how to include disabled people in their workforce. The invitation was also extended to other companies to share ideas on diversity and inclusion and discuss how these issues could be included in their recruitment policies. During this meeting, it became apparent that corporate organisations, including SCB, could benefit from increased awareness about disability issues and the potential that people with disabilities could be employed productively within their companies. It was therefore agreed to invite some disabled people to come and speak to the organisations involved.

Towards the first careers fairFollowing this agreement, Sightsavers, in collaboration with our partner Ghana Blind Union (GBU), invited four visually impaired people to be present at the next meeting to speak about their capabilities and aspirations. After being impressed by the four disabled people, the Chief Executive of SCB agreed to organise a careers fair in collaboration with Sightsavers Ghana. This fair would bring corporate organisations, disabled people and other stakeholders together to share ideas about inclusion and how to create employment opportunities for disabled people. The objectives of the careers fair were to:

v Highlight the various challenges faced by disabled people in their search for work and during employment.

v Build awareness among companies on the skills and capabilities of disabled people.

v Create employment opportunities for disabled people.

v Build confidence among disabled people about their own abilities and the potential opportunities for employment.

The careers fair was held on 29 May 2010 and was attended by Standard Chartered Bank and 26 other corporate organisations from the banking, telecommunications, manufacturing, brewery, oil and recruitment sectors. In


First ever careers fair for people with disabilities in GhanaJoyce Ashun, Country Director, Ghana

Mawuse Yakor, left and her sister Mawunyor at the fair

©A

lber

t Ow

usu-

Ans

ah/A

ctiv

e M

edia

addition to Sightsavers, 10 other NGOs were also present. The fair attracted 120 people, including individuals with physical impairments, those with visual, hearing or speech impairments, and people living with albinism. As per the criteria of the fair, all disabled people held at least a first degree or a higher national diploma.

Highlights of the fairOrganisations attending the fair conducted more than 200 interviews with qualified disabled people for potential employment. The two recruitment agencies present, Montran and L’ane Services, also committed to taking the CVs of 68 applicants in order to actively conduct job searches for them.SCB committed to recruiting four individuals out of the 68 interviews they conducted. Three disabled people were employed by them soon after the event, including George Amoah who features in the case study below. Several other organisations, including Sightsavers, Vodafone and Barclays Bank, also committed to engaging the services of qualified disabled people. Having previously employed a visually impaired person on national service for one year, Sightsavers Ghana is currently employing a second visually impaired person on their front desk. Employed on a temporary three month basis at present, this person is now being considered for a permanent contract.In addition to the direct employment opportunities afforded by the fair, the event also enabled disabled people to put their message across to the corporate world in general. A series of speakers was organised, included Mawuse Yakor who is visually impaired. Mawuse spoke passionately and said “there is the need for employers to look past an individual’s disability to see their professional potential in the workplace”.Two television stations, two radio stations and two print media houses covered the event, providing much needed publicity and raising the awareness of individuals and organisations

beyond those invited to the fair. The Government of Ghana was also represented at the event by officials from the Ministries of Education, Local Government and Rural Development, Employment and Social Welfare.

Learning and challengesThe careers fair event was hailed as a success and will now be held annually in Ghana. A strong NGO-corporate partnership was key to this success, as was setting out clear roles and responsibilities for each partner in developing and managing the event. It is also important that key players articulate their expectations on the use of each other’s logos, flyers, banners etc, and that due recognition is given to all parties involved. From the experience of organising the first careers fair, it is recommended that funding of the event is discussed early on in the planning process. Financial contributions from all partners should be anticipated early on to avoid delays when the process of organising the event is underway. In this case, Sightsavers did not have enough allocation within their existing budget, but SCB agreed to contribute hugely to the event to compensate for this. In identifying disabled people to invite to the event, it was noted that data on graduate disabled people in the country was not readily available. Ghana Blind Union were able to assist in locating and bringing disabled people together for the event, but it is clear that more work needs to be done in collecting such data into a central resource.

Next stepsIn partnership with the Ghana Federation of the Disabled (GFD), the main disabled people’s organisation in Ghana, a three-year project has been developed based on the careers fair concept. If approved, GFD will be the main implementing organisation of this project, which will enhance sustainability and impact.The initiative will involve advocacy for the ratification of the United Nations Convention on the Rights of People with Disabilities (UNCRPD), which will ensure broader recognition of the rights of disabled people, including that of employment. In partnership with SCB, the project also aims to bring more corporate organisations on board. Follow up mechanisms will be put in place to track

Page 19

“All we need is a chance to work and prove our abilities” Farida Bedwie, careers fair participant


how many disabled people from the first and subsequent careers fairs are in employment, and what kinds of support they can be offered in order to perform well in the roles that they have secured. For Sightsavers, even though we had already

been working with disabled people in our programmes, the careers fair served to raise organisational awareness of the important role that we could play in facilitating employment for disabled people.

Case study:George Amoah comes from Nkawkaw in the eastern region of Ghana. He graduated from the University of Ghana in 2006 with a degree in Business Administration and then completed his compulsory one year national service at the Ghana Ports and Harbour Authority (GPHA) in Tema.

Following his national service, George returned home and undertook some voluntary work. He organised classes for people who failed to get the required grades for university and also volunteered as an accountant and administrator at Kidcare International in Ghana, an NGO focusing on education and services for children, particularly orphans. During this time, George made several attempts to apply for jobs, but yielded no results. He then heard through a friend about the careers fair that was due to be held in Accra and quickly submitted his application to be involved. At the fair, George had the opportunity to interact with a

number of HR officers from corporate organisations, including Standard Chartered Bank (SCB). A few days after the fair, SCB invited him to a telephone interview and subsequently offered employment with the bank on an internship basis, starting in June 2010. George works in the client services group, investigating quality issues raised by corporate clients and working to resolve them. He travels to work daily from Tema to Accra, a distance of 30 kilometres. He uses public transport and, just like all the other workers, is expected at work by eight o’clock in the morning. Despite the challenges of using a wheelchair and waiting in a long queue for a bus every morning, George ensures that he always makes it to work on time.In the short time that he has worked at SCB, George has made a name for himself. He is noted as a dedicated person, committed to bringing something positive to the organisation. He has received various accolades during his internship with the bank and is hoping to sign another contract, perhaps on a permanent basis, when his current internship comes to an end. In terms of improving future careers fairs, George suggests that the event should be publicised nationwide, across all possible media, in order to reach out to every disabled person in the country. Public institutions and private employers should also be encouraged to take part in future fairs. To enhance the opportunities for disabled people to access jobs, George also recommends that organisations should be clear about their policies on diversity and inclusion. They should follow the example of SCB, who, through their role in the careers fair, have articulated their policies and demonstrated that they are prepared to live by them.

©G

odw

in A

hiab

u/S

ight

save

rs

George working at his desk

Background Sightsavers supports a community-based rehabilitation (CBR) programme in three rural districts in Bangladesh. This programme was evaluated in 2009, with a focus on the approaches used to promote social inclusion, social mobilisation and community development. The findings revealed that the CBR programme had made significant changes in the lives of people with disabilities, especially blind and low vision (visually impaired) people, whose mobility and self-esteem had increased. One example cited by the CBR evaluation was of a tactile village map,

created by CBR workers, to enable a blind shopkeeper to orientate himself in relation to the village, houses, shops, mosques etc. In this way he was able to fully participate as a shopkeeper in his community. The evaluation demonstrated that the status of people with disabilities at family and community level had been improved, as they had been able to access local services and resources and become more involved in their own communities. Attitudinal change at community level and among local government staff and other stakeholders had been achieved. The strength of networking in Bangladesh, and the role it plays in improving the lives of people with disabilities, was identified by the evaluation team as a key success factor for this programme.

Researching the role of networkingFollowing on from the CBR evaluation, and in order to further explore the role of networking in promoting CBR and social inclusion more widely, a one week study was conducted by a research team in January 2011. The research team consisted of three women; two Sightsavers employees, one from Ghana and one from Bangladesh, and a researcher from the UK. Interviews and focus group discussions

Page 21

A study of the role of networking in promoting social inclusion in Bangladesh Gertrude Fefoame, Africa Social Inclusion Advisor Zakia Haque, Project Manager, BangladeshDiane Mulligan, Programme Development AdvisorSusie Miles, Senior Lecturer in Inclusive Education, Manchester University

Local shop keeper using his tactile village map

©S

ight

save

rs

“I had a strong sense that they were all connected to each other. Networking had gone past helping people set up businesses. They knew who to contact and find the people who know how to help them. The key actors in this programme know each other well and can make appropriate referrals” Diane Mulligan


were conducted with leaders and members of eight non-governmental organisations (NGOs) based in the capital, Dhaka, one government-led foundation and three self-help groups representing rural communities. The guiding research question for this study was, ‘What is the role of networking in promoting social inclusion for people with disabilities in Bangladesh?’ Networking is a complex concept that means different things to different people and tends to be used loosely with little consensus as to its meaning. Having discussed the concept as a research team, we decided not to present any ready-made definitions of networking, but instead to explore participants’ understanding and experience of networks and networking. In addition, there is no direct translation of the words ‘network’ or ‘networking’ in Bangla, with the nearest translation being ‘communication’. The English word ‘network’ was used in interviews conducted in Bangla and research participants told us that ‘networking’ can be used to mean; relationships, coordination, collaboration, partnerships, alliance and allies. The main benefits of networking were perceived to be the sharing of human resources and information.The researchers are still in the process of analysing all the data collected and writing a journal article. Broadly speaking two different types of data were collected; national examples of how networking is leading to rights-based policy development, and local level examples of how networking is impacting on the quality of life of people with disabilities.

National networkingWe will begin with national level issues which arose from the interviews with Dhaka-based organisations:

v Working through mainstream development organisations Bangladesh is one of the most densely populated countries in the world with a population of 164 million. It is also a country where a very large number of NGOs play a key role in delivering services. It therefore makes sense for specialist disability organisations to work through the highly developed structures already established by mainstream agencies, as well as government services, in order to achieve maximum coverage of people with

disabilities. One example of this approach is the Centre for Disability in Development (CDD), a disability-focused NGO which is now working with a number of development organisations who have trained field social workers and mandatory disability resource posts who can identify and respond to the needs of people with a range of disabilities.

v The National Forum of Organisations Working with the Disabled The National Forum of Organisations Working with the Disabled (NFOWD) is an advocacy organisation which works in three main areas:• Coordinating advocacy efforts and

enabling access to resources. • Raising awareness of disability issues

through their network of members, the media and organised events.

• Serving as a resource group for policy development and implementation of programmes by the Government and other organisations.

NFOWD allows smaller organisations to come together and form thematic focus groups that are able to advise the Government on the formulation of policies and implementation of programmes. For example, Sightsavers is a member of the disability, advocacy, education and health thematic groups. This kind of network is unique as it provides no direct services at all, but promotes networking and coordination between all types of organisations and facilitates the sharing of information and resources. NFOWD offers a central point of reference on disability issues and the size of their membership has given them a recognised voice in this sector. Every organisation/individual that we interviewed during the study was either a member of NFOWD or had used them as a reference point, thus demonstrating the role of networking in influencing social inclusion

v National lobbyingThe majority of research participants reported that they engaged in awareness raising through the media and that they had been involved in lobbying for rights-based policies and legislation. The Government of Bangladesh ratified the United Nations Convention on the Rights of People with Disabilities (UNCRPD) in May 2008 and there is a strong civil society lobby which includes lawyers and parliamentarians and

Page 23

is determined to hold the government to account on progress in implementing the Convention.

v The role of governmentThe Foundation is a multi-disciplinary, quasi-government umbrella body on disability issues, composed of government and non-government representatives. The majority of people we spoke to claimed that their organisations had been involved in these initiatives; indicating the power and breadth of networking. Although there is widespread dissatisfaction with the government’s commitment to disability issues, there was evidence of well-established communication and networking channels which enable ongoing dialogue between the Government and non-governmental organisations.

Local networkingA focus group discussion took place with representatives of three self-help groups from different areas of the country. Some of the issues and discussions are detailed below:

v Status in the community and taking a stand for social justice The president of the federation of self-help groups, Tareque, is a paid employee of the mosque which plays a major role in village life. He uses the opportunity of Friday prayers to talk about the rights of disabled people. In his role as self-help

group leader, he also has the responsibility of visiting disabled people in the area to get to know them and to encourage the sharing of experiences between families. In this way he is able to get to know the situation in the whole family and community; he does not focus only on the disabled family member. The following short example highlights the way in which Tareque has used his status in his community to take a stand for social justice; in this case, the right to education.

Fatima was 14 years old. Her parents wanted to arrange her marriage ceremony, but Tareque and two influential community elders decided to try to stop this happening. They believed that Fatima needed to continue her studies until she was 18 years old. She was from a very poor family; their neighbours pressured her parents because they considered her to be old and the marriage offer they had received meant that they would not have had to pay a dowry. Tareque went to Fatima’s house together with the community elders to convince the parents to delay the marriage. They were successful and Fatima was allowed to continue in school. She married a different man when she reached the age of 18 and the parents did not have to pay a dowry. This meant that Fatima’s education was not interrupted, her own children are now more likely to become educated, and her desperately poor parents were not forced to pay a dowry, although they had to support their daughter for a further four years of education.

v SafetyMany parents are afraid to let their girls go out of the house or to school for fear of abuse. The issue of ensuring the safety of young disabled children arose in several of the stories told by the self-help group members. Once the children become members of a self-help group, they become more secure in their communities as girls and women. In the following example the self-help group provided protection for a vulnerable disabled girl.

A 12 year old deaf girl started at the BRAC1 informal school with the support of the self-help group. One day she was sexually assaulted. She informed her mother, who

Conducting interviews during the research study

©S

ight

save

rs


was concerned that this would ruin her chances of getting married. The matter was discussed in the self-help group and the culprit was identified. The self-help group met the village leader and together they came to the decision to punish the man by making him pay financial compensation of 15,000 Taka (50 Taka:US$1). The man paid the ‘fine’ and the family was able to use the money to buy a cow for income generating. As a result of taking a stand against the injustice of sexual assaults on young disabled girls, the community respects the self-help group. They can see that the group is powerful and can achieve results.

Although the deaf girl was very young, she asked to become an associate member of the group as she saw it as a form of protection in the community. Her membership of a community group that had status in the community, and that took a stand on issues of social justice, helped her to feel and stay safe.

v The right to social inclusionIn the following example the self-help group uses networking to challenge social exclusion.

Lists of vulnerable people are held at village level to ensure that land is allocated to those most in need. The self-help group decided to ensure that this list included disabled people. However, when they scrutinised the list of land allocations to landless people, they discovered that no disabled people had been allocated land. They decided to challenge this situation as a group. They have taken their struggle to the district level in face to face meetings and in writing. They have argued that it is their right to have access to land because they are the most vulnerable people in their communities. They are still fighting to be granted access to one acre of land for cultivation.

Although this is an ongoing struggle, it is important to recognise the commitment and organisational skills that this campaign has required. In this way the self-help group has taken a stand on the issue of equal rights

for disabled people in the community in order to promote greater social inclusion.

v Sharing, learning and mentoringAs the self-help groups are now recognised as having brought about positive change in their communities, more and more parents want their young people to be registered in these groups. This serves a dual purpose; the parents see the self-help groups as playing a mentoring role for their children and, at the same time, the groups provide opportunities for safe socialisation. Although the groups are intended for adults, they have found themselves accepting younger members. The self-help group leaders have been able to raise awareness at national level of the issues facing individuals and organisations at village-level through their links with a diverse range of organisations, including those that are disability-specific, such as the Bangladesh Visually Impaired Persons’ Society and national micro-credit organisations.

In conclusionBangladesh has a long history of voluntarism and community networking which goes back hundreds of years. Although the nature of networking is changing, with the increased use of mobile phones and the internet, face-to-face networking has an important role to play. Promoting self-confidence among people with disabilities, challenging negative attitudes in wider society and creating space for people with disabilities to become more visible and engaged in their families and in communities are some of the benefits. The networking process makes effective use of limited resources, maximises effort and builds on existing social structures and community development. The involvement of influential leaders (many of whom are visually impaired) and their organisations in challenging discrimination and promoting a more inclusive approach to development at both local and national levels is transforming the lives of people with visual impairments and other disabilities.

1 BRAC is a development organisation in Bangladesh, dedicated to alleviating poverty by empowering people to bring about change in their own lives

Page 25

Empowering disabled people through employment opportunities in Ampara, Sri Lanka Dr Sunil Fernando, Country Director, Sri LankaPadmasiri Bandara, Programme Officer, Sri Lanka

Nilantha, a young disabled man from the project target area

©S

ight

save

rs

BackgroundDisabled people represent 20 percent of the world’s poorest populations. It is therefore widely recognised, including by the World Bank, that the Millennium Development Goals (MDGs) cannot be met without specific measures to improve disabled people’s inclusion in mainstream development processes. In Sri Lanka, people with disabilities have significantly lower levels of income, as evidenced by the percentages of people who are employed and yet live under US$1 per day; this ranges from 43 to 88 percent for different disabilities, while the national average is approximately 6.6

percent. Furthermore, unemployment amongst people with disabilities is relatively high. One cause of this is lack of access to education and health services. Sightsavers Sri Lanka and their partners aim to advance progress towards MDGs two (achieving universal primary education) and four (reducing child mortality) by providing access to education and basic health services for children with disabilities, and towards MDG three (promoting gender equality and empowering women) by promoting equal access to these services by women with disabilities, who are often doubly disadvantaged by both gender and disability discrimination.


Working in Ampara districtFollowing the tsunami and exposure to armed conflict, Ampara district in the Eastern Province of Sri Lanka is now in the process of development, under the Government’s ‘Re-awakening Eastern’ programme. However, these initiatives do not currently incorporate the needs and rights of people with disabilities, of which there are approximately 8,400 in Ampara. People with disabilities are often left out of development processes due to social stigma and the attitudes of development practitioners. Many families and communities consider their disabled members as incapable, vulnerable or as a burden, treating them with sympathy and failing to recognise their fundamental rights as human beings. Sightsavers Sri Lanka is working with partner organisations to implement a project which will complement Government efforts by

establishing a process for the economic development of people with disabilities. The project sits within the ‘Re-awakening Eastern’ programme which prioritises access to employment and is undertaking necessary village infrastructure development. It will assist the Government in reaching one of the most marginalised groups and aims to provide opportunities for people with disabilities in Ampara through social mobilisation, economic empowerment and the development of partnerships between the public and private sectors. Working together with disabled people, the project will influence local authorities to think about accessibility in all their infrastructure developments, enabling everyone to participate in community life without any barriers. Women with disabilities will be given a priority since, due to marginalisation and exclusion, they are more likely to experience extreme poverty.

The house of a disabled person, due to be re-built

©S

ight

save

rs

Page 27

Specifically, the project seeks to: v Mobilise people with disabilities to raise

awareness of social inclusion issues.

v Deliver economic empowerment to facilitate sustainable household and village livelihoods.

v Develop public and private sector partnerships with disabled people and communities to sustain the work initiated and increase available resources for further development.

The processThe project aims to enhance the economic development of disabled people through access to employment and necessary village infrastructure development. The process begins with the social mobilisation of disabled people in the project’s target areas, a role which is being carried out by local women’s groups. The project will build on existing women’s groups that have already been established by the Women’s Development Centre (WDC) and will mobilise them to establish further active women’s groups. These groups will then facilitate the formation of self-help groups of disabled people and will work closely with social mobilisers from WDC to identify the specific needs of disabled people in their local area. They will look at service provision for health, education, housing, water, sanitation and employment. WDC will promote accessible health and education services through networking with relevant government institutions and Civil Society Organisations (CSOs), and will provide assistance to people with disabilities.Disabled people identified by WDC as needing assistance with housing, water and sanitation or livelihoods are linked with the Development with Disabled Network (DWDN) who will facilitate the provision of these services in consultation with all stakeholders and beneficiaries. Building on their existing work to empower disabled people, DWDN will develop the capacity of disabled people to secure employment and to articulate their needs to local authorities. DWDN will also provide technical expertise in delivering training and capacity building initiatives to CSOs and public and private sector stakeholders.DWDN has already begun to enhance the capacity of 50 CSOs in Ampara, particularly around mainstreaming disability into local

development initiatives. The project will use these CSOs and their networks in developing necessary linkages between government institutions, communities, citizens’ groups and people with disabilities. Working through their network members, DWDN will support disabled people’s groups and community groups established by WDC to influence and lobby stakeholders such as local authorities, private enterprises such as banks and local CSOs, asking them to include disability in their development agendas and to strengthen and protect the rights of people with disabilities. Sightsavers Sri Lanka will monitor overall programme implementation, facilitate advocacy and policy dialogue with government institutions and other stakeholders, develop the capacity of partner organisations and provide support to reporting and monitoring.

Progress to dateThe project was started in September 2010 and 15 women’s groups and 12 self-help groups have so far been established to mobilise disabled people in the target areas. Leaders of the women’s groups received a two week intensive training on disability, orientation and mobility, daily living skills, counselling, nutrition and HIV/Aids, which will help them in working with communities and providing services to people with disabilities. The women’s groups also interact with the families of disabled people, educating them on the importance of including disabled people in society and on the capacity of disabled people to become independent and gain employment. The women’s groups educate family members about mobility and daily living skills, so that they can assist local disabled people effectively. Together with disabled people and their family and community members, the women’s groups have identified the specific needs of disabled people in accessing health, education and other services. Linkages were developed with both public and private institutions working in the health, social services, vocational training and educational sectors in order to provide accessible services. Housing, water and sanitation needs have been identified and forwarded to DWDN for the necessary support. Four awareness programmes have also been conducted for community leaders and local authority officials on the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD).


A disability survey was conducted in the target areas to identify people with disabilities and establish the kinds of services and assistance already available. This survey was augmented with a market survey, where different types of employment opportunities and their viability were assessed. The information from both surveys will be fed into the project to inform the implementation of specific activities. 10 disabled people and their families have received assistance in rebuilding their dilapidated houses and sanitation facilities, or in renovating their existing ones to make them more accessible. 25 people with disabilities are being provided with assistance and appropriate training in order to secure employment. A preliminary workshop was also conducted for potential employers in the district to challenge their attitudes and beliefs and to raise their awareness on the importance of providing employment opportunities for disabled people. The workshop was organised by the Chamber of Commerce in Ampara and assisted by the Employer Federation of Sri Lanka. A careers fair is being planned in the district to provide an opportunity for people with disabilities to present themselves to potential employers and a careers guidance programme is being organised prior to this, to prepare the candidates and enhance their interview skills. To promote opportunities for disabled people to develop their vocational skills and obtain public recognition of their skills and achievements, the project will assist DWDN in organising a vocational skills competition for disabled people. The competition in Ampara will be one of a countrywide series

and will provide a platform for private sector institutions to identify skilled disabled people for employment. Further, it will raise awareness of the need to move away from traditional livelihood options for disabled people, such as weaving chairs or selling lotteries or consumer items door to door, and will promote new opportunities in the fields or information technology, banking, the media etc.

ConclusionThe project in Ampara has made progress towards the social inclusion of disabled people within their communities; namely in the three key areas of mobilisation, empowerment and the development of links between disabled people and key local stakeholders. The project is well established in the target areas and people with disabilities and their families are being mobilised to engage in community activities and development initiatives, and to articulate their needs to local authorities. Awareness is being raised among these authorities on the importance of including people with disabilities in the development agenda within the district. This is very clearly demonstrated by the actions of the Chief Minister of Eastern Province who has opened up a resource centre for people with disabilities to exhibit and market their products. The project will continue to work with beneficiaries and key stakeholders throughout its operation, with the aim of achieving lasting change in the lives of disabled people in Ampara and beyond.

Page 29

IntroductionDeveloped by WHO, ILO, UNESCO1, and the International Disability and Development Consortium (IDDC), the guidelines on community-based rehabilitation provide practical guidance for development practitioners on how to develop or strengthen community-based programmes that are inclusive of disabled people and their families. They are a guide to developing, planning and implementing community-based programmes through the combined efforts of disabled people, their families and communities, as well as representatives from the appropriate health, education, vocational and social sectors. The guidelines emphasise increased collaboration among the different sectors providing services for disabled people and the need for government support and the development of national policies.The guidelines were formally launched on 27 October 2010 at the fourth CBR Africa Network conference in Abuja, Nigeria. Sightsavers Uganda sponsored one employee and one representative from a partner organisation to

attend this conference and since then we have taken the following steps to use the guidelines and embed them in our programming.

Sharing the CBR guidelinesSightsavers Uganda has been keen to share the CBR guidelines with various stakeholders, starting with in-house sharing within the Sightsavers’ country office. Employees were taken through the guidelines and a forum was then held for over 150 participants, including disabled people’s organisations (DPOs), other non-governmental organisations (NGOs), district governments and Ministry of Health officials. This has resulted in a greater appreciation amongst programme staff and stakeholders of the principles of the guidelines and the key areas of focus for programming. Sightsavers Uganda’s focus will be on the empowerment and education components in the CBR matrix, whilst other partners will address livelihoods, health and social components.

CBR stakeholder mappingIn liaison with its partner organisations, Sightsavers Uganda has started to map all the CBR actors in the 14 district local governments, who are key partners. We are endeavouring to establish a network for CBR coordination and referrals, to ensure coherence with the CBR components that Sightsavers Uganda does not currently focus on. We hope to have completed the mapping process by the end of June 2011.

DPO/BPO pre-empowerment assessmentTo roll out our focus on empowerment, an in-depth assessment of three district-based blind people’s organisations (BPOs) and one disabled people’s organisation (DPO) was conducted to appraise their capacity for self-advocacy. This is a result of a partnership with Action for Disability and Development (ADD)

Inside Sightsavers Uganda since the launch of the CBR GuidelinesJulie Nabukeera, Programme Manager, Uganda

Uganda country office team discussing the CBR guidelines during their learning and reflection day

©S

ight

save

rs

1 World Health Organization, International Labour Organization and United Nations Educational, Scientific and Cultural Organization respectively


and is one of a series of partnership steps to support self-advocacy for selected DPOs. A comprehensive plan of action is being developed from the reports.

Model programmes and projects in light of CBRSightsavers Uganda has adopted the CBR guidelines as the working approach to achieving greater social inclusion. Presently, two programmes for health and education respectively are being designed according to the principles laid out in the CBR guidelines. The results of the mapping report, currently being conducted in the 14 district local governments, will provide deeper information to create a network of linkages, collaboration and coordination for these programmes. This will reduce duplication and increase the impact of our programmes.

Collaborating to share the guidelines with national and district-level partnersWe plan to engage with the Ministry of Gender, Labour and Social Development and three organisations who participated at the launch of the guidelines; Action on Disability and Development, Kyambogo University Special Needs Education Faculty and the Ministry of Health. Through this collaboration we hope to share the guidelines with more national and district-level partners and this is planned for August 2011.

Strengthening our CBR network During the national stakeholders’ forum planned for August 2011, we hope to engage with the Ministry of Gender, Labour and Social Development, the forum participants and the Uganda coordinating office for the CBR Africa Network to formally create a national CBR network that will strengthen CBR practice in-country.Sightsavers Uganda has also made efforts to partner with practitioners from broader networks who are working across health, education, social, livelihood and empowerment sectors. Improving our links with these actors should help to widen our reach and avoid the individual components of the CBR matrix being viewed as separate and disconnected.

Learning and reflection: a new day at the country officeWe have initiated an internal learning and reflection day within the Sightsavers Uganda country office. This takes place on the last Friday of every month. Two reflections have so far been undertaken and CBR formed a key portion of our discussions. To date, we have celebrated the change in our understanding of CBR since the launch of the guidelines. Our appreciation of CBR has extended beyond mobility and orientation to the broader concepts and principles set out in the guidelines.The release of the guidelines for community-based rehabilitation is an important step in enhancing our work with disabled people. We are optimistic that the guidelines will help to shape our strategic direction, networks and programmes in achieving social inclusion for disabled people.

Page 31

IntroductionIt is estimated that India has 100 million people who are visually impaired, have dyslexia or another disability1 that means they are unable to access printed material as comfortably, flexibly and conveniently as people without disabilities. In India, people with print impairment are denied their fundamental right to life, dignity, speech, education and information, as their access to printed material is restricted due to copyright law in the country. Similarly, visually impaired people face several challenges in using banking services in India as these are not completely accessible to them. In spite of the fact that the Government of India has ratified the United

Nations Convention on the Rights of Persons with Disabilities (UNCRPD), disabled people in the country still face several challenges, such as the two issues highlighted above. Xavier’s Resource Centre for the Visually Challenged (XRCVC) is a department established by Dr Sam Taraporwala, a blind assistant professor working at Saint Xavier’s college, Mumbai. Set up in 2003, XRCVC is involved in providing advocacy, support services and training to visually impaired individuals. XRCVC had received several complaints from disabled people regarding access to banking and print media and decided to conduct an advocacy campaign, with support from Sightsavers2. All the Indian members of the World Blind Union, along with

Project Access: an advocacy initiative in IndiaDr Rajesh Kapse, Programme Officer, South India

Using technology to access print media in India

©Pe

ter

Cat

on/S

ight

save

rs

1 36 million visually impaired people http://www.worldblindunion.org/en/., 60 million people with dyslexia http://en.wikipedia.org/wiki/Dyslexia#Incidence and 2.4 million with cerebral palsy. http://en.wikipedia.org/wiki/Cerebral_2 “Project Access” An advocacy project on Accessibility issues of Visually Challenged – XRCVC, Mumbai. Oct 2007 Author: Govind Madhav, Programme Officer Sightsavers, Internal document palsy


XRCVC, Sightsavers and the DAISY forum of India3 joined hands to initiate this campaign. Called ‘Project Access’, the campaign targeted the Government of India, publishers and writers for access to print material, and the Reserve Bank of India and other banks on the issue of accessible banking. The project has achieved various successes in last three years, as described in the article below.

Project AccessAfter identifying banking and print media as their advocacy focus, XRCVC designed the Project Access campaign, a structured advocacy project with three objectives:

v To make the printed word easily accessible to print disabled people by changing copyright law.

v To advocate for and contribute to the development and implementation of accessible solutions within the banking system.

v To creating awareness about the lives of visually impaired people within the sighted community and relevant stakeholders, helping to break existing misconceptions.

Accessible printMany visually impaired students had approached XRCVC asking for various books in accessible formats. Dr Sam Taraporwala, the director of XRCVC, therefore contacted the publishers to ask if they could provide electronic copies of the relevant titles. This request was met with some reluctance from the publishers; they were scared of piracy and it was also observed that Indian copyright does not permit conversion of copyrighted work into formats which are accessible by persons with print impairment. Consequently, XRCVC decided to advocate for the Indian copyright laws to be amended and did extensive research into copyright law across the globe. They concluded that 50 nations worldwide have made exceptions to their copyright laws, allowing materials to be printed in formats that will enable print impaired people to access them4. At that time, the Government of India was in the process of passing a bill regarding amendments to the Indian copyright law.

However, it was observed that this bill would not be in favour of visually impaired people. To challenge this, Dr Taraporwala, Ketan Kothari (Programme Officer for Sightsavers South India), and other experts met eminent leaders of the opposition party and advocated for the bill to be opposed. Due to their efforts, the bill was not passed and was sent to Parliament’s standing committee for revision. Following this, a committee of expert organisations was formed, including Inclusive Planet, Mumbai, the Centre for Internet and Society, Bangalore, and the Alternative Law Forum, Bangalore. This committee developed a paper; Right to knowledge for persons with print impairment: a proposal to amend the Indian copyright regime and submitted it to the Registrar of Copyright, Government of India.The advocacy team also presented their case in front of the parliamentary standing committee and explained that, given access to materials in the right format, visually impaired people could read printed media using assistive technology solutions such as screen reading software, magnifiers and CCTV devices. Most of the parliamentary committee members were previously unaware of this fact. Alongside direct advocacy with the Government, XRCVC also contacted several renowned authors and encouraged them to support Project Access. This added weight to the campaign and was useful in convincing the Government of the need for change.In conducting the advocacy campaign, the team did encounter several challenges. Publishers objected strongly to any amendment to the law due to fears about piracy and uncertainly as to how they might safeguard against this. In addition, various stakeholders involved in the campaign, such as organisations of visually impaired people, differed in their understanding of how it should be conducted. However, the project was able to successfully overcome these challenges through open and balanced dialogue with all parties. As a result of the above initiatives, the Government of India has accepted that the copyright law should be changed and the amendment is now in the final stages. This will provide better access to the printed word and most definitely bring a very direct positive change to the lives of millions of persons with print impairment.

3 Digital Accessible Information System http://www.daisy.org/about_us http://www.daisyindia.org/4 “Right to knowledge for persons with print impairment: a proposal to amend the Indian copyright regime” November 2009, Inclusive Planet, Mumbai, Centre for Internet and Society, Bangalore, Alternative Law Forum, Bangalore

Page 33

Accessible bankingThe second advocacy issue addressed by the campaign was access to banking. Despite the Government of India’s ratification of the UNCRPD, the banking system in the country did not permit visually impaired people to open and operate their own bank accounts in the way that sighted people were able to. Similar hurdles were also faced in accessing other financial services, such as ATMs (Automated Teller Machines), insurance, dematerialised investment (DEMAT) accounts etc.The Project Access team met with the Deputy Governor of the Reserve Bank of India to discuss these issues. The Deputy Governor was unaware of the challenges faced by visually impaired people and the team emphasised that banking is one of the most important aspects in a person’s life and that several other countries across the world had made banking services accessible to all. The Deputy Governors then discussed these issues with several bank officials and discovered more about the extent and reality of these challenges. Through the advocacy efforts of Project Access, the Reserve Bank of India immediately issued a circular to all commercial banks in India on the topic of access to banking for visually impaired people5. Issued on June 4 2008, the circular clearly states; “it has been brought to our notice that visually challenged persons are facing problems in availing banking facilities. It may be noted that banking facilities including cheque book facility / operation of ATM / locker etc. cannot be denied to the visually challenged as they are legally competent to contract…… Banks are therefore advised to ensure that all banking

facilities….are invariably offered to the visually challenged without any discrimination.”As a result of this circular, some banks have started providing services to visually impaired people, but several others are still denying this access. One reason for this is a lack of understanding by bank officials on how to make banking accessible. To combat this, the advocacy team, with support from the Access India e-group, a network of blind computer users from all over India, developed operational guidelines for the Indian Bank Association (IBA). These guidelines have been accepted by the IBA and they are now in the process of implementing them. Another challenge is the attitude of some bank officials, who may doubt the ability of a visually impaired person to operate an account independently and have concerns about whether the safety and security of services can be maintained. This issue can be address by giving presentations to the banks and improving their awareness and understanding.

ConclusionAs described above, Project Access is an example of a successful advocacy campaign. A passionate group of visually impaired people advocated strongly on the two issues to various stakeholders, overcoming various challenges and obstacles. They achieved successful results which could have a positive impact on the lives of visually impaired people in India. The following factors contributed to their success:

v Clear identification of need-based advocacy issues.

v A structured programmatic approach.

v Coordination with likeminded organisations and experts.

v Rigorous research to establish sound facts to convince stakeholders.

v Passion and resilience in overcoming obstacles.

Despite the results achieved to date, the advocacy team have identified some remaining challenges around operationalising the new laws and guidelines on the ground. The team is geared up to continue their efforts, using their strategic approach to advocacy and their passion for creating an inclusive world.

5 Banking facilities to the visually challenged, RBI / 2007-08 / 358 DBOD. No .Leg BC. 91 /09.07.005/2007-08, June 4, 2008

Banking systems should be accessible to all

©Pe

ter

Cat

on/S

ight

save

rs


SummaryInaccessible physical infrastructure within a community, specifically water and sanitation (WATSAN), can hinder the social inclusion of people with disabilities. Inclusive design and research into the process of providing adaptations for WATSAN is extremely limited in Pakistan and generally WATSAN facilities are designed without taking into account the specific needs of vulnerable groups, such as disabled people, women, children and older people. In 2010, Sightsavers piloted an initiative in the district of Mansehra, which was affected by the 2005 earthquake. Designed

to promote social inclusion by developing accessible WATSAN, the project focuses on mainstreaming disability into development by mobilising communities around this issue. The project developed an approach for testing in the field and guidelines are being prepared for advocacy and replication of the approach.

Introduction Pakistan is the sixth largest country in the world with a population of around 180 million. According to the 1998 Pakistan population census, the disability ratio in the country is

Promoting social inclusion through accessible water and sanitation servicesMunazza Gillani, Programme Manager, PakistanMuhammad Bilal, Programme Officer, PakistanNiaz Ullah Khan, Country Director, Pakistan

An access ramp at one of the demonstration sites

©H

asna

in/S

ight

save

rs

Page 35

2.49 percent. However, the World Health Organization (WHO) estimates the proportion at 10 percent and non-governmental organisations (NGOs) and disabled people’s organisations (DPOs) in Pakistan claim that disabled people make up seven percent of the total population. This disparity in estimates has hindered the planning of appropriate WATSAN services and facilities for disabled people. Access to safe drinking water and sanitation is a key challenge in Pakistan, and people with disabilities are among one of the vulnerable groups for whom access is particularly limited unless appropriate services and facilities are made available. Access to clean water and effective sanitation has a catalytic effect on many aspects of human development, being essential for a healthy population and environmental sustainability. The WHO estimates that 88 percent of diarrheal disease is attributed to an unsafe water supply and inadequate sanitation and hygiene. High incidence of vector-borne disease, intestinal disease and arsenic poisoning in developing countries is strongly correlated with unsanitary practices and the absence of nearby sources of safe water. Waterborne and infectious diseases are of serious concern in Pakistan, including eye diseases such as trachoma which can be prevented through face washing and better sanitation and environmental hygiene. In addition, convenient access to water and sanitation facilities increases privacy and reduces the risk of violence against disabled people, particularly children and women with disabilities.In 2010, Sightsavers Pakistan piloted a project to improve access to water and sanitation for people with disabilities in the Mansehra district in Khyber Pakhtunkhwa province. According to the 1998 Pakistan national population census, there are about 15,000 people of all ages with disabilities in Mansehra. However, this number rapidly increased to over 30,000 following the earthquake that hit the region on 8 October 2005. Due to poverty and lack of awareness, most disabled people face restricted mobility and remain dependent upon others for their basic needs. They are mostly unseen, unheard and one of the most marginalised group in the community. Disabled people face multiple daily living, social and economic challenges, such as physical and political barriers that hamper their freedom of movement in society. These

barriers further restrict learning and growth opportunities for people with disabilities and, in Mansehra district, there is a pronounced lack of rehabilitation centres with specialised services. Of all poorer people, people with disabilities are the ones that have least access to safe water and sanitation facilities. This restricts their opportunities for growth, development and improved livelihoods. However, most disabled people do not need separate ‘special’ facilities; with a little awareness, planning and adaptations, disabled people can access ordinary water points and toilets. Furthermore, improved, accessible facilities benefit everyone in the community, including elderly people, pregnant women and children, and will ultimately reduce waterborne diseases, trachoma and conjunctivitis.

ApproachSightsavers Pakistan adopted a twin-track approach for the pilot project which ensures that (a) disability issues are actively considered in mainstream development work, and (b) more focused or targeted activities for people with disabilities are implemented where necessary1. By strengthening disability work through the twin-track approach, the project aims to provide an enabling environment for people with disabilities to achieve greater livelihood security, greater equality, full participation in community life and greater independence and self determination. At the community level, the project underpins the inclusion of disabled people by ensuring the development of accessible WATSAN initiatives, with community involvement in the design, execution and implementation of the scheme. As a result of this involvement, the villages are now prioritising the issues and challenges of vulnerable groups in general and disabled people in particular. Specifically, this project will address physical infrastructure barriers that limit access to WATSAN by disabled people and other vulnerable groups. This will be done by:

1. Building the capacity of disabled peopleThe project will work to build the capacity of disabled people to engage with and influence decision makers at the local and national level. As part of the project implementation team,

1 Disability, poverty and development. UK, Department for International Development, 2000 (www.make-development-inclusive.org/docsen/DFIDdisabilityPovertyDev.pdf).


social mobilisers are working at the community level to form inclusive Village Development Committees that include disabled people as equal members and provide a forum for their voice to be heard in local decision making. Disability awareness sessions have been carried out in local communities with the active participation of disabled people, and Village Development Committees have also received training on physical accessibility and inclusion issues beyond the WATSAN perspective. These committees will later work as catalysts for sensitising local communities, as well as local WATSAN service providers, regarding accessible, socially acceptable and affordable physical infrastructure.

2. Establishing demonstration pilot projectsThe project is demonstrating local, cost effective WATSAN solutions by constructing accessible latrines and water points at various communal places such as schools and mosques. Identified by local people, the demonstration sites have generated increased demand for accessible WATSAN and have attracted attention from both the public and private sector. The initiative aims to showcase accessible infrastructure developments which can be easily adopted and implemented by local communities.

3. Building the capacity of WATSAN implementers In parallel to the above activities, the project has a strong focus on local capacity building and is aiming to enhance the capacity of implementers to adapt WATSAN facilities in ways that address the needs of disabled people. With this in mind, local Government officers are being trained on how to design and construct accessible WATSAN schemes to reduce physical barriers and also promote environmentally friendly practices. A training

manual has been prepared, based on the experience of the project, and is being tested within the communities. This will be shared widely with the WATSAN sector in Pakistan.

ConclusionSightsavers is working to promote social inclusion of disabled people and there is growing recognition of inclusive strategies within the Government of Pakistan. However, there is lack of understanding about good inclusive development practices in relation to water and sanitation. Therefore, this project’s focus is on building the capacity of local WATSAN service providers and policy makers to develop demonstrable approach and practices to promote accessible and affordable local WATSAN solutions. Government officials have received training on disability issues and are becoming involved in the design and implementation of the project. It is hoped that this involvement will promote lasting change and good practice within local government and beyond. The project is also working to strengthen the voices and skills of people with disabilities, and other vulnerable groups, so that they are able to influence and advocate with district Governments and other stakeholders for their rights. The inclusion of disabled people in local development initiatives will not only increase their participation in local decision making and consultations, but will also increase their self esteem and dignity within their families and social circles.Overall, the project has taken water and sanitation as a strategic entry point for community development, as the provision of safe drinking water and sanitation services are pre-requisites for an effective primary health care system and support the prevention of many eye diseases, such as trachoma. Beyond the specific activities mentioned above, the project is working to establish linkages among community-based organisations (CBOs), disabled people organisations (DPOs), non-governmental organisations (NGOs) and district governments, with the aim of promoting wider community development and social inclusion. In conclusion, the development of accessible, safe drinking and sanitation services will help to promote necessary changes in attitude at the local level, which are critical for any policy and institutional change.

Ghulam Hussain with accessible facilities constructed by the project

©H

asna

in/S

ight

save

rs

Page 37

IntroductionStatistics on disability indicate that at least 10 percent of the world’s population or 650 million people are disabled1. The 2010 MDG review indicated that “the Millennium Development Goals cannot be achieved without the full and effective inclusion of persons with disabilities and their participation in all stages of the MDGs processes.” These statements and statistics demonstrate the urgent need for the development community to partner with disabled people in delivering positive change in their lives. Sightsavers’ work on social inclusion has evolved from services delivered to the individual to a participative and inclusive approach, as described in this journal. What follows is a summary of learning points from these case studies, which we feel may be useful for both Sightsavers’ programmes and other professionals and organisations working to mainstream disability in their work.

1. Engage communities and beneficiaries By partnering with communities and beneficiaries, and engaging them as drivers of the change process, we have seen greater acceptance and recognition of disabled people as equal members of society. A real indicator of success has been changes in national systems which accommodate the equal participation of disabled people in every day tasks. Our programmes have also empowered disabled people to ensure that their voice is heard in relation to development issues. This approach promotes self-confidence among disabled people and creates space for them to be visible and engaged in their everyday life.

2. Adopt a multi-stakeholder strategy Realising that the CBR matrix proposes a multi-dimensional approach to social inclusion, Sightsavers has taken to working with multiple stakeholders. Having a wide range of partners is beneficial as each brings different experiences and strengths, such as authority, credibility, technical expertise, funding etc.

Another benefit is the effective use of limited resources through maximising efforts and building on existing social and community development structures.The challenge with this approach is coordinating the various actors and ensuring that communities and beneficiaries are not overburdened with differing voices and approaches. Jointly setting clear goals, roles and responsibilities for each stakeholder group has helped Sightsavers and our partners to deliver effective disability-specific programmes and to mainstream disability across our wider programming2.

3. Link social inclusion and poverty reduction Disability is both a cause and consequence of poverty, and progress towards the MDGs is set to be stifled if disabled people are not included in development initiatives. Our programmes have, in part, been using social inclusion as a means to ending poverty and have made successful attempts to link into country poverty reduction strategies. The articles in this series have demonstrated how, through social inclusion principles, Sighstavers has afforded equality of opportunity in employment, education, health, water and sanitation services and in general community life.

ConclusionThe 2010 MDG review highlighted the link between disability and many of the Millennium Development Goals. Social inclusion presents development managers with a double-edged sword in dealing with the dilemma of the human race “failing to achieve the goals it has set for itself”. Sightsavers’ work in social inclusion demonstrates how, from a process perspective, we have adopted social inclusion as a ‘means’ to ensure disabled people have the same opportunities in life as other citizens. On the other hand, we have used social inclusion to define the end towards which we are working, as encapsulated in our organisational vision statement “..visually impaired people participate equally in society.”

Learning summaryTaitos Matafeni, Head of Monitoring and Evaluation Systems

1 Some facts about people with Disabilities. http://www.un.org/disabilities/convention/facts.shtml2 Also referred to as the ‘twin track approach’.

www.sightsavers.org Registered charity numbers 207544 & SC038110

SightsaversGrosvenor HallBolnore RoadHaywards HeathWest SussexRH16 4BXUKTel: +44 (0) 1444 446600Fax: +44 (0) 1444 446688

Documents

15745_Insight Plus Issue 3 FINAL