Ignorance about the plight of the disabled is not just relevant to Pakistan; it is global.

The UN itself woke

up to the issue of the disabled in 1981 and declared it the International Year of Disability. From 1981 to
2006 — in the latter year the UN adopted the Convention on the Rights of Persons with Disabilities
(CRPD) – the disabled of the world kept waiting for their issues to be addressed. In 2008, when the CRPD
became operational, the disabled came to know that the nomenclature used for them had been changed
from ‘disabled persons’ to “persons with disabilities’ (PWDs). Pakistan ratified the CRPD in 2011 and, as
per Article Four of the CRPD, took upon itself the responsibility for ensuring and promoting the full
realisation of all human rights and fundamental freedoms for all PWDs without discrimination of any
kind on the basis of disability.
On the one hand, there is the binding agreement of the CRPD while, on the other hand, there are issues
impeding Pakistan’s way to fulfilling its obligations under the CRPD. Four major issues can be identified in
this regard. The first is the definitional crisis. In the Disabled Persons (Employment and Rehabilitation)
Ordinance of 1981, the term disabled person was used for the target population under four categories:
“blind, deaf, physically handicapped or mentally retarded”. However, the last population census in 1998
counted 2.49 percent of the population as disabled out of a total of 132 million under seven heads
(blind, deaf/mute, crippled, insane, mentally retarded, multiple disability and others). This is how two
definitions predicating on the types of the disabled appeared. Nevertheless, in its preamble, the CRPD
has acknowledged that “disability is an evolving concept” and should be unlimited by definitions, as the
CRPD itself has avoided defining it directly. Furthermore, the preamble tells us that “Disability results
from the interaction between persons and impairments and attitudinal and environmental ba

iers that hinders their full and effective participation in society on an equal basis with others.” Article
One, describing the purpose of the CRPD, says that PWDs “include [not defined as] those who have long-
term physical, mental, intellectual or sensory impairments, which in interaction with various ba

iers may hinder their full and effective participation in society on an equal basis with others.” Thus, the
option for the agreed definitions of both disability and PWDs is still open for Pakistan.
The second issue is the absence of cu

ent data. Since 1998, no census has been conducted to count the exact or approximate number of PWDs
— even if the societal trend to hide a disability or the mention of a PWD in a family as a stigma is
overlooked — to fathom the magnitude of the disability crisis. Similarly, no data is available on the life
expectancy of PWDs born with a disability. Regarding the number of PWDs in Pakistan, reliance is placed
on the World Report on Disability compiled in 2011 jointly by the World Health Organisation (WHO) and
the World Bank (WB). The report said that 15 percent of the world population was PWDs. The
implication is that 15 percent of Pakistan’s projected population at 192 million in 2015 considered PWDs
at about 28 million, a staggering figure. However, the analogy employed overlooks the fact that the
report also counts those who are afflicted with disability owing to any accident or natural catastrophe,
any disease occu

ing late in life or even aging. This point makes one understand the reason CRPD is acknowledging
disability as an evolving concept, both by definition and classification. Nevertheless, to meet the data
collection obligation under Article 31 of the CRPD, the substitute for the census can be adopted by
motivating the recently elected local bodies to collect the disability-specific data (under any evolved
definition that may also include the age group; for instance, child, teenage, adult, middle age and old
PWDs) at the Union Council level.
The third issue is of obsolescent legislation. The 1981 Ordinance — despite being adopted, in the wake
of the 18th Constitutional Amendment took place in 2010, by Punjab and Khyber Pakhtunkhawa
provinces with necessary amendments in 2012 — has outlived its utility for its being deficient in both
regulatory and punitive contents. It focuses mainly on rehabilitation (e.g. medical treatment, segregated
education and vocational training), employment and welfare of PWDs in both government and private
sectors, though the ordinance is silent on the definitions of rehabilitation and welfare. Society in general
has long crossed the limits of the ordinance; Modern research has introduced new models of PWDs’
habilitation and rehabilitation. For instance, the National Policy for Persons with Disabilities (NPPD),
formulated by the government of Pakistan in November 2002, owed to Pakistan’s being signatory to the
Biwako Millennium Framework for Action towards an inclusive, ba

ier-free and rights’ based society for PWDs in Asia and the Pacific (ESCAP) under the UN concluded in
October 2002. To implement the policy, the Pakistan government devised the National Plan of Action in
March 2006 to work five yearly till 2025. Unfortunately, the policy and the implementing plan face five-
pronged problems: they do not flow from the 1981 Ordinance, they cannot ove

ide the 1981 Ordinance, they are not protected by a legislative cover, they do not recommend any
legislation and they are ove

uled by the CRPD, though the CRPD is not too contradictory of them. An amendment to the 1981
Ordinance — even in the adopted version by the provinces — considering the CRPD is required.
The fourth issue is the absence of preventive measures to forestall disabilities to check the growing
enormity of the disability crisis. The 1981 Ordinance is silent on this aspect and so is the CRPD. Though
the NPPD addresses the prevention aspect aptly, it is discredited as has been pointed out. To check the
disability crisis, Pakistan has to put in place a prevention regime. Research can be promoted to look for
ways to prevent disability, both congenital and acquired, especially in children who constitute a major
chunk of PWDs.

Those nations who take care of the distressed segments of their society, can reap the dividends by
helping them play their due role in uplifting their country’s economy.

Unfortunately, the case is quite different in Pakistan. Here, disabled persons have to face multiple
challenges throughout their lives. From getting a good job to receiving medical treatment; from
accessing public transport to getting higher education, people with certain disabilities have to go through
many social barriers in Pakistan.

Recently, this issue was raised by the Department of Special Education at the Arts Auditorium, University
of Karachi (KU), during a seminar.

The seminar, “Awareness in Action towards a resilient society”, was arranged in accordance with the
International Day for Persons with Disabilities.

Speaking to the audience, Department of Special Education Assistant Professor Dr. Shaista Naz said:

Today, there are at least 650 million persons with disabilities around the world, of which 400 million live
in and around the Asia Pacific region. Around 70 million people in the world need a wheelchair of which
5% to 15% have access to one, while 360 million people have moderate to profound hearing loss.
“The day we realize the amount of frustration and difficulties that people with disabilities face in their
daily life, we will be able to grant them equal status in society,” she added.

Dr. Naz said that it is our primary responsibility to facilitate and assist them in executing their day-to-day
tasks.

Dr. Humera Aziz, who’s the Chairperson of KU Department of Special Education, also addressed the
gathering. She said that the majority of people with disabilities also face financial issues due to
unemployment or less paying jobs. She stressed that we must create opportunities for them.

Dr. Aziz said:

Even if they are employed, they face enormous difficulties in commuting since there is no public
transport system favorable for persons with disabilities.

On the other hand, developed countries take great care of their people with certain disabilities. Roads
have special parking slots for them. Public transport treats them well, and every important building,
including schools, colleges, universities, hospitals, and stations, have ramps so that they can commute
easily.

It is high time that Pakistan and its civil society also took steps to make life easier for the disabled people
in the country.

Viwenty months have passed since Pakistan signed the Convention on the Rights of Persons with
Disabilities (CRPD), but plans to implement it, if any, are not known. The government is in danger of
losing the goodwill it had earned by signing the convention.

The convention was adopted in 2006 and came into force in May 2008. It was signed by Pakistan less
than four months later, in September 2008. Judging by Islamabad's record of tardiness in taking notice of
international human rights instruments, except for the Convention on the Rights of the Child, it displayed
unusual speed in signing the convention on the disabled.

But there is nothing unusual in the government's lack of interest in follow-up measures, and this attitude
is the main factor in the denial of the benefits of the international human rights system to the people of
Pakistan.

As a consequence of this attitude perhaps the government has not given due publicity to its good deed.
The media, too, has ignored the matter. It seems that people with handicaps are neglected worldwide. At
a recent meeting of a committee related to the CRPD a member complained that even many among
those working at the UN were not aware of the convention.

However, at least one NGO in Lahore, the Pakistan Society for the Rehabilitation of the Disabled (PSRD),
took the initiative to inform the public of the responsibilities the state had assumed by signing the CRPD.
The society, one of the finest examples of civil society's endeavours for public good, deserves better
recognition and support than it has so far received. Established on a modest scale in 1957, the society
has greatly expanded its activities. Now it runs a modern (and clean) hospital and outpatient
department, a physiotherapy centre (including occupational and speech therapy), a facility for the
production of artificial limbs and a skill development centre.

It also advances credit to disabled persons to become economically independent. In the high school run
by the society special children pursue studies along with children considered normal, a design worth
emulation across the land. And it won the distinction of starting to sensitise the public about the CRPD.

The convention itself follows the pattern adopted for treaties drafted for selected groups (women,
children, etc.) All states that adhere to the convention are required to address the following issues/rights
awareness-raising; right to life, liberty and security of person; the disabled in situations of risk and
humanitarian emergencies; equal protection of the law and access to justice; freedom from torture,
exploitation, violence and abuse; liberty of movement and nationality; living independently and being
included in the community; right to education, health, work, employment, habitation and rehabilitation;
and participation in political and public life, culture, recreation and sport.

The purpose of the convention is “to promote, protect and ensure the full and equal enjoyment of all
human rights and fundamental freedoms by all persons with disabilities, and to promote respect for
their inherent dignity”. Along with the convention, a protocol has been adopted which provides the
disabled in a state party opportunities of seeking redress at the UN.

The definition of persons with disabilities needs to be noted in under-developed societies, such as
Pakistan.

These persons include those who have long-term physical, mental, intellectual or sensory impairments
which in interaction with various barriers may hinder their full and effective participation in society on an
equal basis with others (emphasis added). The same idea is referred to in the preamble where it is said
that disability is an evolving concept and disability results from the interaction between persons with
impairments and attitudinal and environmental barriers that perpetuates or aggravates their disability.

The biggest problem that persons with disabilities face in Pakistan is that the social environment and the
people's culture are mostly hostile to them. Many persons' disabilities are aggravated by society's
attitude towards them. The lives of a large number of people are spoiled and their potential for coming
good is lost because of people's habit of looking down on those with slight impairment and treating such
impairment as the mark of their identification and the dominant feature of their personality.

If a person limps he must be called langra; if a person has lost an eye, he must be summoned as kana.
Children suspected of autism suffer greatly at the hands of parents, siblings and teachers. The
government and civil society will need to coordinate their efforts to cure the people of their unhealthy
attitude towards the disabled. The likes of the brutes who expelled a child from a school because he had
suffered a disability can be found all over Pakistan, in homes as well as in institutions.

Civil society's potential to help the government in this field cannot be denied. Apart from PSRD
mentioned earlier quite a few other organisations are doing well in Karachi, Lahore and Islamabad. The
disabled are generally called 'special persons'. Pakistan has scored notable successes at the Special
Olympics and the blind cricketers are quite popular.
One of the associations that have taken up the cause of the disabled recently claimed the disabled
account for 10 per cent of the country's population and demanded a quota for them in parliament.

Off and on the formal sector, too, shows interest in the disabled people. The Punjab chief minister
recently promised a modern rehabilitation centre. The Supreme Court took notice of a report that seats
reserved for the disabled in 50 government departments were lying vacant, but one does not know what
the outcome was. According to an announcement the disabled can import motor vehicles without
paying custom duty. All this is, however, too little and too disorganised.

The advantage of signing the Convention on the Rights of Persons with Disabilities is that it should
enable the governments at all levels to work out a broad-based plan for guaranteeing special persons
their due. The obvious priorities are

— Immediate ratification of the convention.

— Dissemination of the convention in the establishment and the public at large.

— An authentic census of special persons.

— Strict enforcement of the quota for special persons in government jobs under the Disabled Persons
(Employment and Rehabilitation) Ordinance of 1981.

— Encouragement of schools where special children can study along with others.

— Enforcement of the quota for special persons at institutions of higher education, in addition to those
who can claim seats on merit.

— Development of effective mechanisms to prevent exploitation of special persons in any form.

Above all the government must realise that the greater the attention it pays to the rights and needs of
special persons, the healthier the nation will be.

a Tribune

Although there is no widely accepted definition of persons with disabilities, twodefinitions can be found
in the National Policy for Special Education in Pakistan: “Disability” means the lack of ability to perform
an activity in a manner that is considered to be normal.

A person with disabilities means a person who, on account of injury, disease, or congenital deformity, is
handicapped in undertaking any gainful profession or employment, and includes persons who are
visually impaired, hearing impaired, and physically and mentally disabled.

The 1 998 Population Census defined the term disability as, Any restrictionor lack (resulting from an
impairment) of the ability to perform an activity in themanner and within the range considered normal
for a human being. Impairmentmeans any loss or abnormality of psychological, physiological or
anatomical structure or functional”.

According to the census for 1998, there are 3,286,630 people with disabilityconstituting 2.54 per cent of
the population (Bureau of Statistics, 1998). Thefigure is underestimated, as the definition of disability did
not include moderateand mild disability. Data collectors for the census were not trained to identify
andclassify all forms of disability.
Disability has often been regarded as a peripheral issue in discussions onhealth services. Despite a
number of progressive policies included in thePakistan’s Constitution that declares equal rights for all,
disabled people are stillregarded in the main as an insignificant minority. In the health sector
particularly,they are regarded as cases to be cured, tailing which they are referred towelfare for care. I he
denial of human rights, and the exclusion andmarginalization of disabled people is manifested in many
forms within the healthsector.

To date in Pakistan, services for disabled people have been based on anunderstanding of disability as
individual pathology, the disabled person beingseen as a problem to be corrected. Its development can
be traced to the greatstrides in medical science and technology, which led many to believe that
dysfunction, could be explained through rational scientific argument; the cause of any condition
regarded as abnormal being attributed to the malfunction of a physiological system. Pathology thus
provided the means by which “dis”-ability could be distinguished from able-bodiedness, “ab”norrnality
from normality. Disability as malfunction has since grown to be seen as a specialized health problem, at
the heart of which is an emphasis on clinical diagnosis. Consequently the aim of medical rehabilitation is
to assist the individual to be “as normal as possible”.

in traditional societies such as Pakistan where education is low and economic development has not
taken off, any disability among household members is normally concealed, especially disabilities
acquired from birth or those developed soon thereafter. Intellectual disabilities and physical deformities
arc perceived as stigmata since their existence could jeopardize the “family name”, which becomes
especially important in societies with extended Families. The existence of any disability related to
psychological concerns that results From congenital antecedents is considered a serious threat to a
family’s social status. The family’s concern is related to the social discrimination that other people would
likely demonstrate, which in the view of the family concerned justifies concealing the existence of such
offspring.

Another reason why family events relating to disabilities are concealed relates to the “exchange”
phenomenon in marriages, especially on the bridegroom’s side. The fear that other children in the family
concerned may also carry genes which could adversely affect their progeny means that parents often will
not reveal that such a person exists in the family, since it would be difficult For them to find spouses for
their other, non-disabled children. Such fears are much greater fur families that are socially mobile or
who have a relatively higher social status.

The Religious/Moral model is historically the oldest and is less prevalent today. However, there are many
segment of society in Pakistan that associate disability with sin and shame, and disability is often
associated with feelings of guilt, even if such feelings are not overtly based in religious doctrine. For the
individual with a disability, this model is particularly burdensome. This model has been associated with
shame on the entire family with a member with a disability. Families have hidden away the disabled
family member, keeping them out of school and excluded from any chance at having a meaningful role in
society. Even in less extreme circumstances, this model has resulted in general social ostracism and self-
hatred.

In poverty-stricken developing society, like Pakistan, where additional hands are always needed to assist
with family work, thereby supplementing family income, the existence of a person with a disability is
considered a curse orunfortunate fate for the family concerned. The loss of family labor in addition to
the diversion of family resources to care for the needs of a child with a disability usually results in
additional fertility to offset the loss of that child’s potential contributions to family income. The assumed
need for having additional children could lead to reproduction within a short interval to neutralize
potential social pressure and possible social sanctions. In following this line of reasoning, the cause of
the original congenital disability and the potentially adverse consequences of another pregnancy on
maternal health are relegated to a position of lower importance than the need for reproduction.

In societies lacking social norms and institutions that should provide family support in terms of the
socialization and rehabilitation of persons with disabilities, families are put under extra pressure owing
to the heavy demands on their time to make up for this lack of support. The presence of a disabled
person in a family is thus considered a life-long problem, because the person concerned is expected to
remain always dependent on other family members for support. In addition, the person with a disability
represents a loss of productive potential in terms of society. The social pressure to bear additional
children who can help to support such disabled persons leads to enlargement of the dependent
population. Further, in their haste to respond to social pressures, couples usually ignore the possibility of
giving birth to yet other children with congenital disabilities. These attitudes are among the complex
sociological perspectives involved in treating the subject of disabilities.

of consider these facts, The Tragedy/Charity Model is still exists in Pakistan which actually casts the
disabled person forever in the “poor unfortunate” role, It emphasizes and encourages dependence on
others rather than independence one might say it is a form of “killing with kindness” since if this is taken
to extremes the disabled person may lose those life skills they had and become increasingly dependent.
The disabled person is represented as “brave” and “admirable” solely because they live with their
impairment, an object of pity and the focus of attempts to extort money from others in order to address
the person’s extensive and expensive needs. There is little or no recognition of the potential for
independence or of the role of the disabled person in selecting the services they need or want. however,
important changes were to occur with the evolvement of the modern era profoundly influenced by the
enlightenment.

One of the difficulties likely to be encountered is the negative impression created by the very widespread
presence of disabled persons, whether neighborsor relatives, for whom no rehabilitative treatment is
available. The problems of disability seem to be quite familiar to the general public in Pakistan, whereas
there is little or no conception of solutions. It is not surprising in these circumstances that attitudes focus
on helplessness and hopelessness. It will presumably be difficult to remove this impression before there
has been a major upswing in the provision of rehabilitative services. Equally it will be difficult to provide
facilities without a favorable climate of opinion. Attitude and provision must advance together.

Traditionally used by charities iii the competitive business of fund-raising, the application of the
Tragedy/Charity Model is graphically illustrated in the advertisement on newspapers and televised
Children in Need appeals in which disabled children are depicted alongside young “victims” of famine,
poverty, child abuse and other circumstances. Whilst such appeals raise considerable funds for services
and equipment which are not provided by the government, many disabled people find the negative
victim-image thoroughly offensive.

The idea of if being recipients of charity lowers the self-esteem of people with disabilities. In the eyes of
“pitying” donors, charitable giving carries with it an expectation of gratitude and a set of terms imposed
upon the beneficiary. The first is patronizing; the second limiting upon the choices opens to disabled
people. Also, employers will view disabled people as charitable cases. Rather than address the real issues
of creating a workplace conducive to the employment of people with disabilities, employers may
conclude that making charitable donations meets social and economic obligations.

This is not to advocate dismantling charities and outlaw caring, charitable acts, which enrich our society
and bring badly needed funds. But we do need to educate charity managers and professionals to review
the way they operate and ensure that funds are channeled to promote the empowerment of disabled
people and their full integration into our society as equal citizens — requiring our respect and not our
pity.

The specific type and amount of neglection against disabled children will vary depending upon whether
it occurs within the family, in the community, in institutional settings or in the work place. There are
however, several key issues that appear time and again when such behavior occurs. Most striking is the
issue of reoccurring stigma and prejudice. From the date of independence to date in Pakistan many
although not all communities have dealt poorly with disability. Cultural, religious and popular social
beliefs often assume that a child is born with a disability or becomes disabled after birth as the result of
a curse,’bad blood’, an incestuous relationships, a sin committed in a previous incarnation or a sin
committed by that child’s parents or other family members.

A child born in a community where such beliefs exist is at risk in a number of ways. A disabled child is
more likely to face extreme negative attitudes at birth and this increased risk for ignorance reappears
throughout the life span. This behavior compounds already existing social, educational and economic
marginalization that limits the lives and opportunities of these children. For example, disabled children
are far less likely than their non-disabled peers to be included in the social, economic and cultural life of
their communities; only a small percentage of these children will ever attend school; a majority of street
beggars are disabled children. Disabled children living in remote and rural areas may be at increased risk.

in societies and including Pakistan where there is stigma against those with disability, research indicates
that some parents respond with ignorance because of the shame the child had brought on the family or
respond with violence because a lack of social support leads to intense stress within the family.

in Pakistan, while many parents are submissive towards children where no disability exists, when a
disabled child lives in these setting his or her disability often serves to compound and intensify the
nature and extent of the abuse. For example, a mobility impaired child may be less able to flee when
physically assaulted. A child who is deaf may be unable to communicate about the abuse he or she faces
to anyone outside his or her household, unless these outsiders speak sign language or understand the
home signs the child uses. A child who is intellectually impaired may not be savvy enough to anticipate a
parent’s growing anger or know when to leave the room to avoid being struck.

Regular observations of child rearing practices in Pakistan indicate that a disabled child faces increased
risk as the result of child-produced stress, It is hypothesized that this cycle of increasing tensions can
begin long before the child is diagnosed as having a disability. For example, a child with a hearing
impairment may be regarded as disobedient; a child with vision problems may not make eye contact and
appear to be unresponsive, a child with a neurological disorder maybe difficult to comfort or feed. Other
researchers suggest that parents who become violent towards their disabled child are reacting not to the
child’s condition alone, but to the social isolation and stigma they encounter from surrounding family,
friends and neighbors.
Parents of disabled children often lack social supports as family and friends distance themselves; they
can find no school willing to take their child or theylive in communities where there are few or no social
services to help them with their child’s needs. It is possible that both child-produced stressors and social
isolation are compounded to produce a stressful in a household coping with a disabled child. It is also
true that not all households with disabled children in Pakistan are stress prone and even within the same
communities there are coping mechanisms in some families that prevent this behavior, while children
with identical disabilities in other households are subjected to burden. As with many aspects of negative
attitude towards disabled children, at this point, much more research in Pakistan is needed to allow us to
adequately understand the factors that inhibit or foster these attitudes towards disabled children.

The disabled child in a majority of household may receive less food, medical care or other services. This
can be subtle, for example, parents or caretakers may wait a few additional days before spending scarce
money for medicine or the child may receive less food or less nutritious food than his or her sibling. The
low socioeconomic status of the family and the present inflation rate prevailing in the country may worst
the situation a lot. Such neglect can lead to further impairments in a vicious feedback cycle in which the
disabled child continually loses ground developmentally.

Such neglect may be further exacerbated by gender for example, in Pakistan mostly parents spend huge
money for boy children’s disability that for girl children, despite the fact that disability itself affects equal
numbers of males and females. Neglect, in the form of the lack of adequate medical care, less nutritious
food or lack of access to related resources, is the apparent cause of these deaths.

In Pakistan as a general practice, the child is kept home to ensure his or her own safety, as parents fear
that the child may be struck by a cart or abused by someone in the neighborhood. But in many other
instances, even in educated and/or porch families a child is kept isolated because the family fears the
reaction from other members of the community. As per treatment given by clergyman, children in some
communities are kept shackled in windowless storerooms, hold hands and feet with iron chain, hot
household courtyards or dark attics for night, often with little or no interaction, even by those within the
household. Even in the next door neighbors may not know of the child’s existence. Here is a need to
create awareness among parents to send their disabled in special schools, for this see Box No. 1 for this
purpose.

When it comes to convincing Pakistanis that special education is important, especially the rural poor, the
key individuals that arguments must be targeted toare parents. Parents must be persuaded that special
education is valuable and necessary for their children with special needs.

School administration, social service and child advocacy agencies may be aware that a disabled child Is
the victim of violence or neglect, but choose to keep that child in the household because there are few
or no residential care facilities are available in the country.

The response of disabled children themselves to on-going violence within the home is dictated by a
number of factors. They may be aware that this type of behavior is unacceptable, but fear loss of
relationship with care giver or family member. While this is an issue for many children in violent
households, for disabled children dependent on their abusers for physical care, communication with the
outside world or other disability-specific concerns, these issues are more complex. S/he is also be aware
that this type of behavior is unacceptable, seek to alert authorities, but are not listened to or believed.
Unfortunately, in Pakistan, individuals who work as teachers, attendants for disabled children, or help
transport, feed or care for such children, are often underpaid, overworked and largely unsupervised.
While many who undertake such career choices do so out of the best of motives.

Very few schools have mechanisms in place that allow students, parents to complain about victimization
of these negative attitudes. This is all the more serious because in many areas of Pakistan and specially in
rural areas there are only a handful of schools or educational programs that are available for disabled
children. Parents/caregivers or children may hesitate to complain about abusive behavior in the school,
fearing that they will be dismissed from a program when no alternative exists.

Mostly in Pakistan, Disabled children are often kept in environments that can only be described as
inhumane. Institutions for disabled children are often at the bottom of government priority lists and lack
adequate funding, consistent support or oversight from government or civil society. Institutions are often
overcrowded, unsanitary and suffer from lack of both staff and resources which lead directly to
avoidable suffering and below the growth standards.

The low pay, low social status, long hours and hard working conditions in many institutions means that
workers are hard to find and administrators are quick to hire anyone. Background checks on personnel
often are not done. This allows some individuals, intent on harming or exploiting children, to regularly
seek work in such institutions. Because of lack of a registry or oversight of suchpredators when an
abusive employee is discovered it is not uncommon for that individual to be tired from one institution
and soon turn up working at another institution for disabled children nearby.

Compounding this, as noted earlier, individuals with disability and their families tend to be ftir poorer
than other members of the population, and this poverty can severely limit the ability of disabled children
and their families to afford light for their rights. The large number of disabled children and their families
who live in poverty also reduces that number of disabled young people able to afford related private
special schooling.

Because disabled children frequently receive no formal education or low quality education, their working
lives often begin earlier than those of their nondisabled peers. Furthermore, because they are rarely
trained or apprenticed for a specific trade or skill, they are often sent to work at the most menial jobs,
constituting some of the harshest forms of child labor. While it is known that many disabled children are
in the workplace, little information on these children exists because most find work in informal sectors of
society – as house servants, farm workers, in shops or in factories.

Honestly speaking, in Pakistan, documentation of this attitude against disabled children in the workplace
is therefore absent or very rare. However, knowledge from other realms of disability research can
provide some insight. For example, those disabled children who are unable to work as quickly as their
non- disabled coworkers, or those who are unable to hear to understand or follow directions, are at risk
of being insulted and bullied. Because finding and keeping work for individuals with disability is difficult
in most societies (i.e.: even in developed countries, the unemployment rate for adults with disability
often is above 80%) disabled children and adolescents have little voice in the workplace and are at risk
not only for physical and verbal abuse, but are also less likely to report such abuse or to quit should they
be abused.
In Pakistan, especially in rural areas and also most of the developing and under developing countries, the
most common form of employment outside the household for poor disabled children may be begging.
Disabled children are regularly used to generate income through begging. Some are placed on the
streets to beg by their own families, some are sold by their families to others who keep stables of
disabled children in organized rings of beggars. Either way, reports and anecdotes from dozens of
countries indicate that such children are routinely subjected to violence both in order to keep them on
the streets and once on the streets, by members of the general population, who see such children as
easy prey.

In more recent times, however, the notion of ‘disability’ has come to be conceptualized as a socio-
political construct within a rights-based discourse. The emphasis has shifted from dependence to
independence, as people with disability have sought a political voice, and become politically active
against social forces of disablism. Disability activists, in engaging in identity politics, have adopted the
strategies used by other social movements commanding human and civil rights. And these strategies
have brought gains, but within certain limitations.

In Pakistan, from the mid 1980’s, the country has enacted legislation which embraces a rights-based
discourse rather than a custodial discourse; and which seeks to address issues of social justice and
discrimination. The legislation also embraces the conceptual shift from disability being seen as an
individualized ‘medical problem’ to rather being about community membership and participation, and
access to regular societal activities such as employment, education, recreation and so on. Where access
is inappropriate, inadequate, difficult or ignored, advocacy processes have been initiated to address
situations and promote the people’s rights.

Yet, rights-based discourse, although employed as a political strategy, has also become a way of
constructing disability by locking people with disability into an identity which is based upon membership
of a minority group. Entitlements thus become contingent upon being able to define oneself as a person
with disability. And the conceptual barrier between ‘normal’ and ‘abnormal’ goes unchallenged, so that
while one may have entitlements legislatively guaranteed, ‘community’ which cannot be legislated for,
remains elusive.

While rights-based discourse, at a strategic level, has brought some additional entitlements to people
with disability, it has not significantly altered the way in which disability is constructed and so, despite
legislative changes, some people’s lives have not necessarily changed. Rights-based discourse fails to
meet these challenges for, rather than seeking to dismantle the entire concept of disability, it actually
relies upon such a construction to support its claims for rights and entitlements.

Part of the problem with the subject of education of disabled children in Pakistan is that it suffers from a
lack of identity as a discipline or part of a discipline, and it operates in relative isolation from other
relevant disciplines. Therefore it does not benefit from the research in other disciplines, and lacks
accountability. An alternative approach would aim to acknowledge these difficulties, to draw onother
disciplines where relevant, and to locate the subject within a development framework.

HOW WE IMPROVE THE SITUATION:

Improvement shall only be possible when we will work on each and every sector which prevents
disability to its severe consequences. The following discussion highlights some of these areas.
1. Prevention:

The majority of disabilities are preventable. There are, however, a number of reasons why there is a
failure to prevent disabilities in Pakistan. Although there are a number of policies aimed at preventing
disabilities, there is no coherent coordination between the various government departments to ensure
that these policies are properly carried out. Also, there are a number of areas in which policies should
exist, but do not.

It is recommended that the Ministry of Health, in consultation with other relevant departments and the
Directorate General of Special Education (DGSE), facilitate the development of a National Inter-
SectoralDisability Prevention Strategy that will set national norms and minimum standards for the
prevention of disabilities.

2. Public Education and Awareness Raising:

One of the greatest hurdles disabled people face when trying to access mainstream programs arc
negative attitudes. It is these attitudes that lead to the social exclusion and marginalization of people
with disabilities. Negative attitudes are continually reinforced. Disability is portrayed as a ‘problem’
People with disabilities are viewed as helpless and dependent; as ill and in constant need of care and
medical treatment, or as tragic victims.

Culture plays an important role in the way we relate to people with disabilities. This contributes to the
perception of people with disabilities as different or ‘outsiders’. The changing of attitudes is not
something that happens automatically or spontaneously. Attitude changing is a complex process which
involves moving, in a series of stages, from one set of attitudes to another. Public education and
awareness are central to the changing of attitudes.

3. Health Care:

Appropriate, accessible and affordable health services at primary, secondary and tertiary level are
essential to the equalization of opportunities for people with disabilities. Such services should include
general medical and nursing assistance on an in-patient, out-patient or community home care basis, and
specialized health professional assistance.

4. Rehabilitation:

Access to appropriate rehabilitation services can make the difference between leading an isolated and
economically dependent life and leading an economically independent life and playing an active role in
society. The main policy objectives should be: to enable peo5le with disabilities to reach and maintain
their optimal physical, sensory, intellectual, psychiatric, and/or social functional levels; to provide people
with disabilities with the tools to change their lives and to give them a greater degree of independence;
to prevent secondary disabilities or to reduce the extent of disability; to take into account the specific
needs of different disability groupings.

5. Assistive Devices:

Assistive/rehabilitation technology enables individuals with disabilities to participate on equal terms. If

people with disabilities are to access their rights and responsibilities and participate in society as equal
citizens, they must have access to appropriate and affordable assistive devices.
The production, supply and maintenance of assistive devices are presently uncoordinated. Imported
devices are steeply taxed, making them very expensive. Initiatives to develop appropriate and affordable
assistive technology have, to date, taken place in isolation from general technology development (i.e.
they are aimed at a ‘special market’), with very little participation by consumers, or collaboration
between the various sectors and agencies.

With the assistance of modern technology, products should be developed for use by people with a range
of different disabilities. The aim should be to reduce costs by producing for a larger market. This may
require greater standardization of products.

6. Barrier Free Access:

The way in which the environment is developed and organized contributes, to a large extent, to the level
of independence and equality that people with disabilities enjoy.

There are a number of barriers in the environment which prevent disabled people from enjoying equal
opportunities with non-disabled people. For example:

structural barriers in the built environment; inaccessible service points; inaccessible entrances due to
security systems; poor town planning; and poor interior design.

It is recommended that the Department of Public Works, in consultation with the National Environment
Protection Agency (NEPA) and other stakeholders, develop national guidelines and minimum norms and
standards with regard to barrier-free access.

7. Transport:

There is a need for rapid progress in developing a public transport system that is flexible and accessible.
Without this, people with disabilities will continue to remain largely ‘invisible’ and unable to contribute
to, or benefit from, the services and commercial activities available to most of their fellow citizens. Given
the fact that the ability to use services, or attend school or work, is largely dependent on the ability of
people to get there, the lack of accessible transport is a serious barrier to the full integration into society
of people with disabilities.

A large proportion of the population uses the bus services as their chief mode of public transport. Policy
makers tend to focus on wheelchair-lift equipped buses when considering access. There are, however, a
number of low-cost accessible features that could be considered in the short term.

Dial-a-ride services have proven particularly popular in densely populated areas. The primary distinction
between this service and existing services operated by welfare organizations is that people are able to
use the service for any purpose, whether to work, school or for social reasons.

Although the major airports in Pakistan have introduced extensive upgrading projects to make their
facilities more user-friendly, smaller provincial and regional airports still remain extremely discriminatory
against disabled commuters. This is, in part, due to a lack of information on national guidelines and
minimum standards and norms. The larger airlines have introduced personnel training programs to
facilitate a more sensitive service from airline staff.

8. Communications:
Sign Language is the first and natural language of Deaf people, whatever thespoken language of his or
her hearing parents may be. Sign Language is thecentral focus of Deaf people’s human rights. It is
important to note that Sign Language is a language in its own right, with its own grammar and syntax.
Sign Language uses the modality of space, in contrast with the spoken language which uses the modality
of sound. There are several regional variations of Sign Language in Pakistan.

Special Language Systems/Augmentative and Alternative Communication refer to any mode of

communication used by people who can not use a spoken or sign language. They include Braille, touch,
Bliss symbols or other means of communication.

Interpreter services are linked closely to the communication needs of Deaf people and people with
limited or no speech. These services enable them to communicate freely with society, and arc an
essential clement in the achievement of equal opportunities for people with communication disabilities.
They include Sign Language interpreters, lip speakers,